Development and Evaluation of an Online Acceptance and Commitment Therapy Program for Anxiety: Phase I Iterative Design

This exploratory, nonclinical study evaluated the user experience of an online acceptance and commitment therapy program for anxiety. Forty young Australian adults aged between 18 to 25 years old completed the online program over 2 weeks. System usability and perceived helpfulness were evaluated at posttest. Self-rated levels of anxiety, depression, stress, and psychological flexibility were measured at pretest, posttest, and 2-week follow up. System usability was rated above average and significant improvements were found on all mental health measures from pretest to follow-up, except for stress. These results warrant further scrutiny in a clinical randomized controlled trial on the intervention.     

Relative effectiveness of mindfulness and cognitive behavioral interventions for anxiety disorders: Meta-analytic review

ABSTRACT

Increasingly popular mindfulness intervention innovations seem demonstrably effective in alleviating anxiety among people with anxiety disorders. However, the basis of such primary and synthetic evidence has, for the most part, been comparisons with non-active comparison conditions such as waiting lists. The longest-standing and strongest evidence-informed practices in this field have been cognitive behavioral interventions (CBI). This meta-analysis synthesized evidence from nine randomized trials of the relative effectiveness of mindfulness interventions compared to CBIs (i.e., active control groups) in treating anxiety disorders. The sample-weighted synthesis found no statistically or practically significant differences between the two groups on anxiety alleviation: Cohen’s d = - 0.02 (95% confidence interval = - 0.16, 0.12). Both groups enjoyed large clinical benefits. However, because mindfulness methods may require less professional training and take less time for both workers and clients to master, they are probably less expensive to provide. As they are probably less expensive, but equally effective, it seems that, in a cost-beneficial sense, mindfulness interventions may be more practically effective. These review-generated meta-analytic findings and inferences may be best thought of as developed hypotheses for future research testing. These and other future research needs are discussed.     

Social Work Education and Clinical Learning: Yesterday,Today, and Tomorrow

Social Work Education and Clinical Learning by Simpson, Williams, and Segall is a welcome and timely statement about the nature of clinical social work and its implications for educational curricula. The authors took on an awesome task. Educating students for clinical practice is increasingly more daunting than it has been previously and is in considerable disarray, if not a state of crisis. In addition to amplifying and expanding some of the major points the authors make, this discussion considers where we have been, where we are, and where we are going. It describes the educational landscape today, which the author views as bleak with respect to its preparation of students for clinical social work practice. In keeping with clinical social work’s inclusive definition that encompasses a broad knowledge base, diverse practice roles, and a wide range of interventions, this discussion emphasizes the importance of numerous unifying themes that help to distinguish clinical social work from other approaches or from the use of a fragmented assemblage of techniques. The paper considers the role of evidence-based practice and makes some suggestions about future emphases in clinical social work. It concludes with a call to alter the educational landscape.     

White Privilege and Clinical Social Work Practice: Reflections and Recommendations

This exploratory study examined how seasoned White social workers grappled with the presence and effects of White privilege on their clinical practice. Data were collected in focus groups; findings were surfaced through thematic analysis. Five themes emerged: the role of engaging in continuous self-awareness in clinical practice; the complexity of using intersectionality to inform our work; the necessity of addressing White privilege in clinical conversations; the importance of creating strategies for use of power; and the process of engaging in life-long growth. These workers demonstrated awareness of, and accountability for, White privilege. Implications for progressive social work practice are discussed.     

Science as a Strategy for Social Work

For more than one hundred years, various forms of science have been promoted to boost social work’s status as a profession. Evidence-based practice and talk about the science of social work are only the most recent manifestations of this pattern. Counter to this trend, this article argues that the latest upsurge of interest in scientific social work is no more likely than any of its predecessors to address the problems of the profession. Beginning with a linguistic analysis of the words science and scientific as positive signifiers, the article traces social work’s long history of science talk as a means of reassuring funding agencies and bolstering the profession’s status. Drawing on a critique of this discourse as the latest example of abstracted empiricism, it then contends that while scientific social work can only rarely capture what occurs in the field, its attempt to do so actually undercuts practitioners’ professional judgment and discretion. Last, after rejecting science talk as counterproductive, the article concludes with recommendations for an alternative strategy that might better position social work to reconcile its advocacy of social justice with its concerns about its professional status.     

Cultural Competency and Achieving Styles in Clinical Social Work

Abstract

This paper attempts to build a cultural competency framework by reviewing the literature and laying a conceptual foundation for professional standards in clinical social work. It also explores the implications of cultural competency by relating some important factors to clinical decisions, alliance, and outcome in the mental health field. The pathways and directions of the relationships as well as the potential factors affecting cross-cultural clinical alliance are illuminated in a general model to guide hypothesis formulation in further research. Empirical data are presented on clinical social work practice with Asian American clients in light of a key factor in shaping cultural competency, i.e., clinicians' personal achieving styles. The findings suggest that such styles are culturally bound.     

Social Work,Economic Conversion,and Community Practice:

With the fall of the Berlin Wall, and a new administration in Washington, hope is renewed for a peace economy. This hope is evidenced in the growth of new economic conversion projects ranging from legislative initiatives to new grassroots organizations. This exploratory survey of 15 directors of conversion projects sought to discover the kinds of strategies used and the degree of social work participation. Although results indicate that only one-third of the organizations involved social workers, there is much common ground between conversion strategies, community practice, and social work.     

The Relationship Between Social Work and Psychoanalysis: The Future Impact of Social Workers

Because social workers are likely to have a more expanded role within organized psychoanalysis than previously, it seems timely to consider the numerous challenges and opportunities ahead with respect to social workers’ impact on the practice of psychoanalysis. For those who become social work psychoanalysts, in particular, a pivotal issue is the degree to which they retain their core identity as clinical social workers. It is important for them to integrate and balance the diverse aspects of their dual identity, to participate in our social work organizations, to contribute to developing psychoanalysis, and to work to keep the teaching of contemporary psychoanalytic theories alive in social work education.

Social Work Student Learning Experiences of Family Therapy: Improving Competency in Pedagogy Through Qualitative Research

The purpose of this qualitative study is to evaluate graduate social work student experiences of pedagogy intended to improve competency in family therapy practice. Students from two classes (N = 37) completed open‐ended surveys assessing: perceptions of most helpful pedagogical practices; understanding of needed competencies; and perceived opportunities offered to them during their graduate training for learning about work with couples and families. Results, analysed using grounded theory methodology, revealed that students: (1) believed that experiential activities were especially critical for learning how to do clinical practice with couples and families; (2) understood important competencies related to professional development, therapeutic engagement with the family, and how to approach family practice; and (3) believed they were ‘somewhat prepared’ for practice. Implications include improving understanding of abstract skills in practice with couples and families, and emphasising relationship dynamics more in graduate social work education and training.     

Life-Spheres,Networks, and Sustained Participation in Social Movements: A Phenomenological Approach to Political Commitment

This article proposes an account of individual participation in social movements that combines structural and cultural factors. It aims to explain why certain activists continue to be involved in social movements while others withdraw. When activists remain embedded in social networks relevant for the protest issues and, above all, when they keep a symbolic linkage between their activism and their personal life-spheres, sustained participation is likely to occur. When these two factors become progressively separated from each other and the process of self-interaction by activists loses its strength, disengagement can be expected. The argument is illustrated with life-history interviews of activists who have kept their strong commitment to a major organization of the Swiss solidarity movement, and others that, in contrast, have abandoned their involvement. The findings support the argument that the interplay of the structural positions of actors and the symbolic meanings of mobilization has a strong impact on commitment to social movements and hence on sustained participation or disengagement. In particular, the interviews show the importance of a sense of coherence and of a holistic view of one's personal life for keeping commitment over time. This calls for a view of individual participation in social movements that draws from social phenomenology and symbolic interactionism in order to shed light on the symbolic (subjective) dimensions of participation, yet without neglecting the crucial role played by structural (objective) factors.     

Personal Religiosity and Spirituality Associated with Social Work Practitioners' Use of Religious-Based Intervention Practices

Abstract

Social workers (N = 221) in the Southeastern USA responded to survey questions measuring 3 outcome variables, attitude toward religion in social work, the appropriateness of 15 religious-based interventions, utilization of these practices, and 3 dimensions of spirituality: spiritual experiences (spirituality), religious practices (organized religiosity), and religious affiliation. Attitude was generally favorable, and more than half of the interventions were judged appropriate and utilized by over 50% of the respondents. Beyond identifying with no religion, which predicted lower outcome scores, high spirituality strongly predicted attitude and utilization, whereas extrinsic organized religiosity was unimportant. A process model utilizing path analysis suggested that personal spirituality increases utilization resulting in corresponding perceptions of appropriateness and attitude toward religion in practice. More research was recommended on (1) utilization prevalence in other and diverse samples, and (2) the efficacy of religious-based practice.     

Social Work Education and Clinical Learning

In response to a growing diversity of opinion regarding educational models and essential content in clinical social work education, this paper offers a perspective concerning graduate clinical curricula. Part I, the foundational piece of the paper, discusses the definition of clinical social work, social work’s core orientation and values, and influential contextual issues. The interrelated core orientations guiding knowledge and skill development are identified as the person-in-situation perspective and the concept of relationship. Based on this foundation, Part II identifies elements of a contemporary biopsychosocial knowledge base and essential clinical skills. This paper is intended to stimulate dialogue about a topic of importance to the profession and the clients it serves.     

Communication Patterns and Direct Social Work Practice with Latinos in the U.S.

Abstract

Although Latinos in the United States are projected to become the largest ethnic and cultural population by the 21st century, there continues to be a paucity of literature on the heterogeneity of this population. This article presents a brief perspective of Puerto Ricans in the U.S. including elements of its cultural value system and its relevance to culturally based differences in patterns of communication. The author identifies several cultural values, how they interface with different patterns of communication among Puerto Ricans and implications for direct social work practice.     

Identifying as an evidence-based social worker: the influence of attitudes,access, confidence,and education

This study explored United States-based social workers’ (N = 152) attitudes toward, access to, and confidence in engaging in evidence-based practice (EBP), the extent to which social work education prepared them to engage in EBP, and the factors that contributed to their identification as an evidence-based practitioner. Findings indicated that although practitioners had a positive attitude toward engaging in EBP, they were only moderately confident in doing so, rarely accessed evidence, and were only moderately prepared through their education. Believing that EBP should be implemented, more educational preparation, and positive attitudes contributed to greater identification as an evidence-based practitioner, areas that social work and continuing education should further support to enhance social workers’ EBP skills.     

Mutual Values: Self Psychology, Intersubjectivity, and Social Work

This article explores a representative sample of the values which self psychology, intersubjectivity, and social work have in common. The mutual values chosen for consideration are: (1). The inherent worth of the human being (2). The uniqueness of the individual (3). Beginning where the client is; and (4). The centrality of the relationship in the clinical setting. The focus will be on the theories and methodologies which have emerged from these values in self psychology and intersubjectivity and their utility for clinical social work. The discussion of each value includes a clinical illustration from the author's practice in order to aid in the elucidation of the concepts presented.     

Sustaining and Strengthening a Macro Identity: The Association of Macro Practice Social Work

Macro practice focuses on community-level interventions, such as management, organizing, research, and policy advocacy. Despite social work's deep roots in this type of work, macro practice and macro practitioners often practice without support or connections with other macro practitioners, and are underrepresented in the profession. In 2006, a group of social workers, including academics and practitioners, formed the Association of Macro Practice Social Work (AMPSW). AMPSW works to strengthen the professional identity of macro practitioners, elevate the status of macro social workers, and address common concerns within the social work profession.     

Social Learning Theory and Behavioral Therapy: Considering Human Behaviors within the Social and Cultural Context of Individuals and Families

This article examines theoretical thoughts of social learning theory and behavioral therapy and their influences on human behavior within a social and cultural context. The article utilizes two case illustrations with applications for consumers. It points out the abundance of research studies concerning the effectiveness of social learning theory and the paucity of research studies regarding effectiveness and evidence-based practices with diverse groups. Providing a social and cultural context in working with diverse groups with reference to social learning theory adds to the literature for more cultural considerations in adapting the theory to women, African Americans, and diverse groups.     

Clinical Social Work and Psychoanalysis: Introduction to the Special Issue

As clinical social work developed in America it was highly influenced by the concepts and techniques of psychoanalysis and many of its practitioners became interested in seeking psychoanalytic training. More and more psychoanalysts are now coming from a background in clinical social work due to the development of a network of interdisciplinary training institutes and the opening of the Institutes of the American Psychoanalytic Association to non-medical candidates. This special issue considers how psychoanalysis may be affected as more of its practitioners and contributors come from a background in clinical social work. This introduction reviews the history of the development of clinical social work and outlines the issues related to “lay analysis” in this country.

Social Work with Clients Contemplating Suicide: Complexity and Ambiguity in the Clinical, Ethical, and Legal Considerations

Social workers in agency and private practice settings often work with clients grappling with suicide, either as an acute or chronic situation. Probably more than any other clinical condition, suicide forces the practitioner to confront complex ethical, legal, and psychological questions while managing an urgent circumstance. This article attempts to illuminate the ethical and legal considerations that may arise when a client contemplates suicide. Rather than advancing one answer, we stress that in training and the workplace social workers must fully consider the complexities and ambiguities of a client's experiences as well as their own clinical, ethical, and legal obligations.