Social Workers' Responses to Incontinence,Confusion and Mobility Impairments in Frail Elderly Clients

Social workers in home health care agencies are frequently involved in decisions concerning the independent living of their frail elderly clients. This study analyzes social workers' responses to elderly clients with three health problems that are relatively common among the elderly: urinary incontinence, confusion, and mobility impairments. Responses to clients with incontinence differ from responses to confused or mobility-impaired clients primarily in the specificity of attributions of cause of the problem and in evaluative responses toward the client. The findings are discussed in terms of the potential role of social work as an agent for change in both popular understandings of incontinence in later life and in the delivery of health care to the incontinent elderly.     

Euthanasia and assisted suicide: a survey of registered social workers in British Columbia

This anonymous postal survey explores the attitudes and experiences concerning voluntary euthanasia (VE) and assisted suicide (AS) held by professionally registered members of the British Columbia Association of Social Workers. Social workers determine only a minor moral distinction between VE and AS and a large majority believe both acts should be legal, in certain circumstances (VE 75.9 per cent; AS 78.2 per cent). Approximately 80.0 per cent feel that social workers should be involved in social policy development concerning VE and AS, and, if such acts were to be legal, 70.0 per cent believe social workers should be involved in the decision making process with clients. Over 21.0 per cent of all social workers and nearly 40.0 per cent of social workers with medical employers have been consulted by a patient about VE or AS. Six respondents (1.1 per cent) reported assisting the death of a patient by VE. None had involvement in AS. Further research and education is required to better inform social work practice in this ethical area. Given the unique position of social workers in health care, they should, for the benefit of patients, families, and physicians, actively participate in the discussion concerning end of life decisions.     

Environmental justice at the heart of social work practice: Greening the profession

Social workers face many contemporary challenges. Alongside the difficulties of upholding human rights, social justice and active citizenship, are those of affirming environmental justice and care for planet earth in and through social work practice and addressing climate change and other disasters. I call for social workers to take action that addresses these issues as a strong, united profession that works alongside dispossessed and marginalised people who do not get their share of global resources, despite their limited ecological footprint. I suggest a new paradigm for practice rooted in environmental justice that enhances the well‐being of people, the flora, fauna and the ecosystem that sustains and supports us all – green social work, for practitioners supporting life in one interdependent world.     

Bilingual Social Workers in Mental Health Service Provision: Cultural Competence,Language, and Work Experience

Many agencies actively recruit bilingual social workers. This study presents the reactions of 10 Chinese bilingual social workers to the expectations and demands of their agencies. The study employed a qualitative design with a phenomenological approach. The participants’ responses provide insight into how they manage ethnic and cultural mental health issues in Chinese populations. This study aims to improve social service delivery for clients with limited English proficiency by identifying effective, culturally competent services. The findings suggest that when hiring bilingual social workers, it is just as important for them to be culturally competent as it is for them to be an ethnic or language match with the client base. Having all of these qualities will result in staff members who can provide more effective services by making accurate diagnoses and identifying appropriate treatment plans. In addition to employing bilingual social workers, it is important to maintain good supervision as this will allow supervisees to have a unique perspective on what is involved in providing effective delivery of services to clients with limited English proficiency. Implications for research, practice, and policy are discussed.     

Putting the parity into service‐user participation: An integrated model of social justice

Models of service‐user participation have derived from citizenship or consumerist agendas, neither of which has achieved the structural reforms important for the most marginalised social work clients. This article proposes Fraser's model of ‘parity of participation’ as an appropriately multifaceted frame for capturing the social justice aspirations of service‐user participation. A qualitative case study compared the experiences and expectations of people who had used Australian mental health services with a sample who had used Australian homelessness services to examine their expectations of participation at individual and representative levels. The findings reinforce concerns from Fraser's research about the tendency for identity‐based consumerist notions of participation to reify group identity. This leads to tokenistic service‐user involvement strategies that have little impact on participation at a structural level. Fraser's parity of participation is shown to have untested potential to reshape service‐user participation to meet the social justice aspirations of social work clients. Key Practitioner Message: ● Innovative, service‐user driven strategies for collaboration will be those which challenge existing power structures; ● Service users want their contributions to decision making to generate identifiable change in the system of social services; ● The success of service‐user participation strategies might be the extent to which political, economic and cultural opportunities are enhanced.     

Addressing risk factors of cognitive impairment in adults aging with HIV: a social work model

With advances in life-extending medications and later- life infections, the number of older adults with HIV is increasing. Unfortunately, the synergistic effects of aging with HIV may place many people at risk of developing cognitive impairments which can disrupt everyday functioning. Fortunately, cognitive reserve may be maintained, or in some cases improved, by taking action to prevent or mitigate such loss. Preventative and treatment strategies that support biopsychosocial aspects of cognition include reducing alcohol and substance use; improving nutrition; diminishing the effects of comorbidities; increasing social contact; reducing depression and stress levels; engaging in cognitively stimulating activities; applying cognitive remediation therapies; and incorporating psychopharmacological interventions. Such strategies can improve the physiological integrity and health of the brain, thus supporting neuroplasticity and increasing cognitive reserve. Social workers are in a favorable position to recognize cognitive decline in clients and recommend or administer solutions to address such problems. A model for social workers advocating for older clients with HIV who have cognitive problems is provided.     

A comment on ‘Climate change: Social workers’ roles and contributions to policy debates and interventions'

Peeters J. A comment on ‘Climate change: Social workers’ roles and contributions to policy debates and interventions' In this commenting article, I present several critical remarks about Lena Dominelli's contribution to the issue of climate change and its implications for social work. 1 In my view, her article lacks three important considerations. First, I argue that the issue of climate change should be addressed as part of a broader, fundamental challenge: the transition of the growth‐based economic system upon which our society is built. Second, within a context of social and ecological injustice, dealing with climate change inevitably requires a dimension of social struggle. Third and lastly, I emphasise social work's role in challenging the social, political and economic structures and processes that bring about climate change.     

Family planning: humanism and science

The author used to believe that social workers had built in resistances to suggesting family planning for clients. Today, however, this is not longer so because of the 1967 resolution on the National Association of Social Workers. There is however, serious concern about furnishing contraceptives or family planning information to the unmarried minor. The author contents that physicians and social workers both have to help youth in the confused area of premarital sexual relations. The abortion problem should involve the same professions. The author argues that a) every woman over 40 should have the right to make up her mind about being pregnant and continuing so, and b) every girl of 17 or less should be allowed an abortion if she is pregnant out of wedlock.     

Exploring perceptions of mental health clients and professionals about Buddhism‐based therapies at mental health hospitals in Vietnam

With 80% of Vietnamese people holding key Buddhist beliefs, Buddhism has great impact on the thoughts, emotions, and behavior of Vietnamese people. However, almost no Buddhism‐based psychosocial interventions are offered at formal psychiatric hospitals across Vietnam, nor is there any plan to incorporate these interventions into mental health care. This exploratory study examines the perceptions of mental health clients and staff regarding the effectiveness of Buddhism‐based therapies (BBTs) in mental health treatment in Vietnam, using ethnographic observation and in‐depth interviews with 24 patients and eight professionals at the only psychiatric hospital employing BBT. Participants strongly believed in the positive impact of BBT to help clients manage or improve their symptoms. However, clients and staff advised that BBT should not be used alone; rather it should be used in combination with medication and was best employed for stress‐related disorders. They unanimously supported incorporating BBT into the formal mental health system, especially if the therapies were well developed through collaboration between Buddhist monastics and mental health professionals. Results of the paper suggest that Vietnam should think strategically about developing and incorporating BBT into the formal mental health care system.     

Implementation of Active User Principle: Learning from the Czech Social Services Reform

ABSTRACT

The active user principle introduced in Czech social services by the new Act on Social Services (2007) was expected to induce change of the prevalent paternalistic nature of social service provision. This study examines the relationship between clients and social service workers in social service facilities designed for people without shelter. From 2001 to 2008, instrumental case studies were examined from three different shelter facilities using qualitative interviews (with 17 members of staff) and document analysis. The findings indicated that neither the frontline workers nor the managers could always understand how to implement this principle. Response patterns and the effect it had on recipients are examined. These findings imply that such a profound change needs to be supported with proper explanation, professional training, and practical application skills. Directions for further application and future research are suggested.     

Climate change: social workers' roles and contributions to policy debates and interventions1

Dominelli L. Climate change: social workers' roles and contributions to policy debates and interventions Int J Soc Welfare 2011: 20: 430–438 © 2011 The Author(s), International Journal of Social Welfare © 2011 Blackwell Publishing Ltd and the International Journal of Social Welfare. Climate change is seldom discussed in mainstream social work. Its first presentations on the world stage occurred in Copenhagen during the Conference of the Parties (COP15). This article argues that the profession has an important role to play in: helping people understand the issues; promoting sustainable energy production and consumption; mobilising people to protect their futures through community social work; and proposing solutions to greenhouse gas emissions as indicated in two case studies, one based on a community initiative in the Global South, and the other in the Global North. The article also demonstrates that social workers can foster climate change endeavours that are equitable for all, for example the Equitable Carbon Sharing Scheme.     

Finding the right connections: Peer support within a community‐based mental health service

Gray M., Davies K., Butcher L. Finding the right connections: Peer support within a community‐based mental health service This article reports on a qualitative study that examined the organisational enablers and barriers to implementing peer support work in an Australian, rural, community‐based mental health service. Interviews with 19 peer and non‐peer staff were conducted to identify attitudes towards peer support and whether there were organisational values, practices and strategies that might support the implementation of peer support. The findings revealed that peer support workers were valued for their ability to build trusting connections with clients and to accept client choice in a non‐judgemental way. However, peer support workers tended to ‘fill service gaps’ within intensive, administrative case‐management environments. These findings highlight the importance of an organisational‐wide approach to integrating peer support, where the responsibilities for adopting new ways of working fall to all staff, not just the peer support workers themselves. Key Practitioner Message: ? Practitioners placed high value on the peer support workers on their teams due to their unique personalised engagement with clients; ? The roles of peer support workers were poorly understood by team members; ? Organisational integration of peer support principles could improve the way all staff engage with clients to reflect a recovery orientation.     

Collective empowerment: A comparative study of community work in Mumbai and Stockholm

Mumbai and Stockholm are worlds apart in terms of public services, infrastructures and standard of living. However, both cities have known common problems of social exclusion and marginalisation related to neo‐liberal globalisation. Social workers are facing similar challenges regarding collective empowerment as a strategy for community work. This comparative study explored how collective empowerment is undertaken by community workers. The research participants were 13 informants from community‐work organisations in the two settings. Semi‐structured interviews were used and were analysed with the help of Atlas‐ti 6.2 (ATLAS.ti Scientific Software Development GmbH D‐10623 Berlin Germany). Social work in Mumbai is in a context of extreme poverty and mainly within the informal sector, whereas in Stockholm most social work is done in relation to a public welfare model. In Stockholm, interventions are aimed towards strengthening social networks, without direct aim at social change. In Mumbai, community workers organise people for collective empowerment to strengthen marginalised groups and achieve social change.     

Practical considerations for maintaining independence among individuals with functional impairment

Social workers, gerontologists, and related health professionals must learn to recognize how aging, disability, and chronic illness affects individuals and their families' physical, psychological, and social functioning in order to develop effective interventions for their clients. This article discusses prevention strategies to help facilitate functional consequences of aging, including chronic illness and disease and offers suggestions for assisting clients to cope and manage the consequences of illness in frail elder adults.     

Co‐production in the epidemiological clinic: A decentred analysis of the tensions in community‐based,client‐facing risk work

Public health policies to prevent disease within populations are giving rise to shifting patterns of healthcare delivery in the late modern era. There is an inherent tension in modern medicine between evidence‐based standardisation, on the one hand, and patient‐centred specificity on the other. This tension manifests in recent policy narratives regarding public health risk (which we have characterised in terms of the epidemiological clinic) and co‐production. Drawing on co‐produced data with health trainers (lay health workers tasked with supporting behavioural change in patients at high risk of cardiovascular disease) in a deprived post‐industrial region of England, our decentred analysis focuses on three extended narratives from this data set. Our analysis builds on and develops emerging theories of risk work, informed by Habermas, and we explore the extent to which elite narratives of public health risk are resisted, absorbed, or bracketed off by client‐facing health workers—emphasising the heterogeneity of responses—and locate these responses within the context of the workers' employment conditions, their embodied experiences, and their wider beliefs and traditions. We argue that co‐production—albeit in a highly constrained form—is possible while delivering public health interventions. However, in the context of a community where health is so adversely affected by wider social problems and where task shifting has drawn lower status healthcare workers into these client‐facing roles, workers must find their own ways to negotiate and attempt to reconcile this context with the risk‐framed practices they are required to carry out.     

Social work for vulnerable and marginalized people during COVID-19 in Japan

During the Coronavirus disease pandemic (COVID-19), working conditions became increasingly difficult for social workers, as they had to deal with new challenges and added workloads. This study describes the difficulties faced by social workers of the Self-Reliance Support System in Japan and clarifies the solution for each difficulty while conducting their duties to support vulnerable people during COVID-19. To this end, we conducted an open-ended questionnaire survey and an interview survey. The data were analyzed using qualitative coding. The results showed that the difficulties faced in consultation support work included supporting hitherto socially invisible groups such as sole traders and foreigners. Social workers also faced an ethical dilemma, as they could not provide support to clients who “did not try to solve their problems” or for whom “interventional attempts did not lead to counseling support” and who only sought benefits at the risk of becoming isolated and impoverished. Following this, consultants collaborated to resolve such difficulties while maximizing the use of various local resources. The study's findings clarify that it would be effective to understand the difficulties faced by social workers to obtain hints toward their resolution.     

Social Empathy: A Model Built on Empathy,Contextual Understanding,and Social Responsibility That Promotes Social Justice

ABSTRACT

A model of social empathy is described where social empathy is defined as the ability to more deeply understand people by perceiving or experiencing their life situations and as a result gain insight into structural inequalities and disparities. The three components of the model—individual empathy, contextual understanding, and social responsibility—are explored and explained. Social empathy provides a framework for more effective social policies that address disparities and support social and economic justice for all people. Social workers are well positioned to enhance social empathy, and application and suggestions for further enhancement and research are provided.     

Challenges and dilemmas working with high‐conflict families in child protection casework

Social workers within child protection services report that families marked by high levels of conflict between separated parents are among the most challenging cases to handle. Few studies however have focussed on how social workers themselves experience and meet with parents involved in hostile martial interactions. This article reports on a qualitative study involving 31 social workers and provides an analysis of their experiences and dilemmas in working with such families. Findings demonstrate that social workers struggle to find ways to help high‐conflict families and often find themselves at an impasse. Parents involved in such conflict are highly resistant to change, and social workers struggle to engage with them over concerns about their children. Furthermore, findings suggest that social workers lack organizationally allotted time to assist the parents. I conclude by discussing ways in which emotional support, empowering interventions, and strength‐based approaches enable social workers to manage relationships with high‐conflict families. More research on this topic is needed to support and promote better practices for social workers to be more effective in assisting high‐conflict families.     

Environmental ethics for social work: Social work's responsibility to the non‐human world

Gray M, Coates J. Environmental ethics for social work: Social work's responsibility to the non‐human world This lead article in this Special Issue begins discussion on an environmental ethics for social work and raises arguments as to whether and, if so, why social workers have duties, obligations, responsibilities and commitments to the non‐human world. It provides an overview of the field of environmental ethics in searching for a moral stance to affirm an environmental social work. To what extent should social workers engage in fundamental geopolitical issues concerned with climate change, global warming, environmental degradation, pollution, chemical contamination, sustainable agriculture, disaster management, pet therapy, wilderness protection and so on and, if so, why and how? Are these issues incidental and peripheral and only of concern when they impact upon humans or do social workers have a responsibility beyond human interests? What is the significance of the ‘non‐human’ for social work? The article explores the terrain of the burgeoning field of environmental ethics to determine whether convincing ethical grounds for environmental social work might be found beyond hortatory claims of what the profession ought to be doing to address environmental concerns.