Child Abuse Investigation and Treatment for Deaf and Hard of Hearing Children

Abstract

Deaf children are more susceptible than other children to abuse in home and institutional settings. Many helping professionals are unaware of the unique vulnerabilities and needs of the deaf; this lack of awareness limits the effectiveness of their services to that population. Laws and ethical standards mandate that social workers and others use communication methods that deaf clients can understand; however, many human service agencies rely on less than adequate means of communication in child abuse investigations and other procedures. Such ineffective intervention practices fail to protect a vulnerable population of children who literally cannot speak for themselves.     

No one is listening: Members of the Deaf community share their depression narratives

This exploratory case study conducted in Manitoba, Canada examined a unique social justice issue in the field of mental health, namely, how Deaf adults, all American Sign Language first-language users who were diagnosed with Depression, manage their symptoms in a mental health system that is based on spoken, not signed communication. Using in-depth individual interviews, and a hand-drawn Person and Environment Map, this study offers rich in-depth narratives of the experiences and challenges faced by members of the Deaf community seeking mental health assessment and intervention.     

Addiction Treatment with Deaf and Hard of Hearing People: An Application of the CENAPS Model

ABSTRACT

Alcohol and drug addiction is a significant problem among deaf and hard of hearing people. Looking through a Deaf culture lens, treatment for alcohol and drug addiction is key for providing care for deaf and hard of hearing clients. Using the CENAPS model, an applied cognitive-behavioral therapy program is recommended for addiction treatment. The CENAPS model provides clinicians with tools for stabilizing deaf and hard of hearing clients, supporting their transition to early recovery. Educating the client about the stages of relapse and the stages of recovery, clinicians using this model can better treat and prepare deaf and hard of hearing clients for long-term recovery.     

Self–care practices among social workers: do they predict job satisfaction and turnover intention?

ABSTRACT

The current health and mental health care delivery system in the United States strives to provide efficient quality care at a lower cost. This cost-effective approach and recent budget cuts have created new challenges for social workers. This study explores the relationships between self-care strategies, role stress, job autonomy, and job satisfaction and turnover intention. Four-hundred sixty-nine social workers were surveyed to assess multiple measures of self-care including professional support, professional development, coping strategies, and professional resilience, and their effects on job satisfaction and turnover intention. Role stress and job autonomy were also examined in relation to job satisfaction and turnover intention. The results supported the main hypotheses that claimed that self-care strategies are associated with both job satisfaction and turnover intention. The author discusses the important implications of these findings in education and training of both students and practitioners.     

Culturally responsive social work practice with D/deaf clients

ABSTRACT

D/deaf individuals are often marginalized in our society. A lack of cultural understanding among social workers serving this population, coupled with communication barriers, inconsistent access to interpreters, or misperceptions of culture, adds to the potential for further marginalization. D/deaf individuals seeking mental health and social services live in a unique cultural context with which social workers may not be familiar and experience persistent issues surrounding access to mental health and social services. This article reviews some useful best practices, cultural points to be aware of, and suggests some strategies for providing culturally responsive social work when working D/deaf clients.     

Shit is good: Mental health social work with lives of squalor

This paper investigates the phenomenon of three clients living in squalor, all of whom have severe and enduring mental health problems, and are on the caseload of a mental health social work team. By thinking about the clients both individually and as a group, within a psychoanalytic framework, it attempts to understand their squalor in a new way, with particular regard to the transference and countertransference experienced by the practitioner. By making use of social work literature as well as that concerning organisations and community care, it also discusses the impact these clients make on the wider community around them, and examines some of the dilemmas faced by the practitioner. The implications for social work are serious and far-reaching and these are discussed with regard to long-term intervention as well as professional and personal scrutiny.     

Comorbid Substance Abuse and Mental Illness

Abstract

Literature concerning assessment and treatment of comorbid substance abuse and mental illness is reviewed. Currently, comorbidity is under-diagnosed and dually diagnosed clients are under-served. Those clients, who are so diagnosed, are most often offered dichotomous parallel or serial interventions. However, research suggests that an integrated approach is preferable. Enhanced training of mental health and substance abuse professionals is urgently needed as is further research concerning the efficacy of various treatment modalities. Improved identification and treatment of comorbidity may reduce the revolving door effect among these individuals and thereby lower health care costs.     

Chapter 5. Self-Care in Caregiving

SUMMARY

This chapter discusses strategies to facilitate caregiver self-care from a social work perspective. The functional age model of intergenerational treatment (Greene, 1986, 1994, 2000) is used to explore the context of caregiving, including the developmental course, challenges, rewards, coping methods, and consequences of caregiving for a variety of clients, followed by an exploration of the process of assessing and intervening with the caregiver to foster healthy self-care practices.     

Adolescents Seeking Mental Health Services

Summary

Inner-city adolescents receiving mental health services often get inadequate medical care. However, when those who seek counseling are asked about their health concerns, they say they want to discuss them with their therapists. Based on responses to a clinical self-assessment questionnaire (Adquest), adolescent mental health clients reported sleep difficulties, weight and eating concerns, and frequent headaches and stomachaches. Age and gender differences in patterns of vulnerability and willingness to talk were explored.     

Mental Health Workers Negotiating Risk on the Frontline

Abstract

Following deinstitutionalisation and the shift to models of community care, mental health practice has become increasingly focused on managing the risks posed by service users. However, the effects of risk management on workers’ professional identities have not been investigated empirically in Australia. Drawing on in-depth interviews with mental health workers from Victoria, Australia, this paper explores the diverse ways in which these workers adapted the formal technologies of risk management (e.g., the completion of risk assessment screens) to their professional identities. Some workers experienced risk management technologies as constraining their interventions with clients, while others saw these technologies as providing opportunities to strengthen and enhance their professional skills. Pondering these differences, the author speculates on the emergence of a new form of professional identity in the broader context of contemporary community mental health care.     

Can we talk about the right to healthcare without language? A critique of key international human rights law,drawing on the experiences of a Deaf woman in Cape Town,South Africa

A case study in Cape Town, South Africa, explores the right to health for signing Deaf ¹ 1. By Deaf (capitalised) we understand those permanently sensorily disabled people who are born deaf or who become deaf as children and whose first language is sign – South African Sign Language (SASL) in this country. View all notes patients attending health services and who are unable to communicate in a language they understand. It argues that, without language, Deaf South Africans’ dignity and right to health is violated, resulting in serious consequences such as incorrect diagnosis, improper treatment and standard of care not being applied. It critiques the provisions of the Convention on the Rights of Persons with Disabilities (CRPD) and the limits of General Comment 14 of the International Covenant on Economic, Social and Cultural Rights. The paper demonstrates that Deaf patients do not have informational access to healthcare. It argues that language via professional interpreter services is essential to their South African constitutional right of access to healthcare. General Comment 14 addresses informational accessibility, but this is insufficient without addressing language as a pre-requisite. The CRPD imposes on the South African government human rights obligations to provide professional interpreter services for Deaf people, but unfortunately it allows a loophole by enabling cost to serve as reasonable grounds to defer action.     

Self-Care Practice in Social Work Education: A Systematic Review of Interventions

Social work is a demanding profession as practitioners routinely face difficult situations that affect their well-being. The National Association of Social Workers strongly supports self-care practice as an approved mechanism to offset these challenges, yet practitioners report not learning techniques necessary to perform self-care. In this study, a systematic review compliant with Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards was conducted to identify evidence-based interventions used to improve student self-care practice in social work education. In the four studies meeting inclusion criteria, mindfulness practice was the only empirically evaluated self-care strategy reported—and with mixed results. Mindfulness activities enable social workers to sustain their well-being and is critical to modeling and providing effective service delivery to clients. Areas for further research are indicated.     

Practice Wisdom on Custodial Parenting with Mental Illness: A Strengths View

ABSTRACT

Social work principles of strengths, empowerment, and consumer-centered care for persons with mental illness are currently being adapted to broader contexts. This article presents study findings on practice wisdom about custodial parents with mental illness, a potentially increasing group of consumers in light of mental health reform. The research team organized thirty-six professionals with practice experience into five focus groups. Findings reflect strengths perspective categories of resilience, social support, family functioning, self-care, and parents' positive experience of their symptoms. Implications discuss how providers who work with custodial parents and their children can apply these findings in assessments and interventions.     

Implementation of a Mental Health Task Force in a collegiate-based emergency medical services organization

Abstract

Objective: A Mental Health Task Force (MHTF) was implemented in 2016 by a collegiate-based emergency medical services (CBEMS) organization to (1) improve mental health emergency response and to (2) address concerns for the mental health of CBEMS providers. Participants: Skidmore College EMS is a Basic Life Support First Response service staffed by volunteer undergraduate students. Methods: In coordination with faculty and staff, students in the MHTF developed trainings, peer support structures, community events, policies, and informational resources. Results: Sixteen students joined the MHTF within 1 year. Over 35 Skidmore College EMS members received training on mental health emergency response, peer-support, and self-care. Debriefing programs, mindfulness-based events, shift-length limitations, and access to informational resources promoted the mental health of Skidmore College EMS members. Conclusions: Implementing an MHTF is an innovative, student-led approach to coupling education on emergency response with programming that supports the mental health of CBEMS providers.     

Adapting a Family-Based HIV Prevention Program for HIV-Infected Preadolescents and Their Families

Summary

This article describes a family-based HIV prevention and mental health promotion program specifically designed to meet the needs of perinatally-infected preadolescents and their families. This project represents one of the first attempts to involve perinatally HIV-infected youth in HIV prevention efforts while simultaneously addressing their mental health and health care needs. The program, entitled CHAMP+ (Collaborative HIV Prevention and Adolescent Mental Health Project-Plus), focuses on: (1) the impact of HIV on the family; (2) loss and stigma associated with HIV disease; (3) HIV knowledge and understanding of health and medication protocols; (4) family communication about puberty, sexuality and HIV; (5) social support and decision making related to disclosure; and (6) parental supervision and monitoring related to sexual possibility situations, sexual risk taking behavior and management of youth health and medication. Findings from a preliminary evaluation of CHAMP+ with six families are presented along with a discussion of challenges related to feasibility and implementation within a primary health care setting for perinatally infected youth.     

“A Very Steep Climb”: Therapists’ Perspectives on Barriers to Disclosure of Child Sexual Abuse Experiences for Men

ABSTRACT

Recent studies indicate that men experience unique barriers to disclosure of child sexual abuse. Blind spots held by mental health providers and social service agencies may inadvertently help produce and sustain these barriers. However, therapists who specialize in treating this population may also hold important insights into the barriers clients face. Because delayed and nondisclosure of child sexual abuse have been associated with negative mental health outcomes for adult survivors, understanding these barriers is critical to improve clinical practice and facilitate help-seeking. Using conventional content analysis, this study examined the perceptions of nine therapists who specialize in the treatment of men who were sexually abused in childhood, many of whom are considered pioneers in the field. Analyses identified nine types of barriers, which were organized into three categories: intrapersonal experience (difficult feelings, lack of language, and self-engagement), social milieu (internalized social stigma, negative responses, social loss or judgment, and masculine identity dissonance), and health care environment (structural barriers, relational challenges with therapists, and unhelpful therapeutic strategies). Implications for future research, clinical training, and clinical practice are discussed.     

Use of standardized client simulations in an interprofessional teaching concept for social work and medical students: first results of a pilot study

ABSTRACT

Teaching concepts with standardized clients/patients (SC) had been successfully implemented in the education of health professionals. Benefits were also demonstrated for social work education. Based on former experiences with simulated clients in medical education, we developed an innovative teaching concept for social work and medical students. We focused on the training of consultations with clients suffering from a serious illness like cancer—with different learning goals for medical students (e.g. breaking bad news) and social work students (e.g. psychosocial exploration and counseling). Both groups should gain knowledge about the other professions tasks and learn to handle clients’ emotional reactions. In addition to role-plays with simulated clients in small groups, the concept includes an interprofessional lecture by physicians, psychologists, social workers, and lawyers as well as a visit on the palliative care ward (for social work students only) and a research colloquium. A formative evaluation shows high satisfaction with the teaching concept. The students underline the realistic setting, interprofessional contact, authentic talks and direct feedback. The SC method and its interprofessional application proved to be a practicable and motivating way to enhance conversational skills.     

Chronic care,integrated care,and mental health: Moving the needle now

Healthcare reform is currently a hot topic in the United States, and the Chronic Care Model has frequently been cited as the foundation of recent attempts to integrate mental health and physical health care. However, challenges exist to fully integrated care that have delayed adequately meeting the multiple needs of mental health service recipients. This article highlights multiple changes that can be incorporated into mental health care now, derived from the Chronic Care Model, to better meet clients’ physical and mental health needs. These changes include focusing on population-level data and incorporating technology and multidisciplinary teams in treatment and prevention efforts.