You’re Deaf? Breaking through Myths for Effective Therapeutic Practice

ABSTRACT

Most mental health practitioners provide services to hearing clients and might be unprepared when a deaf individual requests services. The purpose of this article is to explore commonly held stereotypes and myths about deaf people and to provide guidance to clinicians who encounter deaf clients in their practices. Myths and stereotypes can affect the way clinicians perceive their clients’ needs. This can lead to miscommunication, misunderstanding, and misinformation, which can harm the therapeutic relationship, thus making effective therapy unattainable. Clinicians should reframe these beliefs and overcome barriers to make way for the therapeutic process to begin.     

Improving work programs' delivery of information and service to workers' compensation carriers

This paper presents the results of a telephone survey of workers' compensation carriers, addressing how occupational therapy work programs can best meet these carriers' needs. Fifty percent of the market share of workers' compensation carriers in Michigan participated in the survey. Survey results indicated that workers' compensation carriers found Functional Capacity Evaluations, job analyses, and work hardening to be important work rehabilitation services. A significant portion of the respondents (88%) stated that they recognized the need for clinically successful work rehabilitation programs and indicated that if they had return to work rates for different providers, they would utilize providers that had the most successful outcome data in a specific geographical area. Occupational therapists can use these survey results to improve their services and communication with insurance to ensure that injured workers will continue to have access to the efficacious interventions occupational therapists provide in work rehabilitation.     

Rural Telephone Company Adoption of Service Innovations: A Community Field Theory Approach*

Abstract Recent telecommunications innovations have the potential to improve the economic vitality of rural communities, but many rural telephone companies have not adopted them to provide needed advanced services. To explain the differences in adoption by rural telephone companies we distinguish between service innovations, adopted primarily to improve direct services to clients, and operations innovations, adopted primarily to improve the operation of the business. Using community interaction field theory we develop and test a conceptual framework for the adoption of innovative service telecommunications technologies by Iowa rural telephone companies. As field theory predicts, involvement in local economic development activities has a strong, direct effect on innovativeness. Results suggest that the service and operations innovations distinction has theoretical utility in explaining organizational innovativeness.     

Informal care and support for carers in Sweden: patterns of service receipt among informal caregivers and care recipients

This study describes and analyses the kinds of support received by different categories of informal carers, and the kinds of help that care recipients receive in addition to that provided by various categories of carers. Data were collected in a Swedish county in 2000, by means of telephone interviews. The net sample consisted of 2,697 individuals 18–84 years old, and the response rate was 61%. The results showed that relatively few carers in any care category received any kind of support aimed directly at them as carers. The most widespread form of support received by providers of personal care was relief services. Those most likely to be receiving care from the public care system were people also receiving personal care from an informal caregiver. Nevertheless, the majority of those receiving personal care from an informal carer did not receive any help from the public care system or from voluntary organizations or for-profit agencies. These results indicate that social policy and social work need to clarify the aims of the services they provide. They also need to take the needs of both caregivers and recipients into account when discussing support systems.     

Learning opportunities through camping for mental health nursing

1. To equip nurses with the skills necessary for working with disturbed people, nurse educators need to be mindful of not watering down the essential skills necessary for nurses to deal with difficult behaviour in all branches of nursing. 2. These components of a mental health clinical experience should equip the graduate to deal with the pressures of dealing with disturbed people in any environment, as the skills learned generalize to any branch of nursing. 3. Universities can combine with traditional hospital services and community mental health services to provide services to clients with mental illness. An additional benefit is in providing students with an intensive clinical learning experience that reinforces the theory taught in the classroom.     

Telephone counseling and the masturbator: A dilemma

Summary The problems facing telephone counseling services who receive calls from men who desire to masturbate while talking to a female are discussed. Some suggestions are made as to how the counselor can handle this type of call, but it is noted that there is no evidence that telephone counseling is feasible with such callers.     

Families' values and attitudes regarding responsibility for the frail elderly: implications for aging policy

This study examines the norms and values associated with care to disabled and frail aging parents, in particular those with regard to the sharing of responsibilities for care between families and formal services, and this within three age cohorts in Quebec, Canada. It is based on a telephone interview of 1,315 people. Factor analysis yielded four factors: (1) family responsibility; (2) uncompromising family obligations; (3) acceptance of services; (4) distrust of services. Analyses of the data indicate that all three age cohorts consider that families have responsibilities for their aging family members, at the same time that they score very high on the acceptance of service scale. This article discusses these seemingly paradoxical results and their implications for aging policy.     

Lessons learned from children who have experienced homelessness: what services need to know

Children who accompany their parents or guardians during a period of homelessness make up 37% (more than one in three) of all people accessing the Supported Accommodation Assistance Program (SAAP) services. This paper describes an Australian qualitative study that explored the experiences of children who accompanied their families during periods of homelessness. It focuses particularly on what children and young people say they want from the services that they come in contact with; particularly specialised homelessness services such as housing support services and refuges. Key themes that emerged from the research include: the need for services to engage with children as individuals in their own right, to listen to and acknowledge their stories, to have services that meet their individual needs, to act and respond when children feel unsafe and for workers who can provide support to children to talk to parents about what is going on. Children and young people wanted workers to know that they felt their parents were doing their best to keep them safe. They focused on what their parents could do and did do rather than what they were not able to provide. They called on the human service system to do the same.     

Briefly Noted

The Centers for Medicare & Medicaid Services (CMS) has expanded Medicare beneficiaries' access to telehealth, allowing payment for individual psychotherapy, patient education and group psychotherapy that are delivered in “temporary expansion locations, including patients' homes.” In addition, it will consider adding more services if providers show they are interested in doing this. The April 30 decision will temporarily allow Community Mental Health Centers to offer partial hospitalization and other mental health services to clients in their homes. The CMS previously announced that Medicare would pay for certain services conducted by audio‐only telephone between beneficiaries and their doctors, but has broadened that list to include many behavioral health and patient education services. The payments for telephone visits now match payments for similar office and outpatient visits, retroactive to March 1, 2020. Instead of using a rulemaking process to add Medicare services that may be furnished via telehealth, the CMS will continue to add these during the COVID‐19 emergency on a subregulatory basis, taking into consideration “requests by practitioners now learning to use telehealth as broadly as possible.” And the CMS is waiving the video requirement for certain “evaluation and management services” — the office visits with the doctor — and now these can be provided by telephone only. Some beneficiaries don't have access to the technology for video, or don't want to use it. For more information, go to https://www.cms.gov/newsroom/press‐releases/trump‐administration‐issues‐second‐round‐sweeping‐changes‐support‐us‐healthcare‐system‐during‐covid .     

Government Policies and Disabled People in American Indian Communities

Although services and resources for disabled people in the United States have improved greatly as a result of legislation and advocacy efforts, many of the disabled in American Indian communities have yet to benefit from these advances. Inaccessibility to services is often complicated by problems and debates over which agency, state or federal, is responsible or has jurisdiction to provide the services. Meanwhile, Indian communities struggle to accomplish what they can with limited resources.     

An Evaluation of Caller Satisfaction with Solution-Focused Telephone Counselling

Abstract

‘Practice Forum’ is intended to provide a forum for social work practitioners to share their practice with others; to describe what they are doing and assess its effectiveness.

We extend an invitation to all social work practitioners to submit articles for ‘Practice Forum’ and we look forward to receiving your contribution.

The telephone is a potentially valuable intervention tool in family counselling. The Child, Adolescent & Family Health Service has been experimenting with a response which combines the traditional advantages of telephone counselling with aspects of Steve deShazer's solution-focused approach (deShazer 1985). In 1990 a study was conducted to evaluate caller satisfaction with this approach. Results indicate a high level of satisfaction with the counselling. At a time of increasing funding cuts and lengthening waiting lists, it is important that as many options as possible remain available to our clients. An expansion in effective telephone counselling services may well be one way of achieving this.     

Mental health needs assessment of children and adolescents

Needs assessment is essential input for program planning. Little data are, however, available about the various approaches and whether strategies for needs assessment are viable. It was found by an inexpensive methodology that opinions about the importance of various services, opinions about the potential acceptance of services, services provided, and the total need for services are interrelated. A hybrid approach that utilized data from teachers and the people that provide mental health services was also a practical means to obtain information about the unmet needs of children and adolescents in the country. Data supported the value of this technique for the assessment of the unmet needs of children and adolescents. Thus, an inexpensive methodology can provide useful information from multiple perspectives.     

Beginnings and endings; Is there a way out of psychiatric services?

An historical and conceptual overview of psychiatric rehabilitation services is presented as a challenge to the appropriateness of traditional community based psychiatric services which isolate people from the community. The position is taken that the goal of psychiatric rehabilitation services should be to link people to normal community services and support systems. The problems which can arise from treating people in a separate psychiatric system are illustrated by tracing the development of a supported employment program through periods of high employment and high unemployment.     

How Far to Gay? The Politics of HIV in Learning Disability

This paper examines work in sexual health and HIV prevention in services for people with learning disabilities from a political stance associated with the rehomosexualisation of AIDS in Britain. Arguments are made for the re-homosexualisation of AIDS in services for people with learning disabilities, based on evidence of where HIV risk lies in relation to men with learning disabilities who have sex with men. This provides an opportunity to critically review approaches and responses to HIV risk assessment and risk management in services for people with learning disabilities, with reference to the assumptions which underpin practice and issues of sexual identity. The case is made for a more radical sexual politics in learning disability to help combat HIV and to provide more realistic approaches to service commissioning and safer sex education. Pointers for service development and key areas where the re-homosexualisation of AIDS can inform practice and resource development are also provided.     

Families' Values and Attitudes Regarding Responsibility for the Frail Elderly

Abstract

This study examines the norms and values associated with care to disabled and frail aging parents, in particular those with regard to the sharing of responsibilities for care between families and formal services, and this within three age cohorts in Quebec, Canada. It is based on a telephone interview of 1,315 people. Factor analysis yielded four factors: (1) family responsibility; (2) uncompromising family obligations; (3) acceptance of services; (4) distrust of services. Analyses of the data indicate that all three age cohorts consider that families have responsibilities for their aging family members, at the same time that they score very high on the acceptance of service scale. This article discusses these seemingly paradoxical results and their implications for aging policy.     

Consumer-operated self-help services

To create a mental health system focused on recovery, consumer-operated services, for which an evidence base is emerging, should be promoted. Consumer-operated services have become a viable, cost-effective model designed to provide social support and recovery opportunities for people diagnosed with a psychiatric disability who are living in the community. This article describes the consumer-operated services model and uses a self-help center as an example. The core components of consumer-operated self-help centers are outlined. Qualitative data gathered through a larger study of self-help centers is presented. The article highlights the benefits of and areas for improving this innovative resource, which offers many advantages and opportunities for people living with a psychiatric disability in the community.     

Telephone therapy: An alternative to isolation

While a fair amount has been written on the use of the telephone for crisis intervention and management of medical and psychosocial problems, little has been written about the telephone as the primary modality for ongoing therapy. This paper presents the author's experience in providing weekly telephone therapy for two women for over one and one half years. Questions related to the meaning of the telephone therapy for each of the clients and the social worker are discussed. It is concluded that the creative use of the telephone may make supportive therapy possible for some clients who would not otherwise pursue therapy.     

Belonging to the library: humanising the space for social work education

Abstract

This article describes the running of four Living Libraries on a UK postgraduate social work course. A Living Library is a metaphoric remodelling of a conventional library where people, as authors of their experiences, provide specialist knowledge based on authorial areas of expertise. In the Living Libraries discussed here, ‘Living Books’ carried stories of social work—their narratives were of lived experiences as people using social care services; as carers in personal relationships with others who use social care services; or, as social work practitioners. The focus of this article is on those Living Libraries involving the participation of the first two of these groups. Drawing on social psychology, phenomenology and human geography, we propose that a Living Library can act as a connective space within social work education by engendering a discursive forum where all participants—people with experiences of services, students, practitioners and social work educators—are given both the freedom and obligation to talk openly about their differential experiences, fears and hopes for social work. Through this process, opportunities are created to consider how improvements that meet all stakeholders’ interests may be achieved.     

The Uphill Struggle: services for Deaf and hard of hearing people - issues of equality, participation and access

This article focuses upon the ways in which Deaf and hard of hearing people are excluded from participation in society. In particular, the focus is upon the ordinary expectations that members of society have in terms of participating as citizens and performing socially sanctioned, adult roles. The roles of 'citizen', 'employee', 'parent' and 'patient' are discussed. The data illustrate how the organisation and delivery of services can undermine, rather than facilitate, the performance of these roles. Despite policy emphasis on social inclusion, current services and legislation fail to provide a firm basis for the full participation of Deaf and hard of hearing people in British society.