Integration of Supportive Psychotherapy with Case Management for Older Adults with Borderline Personality Disorder

This article attempts to demonstrate how supportive psychotherapy may serve as a companion therapeutic modality for case management activities with older adult clients suffering with borderline personality disorder (BPD). Justification for this approach is provided and techniques and interventions are identified. Three case examples demonstrating the modalities integration are provided.     

Short-term treatment with the adolescent client

Short-term treatment is proposed as the treatment of choice for adolescents because it is consistent with the developmental needs and goals of that age group. Several case illustrations have been provided to show the value and benefit of such an approach for the adolescent client as well as for the therapist.     

The price for information about probabilities and its relation with risk and ambiguity

In this article, ambiguity attitude is measured through the maximum price a decision maker is willing to pay to know the probability of an event. Two problems are examined in which the decision maker faces an act: in one case, buying information implies playing a lottery, while, in the other case, buying information gives also the option to avoid playing the lottery. In both decision settings, relying on the Choquet expected utility model, we study how the decision maker??s risk and ambiguity attitudes affect the reservation price for ambiguity resolution. These effects are analyzed for different levels of ambiguity of the act. Operating instructions for the elicitation of the reservation price for ambiguity resolution in an experimental setting are provided at the end of the article.     

Matching Practice Skills with Client Problems

Abstract

Despite the increasing pressure to measure social work practice skills and relate those activities to client outcomes and treatment costs, relatively little social work research has been devoted to the development of social work process instruments. The recent development of the Practice Skills Inventory has provided practitioners with a useful tool for measuring the frequency with which practitioners employ specific categories of common social work intervention skills. However, it is important to demonstrate that social workers employ these practice skills differentially depending on clients' presenting problems. The current study of 281 experienced MSW practitioners demonstrates that they, indeed, emphasize supportive, therapeutic, case management and insight facilitation skills differentially depending on the problems experienced by their clients. Implications for practice and evaluation research are addressed.     

An Axiomatization of Cumulative Prospect Theory for Decision Under Risk

Cumulative prospect theory was introduced by Tversky and Kahneman so as to combine the empirical realism of their original prospect theory with the theoretical advantages of Quiggin's rank-dependent utility. Preference axiomatizations were provided in several papers. All those axiomatizations, however, only consider decision under uncertainty. No axiomatization has been provided as yet for decision under risk, i.e., the case in which given probabilities are transformed. Providing the latter is the purpose of this note. The resulting axiomatization is considerably simpler than that for uncertainty.     

End of Life,Chronic Illness,and Trans-Identities

In this study, the experiences and needs of a sample of 1,963 current, global, English-speaking, transgender-identified adults responding to the Transgender MetLife Survey (TMLS) as related to a number of later-life and end-of-life (EOL) preparations and concerns were examined. EOL concerns are integrated with concerns and challenges around chronic illness and disability. Overall, this population was significantly ill-prepared for the major legalities and events that occur in the later to EOL time periods. The population was found to harbor significant fears around the future. Drawing on the author's decades of survey research in transgender aging and case data along with current scientific and online literature, illustrative quotations and case examples are provided.     

Culturally Competent Approaches for Counseling Urban Appalachian Clients: An Exploratory Case Study

ABSTRACT

The authors examine the application of a strengths-based empowerment approach to working with an urban Appalachian woman and her family. The purpose of this article is to start the research process by utilizing the lessons learned to assist health and human service practitioners. Key points are identified in developing awareness and intervention skills when working with clients who have an Appalachian cultural heritage. This case study utilizes a culturally competent framework for assessing and intervening with Appalachian clients that emphasizes the strengths and empowerment literature. As the foundation for further research, this case study provides a rationale for starting evidence-based practice incorporating a strengths-based empowerment theme. Case study research is limited by its focus on one individual within a specific span of time and cultural context; findings cannot always be generalized to a similar population. Suggestions for further research in this area are provided.     

The Construction of a Simple Book

A book is made for a horse race, and punters place their bets. The problem considered here is how the bookmaker should construct his book. Before this can be solved, it has to be determined how the punters will react to any proposed book. Much of the detailed discussion is confined to a race with two horses, though some results apply in the general case. The punters' problem is solved using a utility function, special attention being paid to the case of constant risk-aversion. Two solutions are provided for the bookmaker's problem, dependent on whether it is desired to maximize expected gain, or achieve the same gain whatever horse wins.     

The risk aversion measure without the independence axiom

The risk premium (conveniently normalized) is defined as the measure of risk aversion. This measure does not require any relevant assumption in the theory of choice under uncertainty except the existence of a certainty equivalent. In particular, the independence axiom is not required. The measure of risk aversion of an action is provided not only for the case with one commodity and two consequences but also for the case with many commodities and consequences. The measure of mean risk aversion of all actions with given consequences is introduced and the local measure of risk aversion is obtained by making all these consequences approach the consequence under consideration. This measure is demonstrated to be zero when the von Neumann-Morgenstern utility function exists. In this case a measure of risk aversion of the second order is introduced, which turns out to be equal to the Arrow-Pratt absolute index when there is only one commodity and similar to the generalized measures proposed by several authors when there are many commodities and two consequences.Helpful comments by I. Gilboa and suggestions by the referee are gratefully acknowledged.     

II. The influence of differences in age,sex, and intelligence in determining the attitudes of siblings toward each other 1

This article explores the relational process in a long-term psychodynamic psychotherapy case of a patient with binge eating disorder and the subsequent impacts on treatment when the therapist also struggles with disordered eating. This in-depth case study seeks to examine the reciprocal influence of the subjectivities experienced by the patient and therapist on the formation, maintenance, and quality of the therapeutic relationship and the course of treatment. Drawing on intersubjective theory, a narrowed focus on transference/countertransference dynamics seeks to examine the complexities of a relational approach in the treatment of binge eating disorder. A review of the literature suggests that an exploration of this dimension of treatment breaks new clinical ground and serves to provide more specified and nuanced perspectives for clinicians treating this population. Several clinical vignettes are provided to illustrate the concepts under examination. The use of case composites and thick disguise of patient information has been used to protect confidentiality in this analysis.     

Personal and Aggregate Unemployment and Psychological Symptoms

Four different types of individual-level unemployment experiences were studied in relation to psychological symptoms: (1) current unemployment following a recent involuntary job loss, (2) unemployment among students or homemakers, (3) reemployment after recent job loss, and (4) either voluntary or long-term (greater than 6 months) unemployment. Aggregate unemployment (the prevailing rate in the surveyed community) was also studied, both alone and in interaction with each of the four individual-level unemployment conditions. These five variables were each related positively to psychological symptoms, whether measured as a continuous variable or as a dichotomous variable simulating a case/non- case split, and controlling for the usual demographic variables and various other stressful life events. Little evidence was found for interactions of the unemployment conditions with aggregate unemployment or with potential moderators. A small panel study provided a partial longitudinal check for several of these cross-sectional findings. The findings are discussed in terms of public policy options.     

Expanding the role of long-term care social workers: assessment and intervention related to urinary incontinence

Urinary incontinence (UI) is a common and stigmatizing problem faced by long-term care (LTC) residents. It is typically addressed by medical professionals, with social work rarely involved. The purpose of this article is to illustrate how social workers can address the psychosocial implications of UI while working with residents and their family members as part of an interdisciplinary team. Using a case example and the NASW objectives for LTC, recommendations on how the role of the LTC social workers can be expanded to better address both the needs of residents, families, and the larger LTC system are provided.     

Expanding the Role of Long-Term Care Social Workers: Assessment and Intervention Related to Urinary Incontinence

Urinary incontinence (UI) is a common and stigmatizing problem faced by long-term care (LTC) residents. It is typically addressed by medical professionals, with social work rarely involved. The purpose of this article is to illustrate how social workers can address the psychosocial implications of UI while working with residents and their family members as part of an interdisciplinary team. Using a case example and the NASW objectives for LTC, recommendations on how the role of the LTC social workers can be expanded to better address both the needs of residents, families, and the larger LTC system are provided.     

论我国人身权延伸的保护

随着社会文明的不断进步和世界人权状况的不断改善,人身权方面的立法也逐步趋于完善.在司法实践中又出现了关于侵犯死者名誉权方面的判例,说明人们对人身权法律保护的需求又有所拓展.最高人民法院的几个司法解释明确地规定了人身权延伸保护的内容和方式,为司法实践提供了法律依据.     

Social workers' reflexive understandings of their “everyday” communications with children

Over the past two decades, the use of ethnographic research methods, in combination with a range of discursive, conversational, and multimodal analytical approaches, have provided vivid accounts of the complex nature of social workers' everyday communication. This paper discusses the potential and the problems of combining a video‐stimulated recall methodology with an explicit theoretical framework, in order to generate critical reflexive “insider” accounts of social workers' direct encounters with children. The framework employed was based on an adaptation of Goffman's concepts of “framing” and “footing,” which were integrated into an analytical process designed to theorize social workers' critiques regarding the nature of their communication with children. Three detailed case exemplars are used to demonstrate the potential of this methodology to explore the “delicate” agency required by social workers in the practice of authentic communication in complex professional inquiries with children. The paper concludes with a brief discussion of the theoretical and practical issues associated with utilizing reflexive methodologies in professional contexts.     

Theory and implementation of coalitional analysis in cooperative decision making

Stability definitions for describing human behavior under conflict when coalitions may form are generalized within the Graph Model for Conflict Resolution and algebraic formulations of these definitions are provided to allow computer implementation. The more general definitions of coalitional stabilities relax the assumption of transitive graphs capturing movements under the control of decision makers, either independently or cooperatively, and allow the convenient expansion to the case of coalitions of the four basic individual stabilities consisting of Nash stability, general metarationality, symmetric metarationality, and sequential stability. To permit the various coalitional stabilities to be efficiently calculated and conveniently encoded within a decision support system, algebraic expressions for the coalitional stabilities are provided in this research. Furthermore, a range of the theorems establish the mathematical credibility of employing the innovative algebraic approach to conflict resolution when coalitions are present. Finally, a conflict over the proposed exportation of bulk water from Lake Gisborne within the Canadian Province of Newfoundland and Labrador is modelled and analyzed to illustrate the practical application of the different coalitional stabilities and the strategic insights they provide.     

The Influence of Transformational Leadership and Job Burnout on Child Protective Services Case Managers' Commitment and Intent to Quit

ABSTRACT

Job burnout is prevalent in child welfare with turnover rates estimated between 20% and 40% nationwide. Although effective leadership has been shown to facilitate positive job attitudes and low job burnout in many industries, including healthcare organizations, limited research exists examining whether transformational leadership affects job burnout and job attitudes among child protective services (CPS) case managers. Moreover, no research exists examining whether job burnout mediates the relationships between transformational leadership and job attitudes. This study was designed to examine the relationships between transformational leadership, job burnout, and job attitudes among CPS case managers and whether job burnout mediates those relationships. Bass's theory of transformational leadership and Maslach's theory of job burnout provided the theoretical frameworks for this study. In this nonexperimental study, 197 CPS case managers (83% women) participated by completing an online survey. Results indicated that transformational leadership and job burnout correlated with each other and with job attitudes as hypothesized, and job burnout partially mediated the relationships between transformational leadership and the criterion variables. Our findings suggest that child welfare organizations should hire and/or train transformational leaders to reduce job burnout and increase job attitudes among CPS case managers. Directions for future research are discussed.     

Facilitating forgiveness and peaceful closure: the therapeutic value of psychosocial intervention in end-of-life care

The importance of addressing psychosocial concerns with dying patients is pivotal to facilitating peaceful closure in end of- life care. The social worker's role in recognizing and providing skilled, psychosocial intervention with patients and families in hospice programs is significant. In this article, the literature in this area is examined and a case example of a hospice patient's need for closure and the responsive social work intervention for the patient in his moment of death is provided. The case offers social work knowledge and skills and demonstrates the therapeutic benefit of addressing psychosocial needs in end-of-life care. The importance of targeted training and continued skill development for social workers in end-of-life treatment settings is emphasized.     

Research Review: Parents' service experience – a missing element in research on foster care case outcomes

A large body of child protection literature focuses on termination of parental rights, family reunification, and children's re‐entry into care as outcomes for children in foster care. Studies have investigated child, placement, family, and parent variables as predictors of case outcome. However, one important group of variables remains largely unstudied: factors related to parents’ service experience. Parents’ service experience includes parents’ perceptions of and involvement in the various services in which they must participate in order to recover their children from foster care (e.g. mandated treatment programmes such as substance abuse rehabilitation, parenting skills classes, etc.). The parental perspective on the foster care process is a critical element in the life of a child protection case, and its influence on case outcome must be explored. A brief review of the current literature on case outcome predictors is provided and parents’ service experience is highlighted as an area in need of investigation. Suggestions for the measurement of parents’ service experience are also offered.     

Effective services for improving education and employment outcomes for children and alumni of foster care service: correlates and educational and employment outcomes

Outcomes for youth from foster care have been found to be poor. The education and employment outcomes of youth and alumni of foster care served by transition programmes located in five major US cities were examined. Data were collected by case managers and reported to evaluators quarterly on 1058 youth from foster care for over 2 years. Job preparation, transportation, child care, education support services and life skills were the most common services provided to youth. During the 2‐year study period, 35% of participants obtained employment, 23% obtained a General Education Development or diploma, and 17% enrolled in post‐secondary education. It was found that the longer the youth were enrolled, the more education and employment outcomes they achieved. Further, job preparation and income support services were associated significantly with achieving any positive education or employment outcome. Results indicated that certain services provided over an extended period of time can improve outcomes for youth placed in foster care. For youth to achieve positive outcomes as they transition to adulthood, additional services are necessary. Other implications are discussed.