The Use of Humor,Jesting, and Playfulness With Traumatized Elderly

Current statistics indicate that there are a fair proportion of American elderly who have been traumatized in a variety of ways during their lifetime. Social workers and health care workers are likely to encounter this population in a myriad of contexts. This article presents the benefits of humorous interventions in trauma work, guidelines for its use, and case examples when working with the elderly.     

An Interview with Dr. Cornelius Foley: Humor,Palliative Care and Hospice

Dr. Cornelius Foley, a geriatrician, is Director of Parker Jewish Institute, New Hyde Park, New York. Dr. Foley discussed the use of humor in his work in a hospice and palliative care environment with Dr. Kathleen Monahan.     

The Greatest Veneration: Humor as a Coping Strategy for the Challenges of Aging

One hundred and thirty million Traditionalists and Baby Boomers are tackling the reality of aging. It may be captured by the lyrics to the Alan Menken–Tim Rice song “A Whole New World.” The salient characteristics and experiences of these two generations are examined along with a few of the mental and physical challenges they are encountering. Then the research on and applications of humor and laughter to these challenges are reviewed. Particular attention is given to the psychological, physiological, and medical studies that have specific implications for seniors. Coping strategies to deal with daily life challenges are described in terms of detachment from crises and problem situations and coping with interpersonal conflict. The Coping Humor Scale is provided for readers to assess their own coping skills. Then a list of techniques seniors can use to improve their own coping skills, including how to search for humor opportunities, is provided. Despite the potential research-based benefits of humor and laughter, their application to the lives of seniors are not well known. Those benefits should be part of the trend toward complementary or alternative medical treatments over the past two decades. It does not get any more “alternative” than “humor.”     

Hospice and Self-Assessed Quality of Life in the Dying: A Review

This review summarizes the impact of hospice and palliative end-of-life care on the self-assessed quality of life (QoL) in terminally ill persons. Articles were included if researchers utilized at least two observations post–hospice admission and were published in English between January of 2000 and December 2012. Findings from included studies synthesize results of a variety of terminal patients (n = 1,017) across settings. Only one study utilized a non-treatment control group. The remaining studies compared variations of program inclusions, settings, or QoL scores across carcinoma site. The studies included indicated mixed outcomes related to the effect of hospice on QoL in the dying.     

End‐of‐Life Treatment Preferences Among Older Adults: An Assessment of Psychosocial Influences1

We explore the content and correlates of older adults’ end‐of‐life treatment preferences in two hypothetical terminal illness scenarios: severe physical pain with no cognitive impairment, and severe cognitive impairment with no physical pain. For each scenario, we assess whether participants would reject life‐prolonging treatment, accept treatment, or do not know their preferences. Using data from the 2004 wave of the Wisconsin Longitudinal Study (N = 5,106), we estimate multinomial logistic regression models to evaluate whether treatment preferences are associated with direct experience with end‐of‐life issues, personal beliefs, health, and sociodemographic characteristics. Persons who have made formal end‐of‐life preparations, persons with no religious affiliation, mainline Protestants, and persons who are pessimistic about their own life expectancy are more likely to reject treatment in both scenarios. Women and persons who witnessed the painful death of a loved one are more likely to reject treatment in the cognitive impairment scenario only. Consistent with rational choice perspectives, our results suggest that individuals prefer treatments that they perceive to have highly probable desirable consequences for both self and family.     

Collaborative care for individuals with bipolar disorder or schizophrenia and co-occurring physical health conditions: A systematic review

While rates of chronic physical health conditions are increasing for the general population, individuals with severe mental illness are at greater risk. Co-occurring mental and physical health conditions are associated with poor health care utilization, socioeconomic, and patient-reported health status outcomes. This study used systematic review procedures to investigate the effectiveness of collaborative care models for improving the health of adults with bipolar disorder or schizophrenia and co-occurring chronic physical health conditions. Six studies met inclusion criteria, and included outcomes related to quality of life, physical health, and mental health. Collective and study-level results are reported and discussed, including implications for social work practice and research.     

To Life: Optimism Bias and Technological Ties in the Face of the Worst

This essay addresses a recent media controversy. Two journalists actively questioned the appropriateness of a popular blog that chronicles a young woman's fight with cancer. Elaine Replogle ( 2014 ) unfolds the facts of this case and discusses the role of fame and status in understanding the journalists' response to the blog. Here, I extend that conversation, exploring how our culture's optimism bias, as well as the increasing importance of our technological ties, informs our understanding of both the blog and its critics.     

Mental Illness in Assisted Living: Challenges for Quality of Life and Care

ABSTRACT

An unknown number of mentally ill elders in the United States receive care in assisted living, along with persons facing physical or cognitive challenges. While dementia is familiar in assisted living, our data indicate that neither staff nor residents are prepared to work or live with the mentally ill. Challenges are created for professionals, since these residents bring diverse needs. Daily interresident interactions are also disrupted or stressful. Qualitative data describe the impacts on quality of resident life as well as care and management dilemmas identified within five assisted-living settings having varying presence of mental illness among residents.     

Making connections: Severe mental illness and closeness with other people

Much has been written about social lives of people with severe mental illness (SMI). Before social lives can flourish, however, people with SMI must first get close to other people. We studied this closeness by holding three hour-long focus groups at Fountain House, a community mental health agency in New York City. We found that closeness between two people with SMI is challenging because someone with depression, for example, may have trouble understanding someone with a different disorder (e.g., schizophrenia). Romantically, closeness is also challenging—SMI is hard to explain to partners. In the workplace, closeness is difficult because SMI can alienate co-workers. It could push them away. In mental health programs, we found that closeness has more of a chance to develop (1) during evening and weekend activities; (2) when activities are planned often enough to prevent isolation; and (3) when staff reach out to people before extended absence causes distance.     

“Let’s Talk About Children” resource: A parallel mixed method evaluation

Psycho-education interventions for families affected by parental mental illness have been found to be effective. This study aimed to assess the feasibility of a psycho-educational resource for parents, designed to initiate family discussions about parental mental illness and educate parents about the impact of their illness on children. In a mixed methods design, 19 parents read the “Let’s Talk About Children” psycho-educational resource and completed pre-and-post questionnaires measuring their perspectives of mental illness and awareness of the impact of mental illness on their children and family. 18 of these participated in a follow-up, one hour, individual interview to obtain further feedback on the resource. After viewing the resource, changes in parents’ attitudes and/or behavior in relation to mental illness and parenting were recorded. Interview findings indicate that the resource gave parents an awareness of the skills and knowledge needed for initiating family discussions about parental mental illness. The results of this study can be used to inform future interventions targeting parents who experience mental illness.     

Mental health in vietnam and the move to incorporate social work: A mixed methods study of staff perceptions and expectations

In 2010, Vietnam established social work as a profession. As part of their strategic plan, the government aims to incorporate social work into existing hospitals and health care facilities in the country, including psychiatric hospitals and mental health care centers. This paper, based upon survey and focus group data from 194 people working in three major mental health facilities in Hanoi, explores direct care staffs’ perceptions of this historic incorporation of social work, with a particular eye to the benefits and challenges of the transition. Results show most staff members thought social workers would provide great support to the many unmet needs of their largely underserved and impoverished patients. They also viewed social workers as a potential resource to the treatment team by reducing work overload. Existing staff, however, were less attuned to the clinical functions of social workers in mental health settings, often equating social work with community development and social movements. Some were concerned about social workers taking on their tasks; others about new social workers being hindered by the professional hierarchy in which doctors were placed at the top. Successful integration of social workers will hinge on strong support from policy-makers and leaders of mental health systems.     

Community-based psychosocial rehabilitation for schizophrenia service users in the north west province of South Africa: A formative study

Psychosocial support is recognized as important for recovery for service users with schizophrenia, in addition to provision of antipsychotic medication. This study aimed to develop a community-based psychosocial rehabilitation programme for service users with schizophrenia to be facilitated by auxiliary social workers, and to investigate acceptability and feasibility of the programme. A task-sharing approach was adopted in which auxiliary social workers were trained to facilitate psychosocial rehabilitation groups. In-depth individual qualitative interviews were conducted with six group members at baseline, midpoint, and endpoint (18 interviews in total). NVivo10 was used to store data and conduct qualitative framework analysis. Participants reported benefits of the programme, including improvements in group members’ self-esteem, social support, illness knowledge, self-care, and contribution to their households. A key barrier to acceptability was the lack of provision of income generating opportunities. Implementation challenges include difficulties in tracing and engaging service users and families, lack of an appropriate venue, and issues with supply of antipsychotic medication. This study has provided evidence for the benefits and acceptability of this contextually adapted programme. Key barriers to implementation can be addressed through the provision of the necessary resources for auxiliary social worker input in the community.     

Navigating stormy waters: Challenges and opportunities for social work in mental health

The reforms driven by the National Mental Health Strategy have created both opportunities and challenges for social work as a profession. This paper examines the rapidly changing context for practice in mental health, including policy change, and developments in the education and training of the mental health workforce. Key practice issues identified for social work include: (i) the need to establish a viable paradigm for practice; (ii) a more positive response to the challenge of evidence-based practice models; (iii) a national agenda for education and training; and (iv) the importance of working collaboratively with consumers and families in a way that values their human rights and the lived experience of mental illness.     

Social Support and the Mental Health of Family Caregivers: Sons and Daughters Caring for Aging Parents in Japan

The prevalence of depressive symptoms among family caregivers has been documented as a serious social problem that could threaten the lives of the elderly and their family caregivers. Social support is considered to be a promising remedy for this problem, although a comprehensive examination of the availability and effectiveness of social support that includes both formal and informal support across multiple dimensions remains limited. In addition, little research has been conducted in Japan on gender differences in stress processes. This study tried to fill those gaps by analyzing recent survey data on sons and daughters who are caring for their elderly parents. The results indicate that sons and daughters have similar levels of formal and informal support for daily care and advice, while there are some gender differences in regard to the availability of other types of social support. It was also found that many types of informal support were significantly associated with a lower caregiver burden for daughters, although this was not necessarily the case for formal support. General instrumental support from formal sources was even associated with higher levels of distress. For sons acting as caregivers, daily caregiving support was the only formal support that was significantly associated with their lower level of distress. Issues of formal support are discussed, in order to reduce the psychological burdens borne by sons and daughters who care for their parents at home.     

Mental Health Knowledge Gaps in the Child Protection Work with Parents: A Narrative Review of the Social Work Literature

This is a narrative review of the latest peer-reviewed social work literature on the child protection work with parents. Aiming to identify knowledge gaps, the study researches the mental health aspects of the implicit or explicit theoretical perspectives underpinning the assessment and intervention with parents. An electronic database search extracted 38 peer-reviewed journal articles. It was found that the theoretical perspectives the publications adopted were the managerial, the critical, the humanistic, the psychodynamic and the behavioural. The study identified mental health knowledge gaps in the assessment and intervention work with parents across all theoretical perspectives and stressed the need for process and effectiveness studies on the work with parents, under explicit theoretical perspectives. The study finally highlights the need for the social work profession to increase its mental health literacy through mental health education for students and practitioners alike.     

Strengthening Families Through Volunteerism: Integrating Family Volunteerism and Family Life Education

This article builds on increasing interest in family volunteering by presenting it as a family life education tool for strengthening relationships and family functioning. In this context, family volunteering is similar to service learning in which families learn together while giving back to their community. Informed by a discussion on bioecological systems theory, psychosocial development theory, and select studies on volunteering, this article seeks to discover how family volunteering benefits individual and family growth. Existing research indicates that, due to its rich resources, it can deepen relationships, reinforce effective interpersonal skills, and help individuals overcome life's crises. Implications for family life educators and future research are presented, including the need for collaboration and stronger data on which to base flexible and fun volunteer opportunities for families.     

Reducing mental illness stigma and fostering empathic citizenship: Community arts collaborative approach

An art therapy-informed community arts project to reduce stigma towards people living with mental illness in Hong Kong included three phases: 1) a public exhibition to raise awareness; 2) a workshop for viewers to create response art and generate approaches to alleviate stigma; and 3) a forum for people living with mental illness and viewers to create art and discuss programmatic recommendations. Results suggested that: 1) art exhibits paired with reflection fostered empathy; 2) creating art promoted a wider perspective and initiated dialogue; and 3) collaborative art making facilitated meaningful interaction. These findings offer promising strategies for art and social change.     

The role of social work in the field of mental health: dual diagnoses as a challenge for social workers

This paper provides a discussion about the relevance of medical terminology within the social work context. The authors use the example of dual diagnoses to argue for less stigmatised attitudes toward people who become, in the process of help, labelled as people with dual diagnoses. It sets out that using medical terminology in the field of social work is more often a strategy to exclude people from the system of help than as a moment of providing adequate help. It is concluded that social workers do not need the knowledge about diagnoses – knowing the diagnosis is important only as information that illustrates users’ specific experience and perception of reality, the available resources and obstacles that people face in their everyday life. The planning of a social work intervention should be based on an operational definition of everyday life, e.g. how people live through the day, what are the important and valued roles they play in life, what are their wishes and needs.