Issues of confidentiality when working with persons with AIDS

Acquired Immunodeficiency Syndrome (AIDS) has increasingly become a serious public health threat in our contemporary society. The number of cases has grown rapidly since the disease was first reported and the total number of cases has been estimated to be close to 270,000 in the United States alone, according to some sources (Gray, 1988). Many of the affected, their sexual partners and families, will be recipients of social work services. In addition to therapeutic skills for effective intervention, the issues of confidentiality and related legal and ethical implications warrant serious examination and consideration for all clinical social workers working with this population. Specific practice suggestions will be explored.     

International labour standards: Recent developments in complementarity between the international and national supervisory systems

Far from competing against one another, the national and international systems of labour regulation are interlocked. ILO standards have been used in recent rulings by the highest jurisdictions of some countries. Examining two decisions by the Supreme Court of Canada and another by the Paris Court of Appeal, the authors clarify the circumstances in which national courts make use of these international sources of law and consequent legal implications. The cases involve proceedings before national courts and ILO bodies, and France and Canada also have different legal cultures, enabling a discussion of how national jurisdictions actually appropriate international labour standards.     

Mental Health Law: Innovations in Education and Representation

What do we know about the lives of people with learning difficulties? What do we know about the lives of people who have used mental health services? People require legal representation to obtain access to the basics of life. Legal representation for people with mental disabilities or learning difficulties also provides a forum for client empowerment. Legal representation has historically been dominated by professionals trained in traditional methods. A mental health law clinic, based upon consumer objectives, provides an opportunity to apply critical legal theory to the practice of law. Legal and citizen advocacy are combined to provide maximum participation in obtaining results. In this article, the author traces the development of a mental health law clinic by documenting the value of clinical legal education and the necessity of commitment to consumer-centred representation.     

The Notion of Justice in Social Workers' Decisions About Children

This paper investigates the notion of justice in social work with a view to understanding the kind of decisions which may be made for ‘children in need’. The approach is both theoretical and empirical. By examining the reasoning of social workers in cases where children have been admitted voluntarily to local authority care, the author explores the value-base of the professionals in difficult cases. The result is a picture of justice which has both social and legal dimensions, combined in a way which can be explained by reference to practice theory.     

Social Work Education and Clinical Learning: Yesterday,Today, and Tomorrow

Social Work Education and Clinical Learning by Simpson, Williams, and Segall is a welcome and timely statement about the nature of clinical social work and its implications for educational curricula. The authors took on an awesome task. Educating students for clinical practice is increasingly more daunting than it has been previously and is in considerable disarray, if not a state of crisis. In addition to amplifying and expanding some of the major points the authors make, this discussion considers where we have been, where we are, and where we are going. It describes the educational landscape today, which the author views as bleak with respect to its preparation of students for clinical social work practice. In keeping with clinical social work’s inclusive definition that encompasses a broad knowledge base, diverse practice roles, and a wide range of interventions, this discussion emphasizes the importance of numerous unifying themes that help to distinguish clinical social work from other approaches or from the use of a fragmented assemblage of techniques. The paper considers the role of evidence-based practice and makes some suggestions about future emphases in clinical social work. It concludes with a call to alter the educational landscape.     

Self-neglect: Implications for prosecutors

Historically, the view of elder mistreatment in the United States has been similar to that of child abuse and has been detrimental to the understanding of elder mistreatment. Until recently, there was little understanding of the complexity of elder mistreatment and the legal system lacked appropriate laws with which to handle this growing problem. Over the last two decades, legislation, laws, and criminal codes of conduct have been developed to tackle the problem of elder mistreatment. However, little knowledge or understanding of the public health problems and legal implications related to the most common form of elder mistreatment referred to Adult Protective Services (APS), elder self-neglect, is available. The growth of this national problem has expanded the role of the legal system and pushed the development of interdisciplinary research with the intent of defining and understanding the problem of self-neglect and with the ultimate goal of expanding intervention strategies. The Consortium for Research in Elder Self-Neglect of Texas (CREST) is the leader in this field and the pilot study suggests numerous medical and legal implications for both intervention and future research.     

Tort Reform and Access to Justice: How Legal Environments Shape Lawyers’ Case Selection

How do lawyers decide which cases to accept? Previous studies suggest that they use a simple risk/return formula to make such decisions. I argue, however, that legal environments also shape lawyers’ decisions. Analyses of in-depth interviews with lawyers across four states demonstrate that lawyers make different decisions about cases in different legal environments. Lawyers in states without tort reform emphasize the importance of how “likeable” a client may be to a potential jury, whereas lawyers in states with tort reform instead focus on the defendant’s “liability.” These differences have important implications for who has access to the civil justice system, and for consumer and medical protections more generally.     

‘From awareness to practice’: children,domestic violence and child welfare

This paper traces the development of social care practice in relation to child witnesses of domestic violence. It suggests that this development has been dominated by subsuming the needs of these children into a child protection process. The paper outlines how this has led to significant (but often unclear) legal and policy initiatives which have failed, as yet, to be translated into practice. The paper argues that there are a number of important reasons why child witnesses of domestic violence should not always be assumed to need the response of a child protection system and that a future practice, legal and policy response should be based on a wider understanding of their needs. Copyright © 2006 John Wiley & Sons, Ltd.     

EMPIRICAL VALUES AND THE CULTURE OF FAMILY THERAPY*

The research-clinical practice connection is weak in family therapy. Some have argued, in an inordinate ideological and political tone, that traditional research methods are inappropriate for family therapy. This position mischaracterizes modern day clinical researchers and research. In presenting 10 key dimensions of the research-clinical practice issue in family therapy, this paper addresses some of these misrepresentations. If research and practice are to interact more productively, a major commitment, the scope and implications of which have not yet been realized, will need to be made. Actualizing the research-practice link is a training problem and a fundamental professional issue. Progress in this realm would change the particulars of clinical practice as we know it. These processes will involve nothing less than remaking the culture of family therapy.     

Professional status at midcareer: The influence of social and academic origins on lawyers' achievement

Research on intraoccupational status attainment within the legal profession is extensive, but it has not generated consistent findings on the effects of social backgrounds and academic performance in college and law school on types of legal employment. This research has been either carried out on lawyers employed in geographically circumscribed communities or has been limited to particular types of lawyers. This study investigates the effects of social backgrounds and academic achievement on types of legal practice for a national sample of lawyers a quarter of a century after their graduation from college. We find that occupational inheritance and religion predict academic achievement in college and law school, and that these variables in combination influence the allocation of lawyers to solo and firm practice. An important contextual feature structuring legal careers is the population size of the communities in which these lawyers practice.An earlier version of this article was presented at the annual meeting of the Eastern Sociological Society, Providence, Rhode Island, April 1991. The authors are listed alphabetically.     

Self-Neglect: Implications for Prosecutors

ABSTRACT

Historically, the view of elder mistreatment in the United States has been similar to that of child abuse and has been detrimental to the understanding of elder mistreatment. Until recently, there was little understanding of the complexity of elder mistreatment and the legal system lacked appropriate laws with which to handle this growing problem. Over the last two decades, legislation, laws, and criminal codes of conduct have been developed to tackle the problem of elder mistreatment. However, little knowledge or understanding of the public health problems and legal implications related to the most common form of elder mistreatment referred to Adult Protective Services (APS), elder self-neglect, is available. The growth of this national problem has expanded the role of the legal system and pushed the development of interdisciplinary research with the intent of defining and understanding the problem of self-neglect and with the ultimate goal of expanding intervention strategies. The Consortium for Research in Elder Self-Neglect of Texas (CREST) is the leader in this field and the pilot study suggests numerous medical and legal implications for both intervention and future research.     

A Case-based Collaborative Learning Model for Teaching Advocacy

Social work graduate school programs focusing on clinical practice have traditionally attended less to the profession's advocacy role. Masters-level clinical social work students, therefore, may not receive adequate training to understand their roles in advocating for or against policies that directly impact their practice. This article proposes a collaborative learning model called ‘Advocacy Week’, which prepares students for a statewide NASW-sponsored Advocacy Day. Using case presentations prepared in collaboration with clinical and policy social work faculty, aspiring clinical social work practitioners are exposed to the relevance of advocacy. Preliminary findings suggest that graduate students exposed to this model become aware of their advocate role as part of their clinical practice, a knowledge which has implications for social work education.     

Publication bias and outcome reporting bias: agomelatine as a case example

Publication bias and outcome reporting bias contribute to distorted perceptions of drug efficacy and the underreporting of adverse events. To demonstrate these biases, this article describes how the clinical profile of the antidepressant agent agomelatine (Valdoxan(?)) has been presented in the literature. Agomelatine has been systematically assessed in 10 short-term placebo-controlled studies and three long-term placebo-controlled relapse prevention studies. Five published trials demonstrated clinically modest but statistically significant benefits over placebo. Five unpublished trials did not find agomelatine more effective than placebo, but in two of these studies the active comparison drug (fluoxetine [Prozac(?)] or paroxetine [Paxil(?)]) was more effective than placebo. Agomelatine was more effective than placebo in one of three relapse prevention studies, but only the positive study was published. Based on what is evident in the entire published and unpublished dataset, agomelatine does not have a tremendously superior sleep and sexual effects profile. The risk of liver toxicity is also not prominently highlighted in the published literature.     

Multiple-Family Groups: Practice Implications for the 21st Century

ABSTRACT

Multiple-Family Groups have been utilized in a variety of settings for almost fifty years in this country. This unique practice approach has undergone many changes and refinements during this period of development. The primary purpose of this chapter is to provide readers with a delineation of the current practice implications of this treatment modality. The history of Multiple-Family Groups (MFG) will be reviewed to provide a historical framework for an increased understanding of its current usages. In addition, new directions for research and further refinement of this practice model will be outlined for clinical practitioners.     

A new route to norms evolution: insights from India’s right to food campaign

For over a decade, activists in India have waged a nationwide Right to Food (RTF) campaign aimed at highlighting persistent undernutrition in their country and galvanizing corresponding legal and administrative reform. This article draws on original interview data to demonstrate the process through which the campaign has forged a new and more robust interpretation of the RTF than that prevailing in international law and practice. It has done so by relying largely on domestic law, institutions, and networks rather than through ‘vernacularization’ of international norms or transnational advocacy. The campaign’s innovative conceptualization of the RTF along with the ongoing challenges it faces in attempting to influence the implementation of that right have broader implications for human rights theory and advocacy beyond India.     

Unacknowledged Rape: The Influences of Child Sexual Abuse and Personality Traits

Evidence supports that the majority of young women who experience sexual victimization that meets the legal definition of rape do not label their experiences as rape—this has been termed unacknowledged rape. In a sample of 77 young adult women, the odds of unacknowledged rape significantly increased as a function of less severe child sexual abuse histories and greater levels of dysfunctional personality traits. Potential explanations for these findings as well as clinical implications are discussed. Because of the potential psychological and societal consequences of unacknowledged rape, it is vital that researchers continue to examine this phenomenon.     

Elder Abuse: Clinical,Ethical, and Legal Considerations in Social Work Practice

As a consequence of the steadily growing older population, and increased demands on family for community based care of elderly, elder abuse is an issue to be considered in all domains of social work practice. Intervention in cases of elder abuse is often fraught with ambiguity and ethical dilemmas as the application of professional principles is less than straightforward, bringing to the fore personal, legal, and ethical concerns in the management of the client’s safety and well-being. This article addresses challenges which arise from the complexity of elder abuse cases and reviews clinical, ethical, and legal obligations to inform ethical decision-making.     

Using Objectification Theory to Examine the Effects of Media on Gay Male Body Image

Research has increasingly noted that gay male adults are more at risk for developing body image dissatisfaction than other male populations. Body image issues warrant attention, particularly since they have been connected to the development of disordered eating patterns. Studies have often traced gay male body dissatisfaction to various sociocultural elements and phenomena, particularly the media. In fact, various media genres have been implicated as being instrumental in propagating idealized male physiques, which in turn may negatively influence observers. Using objectification theory, this paper aims to review the process by which media imagery are internalized by some gay men and how such internalizations harmfully impact their body image. The clinical implications and treatment of body dissatisfaction will be reviewed in terms of social work practice with gay male populations.     

This is Common Factors

Common factors are conditions and processes present in, among, and surrounding participants in clinical work. In the past 20 years, increasing attention and research on common factors has generated a great deal of discussion in clinical psychology, psychiatry, marriage and family therapy, and to a lesser extent, social work. While there is no single definition of common factors, they are generally discussed as the non-technical aspects of therapeutic work—such as the relationship between the practitioner and client and the expectancy of the client—that have been shown to be associated with successful outcomes. Common factors also include attributes of the practitioner and client, the support system of the client, the institutional and organizational conditions in which the practitioner practices, and also the strategic actions employed by the practitioner, client, and all those involved in the work that promote change. This paper will discuss key concepts in a common factors practice perspective and how evidence is used by common factors practitioners, highlight features of common factors practice, and suggest implications for developing a common factors practice approach.