Family Caregiver Communication in the ICU: Toward a Relational View of Health Literacy

We interviewed 18 family caregivers about their communication experiences in the ICUs at an urban hospital. Analysis of their narratives suggests health literacy is important in family caregiver/healthcare provider communication, especially as complicated illnesses move the caregiver deeper into decision making. Using the domains of Yuen et al.’s conceptual model of caregiver health literacy (2015), we identified three themes within the context of ICU communication: agency, coordinated communication, and caregiver’s evolving role. We saw family caregivers negotiating domains of health literacy as they built upon knowledge of the patient’s needs, their rights as family caregivers, and the hierarchy of the professional staff. We found that these narratives represent co-created, or relational communication, rather than individual health literacy skills. Conceptualized in the transaction of relationship, health literacy is enacted; it is socially constructed and is the scaffolding upon which family caregivers make decisions, care for their loved one, and care for themselves.     

Mental illness etiology beliefs among African American men with serious mental illness and their social support networks

Semi-structured qualitative interviews were conducted with 26 African American men with serious mental illness who were consumers of community mental health services and 26 members of their social support networks. All participants were asked what they believed had caused the consumers’ mental illness. Consumer participants most commonly identified chronic life stressors as a causal factor, while social supports most often identified intrinsic factors such as genetics or biology as causes of mental illness. Some support participants believed that unintentional drug use had precipitated the onset of mental illness or had no causal theories. The fact that some support participants could not identify a causal explanation may indicate failure on the part of mental health care systems to engage with consumers’ social support networks and provide education about mental illness and its causes. The implications of etiology beliefs on mental health service utilization are discussed.     

Attention to Threat as a Predictor of Shyness in the Context of Internalizing and Externalizing Behavior

The duration of children's attention to putative threat has been documented as a consistent predictor of later anxiety in inhibited children across childhood (Fox, New Directions for Child and Adolescent Development, 127, 2010, 33; Pérez‐Edgar & Fox, Child and Adolescent Psychiatric Clinics of North America, 14, 2005, 681). However, attention to threat has not been broadly examined within existing behavioral contexts and has seldom been studied in very early childhood. Whereas toddlers with high levels of internalizing behavior may view fear‐inducing stimuli as a threat, toddlers with high levels of externalizing behavior may demonstrate attention out of interest or sensation seeking. Thus, attention to threat was expected to predict increased toddler shyness in the context of either high internalizing problems or low externalizing behavior. We examined 117 twenty‐four‐month‐old toddlers to determine whether attention to threat interacted with internalizing and externalizing behavior at 24 months of age to predict toddler shyness one year later. Results indicated that attention to threat predicted toddlers' lower shyness at 36 months when toddlers’ externalizing behavior at age 24 months were high, but there was no significant interaction between toddlers’ internalizing behavior and their attention to threat in predicting later shyness. These results expand our understanding of the contexts in which attention to threat in early childhood is a viable predictor of later shyness.     

Through the Ages: Developing Relationships Between the Young and the Old

This article evaluates a program between students at a primary school and aged care residents. The aim of the program was to increase respect and appreciation between the groups. Visiting programs between children and the elderly are well documented, and assumes that the contact will benefit both groups. However the research is contradictory. To ensure that this program was achieving its goals, pre-post test data using the Children’s Perceptions of Aging and Elderly test was collected. Significant improvements in attitude were seen in two items. Overall, there was an improvement in attitude in 12 of the 18 instrument items.     

Preschool Policymaking by Stealth: Application of an Alternative Framework for the Policy Process

This study uses the design and passage of universal preschool in two states, Oklahoma and West Virginia, to present an alternative framework for understanding the policy process, Policymaking by Stealth, and demonstrate its usefulness both in expanding the understanding of the politics of public preschool and as a tool for social work policy practice. An overview of the current state of preschool policy in the United States and the political history of federal preschool policy is presented first to provide context to the analysis, followed by an introduction to the analytic framework, and then a formal analysis of the policy passage processes in the two states via the lens of Policymaking by Stealth. The contributions of this new framework to the study of the policy process in general and the practice of policymaking in complex political contexts are discussed.     

Wearable tech,bodies, and gender

New forms of wearable technology are blurring the lines between technology and bodies, raising questions about personhood, selfhood, and what it means to be human. Consequently, scholars are examining these iterations of body/machine interface and human machine communication from a variety of angles. While fashion scholars focused primarily on garments and celebrating potential techno‐futures, media and communication scholars more critically examined how wearable tech mediates bodies and relationships. Social scientists are concerned with issues of labor, privacy, data ownership, and value, drawing on ethnographic studies of the Quantified Self (QS) community and the phenomenon of self‐tracking more generally. This scholarship is rooted in studies and theorizations of ubiquitous computing, feminist science and technology studies (STS), and fashion and dress as both ornament and second skin. Generally, it asks how wearable technology can augment the human body, how it affects human relationships to self and other, and whether wearable technology can promote human autonomy, when it is locked into commercial and power relationships that don't necessarily have the users' best interests at heart. The essay ends by briefly outlining of directions for further research, urging further investigation into wearable tech exhibiting gendered attitudes toward “femme” women, and calling for increased attention to issues raised by wearable technology's coming merger with the growing fields of biotech and synthetic biology.     

Students’ conceptualisations of critical reflection

Critical reflection involves the identification of deeply seated assumptions about the social world and the individual’s connection with it; however, its scope and practice are contested. While ambivalence about its definition remains, critical reflection is described as a threshold concept in social welfare and social work education. This study investigated students’ conceptualisations of critical reflection by analysing the ‘learned’ critical reflection curricula of five core units in an Australian University. A content analysis of 162 assignments submitted by 86 students in 2013 and 2014 was conducted. Findings revealed students conceptualised critical reflection as a process that raised self-awareness, supported the application of theory in practice and, reinforced aspects of their professional identity. However, students adapted the process to fit their purpose and, when personal views clashed with professional practice, rather than examining the tensions that emerged, students privileged professional practice and silenced their personal views. Students did not engage with critical reflection to foster social change; rather their utilitarian approach positioned them to demonstrate competence in professional procedures. These findings highlight the influence of the contexts within which critical reflection is practised and informs the further development of the authors’ pedagogy.     

The role of empathy in training social work students in motivational interviewing

Motivational interviewing (MI), an evidence-based approach with empathy as a key principle, effectively addresses client concerns found in the child welfare population. Training social workers in MI, and to be empathic, would increase the likelihood of better service delivery. Live supervision (LS) is a form of training that provides real-time feedback by clinical supervisors. This randomized comparison trial compared the effectiveness of LS or Teaching as Usual (TAU) on empathy in 54 MSW and BSW social work students. TAU involved students receiving online modules and assigned readings. Data were collected at baseline, after the interventions, and at five months follow-up. Differences in perceived empathy and empathic behaviors were measured by the Motivational Interviewing Treatment Integrity (MITI) and Toronto Empathy Questionnaire (TEQ). The study also assessed whether demographic variables or perceived empathy (TEQ) predicted empathic behaviors (MITI). Results indicate that, while both groups improved on empathy as measured by the MITI and TEQ, the LS group demonstrated more improvement. Demographic variables had no impact on empathy. The TEQ and MITI also did not demonstrate predictability suggesting the complexity of measuring empathy. The implications for social work education and future training are discussed.     

Are Hearing Voices Networks Compatible with Cognitive Behavioural Therapy for Psychosis?

The most extensively evaluated intervention for auditory hallucinations is Cognitive Behavioural Therapy for Psychosis (CBTp), which is usually delivered in statutory settings by experienced clinicians. In contrast, peer support networks, such as the Hearing Voices Network (HVN), operate informally using peers to normalise and manage voices. This article compares these two approaches to identify points of synergy and difference. Its analysis suggests the two approaches share many features, but also deviate in important ways that could compensate for each other. Instead of competing with each other as might first be thought, they may actually be complementary. Further, HVN may align comfortably with the values and principles of social work. Social workers seeking to engage with voice hearers may be advised to study the underlying principles of each approach to guide the way in which they can capitalise on intervention opportunities to better assist voice hearers.