Social Work with Clients Contemplating Suicide: Complexity and Ambiguity in the Clinical, Ethical, and Legal Considerations

Social workers in agency and private practice settings often work with clients grappling with suicide, either as an acute or chronic situation. Probably more than any other clinical condition, suicide forces the practitioner to confront complex ethical, legal, and psychological questions while managing an urgent circumstance. This article attempts to illuminate the ethical and legal considerations that may arise when a client contemplates suicide. Rather than advancing one answer, we stress that in training and the workplace social workers must fully consider the complexities and ambiguities of a client's experiences as well as their own clinical, ethical, and legal obligations.     

Alternative Worldviews and the Utilization of Conventional and Complementary Medicine*

We use the Midlife in the United States (MIDUS) database and an expanded Anderson model that incorporates health beliefs, including sacred worldviews as predisposing factors, to explore conventional and complementary and alternative medical (CAM) service use. Findings are that health care need, especially the number of chronic conditions is positively associated with both conventional and CAM services use. However, net of need, health beliefs and sacred worldviews differentiate CAM users versus nonusers or the number of different CAM practices that are used. Higher self‐rated spirituality is associated with being a CAM user and, if a user, with adopting a wider range of practices. Individuals with higher self‐rated religiosity are not more or less likely to be CAM users but adopt significantly fewer techniques, if users. We discuss the attraction to very different faces of health care, on the basis of religiosity, spirituality, and other health beliefs, with implications for policymakers and care providers.     

Factors associated with exercise participation in adults with arthritis

Most people with arthritis are not regularly active. Understanding what factors influence exercise is essential for designing programs to increase participation. The objective of this study was to examine the correlates of exercise in people with arthritis. Using a cross-sectional design, sociodemographic, health-related, and psychosocial variables were collected from community-dwelling individuals with arthritis (N = 141). Associations with exercise level were examined with bivariate statistics (ANOVAs, chi-squares) and logistic-regression analyses. Exercisers were less likely than nonexercisers and insufficiently active people to report that arthritis negatively affected their physical and social functioning, and they reported more positive affect and greater self-efficacy (p < .05). Exercisers also reported less pain than nonexercisers (p < .05). In multiple logistic-regression analyses, self-efficacy and physical limitations remained independent predictors of exercise. The results suggest the need to target exercise self-efficacy when designing exercise interventions. Results also suggest the need to tailor exercise programs to individuals' physical limitations.     

Do teenage mothers experience childbirth as traumatic?

Although several hundred thousand teenagers give birth each year in the United States, little is known about their psychological experience of childbirth, especially with respect to its traumatic impact. This article highlights the findings of a pilot study of 28 teenage mothers who reported on their traumatic and depressive symptoms related to childbirth. Literature on adolescent childbearing, posttraumatic stress, and postpartum depression is also reviewed.     

Managing a depressed and suicidal loved one at home: impact on the family

This qualitative study examined the process families use to care for a depressed and suicidal family member at home. The grounded theory method was used for data collection and analysis. Seventeen family members were interviewed. The data revealed the basic social process of Maintaining Vigilance Through Managing, which depicts an ongoing, cyclical process that begins at a point of not knowing. Family members then move on to identifying, then gaining awareness, followed by knowing or understanding. This allows them to take action, then to proceed to watching and waiting. They then return to gaining awareness armed with new knowledge or understanding. It is at this point that the process becomes cyclical. It varies in intensity over time, depending on the level of depression and the risk for suicide. To preserve the integrity of these families, nurses must help develop strategies to guide them through this process as they care for their depressed and suicidal loved one.     

Moving to a hostel: The perceptions of older people who move from hospital to hostel (‘low level’) care

Abstract

The aims of this research were threefold: to explore the perceptions of older people regarding the process of transition from hospital to hostel ('low level') care; to examine their experiences of hostel living after transfer; and to develop, on the basis of these findings, appropriate professional practice guidelines.     

A Process Model of Parenting and Adolescents' Friendship Competence

This study examined the prospective relationship between negative parenting behaviors and adolescents' friendship competence in a community sample of 416 two‐parent families in the Southeastern USA. Adolescents' externalizing problems and their emotional insecurity with parents were examined as mediators. Parents' psychological control was uniquely associated with adolescents' friendship competence. When both mediators were included in the same model, adolescents' perceptions of emotional insecurity in the parent–adolescent relationship fully mediated the association between parents' psychological control and adolescents' friendship competence. Parental hostility was associated with friendship competence indirectly through adolescents' emotional insecurity. Results contribute to identifying the mechanisms by which parenting affects youths' friendship competence, which is important in informing theory and practice regarding interpersonal relationships in adolescence.     

When Social Workers Are Stalked: Risks,Strategies, and Legal Protections

By virtue of their work, social workers are at risk of becoming victims of stalking. This is because social workers assist individuals who suffer from major mental health problems that may cause them to develop delusional beliefs about their therapists, and because social workers may need to exercise authority against individuals with personality disturbances that present a risk to others. Surveys suggest that 16% of social workers have been stalked at one point in their career by a client. Stalking of social workers by clients has far-reaching personal and professional implications, potentially affecting all aspects of an individual’s life. This paper reviews the nature and incidence of stalking of social workers, the legal remedies available to social workers who are victims of stalking, and strategies for protection.