Overcoming Barriers to Using Empirically Supported Therapies to Treat Childhood Anxiety Disorders in Social Work Practice

Anxiety disorders are among the most common psychiatric disorders in children and adolescents. Most empirically supported treatments (ESTs) for pediatric anxiety disorders include various cognitive-behavioral methods. Although demonstrated efficacious in controlled and clinic settings, there are barriers to implementing these types of therapies in social work settings due to beliefs about the usefulness of ESTs in community settings; limitations of treatment manuals; time constraints of implementing ESTs; fidelity and flexibility of implementing ESTs; and limited training opportunities. This article provides an overview of ESTs for childhood anxiety disorders, highlighting options for overcoming common barriers to implementing ESTs. Collaborative multi-method approaches to advance implementation of ESTs in social work practice are suggested.     

Impulse Control Disorder Behaviors Associated with Pramipexole Used to Treat Fibromyalgia

Objective: Compulsivity has been associated with use of dopamine agonists used to treat Parkinson’s disease (PD). Increasing use of these agents to treat fibromyalgia (FM) raises concern for this unexpected toxicity in a new group of patients. This is the first report of compulsive gambling and shopping among patients taking dopamine agonists for treatment of FM. Design: A retrospective chart review of all patients in a large, active FM research practice was used to identify compulsivity associated with dopamine agonists and describe its remission following dug withdrawal. Results: Of 3006 patients with FM treated between 2002 and 2006, 1356 had taken ≥1 dose of a dopamine agonist ( >95% pramipexole). Twenty-one (3 male, 18 female) were identified with compulsive gambling (33%), shopping (40%) or both (27%) after taking a 4.5 mg mean dose of pramipexole at bedtime for 14.4 ± 14.9 months. Compulsivity resolved in 3–10 days for 19 of 21 patients and by 3 months for all following a monitored, compulsory tapered discontinuation over 7 days. Conclusions: While biologic aspects of PD and FM differ considerably, compulsive gambling and shopping have become important, yet unexpected concerns related to use of dopamine agonists for patients with FM and their treating clinicians.     

Adolescent Deliberate Self‐Harm: Linkages to Emotion Regulation and Family Emotional Climate

Parents' responses to their children's emotional expressivity have been shown to significantly influence children's subsequent psychosocial functioning. This study hypothesized that adolescents' deliberate self‐harm (DSH) may be an outcome associated with poor emotion regulation as well as an invalidating family environment. The mediational role of specific emotion processes (i.e., poor awareness of emotion, difficulties expressing emotions) between family emotional environment and the frequency of DSH was examined with 131 psychiatrically hospitalized adolescents (M age=14.84 years, SD=1.75 years). Results indicated that adolescents who self‐injured reported that this behavior reduced their negative emotional states. Structural equation modeling provided support for the proposed model that family climate influences frequency of DSH through emotion regulation skills but the model held for girls only. A direct model effect was not supported. Emotion regulation partially mediated the relationship between family climate and DSH, and direct effects were also observed.     

Culture: A Possible Predictor of Morality for African American Adolescents

This study examined the ways in which cultural orientation (communalism and material well‐being) and empathy influence the moral reasoning of African American middle to late adolescents. Specifically, this study utilized path analysis to investigate Ward's (1995) hypothesis that a communal orientation would promote morality among African American adolescents, while a material well‐being orientation would mitigate against it. In addition, it was hypothesized that empathy would mediate the relationship between cultural orientation and moral reasoning. Thirty‐seven high school students and 35 college students participated in the study. Results revealed that communalism was a significant predictor of empathy. Despite prediction, communalism and material well‐being were not predictors of moral reasoning. The findings did not yield support for empathy functioning as a mediator between communalism and moral reasoning. These findings are discussed in terms of previous findings, methodological limitations, and implications for future research.     

Do institutions really matter for saving among low-income households? A comparative approach

This study aims to examine the extent to which competing theories explain saving of low-income households in Individual Development Accounts (IDAs). Competing theories include the individual-oriented perspective, a social stratification perspective, and institutional saving theory. We use American Dream Demonstration (ADD) data collected at the Tulsa IDA program. Compared with the individual perspective and the social stratification perspective, institutional features explain a large part of the variance in saving outcomes measured by average monthly net deposit (AMND) and deposit frequency. Findings suggest that institutional structures encouraging low-income households to save may contribute to more inclusive asset-based policy.     

On ‘flip‐flopping’: Branded stance‐taking in U.S. electoral politics1

This article examines stance in U.S. political discourse, taking as its empirical point of departure Democratic candidate John Kerry's epistemic stance‐taking in the televised 2004 presidential debates. Kerry's stance‐taking is shown to help display the characterological attribute of ‘conviction’ and serve as a rejoinder to critics who had branded him as a ‘flip‐flopper.’ His stance‐taking is thus not primarily ‘to’ or ‘for’ copresent interactants, but is largely interdiscursive in character. ‘Conviction’ and its opposite, ‘flip‐flopping,’ suggest further how stance‐taking itself has been an object of typification in the agonistic dynamics of candidate branding and counter‐branding. In moving from epistemic stance‐taking in discourse to models of the stance‐taker as a social type, this article addresses questions about the units and levels of analysis needed to study stance in contemporary political discourse.     

Exploring types of interference between work and non-work: using a diary study approach

Studies of work and family issues have used predominately between-subject cross-sectional designs. While some researchers have called for more longitudinal studies, others have suggested that a more strategic way forward for the field is the use of daily diary studies (Frone, Russell, & Cooper, 1992). This study explores different types of interference between work and non-work domains, using a diary study methodology. This study consisted of a two-week diary study among 12 Irish employees. Analysis involved a two-step procedure involving both content analysis and interpretative phenomenological analysis (IPA). Results indicated that while individuals reported strain-based and time-based interference, evidence was also found of interference concerning persistent and intrusive thoughts. Despite some limitations to the study, this paper demonstrates that diary studies represent an opportunity for researchers to explore work and non-work experiences in a sensitive and ecologically valid way.     

Reactions of students to different settings of field experience

The study assessed Israeli students’ emotional–experiential reaction and attitude to different client populations, following a week-long experience in one of five social services settings. The study provides preliminary findings regarding the implications of first year students’ experience on their emphatic skills, a subject that generally has not received adequate scholarly attention. Using a purpose-built, self-administered questionnaire, we found students’ emotional–experiential response to their experience differed by the setting in which they were placed, being lowest in the Bedouin oriented services, intermediate among those placed in juvenile correction services, and highest in mental health, adult and child disability services. Responses were independent of all other explanatory variables, including sex, cognitive ability, previous training experience and perceptual shifts concerning the population served. We discuss possible reasons for these differences.