A systematic review on community-based interventions for elder abuse and neglect

Elder abuse and neglect is a societal issue that requires prevention and intervention strategies at the practice and policy level. A systematic review on the efficacy of community-based elder abuse interventions was undertaken to advance the state of knowledge in the field. The peer-reviewed literature between 2009 and December 2015 were searched across four databases. Two raters independently reviewed all articles, assessed their methodological quality, and used a modified Sackett Scale to assign levels of evidence. Four thousand nine hundred and five articles were identified; nine were selected for inclusion. Although there was Level-1 evidence for psychological interventions (n = 2), only one study on strategies for relatives (START) led to a reported decrease in elder abuse. There was Level-4 evidence for conservatorship, an elder abuse intervention/prevention program (ECARE), and a multidisciplinary intervention (n = 4), in which one study yielded significant decreases in elder abuse and/or neglect. The remaining three were classified as Level-5 evidence (n = 3) for elder mediation and multidisciplinary interventions. There are limited studies with high levels of evidence for interventions that decrease elder abuse and neglect. The scarcity of community-based interventions for older adults and caregivers highlights the need for further work to elevate the quality of studies.     

Severe borderlines and self psychology

This paper will discuss work with a woman diagnosed as having borderline personality disorder because of classic symptoms of intense unstable affect, recurrent suicidality, self-mutilation, and primitive defensive organization. Once a selfobject transference tie was established, the borderline symptoms remitted. Discussion of this case will focus on the clinical application of concepts from the field of psychoanalytic self psychology, particularly the concepts of self-object functions and intersubjectivity, in work with patients diagnosed as borderline.     

Respite and family support services: Responding to the need

Increased focus on the needs of parents and guardians for structured opportunities for temporary relief from care of disabled persons has stimulated policy and implementation initiatives at the state government level on behalf of these families. This article presents qualitative and quantitative data on the need for respite services not only in terms of relief, but as a positive, supportive force in the prevention of permanent placement outside the home. Current services are outlined and issues important to clinicians and managers working with such families are discussed.Planning and Development     

From psychoanalysis to clinical social work: An evolutionary process

The development of psychoanalytically oriented social work is traced from its beginnings in 1918. The author distinguishes between practitioners who do social work and those who do psychoanalytic therapy. Such therapy is defined as a method which attends to the dialectic interplay between conscious and unconscious forces. Social workers who receive analytic training may facilitate a much needed revival of psychoanalysis as the social enterprise which Freud originally envisioned.Keynote address at the Third National Clinical Conference of the Comittee on Psychoanalysis at New York on November 1, 1990.