The Clinical Aspects of Case Management and its Role in Graduate Field Education

In graduate social work education, faculty advisors together with practice instructors can improve social work students' skills to link the practical aspects of ‘work responsibilities’ to the clinical underpinnings of case management. Often students are taught the direct services (case management) with a view solely focused on the practical aspects of care, and this curtails the students' opportunity to learn the clinical interventions that exist in all components of social work: to identify, understand and apply clinical dynamics to presenting problems. The authors discuss their work in addressing case management from a clinical perspective with MSW students and recommendations for its inclusion in graduate social work programs.     

Startling affect in therapeutic relationships: Relational formulation of experience∗

Open internal boundaries allow therapists to receive patients’ unconscious communications and to hold disavowed affects and self states, thus making possible new relational and affective development. Such deep engagement with patients inevitably stirs intense feelings that may be difficult for therapists to bear. Unwanted affect and unconscious points of identification with patients may stimulate therapists’ shame and guilt leading to states of disequilibrium. A therapeutic stance which is fluid and open to intrapsychic and interpersonal influence, allows for the experience and elaboration of complex unconscious affects, points of identification and self‐other configurations. Clarity concerning intrapsychic and interpersonal boundaries in the therapeutic relationship is most helpful. Relational formulations of case material focusing on startling affects are offered.     

HIV and PTSD: A Confirmatory Factor Analysis of the PCL Screening Instrument

ABSTRACT

The findings are reported from a confirmatory factor analysis (CFA) of the posttraumatic screening checklist (PCL) created by Weathers et al. (1993) Weathers, F. W., Litz, B. T., Herman, D. S., Huska, J. A. and Keane, T. M. 1993. The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility, Presented at Annual Meeting of the International Society for Traumatic Stress Studies, San Antonio, TX. [Google Scholar]. One hundred and eighty-six individuals receiving either preventive HIV information or ongoing HIV counseling from community-based AIDS organizations in the New York City area completed the PCL checklist. To identify a model relevant to screening posttraumatic stress disorder (PTSD) within the HIV/AIDS community, six CFAs were conducted. Results indicated that the PTSD scale should include attention to four general areas: a) reexperiencing the traumatic event; b) avoidance of anything associated with the traumatic event; c) a sense of numbing; and d) a hyperarousal state. The CFA produced a more concise model of 12 items, relevant to the HIV community. Future research suggests that the relationships between different components of trauma exposure and different manifestations of PTSD should be examined further.     

Lesbian and Gay Elders and Long-Term Care: Identifying the Unique Psychosocial Perspectives and Challenges

This qualitative study of lesbian and gay elders seeks to identify the psychosocial challenges this community faces regarding long-term care. Two focus groups were conducted among 16 gay elders in community and long-term care settings. Participants reported fear of being rejected or neglected by healthcare providers, particularly personal care aides; fear of not being accepted and respected by other residents; fear of having to go back into the closet if placed in long-term care; and a preference for gay-friendly care. Participants suggested staff training to promote acceptance and respect for gay people, and favorably perceived gay-specific and gay-friendly living arrangements.     

Assessment of the Refined Aging Semantic Differential: Recommendations for Enhancing Validity

The US population is aging. Traditional perspectives have emphasized that a substantial increase in the number of gerontological social workers is needed to care for this population. However, published evidence demonstrates that, along with population growth, economic and social factors must be taken into account before predicting future gerontological social work demand. Structural lag theory is introduced to explain how these factors affect the profession and may limit its presence in gerontological work settings. Recommendations are made to correct the lag, allowing the social work profession a more substantive voice in the aging enterprise.     

Predictors of Depression Among Caregivers of Older Adults With Severe Mental Illness

Caregivers of older persons with severe mental illness (SMI) contend with the double challenge of providing assistance related to both the psychiatric condition and older age of their family member. Study explored factors influencing negative psychological outcomes experienced by caregivers (n = 96) of older adults with SMI. One-quarter of caregivers scored at or above the clinical point for depression. Low income, care recipient gender, poor health, problems dealing with care recipient’s symptoms and the interaction of health and problems dealing with symptoms were associated with higher rates of depression. Implications for service provision and future research are discussed.     

Age differences in IDA savings outcomes: findings from the American Dream Demonstration

This study aims to develop a greater understanding of age differences in savings outcomes within Individual Development Accounts (IDAs). Participant data from the American Dream Demonstration (ADD) are examined for age differences in accumulated net deposits, average monthly net deposits, and deposit frequency. ADDprogram data are examined for savings match rates, monthly savings targets, direct deposit, and hours of financial education offered. Results indicate that, on average, older IDA participants have better savings outcomes than younger participants. Findings from this study suggest that impoverished middleaged and older adults can save if provided an opportunity and incentives. However, success will depend on the characteristics of the programs.     

Who is it that Would Make Business Schools More Critical? A Response to Tatli

Our short paper, as a response to Tatli's recent comment on our work, provides the opportunity to develop further an exploration of problems that both Tatli and ourselves identify in critical management studies (CMS). Here, we articulate ideas that we shied away from in our original paper, notably regarding an unreflexive masculinity that dominates some aspects of CMS. We suggest that many of Dr Tatli's concerns resonate with our own. This response therefore aims to generate further debate about CMS and how it may be perpetuating some of those very practices it abhors in management and organizations.     

By what measure? family time devoted to children in the united states

We argue that previous research on time devoted to child care has paid insufficient attention to the conceptualization of care time. Three separate problems are evident. First, the conventional focus on explicit activities with children distracts attention from the larger responsibilities of "passive" care, which ranges from time when children are sleeping to time when they are in the same general area but are not engaged in an activity with parents. Second, the empirical analysis of activity time focuses almost exclusively on parents, overlooking the role of relatives such as grandmothers and siblings. Third, the measurement of active care time often ignores the impact of overlaps among both care providers and recipients. Our analysis of the Child Development Supplement of the Panel Study of Income Dynamics sheds light on these three problems and presents new measures of passive and active care time.