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.     

Children’s Psychosocial Rehabilitation: Clinical Outcomes for Youth with Serious Emotional Disturbance Living in Foster Care

Children living in foster care are an especially vulnerable population who often come to the attention of Medicaid mental health providers. These children experience a high incidence of emotional and behavioral disorders and may have specialized treatment needs related to their living arrangement status. This study assessed whether Children’s Psychosocial Rehabilitation could effectively treat youth with severe emotional and behavioral disorders who live in foster care. Analysis of data from an open trial of 218 clinically-impaired youth, aged 3–18 years, revealed no reliable differences in treatment outcome between foster versus non-foster children, with a trend toward more favorable outcomes for foster youth. Findings justify further study of the effectiveness of this Medicaid-funded service for the treatment of youth in care.     

Violence Exposure Among Children of Incarcerated Mothers

Social workers are becoming increasingly aware of the unique experiences faced by children of incarcerated parents. Little is known, however, about their experiences prior to their parents being incarcerated. Using data from a broader study of incarcerated women, we examined women’s accounts of their children’s exposure to violence prior to maternal incarceration. Open-ended interviews addressed family and relationship history, physical and psychological victimization, lifetime delinquency and crime, and interactions with service and justice systems. Interviews were analyzed using ATLAS/ti software and a grounded-theory approach. The emergent themes revealed a myriad of consequences experienced by the children, including child witnessing of violence, emotional sequelae, bodily harm from abuse and neglect, sexual abuse, and birth defects from prenatal violence. Implications for research and practice are discussed.     

Do Work Demands and Resources Predict Work-to-Family Conflict and Facilitation? A Study of Iranian Male Employees

This study examined the effects of some work demands-resources on two dimensions of work-to-family interface among Iranian employees. The results of canonical correlation and multiple-regression showed that among work resources (i.e., social support and autonomy), social support was associated negatively with work-to-family conflict and autonomy was associated positively with work-to-family facilitation. Also, among work demands (i.e., job demands and working hours), job demands were associated with both work-to-family conflict and work-to-family facilitation. Unlike previous studies, working hours shows a positive association with work-to-family facilitation, which may be explained by the specific cultural context in Iran. The findings of the study will be of importance to employees and organizations.

Barriers to Help-seeking for a Gambling Problem: The Experiences of Gamblers Who Have Sought Specialist Assistance and the Perceptions of Those Who Have Not

This paper presents barriers to help-seeking data as reported by users of a national gambling helpline (help-seekers, HS, N = 125) as well as data pertaining to perceived barriers to seeking help as reported by gamblers recruited from the general population (non-help-seekers, NHS, N = 104). All data were collected via a structured, multi-modal survey. When asked to identify actual or perceived barriers to seeking help, responses indicative of pride (78% of HS participants, 84% of NHS participants), shame (73% of HS participants, 84% of NHS participants) or denial (87% of NHS participants) were most frequently reported. These three factors were also most often identified as the real or perceived primary barrier to help-seeking (collectively accounting for 55% of HS, and 60% of NHS, responses to this question) and were the only barriers to be identified by more than 10% of either HS and NHS participants without prompting. It was of note, however, that participants in both groups identified multiple barriers to help-seeking (mean of 6.7 and 12.2, respectively) and that, when presented with a list of 21 possible barrier items, NHS participants endorsed 19 of the listed items significantly more often than their HS counterparts. The implications of these findings, with respect to promoting greater or earlier help-seeking activity amongst problem gamblers, are discussed.

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.     

Wealth Holdings and Portfolio Allocation of the Elderly: The Role of Marital History

This paper investigates the role of marital history in terms of explaining differences in wealth holdings and portfolio allocation of older individuals by studying data from the first wave of Health and Retirement Study which was conducted in 1992. The results generally suggest that both men and women suffer from the negative shocks of past marital dissolutions in terms of household wealth accumulation. The significance level, however, differs across currently married couples, single males, and single females. The examination of the asset components of net worth also indicates that both the probability of owning a particular asset and the fraction of wealth allocated to that asset might vary depending on the elderly individuals’ marital history.

Professors,Ideology and Housework

This paper presents, for the first time, multivariate analyses of Canadian national data and tests the relationship between class-based egalitarianism and housework for married and cohabiting male and female university professors in 2000. Consistent with evidence in the general population, gender accounts for more variation in housework than a host of other predictors (i.e., class- and gender-based ideology, institutional contexts and resources, available time, presence of children, age, minority racial status, and religiosity). Nevertheless, these forces play important roles in increasing or decreasing domestic labor contributions of both male and female academics. Among these, professors who possess class-based egalitarian views do more housework, and egalitarianism increases domestic labor contributions of males and decreases that of females.     

Embodied cognitive neuroscience and its consequences for psychiatry

Recent years have seen the emergence of a new interdisciplinary field called embodied or enactive cognitive science. Whereas traditional representationalism rests on a fixed inside–outside distinction, the embodied cognition perspective views mind and brain as a biological system that is rooted in body experience and interaction with other individuals. Embodiment refers to both the embedding of cognitive processes in brain circuitry and to the origin of these processes in an organism’s sensory–motor experience. Thus, action and perception are no longer interpreted in terms of the classic physical–mental dichotomy, but rather as closely interlinked. This paper describes the cycles of brain–organism interaction, of sensory–motor interaction with the environment and of embodied interaction with others. The brain is then interpreted as an organ of modulation and transformation that mediates the cycles of organism–environment interaction. Finally, consequences of the embodied and enactive approach for psychiatry are pointed out, in particular for a circular concept of mental illness.