Response to Shaffer (1996): The Case for a 'Complex Systems' Conceptualisation of Addiction

This paper responds to some of the issues raised by Shaffer's (1996) paper, Understanding the Means and Objects of Addiction. The authors agree with, and in many respects support, the assertions made by Shaffer with respect to the conceptualisation of the problem of addiction. In particular, that it is the relationship of the addicted person with the object of their behaviour that defines addiction. However, it is argued that in addition to providing an operational definition for addiction, it is important to provide an explicit framework for the development of insight into the 'synergistic nature' of the multiple factors affecting the addiction process. That is, it is necessary to account for both the commonalities and the differences found across the spectrum of addictive behaviours. It is proposed that this might be provided by a 'complex systems' approach to the field of addiction.     

Developing and Leading Telephone Groups

Telephone groups are an important for meeting the needs of clients who cannot get to face-to-face groups, or prefer the convenience of meeting by telephone. This article describes the knowledge and skills that social group workers need to develop, implement, and lead telephone groups. Particular attention is paid to the clinical adaptations that are needed when leading telephone as compared to face-to-face groups using examples from caregiver psychoeducational and support groups.     

The language and policy of care and parenting: Understanding the uncertainty about key players’ roles in foster care provision

Recent debates about the care provided to looked-after children have been characterised by uncertainty about the differing roles and responsibilities of foster carers, birth parents, and social workers. To explore the assumptions underlying these uncertainties, we drew upon Foucauldian Discourse Analysis and compared the discourses used by professionals (social workers in a group discussion about foster placement breakdown) with those used by policy-makers (in the Governmental green paper ‘Care Matters’). In both cases, a discourse based upon Attachment Theory was used to explain why placements succeed and fail, and to predict the repercussions of failure. However, there was a key difference in the way that professionals and policy-makers constructed the roles of key players in foster placements. The social workers constructed the birth parents as the parental figures for children in care, constructing themselves in a non-parental role. ‘Care Matters’ largely ignores the role of birth parents, and instead constructs social workers as parental figures. Neither source viewed foster carers as parental and ‘Care Matters’ positions this group as strictly professional. We discuss the incongruence of foster placements being understood through Attachment Theory, while foster carers are understood as non-parental figures, and also the repercussions of labelling a social worker as a parent, and the professionalization of the role of the foster carer.     

The Impact of Self-Esteem Group Work Practice with Rural Elementary Male Students

The present pilot study examines the effect of a social work self-esteem group as a method for improving the self-esteem and classroom behavior of disruptive male students in an elementary school in rural Georgia. Teachers, educators, and administrators in school systems across the nation are continuously bombarded with a disproportionate number of students who fail to display acceptable standards for appropriate classroom behavior, particularly male students. Research efforts have been directed toward identifying effective social work practice interventions that will bring about meaningful proactive changes to elementary student populations who exhibit such behaviors. A validated outcome measure was included in an uncontrolled pretest–posttest design to determine quantifiable changes. Findings from this study show that after the social work group intervention, posttest scores tended to be lower than pretest scores, which would indicate that there was a notable improvement in elementary students’ self-esteem and class behavior between pretest and posttest assessments. Implications for social work practice are discussed.     

Predisposing Factors for Elevated Restricted and Repetitive Behavior in Typically Developing Toddlers

Little is known about the relation between levels of restricted and repetitive behavior (RRB) in infants and parent factors. The present study investigated maternal and psychosocial factors (depressive symptoms, socio‐economic status, social support) and mother–infant engagement factors (mind‐mindedness, sensitivity, and infant–mother attachment security) as predictors of children's RRB at age 26 months in a sample of 206 mothers and children. Maternal depressive symptoms predicted levels of sensory and motor repetitive behavior and rigid, routinized, and ritualistic repetitive behavior. Lower socioeconomic status also predicted independent variance in children's sensory and motor repetitive behavior. The relations between maternal depressive symptoms and both types of RRB were not mediated through observational measures of maternal sensitivity or mind‐mindedness at 8 months, or attachment security at 15 months. The results are discussed in terms of whether stress regulation, self‐stimulation, and genetic susceptibility can help explain the observed link between maternal depressive symptoms and RRB in the child.     

What's a medication group?

For therapists interested in a didactic model, a Medication Group can be an ideal vehicle for patient education. Our patients are remarkably well informed on dopamine, tardive dyskinesia, side effects, types and levels of drugs, early symptoms, individual stressors and coping mechanisms. They request and titrate drug levels according to their own identification of symptom distress. There is no question that the ability to control their symptoms and medications is a positive and important experience for them. The focus for this paper, however, has been an exploration of a group therapeutic strategy which deals with the phenomenological needs of chronic schizophrenics to address the residual or negative symptoms of schizophrenia, and not their educational needs.