Colorful Disclosures: Identifying Identity-Based Differences and Enhancing Critical Consciousness in Supervision

ABSTRACT

Managing microaggressions and marginalizing experiences while negotiating the ongoing oppression that occurs in micro, mezzo, and macro settings can be particularly challenging for clinicians of color. Thus, supervision with clinicians of color must include affirmation, empowerment, and exploration of the intracultural/intercultural dynamics inherent in the treatment-providing process and clinical supervision. Through case studies, autoethnographic studies of our supervision experiences, and interviews with supervisors and supervisees, we reflect on how axes of identity, including race, power, and privilege, inform practitioners’ clinical lenses and affect their vulnerability in treatment and the clinical supervision dyad. Special attention is placed on the clinical supervisor–clinician–client triad (the triple process) and the interpersonal dynamics of cultural sensitivity, cultural humility, and authentic responsiveness that supervisors aim to model and cultivate in the supervisory relationship. In addition to sustaining clinical growth for clinicians of color, adding this level of complexity to supervision supports equity in direct clinical practice, enhancing efficacy outcomes for clients and communities. Recommendations and pedagogical strategies are offered to support supervisors in initiating difficult dialogues and shifting the paradigm to promote this transformational perspective.     

Goal-Directed Supervision of Social Work Students in Field Placement

Abstract

Permanency Planning for Children , by Anthony N. Maluccio, Edith Fein, and Kathleen A. Olmstead. London: Tavistock Publications, 1986. Reviewed by Donald Brieland

Feminist Visions for Social Work , edited by Nancy Van Den Bergh and Lynn B. Cooper. Silver Spring, MD: National Association of Social Workers, 1986. Reviewed by Cleo S. Berkum, DSW

People and Contexts: Social Development from Birth to Old Age , by Henry S. Maas. Englewood Cliffs, NJ: Prentice-Hall, Inc. 1984. Reviewed by Harris Chaiklin

Case Management in Human Service Practice by Marie Weil, James M. Karls, and Associates. San Francisco: Jossey-Bass Publishers, 1985. Reviewed by Doman Lum

Law and the Mental Health System: Civil and Criminal Aspects , by Ralph Reisner. St. Paul, MN: West Publishing Co., 1985. Reviewed by Wynne Sandra Korr

Testing the Social Safety Net , by Martha R. Burt and Karen J. Pittman. Washington, DC: The Urban Institute, 1985. Reviewed by Julia M. Watkins     

Patterns and Predictors of Early Care and Education for Children in Foster Care

Patterns and predictors of center-based early care and education (ECE) of children in foster care were examined. Participants included 192 pre-Kindergarten age children in foster care. Foster parents reported demographics, ECE and other service use. Foster care history data was abstracted from case files. High rates of attendance in ECE prior to Kindergarten, including Head Start, other center-based ECE, or both were found. Children who attended Head Start were younger when first placed in foster care. Children who attended other center-based ECE services were more likely to live with kinship foster parents and foster families with higher incomes. Latent class analysis of ECE quantity, quality, type, and duration revealed three patterns: part-time Head Start, part-time other ECE, and full-time mixed ECE. Child and foster family characteristics predicted these patterns, illustrating distinct groups with potential implications for the development of children in foster care.     

Demanding work schedules and mental health in nursing assistants working in nursing homes

Nursing home assistants have physically and emotionally challenging jobs, and they often work demanding schedules in order to provide 24-h care. While the physical effects of demanding work schedules have been studied, little is known about the impact on mental health. This study explored the relationship between demanding scheduling variables and mental health indicators of depression, anxiety and somatization. A cross-section of 473 US female nursing assistants working in nursing homes was surveyed. Work schedule characteristics included shiftwork, hours per day and week, days per week, number of weekends per month, number of double shifts per month, breaks, and number of jobs worked. Working two or more double-shifts per month was associated with increased risk for all mental health indicators, and working 6–7 days per week was associated with depression and somatization. There was a trend for increasing odds of adverse mental health with increased numbers of demanding work schedule factors. The odds of depression was increased four-fold when working 50+ h/week, more than two weekends/month and more than two double shifts/month. Providing work schedules that are less unhealthy may have implications for both worker retention and the quality of care delivered to nursing home residents.     

A Convolution Estimator for the Density of Nonlinear Regression Observations

Abstract. The problem of estimating an unknown density function has been widely studied. In this article, we present a convolution estimator for the density of the responses in a nonlinear heterogenous regression model. The rate of convergence for the mean square error of the convolution estimator is of order n ^?1 under certain regularity conditions. This is faster than the rate for the kernel density method. We derive explicit expressions for the asymptotic variance and the bias of the new estimator, and further a data‐driven bandwidth selector is proposed. We conduct simulation experiments to check the finite sample properties, and the convolution estimator performs substantially better than the kernel density estimator for well‐behaved noise densities.     

An Examination of Fieldwork Models at Adelphi University School of Social Work

Practitioners' orientation toward research was compared with that of social work students. Practitioners' views on the importance and usefulness of research were significantly less favorable than those of graduate students in social work and more similar to students at the BSW level; but no differences were found with regard to belief in the unbiased nature of social work research. The differences between the practitioners and graduate students might be a manifestation of the failure of the curriculum to articulate research concepts and methodology in a manner responsive to the realities of practice.     

The Impact of Cytochrome P450 2E1-Dependent Metabolic Variance on a Risk-Relevant Pharmacokinetic Outcome in Humans

Risk assessments include assumptions about sensitive subpopulations, such as the fraction of the general population that is sensitive and the extent that biochemical or physiological attributes influence sensitivity. Uncertainty factors (UF) account for both pharmacokinetic (PK) and pharmacodynamic (PD) components, allowing the inclusion of risk-relevant information to replace default assumptions about PK and PD variance (uncertainty). Large numbers of human organ donor samples and recent advances in methods to extrapolate in vitro enzyme expression and activity data to the intact human enable the investigation of the impact of PK variability on human susceptibility. The hepatotoxicity of trichloroethylene (TCE) is mediated by acid metabolites formed by cytochrome P450 2E1 (CYP2E1) oxidation, and differences in the CYP2E1 expression are hypothesized to affect susceptibility to TCE's liver injury. This study was designed specifically to examine the contribution of statistically quantified variance in enzyme content and activity on the risk of hepatotoxic injury among adult humans. We combined data sets describing (1) the microsomal protein content of human liver, (2) the CYP2E1 content of human liver microsomal protein, and (3) the in vitro Vmax for TCE oxidation by humans. The 5th and 95th percentiles of the resulting distribution (TCE oxidized per minute per gram liver) differed by approximately sixfold. These values were converted to mg TCE oxidized/h/kg body mass and incorporated in a human PBPK model. Simulations of 8-hour inhalation exposure to 50 ppm and oral exposure to 5 micro g TCE/L in 2 L drinking water showed that the amount of TCE oxidized in the liver differs by 2% or less under extreme values of CYP2E1 expression and activity (here, selected as the 5th and 95th percentiles of the resulting distribution). This indicates that differences in enzyme expression and TCE oxidation among the central 90% of the adult human population account for approximately 2% of the difference in production of the risk-relevant PK outcome for TCE-mediated liver injury. Integration of in vitro metabolism information into physiological models may reduce the uncertainties associated with risk contributions of differences in enzyme expression and the UF that represent PK variability.