Spirit of aging rising: cross-cutting thematic modules to enrich foundation graduate social work courses

To enrich an urban generalist MSW program serving a diverse aging community, an innovative approach was initiated. A team of students, faculty and a field instructor collaborated in creating and evaluating 3 sets of cross-cutting thematic modules. An overview of the thematic modules (addressing elder abuse, family caregiving, and mental health), integrated across multiple curriculum areas (Human Behavior and the Social Environment, Macro/Policy, Practice and Research), is presented along with results of a faculty focus group evaluating the process of coordinating module content for one full week of class per foundation area (one topic per quarter).     

Borderline personality disorder: Psychosocial considerations and rehabilitation implications

The article describes the medical and psychosocial aspects of borderline personality disorder, a common and sometimes severe psychiatric condition marked by emotional instability and problems with interpersonal relationships. Medication, psychosocial and other treatment issues are discussed within the context of the rehabilitation counselor's role in providing vocational services for people with borderline personality disorder.     

Involving parents in the treatment of behaviorally disordered children

Effective psychiatric treatment for children requires the active participation of the children's parents. This paper describes a training model that has been applied successfully to diverse groups of parents of hospitalized children. Lecture, role-playing, and other techniques are used to help parents implement social learning concepts with their children. Applications range from the judicious use of praise to elaborate contingency management systems, depending upon the abilities and needs of the parents. The authors argue that this model has wide applicability and is especially amenable to an outpatient setting.     

Lesbian, gay, and bisexual clients' experiences in treatment for addiction

This study examined the extent to which lesbian, gay, and bisexual clients perceived their addiction counselors and treatment programs to be sensitive to issues related to sexual orientation. The experiences they considered most successful were reported as more affirmative than experiences they considered least successful; however, in neither situation were counselors or treatment programs consistently affirmative.     

Design and analysis considerations for comparing dynamic treatment regimens with binary outcomes from sequential multiple assignment randomized trials

In behavioral, educational and medical practice, interventions are often personalized over time using strategies that are based on individual behaviors and characteristics and changes in symptoms, severity, or adherence that are a result of one's treatment. Such strategies that more closely mimic real practice, are known as dynamic treatment regimens (DTRs). A sequential multiple assignment randomized trial (SMART) is a multi-stage trial design that can be used to construct effective DTRs. This article reviews a simple to use ‘weighted and replicated’ estimation technique for comparing DTRs embedded in a SMART design using logistic regression for a binary, end-of-study outcome variable. Based on a Wald test that compares two embedded DTRs of interest from the ‘weighted and replicated’ regression model, a sample size calculation is presented with a corresponding user-friendly applet to aid in the process of designing a SMART. The analytic models and sample size calculations are presented for three of the more commonly used two-stage SMART designs. Simulations for the sample size calculation show the empirical power reaches expected levels. A data analysis example with corresponding code is presented in the appendix using data from a SMART developing an effective DTR in autism.     

A grassroots prototype for trauma-informed child welfare system change

The development of trauma-informed child welfare systems (TICWSs) that advance individual agency practice to target transformation of the system as a whole has been conceptualized but not documented. A grassroots effort to build a TICWS with key participants (e.g., Department of Human Services, Community Mental Health, Family Court, schools) in nine Michigan communities provides a field tested model for implementation. This article described what emerged as the core elements for a TICWS, which includes (1) development and support of a project champion, (2) trauma identification, (3) comprehensive assessment of traumatic impact, (4) evidence based trauma treatment, (5) establishing a common trauma language, and (6) trauma-informed decision-making. Several new instruments for assessing aTICWS are identified. Lessons learned are highlighted for consideration of communities seeking to develop TICWSs.