Medicine and Health Sciences Commons^™

Affective Depression Mediates Ptsd To Suicide In A Sample Of Treatment-Seeking First Responders, James Whitworth, Jeanine Galusha, Jose Carbajal, Warren Ponder, Donna Schuman

Faculty Publications

Objective: The aim of this study was to examine the associations of comorbid

posttraumatic stress disorder (PTSD), affective or somatic depression, and

suicide among first responders (FRs). Method: We used baseline data from

FRs (N = 232) who sought services at a nonprofit mental health agency specializing

in treating trauma exposed FRs. We conducted two PROCESS simple

mediation models with PTSD as the predictor, affective depression and somatic

depression as the mediators, and suicidality as the dependent variable.

Results: Affective depression significantly mediated the relationship between

PTSD and suicidality, whereas somatic depression did not. The direct effect …

The Intersection Of Rural Residence And Minority Race/Ethnicity In Cancer Disparities In The United States, Whitney Zahnd, Cathryn Murphy, Marie Knoll, Gabriel A. Benavidez, Kelsey R. Day, Radhika Ranganathan, Parthenia Luke, Anja Zgodic, Kewei Shi, Melinda A. Merrell, Elizabeth L. Crouch, Heather M. Brandt, Jan M. Eberth

Faculty Publications

One in every twenty-five persons in America is a racial/ethnic minority who lives in a rural area. Our objective was to summarize how racism and, subsequently, the social determinants of health disproportionately affect rural racial/ethnic minority populations, provide a review of the cancer disparities experienced by rural racial/ethnic minority groups, and recommend policy, research, and intervention approaches to reduce these disparities. We found that rural Black and American Indian/Alaska Native populations experience greater poverty and lack of access to care, which expose them to greater risk of developing cancer and experiencing poorer cancer outcomes in treatment and ultimately survival. There …

Conducting Qualitative Interviews By Telephone: Lessons Learned From A Study Of Alcohol Use Among Sexual Minority And Heterosexual Women, Laurie Drabble, Karen Trocki, Brenda Salcedo, Patricia Walker, Rachael Korcha

Faculty Publications

This study explored effective interviewer strategies and lessons learned based on collection of narrative data by telephone with a subsample of women from a population-based survey, which included sexual minority women. Qualitative follow-up, in-depth life history interviews were conducted over the telephone with 48 women who had participated in the 2009–2010 National Alcohol Survey. Questions explored the lives and experiences of women, including use of alcohol and drugs, social relationships, identity, and past traumatic experiences. Strategies for success in interviews emerged in three overarching areas: (1) cultivating rapport and maintaining connection; (2) demonstrating responsiveness to interviewee content, concerns; and (3) …

Prevention Strategies And Mental Health In Vietnam, Edward Cohen

Faculty Publications

This paper addresses the current state of mental health services in Vietnam and provides recommendations for improving the care of people with mental illness. Vietnam’s mental health problems are as prevalent as anywhere else in the world. The country has recently begun an initiative to reform mental health care by improving community-based services for people with serious mental illness. However, mental illness has not been a part of public discourse in Vietnam. There is little recognition of prevalent common mental illnesses (such as depression, anxiety and alcohol abuse) and the care of people with serious mental illnesses relies on either …

Evolving Ethical Standards In The Digital Age, Frederic G. Reamer

Faculty Publications

Ethical standards in social work have matured significantly since the formal inauguration of the profession in the late 19th century. This article traces the global evolution of ethical standards in social work, focusing especially on current challenges in the digital age. The author discusses changes over time in social workers’ understanding of ethical issues and development of conceptual frameworks and protocols for managing them. Social workers’ increasing use of digital technology poses novel and unprecedented ethical challenges pertaining to privacy, confidentiality, informed consent, professional boundaries, conflicts of interest, documentation, client abandonment, and professionalism, among others. The article outlines emerging ethical …

Clinical Social Work In A Digital Environment: Ethical And Risk-Management Challenges, Frederic G. Reamer

Faculty Publications

Clinical social workers’ use of digital and other technology to provide distance counseling services is proliferating. Increasing numbers of contemporary practitioners are using video counseling, email chat, social networking websites, text messaging, smartphone apps, avatar-based websites, self-guided web-based interventions, and other technology to provide clinical services to clients, some of whom they may never meet in person. The advent of this technology has produced a wide range of ethical challenges related to social workers’ application of traditional social work ethics concepts: client informed consent; client privacy and confidentiality; boundaries and dual relationships; conflicts of interest; practitioner competence; records and documentation; …

The Evolution Of Social Work Ethics: Bearing Witness, Frederic G. Reamer

Faculty Publications

The evolution of ethical standards in social work, and conceptual frameworks for examining ethical issues, is among the most compelling developments in the history of the profession. Since the formal inauguration of social work in the late nineteenth century, the profession has moved from relatively simplistic and moralistic perspectives to conceptually rich analyses of ethical issues and ethical guidelines. This article examines the evolution of social work ethics from the profession’s earliest days and speculates about future challenges and directions.

State Responses To Alcohol Use And Pregnancy: Findings From The Alcohol Policy Information System, Laurie Drabble, Sue Thomas, Lisa O'Connor, Sarah Roberts

Faculty Publications

This article describes U.S. state policies related to alcohol use during pregnancy, using data from the National Institute on Alcohol Abuse and Alcoholism Alcohol Policy Information System. Specifically, this study examines trends in policies enacted by states over time and types of policies enacted across states in the United States, with a focus on whether laws were supportive or punitive toward women. Findings revealed substantial variability in characteristics of policies (19 primarily supportive, 12 primarily punitive, 12 with a mixed approach, and 8 with no policies). Findings underscore the need to examine possible consequences of policies, especially of punitive policies …

Strategies Employed By Inner-City Activists To Reduce Alcohol-Related Problems And Advance Social Justice, Laurie Drabble, Denise Herd

Faculty Publications

This study explored strategies employed by activists engaged in efforts to change policies and laws related to selling and promoting alcoholic beverages based on in-depth interviews with 184 social activists in seven U.S. major cities. Nine strategies aimed at improving local conditions and influencing policy were described by activists across regional contexts. Grassroots mobilization was central to all other strategies, which included the creation or enforcement of laws, meeting with elected officials, media advocacy, working with police/law enforcement, education and training, direct action, changing community norms, and negotiating with store owners.

Alcohol In The Life Narratives Of Women: Commonalities And Differences By Sexual Orientation, Laurie A. Drabble, K. Trocki

Faculty Publications

Aim: The aim of this study was to explore social representations of alcohol use among women, with a focus on possible differences between sexual minority and heterosexual women. Methods: This qualitative study was part of a larger study examining mediators of heavier drinking among sexual minority women (lesbian identified, bisexual identified, and heterosexual identified with same sex partners) compared to heterosexual women based on the National Alcohol Survey. Qualitative in-depth life history interviews were conducted over the telephone with 48 women who had participated in the 2009–2010 National Alcohol Survey, including respondents representing different sexual orientation groups. Questions explored the …

Distance And Online Social Work Education: Novel Ethical Challenges, Frederic G. Reamer

Faculty Publications

Digital technology has transformed social work education. Today’s students can take individual courses and earn an entire degree without ever meeting their faculty members in person. Technological innovations such as videoconferencing, live online chat, asynchronous podcasts, and webinars enable social work educators to reach students whose personal circumstances and geographical locations make it difficult for them to attend school in person. This paper highlights complex ethical issues associated with the proliferation of digital and online social work education. Key ethical issues concern student access; course and degree program quality and integrity; academic honesty and gatekeeping; and privacy and surveillance.

Advancing Trauma-Informed Systems Change In A Family Drug Treatment Court Context, Laurie Drabble, Shelby Jones, Vivian Brown

Faculty Publications

A growing body of literature documents the importance of trauma-informed and trauma-specific services and systems change in both addiction treatment and child welfare fields. The overall aim of this qualitative study was to explore barriers, benefits, and facilitating factors associated with a trauma-informed systems assessment and improvement initiative conducted in the context of a family drug treatment court (FDTC). Semistructured in-depth interviews with 12 key informants and historical analyses of project documents over a 4-year time span were conducted. Results underscore the relevance of trauma-informed systems change in collaborative contexts designed to address the complex needs of children and families.

Lines In The Sand: Social Representations Of Substance Use Boundaries In Life Narratives, K. F. Trocki, L. O. Michalak, Laurie A. Drabble

Faculty Publications

This study identifies social representations in interviews about alcohol and substance use in the discourse of 129 young adults, who were interviewed for 2.5 to 3.5 hr each for their life histories and use or nonuse of alcoholic beverages and drugs. Respondents spontaneously delineated their substance use boundaries, creating a continuum of behaviors with boundary points separating acceptable from unacceptable behaviors. They used signaling expressions to indicate go and stop signs and movement along the substance use continuum and reported negotiating substance use boundaries both internally and with peers. A ubiquitous narrative element was the cautionary tale, in which a …

In Memoriam: James A. Inciardi, Professor Of Sociology & Criminal Justice And Director Of The Center For Drug & Alcohol Studies At The University Of Delaware, Wendee Wechsberg, Duane C. Mcbride, Hilary Surratt

Faculty Publications

No abstract provided.

Does State Certification Or Licensure Influence Outpatient Substance Abuse Treatment Program Practices?, Jamie Chriqui, Yvonne Terry-Mcelrath, Duane C. Mcbride, S Eidson, Curtis Vanderwaal

Faculty Publications

In the United States, state governments legally authorize outpatient substance abuse treatment programs. In some states, programs are certified or accredited (ideal standards). Other states license programs (minimal standards). Additionally, some states authorize programs through "deemed status", which is afforded to programs attaining accreditation from a national accrediting body. Primary legal research and the National Survey of Substance Abuse Treatment Services' (N-SSATS) data were used to examine the relationships between state authorization type (certification/accreditation vs licensure with and without deemed status) and outpatient treatment program practices. Programs in certification/accreditation (vs licensure) states had significantly higher odds of offering wrap-around and …

Ethical Issues In Open Adoption, Frederic G. Reamer, Deborah H. Siegel

Faculty Publications

Total secrecy and confidentiality no longer typify adoption in the United States. Today, most adoptions involve an exchange of information or some form of contact between the birth family and adoptive family - so-called open adoptions. This article provides a comprehensive overview of ethical issues associated with various forms of open adoption, including issues of privacy, confidentiality, self-determination, paternalism, conflicts of interest, deception, and truthtelling.We present guidelines for social work practice in open adoptions, based on current ethical theory and ethical standards in social work.

Progress And Opportunities In Lesbian, Gay, Bisexual And Transgender Health Communications, Laurie A. Drabble, J. Keatley, G. Marcelle

Faculty Publications

This article describes elements of effective health communication and highlights strategies that may best be adopted or adapted in relation to lesbian, gay, bisexual, and transgender (LGBT) populations. Studies have documented the utility of multidimensional approaches to health communication from the macro level of interventions targeting entire populations to the micro level of communication between health care provider and consumer. Although evidence of health disparities in LGBT communities underscores the importance of population-specific interventions, health promotion campaigns rarely target these populations and health communication activities seldom account for the diversity of LGBT communities. Advances in health communication suggest promising direction …

Alcohol, Tobacco, And Pharmaceutical Industry Funding: Considerations For Organizations Serving Lesbian, Gay, Bisexual And Transgender Communities, Laurie A. Drabble

Faculty Publications

Emerging research suggests that alcohol, tobacco and drug-related problems may be higher in lesbian and gay communities than in the population as a whole. At the same time, alcohol, tobacco and pharmaceutical industries have increased marketing strategies that are targeted specifically to lesbian and gay communities. Lesbian, Gay, Bisexual and Transgender (LGBT) and HTV/AIDS organizations, often marginalized and under-funded, have frequently faced significant challenges in funding programs and special events. These organizations are often the very same groups needed to promote and support effective substance abuse countermeasures in LGBT communities. Agency leaders, community members, and substance abuse prevention advocates all …