Clinical and Medical Social Work Commons^™

Improving The Mental Health Care Delivery System For Elderly Nursing Home Patients, Richard J. Caston, Sharon Kohls, Susanna Bozinovski

The Journal of Sociology & Social Welfare

It is well known that the mental health care delivery system for aged nursing home patients is inadequate. Based on information gained from face to face interviews and from a mail survey of nursing home personnel, the range and usefulness of the resources and services available for mental health care in nursing homes are identified. This information is then used to derive recommendations for the development of a more effective mental health care delivery package for nursing homes.

Child Abuse And Mental Health: An Examination Of Some Long Term Effects For Prison Inmates, Michael J. Belyea, Matthew T. Zingraff

The Journal of Sociology & Social Welfare

This study examines the effects of childhood abuse on future adult mental health. A statistically significant relationship was found between abuse and mental health problems. This relationship remained even after controlling for parental characteristics and the effects of an abusive environment. These findings suggest that one way to deal with the consequences of abuse would be to develop long term intervention strategies.

Social Work Intervention With The Aged: Toward A Change In The Institutionalized Thought Structure, Shimon S. Gottschalk, Michael Frumkin, Allan V. Kaufman

The Journal of Sociology & Social Welfare

The social problems associated with aging are viewed as derived from a series of socially defined meanings in the areas of: (1) power/authority,(2) responsibility, (3) productivity/work, (4) dependence/ independence,and (5) knowledge/rationality. A parallel series of alternative meanings is proposed which make possible the creation of alternative institutional forms which hold promise for making contemporary problems substantially obsolete. An era of post-professinalism is envisioned in which helping agents become political activists committed to social change on the cognitive, as well as the material level.

Empathy/Role Taking: A Theoretical Model For Feminist Therapy, Michele Wilson, Gayle Twilbeck Wykle

The Journal of Sociology & Social Welfare

Feminist therapy is directed not only at individual, but also at social change. Because of this dual aim of feminist therapy, the symbolic interactionist perspective, which describes individual initiative as a source of social change, is suggested as a theoretical orientation which can provide a useful model for feminist therapy. More specifically, the empathy/role-taking model for the clienttherapist relationship is outlined here.

The Politics Of Mental Health After Care, Steve Rose

The Journal of Sociology & Social Welfare

Essential to the development of a positive practice in mental health after-care is a precise formulation of clients' needs. Clarity about a statement of needs provides added information about anticipated obstacles to meeting those needs, both at the client and systemic levels. To accomplish this preliminary task, it becomes necessary to create what we refer to as a "problem definitional" level of theory. Problem defining theory mediates between more global theory, which establishes a larger context for understanding the broad policy issues and direct implications,* and the articulation of practice theory.

The Non-Orthodox Cancer Therapy Movement: Emergent Organization In Health Care Crisis, Joseph Behar

The Journal of Sociology & Social Welfare

The ideology and organization of the non-orthodox cancer therapy movement are analyzed as social constructions in an area of professional ambiguity and failure. The movement articulates, integrates, and orders the personally and socially disabling consequences of health care failure in cancer. The protest activities of the movement are characterized by political opposition to medical "orthodoxy" and "monopoly." The challenges of the non-orthodox movement are generally ineffective, non-legitimated, or coopted. Yet, in providing conceptual and organizational frames for the disordering consequences of medical failure and in establishing a politically polarized deviant position in relation to conventional practice, this movement socially organizes …

Regional Planning Of Mental Health Services: An Illinois Case Example, Wynne Sandra Korr

The Journal of Sociology & Social Welfare

Now that Reagan has ended a twenty-year pattern of federal involvement in setting mental health policy priorities, states must develop models for implementing and maintaining services to the mentally ill. The Illinois model of regional offices which plan and monitor programs is described. A case example showing how one such office developed services in a minority community is given. Examples of the work of other offices illustrate the flexibility of this model in meeting special community needs.

Disinnovation In The American States: Policy Toward Health Systems Agencies, Keith Mueller, John Comer

The Journal of Sociology & Social Welfare

Requiring the states to involve consumers in health planning through local health planning boards (HSAs) was an attempt by the federal government to control health care costs. Elimination of this requirement more recently has meant some states have discontinued the program. The elimination of HSAs can be considered a case of policy disinnovation. Drawing on the innovation literature, the following variables were expected to correlate, although negatively, with elimination of HSAs: value added to manufacturing, average acre value of farms, per capita income, population living in metropolitan areas, and party competition. All were found to correlate negatively. Predisposition to spend …

"Medical Democracy In A Health Systems Agency: The Role Of Staff", James Latimore

The Journal of Sociology & Social Welfare

The performance of consumers or laypersons in government programs has been studied extensively, usually from the standpoint of the control exercised by providers or other professionals, or correlative, what consumers need in order to be on an equal footing with the experts. At stake is lay control -i.e., democracy. This case study of one Health Systems Agency (HSA) in contrast, focuses attention on the crucial role of the HSA staff in the democratization of health care. Outcomes, such as cost-containment and allocation of resources, can be examined in terms of the staff's interests and the constraints of its multi-leveled environment. …

Scientific Ideologies And Conceptions Of Drinking Behavior And Alcoholism, Keith M. Kilty

The Journal of Sociology & Social Welfare

Conventional explanations of drinking behavior and alcoholism suffer from serious inadequacies, due in large part to their unquestioning acceptance of certain assumptions about the effects of alcohol on human behavior that are rooted in moral prescriptions. That is, most contemporary models of drinking behavior assume that the consumption of alcohol leads to the loss of inhibitions or self-control, ultimately leading to behaviors that are not predictable by either the drinker or society. This perspective has become so deeply ingrained in the social scientific literature that it is no longer even perceived as hypothetical; instead, it has taken on the character …

Shared Ethnicity As A Correlate Of Acceptance Of The Formerly Hospitalized Mentally Ill, Jonathan Rabinowitz

The Journal of Sociology & Social Welfare

This study looked at shared ethnicity of former mental patient and community member as a possible correlate of acceptance of the formerly hospitalized mental patient as a potential tenant. This study is an exploratory study with a comparative perspective using a design in which the willingness to accept a former mental patient as a renter in one of four groups is explored. Current research in this field has ignored the variable of shared ethnicity. The findings of this study did not reach the .05 level of significance, however the results seem to indicate that in some cases shared ethnicity is …

Program In Social Work With Groups: A Jungian Perspective, Herman Borenzweig

The Journal of Sociology & Social Welfare

In their text Social Group Work Practice, published in 1949 and affectionately called, "The Green Bible," by many social workers trained within its tradition, Wilson and RylandI portray program as, "the use of activities for attaining and maintaining mental health." By deemphasizing recreational modalities, social group workers have sacrificed their holistic practice, allowing other professionals to fill this vacuum. Recently, for example, "Sing your way back to health," is a "new" therapy in Los Angeles. Also, many Gestalt therapy exercises owe a debt to J.L. Moreno's psychodrama. Singing, drama, are but two of the many program tools taught as practice …

Meaning In Work: Toward A Clinical Approach To Work Dissatisfaction, Shimshon M. Neikrug

The Journal of Sociology & Social Welfare

This paper deals with issues relating to the meaning of work for the worker and clinical implications for the social worker intervening in the field of industrial and occupational social work. The problems of work dissatisfaction and alienation in work are analyzed. The author presents two concepts, work as play and logotherapy, as being useful in the clinical intervention in work related problems. It is concluded that the absence of work dissatisfaction need not be the goal of intervention, rather the clinical encounter can strive for meaningfulness, growth, and self-discovery.

Women And Chronic Renal Failure: Some Neglected Issues, Nancy G. Kutner, Heather L. Gray

The Journal of Sociology & Social Welfare

It has been assumed until recently that chronic renal failure is more prevalent among men than among women, but data now indicate that at least half of all renal patients are women. The literature continues to focus on adjustment problems of male patients, especially sexual adjustment and job-loss problems, and to assume that women can adjust more easily because of their ability to maintain the homemaker role. However, women patients whose work status is that of homemaker are found to have the highest depression scores, and job loss results in low satisfaction for those who have held meaningful outside jobs. …

A Peer Counseling Training Program For Disabled Women: A Tool For Social And Individual Change, Marsha Saxton

The Journal of Sociology & Social Welfare

This article presents a description of a successful peer counseling training program for disabled women, offered in a community-based self help organization. The program provides both training in peer counseling skills, and a personal growth experience. It was carried out in a group context specifically designed for the needs of women with disabilities. The counseling approach, the training format and curriculum, and the evaluation procedures can all serve as a basis for agencies interested in developing similar programs.

Toward A Model Of Factors Influencing The Hiring Of Women With A History Of Breast Cancer, Nancy Mccharen, Jo Anne L. Earp

The Journal of Sociology & Social Welfare

Whether surgical treatment for cancer which results in the removal of an external part of the body is viewed by employers as a medical disability that interferes with the performance of job-related functions, or fits a more stereotypic definition of a physical handicap that might even prevent an employee from being hired, has not been adequately studied. To identify factors which influence employers' decisions to hire women who have had breast cancer, a model of factors influencing the decision to hire was developed. A random sample of personnel directors from an industrialized North Carolina county was surveyed. A majority had …

Benefits For The Disabled: How Beneficial For Women?, Elizabeth Ann Kutza

The Journal of Sociology & Social Welfare

The social and economic consequence of disability is of increasing interest in American society today. The numbers of persons reporting disabling conditions is rising, as is the number of persons qualifying for public disability benefits. This article examines the impact of current United States disability policy on disabled women, and concludes that the major programs - disability insurance, supplemental security income, workers' compensation, vocational rehabilitation - because of their relationship to labor market participation, disadvantage women. Women not only receive fewer, but less generous benefits. Explanations of this outcome, and implications for future policy are addressed.

The Self Disclosure Of Clinical Social Workers, Herman Borenzweig

The Journal of Sociology & Social Welfare

My interest in this study arose from what I believed to be the discrepancy between the conventional wisdom about self disclosure and its occurrence in the practice of clinical social work. Bradmiller'sI study, one of the few studies about self disclosure in the practice of social work, found that persons with masters degrees in social work (MSW's) disclose significantly more to their colleagues than do undergraduate social work majors. The MSW's in Bradmiller's study self disclosed to clients at a lesser rate than they did to other target persons. Bradmiller2 interprets her study, " ...... most simply as an indication …

Psychological And Emotional Impact Of Unemployment, Michael Borrero

The Journal of Sociology & Social Welfare

Having seen the discussion of the meaning of work and the important role it plays in our lives, as developed by Borrero and Rivera, we now need to address what happens to people when they want to work but are unable to because of economic recessions, depressions and economic policies. The focus of the following paper is to review the literature concerning the psychological and emotional stresses that are brought about as a result of unemployment.

The Perceived Effectiveness Of Medical Social Work Faculty, Richard M. Grinnell Jr., Nancy S. Kyte, Richard L. Gorsuch

The Journal of Sociology & Social Welfare

Within the health care field, medical social work has expanded rapidly over the past few years (Bracht, 1974). Medical social workers comprise approximately 1.5 percent of the total medical schools' faculty in the United States (Grinnell, Kyte & Hunter, 1976). There is additional evidence that medical social work faculty will increase over the years to come (Grinnell, Kyte, Hunter & Larson, 1976; Crinnell, Kyte & Hunter, 1976; Grinnell & Kyte, 1978b; & Grinnell & Kyte, 1979). Additionally, empirical studies have been conducted that analyzed the functions of social work faculty in medical schools (Grinnell & Kyte, 1978c; Grinnell & Kyte, …

Organizational Structure And Professional Norms In An Alternative Health Care Setting: Physicians In Health Maintenance Organizations, Judith K. Barr, Marcia K. Steinberg

The Journal of Sociology & Social Welfare

The development of new organizational forms for the delivery of health and medical care in the U.S. includes health maintenance organizations (HMOs), designed to provide a set of comprehensive basic health services to a defined population for a fixed prepaid premium. As complex organizations, HMOs have the potential for limiting the autonomy of professionals working in them. This paper describes the legal requirements and organizational mechanisms under which physicians practice in HMOs and considers the potential for conflict between the organization and professional norms.

On the basis of document and interview data from nine HMOs, it appears that mechanisms developed …

The Paradoxes Of Health Planning, Bonnie Morel Edington

The Journal of Sociology & Social Welfare

The National Health Planning Act of 1974 designated 200 Health Systems Agencies (HSAs) nationally and a State Health Planning and Development Agency in each state. Components of the law are analyzed to illustrate its ambiguities and contradictions. The components analyzed are: the findings which led to the passage of the law; the law's purpose; the ten national health priorities; the National Guidelines for Health Planning; the purposes of the HSAs and the data they are to assemble and analyze. The major contradiction is that agencies designated to focus on cost containment in health care are expected to make health care …

Journal Of Sociology & Social Welfare Vol. 7, No. 3 (May 1980)

The Journal of Sociology & Social Welfare

SPECIAL ISSUE - CHALLENGE AND INNOVATION IN AMERICAN HEALTH CARE POLICY

• Editor' s Introduction
• American Health Care: Paradigm Structures and the Parameters of Change - ALLEN W. IMERSHEIN
• The Public and Care by Non-Physicians: Health Policy Considerations - BEBE F. LAVIN
• Organizational Structure and Professional Norms in an Alternative Health Care Setting: Physicians in Health Maintenance Organizations - JUDITH K. BARR and MARCIA K. STEINBERG - The Paradoxes of Health Planning - BONNIE MOREL EDINGTON
• Veteran's Medical Care: The Politics of an American Government Health Service - JUDITH N. LASKER
• Mission Neighborhood Health Center: A Case Study of the Department …

Changing Physician Ideologies On The Care Of The Dying: Themes And Possible Explanations, John Macdougall

The Journal of Sociology & Social Welfare

An analysis of changing physician ideologies regarding the care of elderly dying patients, as expressed in technical journals read by American physicians. Markedly more titles concerning terminal care are found in Index Medicus in 1968- 78 than in 1960-67. In one journal, physicians are only after 1964 urged to tell patients openly about their condition and after 1969, to improve cooperation within professional teams. Two explanations of these data are tentatively explored: 1) a Parsonian explanation, whereby medical ideologies reflect professional autonomy and the influence of internalized moral norms; 2) a Marxist explanation, whereby medical ideologies reflect physicians' transformation from …

Aspects Of The Sociology Of Psychiatry, Hans S. Falck

The Journal of Sociology & Social Welfare

There can be little doubt that for the social scientist interested in the case of psychiatry there is much to learn. Not only is psychiatry a specialty in medicine, with a variety of subspecialities, is also enjoys links to other professions such as clinical psychology, psychiatric nursing and psychiatric social work. While in some sense this provides psychiatry the opportunity to be the renaissance man in medicine -- a situation which might elicit envy from others less universal and catholic -- it also causes it great difficulties and troubles. Nooone seems to know where psychiatry begins and ends; it suffers …

Procedures For The Maintenance And Generalization Of Achieved Behavioral Change, John S. Wodarski

The Journal of Sociology & Social Welfare

Procedures for the maintenance and generalization of achieved behavioral change in anti-social adolescents are reviewed. A review of follow-up studies which provides the rationale for the incorporation of such procedures in practice is initially elaborated. Specific items discussed are possible avenues to the maintenance and generalization of behavior: social networks, peers, and parents; training socially relevant behaviors; changing the conditions of training; gradually removing or fading the contingencies; delayed reinforcement; and self control procedures. Throughout the manuscript relevant case illustrations are reviewed.

Employment, Theory And Practice In Qualitative Medical Sociology, Mary Jo Deegan

The Journal of Sociology & Social Welfare

Applied qualitative medical sociology is almost an unheard of phenomenon. When it is done, however, It is usually accomplished by sociologists employed in academic institutions. Here we discuss the possibility of such a specialty, building upon the established literature and resources, as a potential area of employment and expanded sociology practice. Three "types" of approaches: symbolic interaction, phenomenology and Marxism are used to suggest the diversity and resources available in qualitative sociology.

The Transition To Medicalized Views: Alcoholism And Social Workers, H. Paul Chalfant, Dorinda N. Noble

The Journal of Sociology & Social Welfare

More deviant behaviors in our society are coming to be defined as medical rather than criminal, so that more control of such behavior is coming under medical and helping professions. Some conditions, e.g., alcoholism, seem to be caught "in between," with serious consequences. This paper looks at social worker perception of the alcoholic as "sick," in terms of a sociological conception of sickness as a social role. A bi-mdal distribution is found for acceptance and nonacceptance. Also, a significant number are ambivalent. The implications of this lack of consensus are discussed.

The Influence Of The Agency Environment On Clinical Practice, Anthony N. Maluccio

The Journal of Sociology & Social Welfare

In an in-depth, exploratory study of their perception of treatment in a family service agency, it was found that clients stressed the impact of the agency’s, social and physical environment on the helping process and its outcome. Workers, in contrast, took the environment for granted or had little to say about it. This paper discusses the findings and selected practice implications.

Lessons From Private Health Insurance, Martha N. Ozawa

The Journal of Sociology & Social Welfare

All across the country there is a sense of urgency, and even of crisis over what is happening in the health industry. Of special concern are the rapid rate of increase in the cost of health care services and the increasing national expenditures for health care. For fiscal year 1976, the total U.S. spending for health care reached $149.8 billion, or a per capita expenditure of $638. Expressed as a percentage of the gross national product (GNP), the national spending for health care reached a record-breaking 8.6 percent.1 From the early 1960s--except during the period from August 1971 through April …