Clinical and Medical Social Work Commons^™

The Impact Of Drgs On Social Workers In A University-Affiliated, Teaching Hospital System, Joan M. Merdinger, Fredrick J. Garrity, Robert L. Treichler

The Journal of Sociology & Social Welfare

The impact of DRGs on social workers in four social work departments located in one Northeast State was assessed by interviews with all social work staff and administrators. The impact of DRGs was determined to be substantial. Implications for social work education and practice are considered.

Differential Perception And Adolescent Drinking In The United States: Preliminary Considerations, John B. Harms, James L. Wolk

The Journal of Sociology & Social Welfare

This paper addresses adolescent drinking from a perspective very similar to Sutherland's differential association theory. Drinking occurs when positive perceptions of drinking outweigh or outnumber negative ones. Our research focuses on images of drinking communicated by rationalized sources organized specifically to shape perceptions of drinking. We call these organizations "agencies" and assess their impact on perceptions of drinking. It is our contention that the political economic context of the United States in which these agencies function is such that positive images of drinking outnumber and outweigh negative ones, and that this is an important factor contributing to adolescent drinking.

A Redefinition Of The Problem Of Homelessness Among Persons With A Chronic Mental Illness, Donald M. Linhorst

The Journal of Sociology & Social Welfare

Two definitions of the problem of homelessness among persons with a chronic mental illness are examined, along with their implied solutions and ramifications for policy. Homelessness among this group is first viewed as the result of deinstitutionalization, and secondly, as the outcome of a critical shortage of low-income housing. Solutions stemming from the deinstitutionalization definition of homelessness, reinstitutionalization or improvement in the mental health system, are seen as inadequate to deal with the problem of homelessness among the mentally ill. Instead, state departments of mental health are called upon to provide a leadership role in the development of affordable housing.

Advocacy/Empowerment: An Approach To Clinical Practice For Social Work, Stephen M. Rose

The Journal of Sociology & Social Welfare

Social Work has been embedded in a structural and ideological contradiction throughout its history. The profession, its employing institutions, and the problems confronted by its clients are all produced by the same political economy that pays its workers and supports its schools. Ideologically, the profession has avoided the confrontation implied by its dependency upon individual defect explanatory or causal analysis frameworks that constitute a betrayal of its real constituencies. An advocacy! empowerment paradigm is offered as an alternative.

A Cross-Cultural Analysis Of Psychiatric Symptom Expression Using Langner's Twenty-Two Item Index, Robert Nishimoto

The Journal of Sociology & Social Welfare

An analysis of psychiatric symptom response using Langner's twentytwo item index was conducted across three cultural settings. Respondents were Anglo-American, Vietnamese Chinese, and Mexican. Some similarities did exist in response patterns and in those symptom items highly correlated with the total psychiatric screening score. Close examination revealed between-group differences indicating that not all twenty-two items were valid indicators of psychological disorder across cultures. The study highlights issues in the development and use of symptom checklists to measure and assess mental health constructs across cultures.

Community Mental Health: A View From American History, Mary Ann Jimenez

The Journal of Sociology & Social Welfare

The limitations of the movement for deinstitutionalization of the chronically mentally disordered have been the subject of a repeated series of investigations and analyses in the last 10 years. These critiques can be summed up in the undeniable observation that the chronically mentally disordered have by and large failed to benefit from deinstitutionalization in the ways that the original advocates and planners of this policy had hoped. The promise of community mental health, at least as articulated by the scores of witnesses before Congressional committees in the early 1960's, has not been realized for this population.

Mental Health Treatment Refusal In Correctional Institutions: A Sociological And Legal Analysis, Rudolph Alexander Jr.

The Journal of Sociology & Social Welfare

Recently, the courts have recognized the right to a minimum level of mental health treatment for individuals confined in both mental and correctional institutions, utilizing a different rationale for each system. As mental health administrators in state mental hospitals accepted that they were responsible for providing an increased level of mental health services, they were disappointed that courts had subsequently ruled that individuals in state hospitals had a right to refuse treatment. The purpose of this paper is to elaborate, sociologically and legally, upon treatment refusal in the correctional system since most of the attention on treatment refusal has focused …

What Social Workers Do: Implications For The Reclassification Debate, Charles Green

The Journal of Sociology & Social Welfare

The reclassification trend is one of the most formidable issues facing American social work today. Social work's vulnerability stemming from a general ambiquity about its distinct role and boundaries, competition from emerging helping occupations, and its debated professionalism is a major contributing factor. Often ignored in recent efforts to address reclassification is empirical evidence of social work's distinct performance in the human services versus other occupational groups. In this article comparative research findings supporting social work's unique performance are presented and their relevance for reclassification discussed.

The Social Class And Mental Illness Correlation: Implications Of The Research For Policy And Practice, Christopher G. Hudson

The Journal of Sociology & Social Welfare

Ongoing efforts to unravel the causal issues involved in the correlation between socioeconomic status and mental illness suggest that the hypothesis of a recursive or interactive relationship may be the most tenable, at least with the psychoses. Implications of this research are explored, with particular attention paid to the mental health costs of economic policies, the principles with which states allocate mental health resources, and the use of this knowledge-base in service planning.

Technology In Clinical Practice And The "Technological Ethic", John W. Murphy, John T. Pardeck

The Journal of Sociology & Social Welfare

Computers are being introduced into practically every area of clinical practice. The use of this technology by practitioners has not gone unchallenged. Specifically, new ethical problems are thought to be associated with using computers to make clinical assessments. Logistical and procedural difficulties, however, have been the primary focus of concern. In this paper the critique of computerized evaluation is expanded, with attention directed to the computer "micro-world." Because the computer micro-world consists of several unwarranted assumptions about the nature of social reality, clinical practice may be affected in many undesireable ways. The theoretical underside of computer use is illustrated to …

A Commentary On The Social Class And Mental Illness Correlation: Implications Of The Research For Policy And Practice, Julius A. Roth

The Journal of Sociology & Social Welfare

This paper represents an extraordinary review of literature on the association between SES and mental illness. I think most social scientists would find it impressive. It also conveys some cogent reasoning about the relevance of these findings for social policy. I think most social workers would find it impressive.

Reconsidering Drug Involvement Among Youth And Young Adults: Implications For Targeted Primary Prevention, Mark W. Fraser

The Journal of Sociology & Social Welfare

The purpose of this; paper is to review two dominant social perspectives on the etiology of substance abuse among youths and young adults-the stage and risk factor outlooks-and to discuss them in light of recent demographic and ecological research. The differential demography of drug abuse strongly suggests that the environmental context influences the use and abuse of substances. In an era of great public concern about substance abuse, the use of individually-focused perspectives appears to have resulted in person-centered skills training programs and "say no" media campaigns. Consideration of community-level factors in the etiology of drug abuse permits the identification …

Historical Perspectives On The Care And Treatment Of The Mentally Ill, Albert R. Roberts, Linda Farms Kurtz

The Journal of Sociology & Social Welfare

An examination of the history of mental illness and its treatment over the centuries reveals that the mentally ill have few advocates except each other and that their treatment has consisted of confinement and neglect. Reformers have pioneered for change, experienced brief success, but ultimately conditions for the mentally ill regress. Society continues to abhor mental illness as though its collective consciousness still believes in possession by evil spirits. Discussion of the early history moves from banishment to ships of fools, to European asylums, and to institutions run by the states in America. More recent history focuses on the National …

Community-Based Self-Help Groups For The Treatment Of Agoraphobia, Bruce A. Thyer

The Journal of Sociology & Social Welfare

The design and conduct of community-based self-help groups for the treatment of agoraphobia are discussed. Such groups incorporate procedures encouraging members to engage in prolonged therapeutic exposure to anxiety-evoking situations. Exposure therapy and its variants have been empirically established as the treatment of choice for agoraphobia, and self-help groups lend themselves extremely well to community mental health outreach and service efforts.

Stress Of The Caregiver: Effective Management Of Dementia Patients In Hospital And Community Settings, Ruth E. Dunkle, Michael Nevin

The Journal of Sociology & Social Welfare

This study explores the management problems among elders with dementia and their medical and family caregivers. Twenty-five patients were interviewed as well as professional health care personnel and a family member. Findings indicated that professional assessment facilitates home caregiving but has little bearing on successful coping by the caregiver. Variability of coping relates to the strategy employed.

Professional Autonomy In Community Mental Health Centers, William E. Buffum

The Journal of Sociology & Social Welfare

Professional community mental health workers want considerable autonomy in doing their work, but too much autonomy can lead to frustration and less satisfaction with work. This finding of a study of 93 mental health professionals in three community mental health centers is in sharp contrast with a comparison group of 60 professionals in a chemical plant. The article cautions against the direct translation of research on all professionals to community mental health professionals.

Holidays As Multiple Realities: Experiencing Good Times And Bad Times After A Disabling Injury, Mary Jo Deegan

The Journal of Sociology & Social Welfare

Holidays are idealized as times of celebration. They are embedded in cultural symbols, family patterns, and lived experience. Because all holidays are not good times, however, the lived experience of holidays is considerably more complex than its symbolization. This ambivalence is dramatically deepened for recently disabled adults who view holidays as a specially strained time of remembrance. Past holidays are often idealized in a new way as one's biography is placed into a new embodied reality. Simultaneously, holidays remain days when one is supposed to celebrate, and often denote some celebration for the injured. The resulting experience is a melange …

A Perspective On Differential Services In Counseling: Altruism And Likeness, James Latimore

The Journal of Sociology & Social Welfare

In this exploratory study using a small sample, an attempt is made to understand the differential services provided by vocational counselors in a non-profit agency, a setting in which a strong identification with clients is encouraged. The services are measured and the unequal measures of service are related to the degree to which the client is seen as an image of the counselor in certain respects. Counseling is viewed as an altruistic occupation and the differential services are analyzed in this context. In general, it is suggested that the differential counseling and psycho-therapeutic services noted by other writers all reflect …

Measuring Domestic Violence In An Alcoholic Population, Larry R. Livingston

The Journal of Sociology & Social Welfare

A survey of 107 adults receiving residential treatment for substance abuse was conducted, to determine characteristics of domestic violence in relationships. The survey incorporated instruments to measure the degree of substance abuse (the Michigan Alcoholism Screening Test or MAST) as well as types and frequencies of domestic violence (the Conflict Tactics Scale or CTS-N). Findings are then compared to a national study of 2143 normals (Straus, Gelles, & Steinmetz, 1980) to ascertain differences in domestic violence.

Findings indicate that 83% of alcoholic subjects behaved violently in past relationships, compared to 28% of the normal population. Fifty-five percent of the alcoholics …

The Sociology Of Alcoholism Counseling: A Social Worker's Perspective, Katherine Van Wormer

The Journal of Sociology & Social Welfare

An occupation - alcoholism counseling - strives to gain professional status. Still a field largely dominated by counselors who derive their status more from personal attributes - the fact of being recovering alcoholics - rather than from achievement of impersonally applied standards, chemical dependency counseling is in a state of flux. This sociological analysis examines recent developments in the field. Special emphasis is on roles for social workers.

Scientific Technology And The Human Condition, Vernon R. Wiehe

The Journal of Sociology & Social Welfare

Society applauds the recent advancements of scientific technology in fields such as medicine, energy, and communication. While humankind profits in many ways from this technology, a few voices are heard cautioning society to consider the implications of these developments. This paper discusses the gulf which appears to exist between scientific technology and the human condition. Reasons for this gulf are: I ) the failure to develop a philosophy of science in which human values, and aspirations are viewed within the context of scientific technology, 2) the reductionist approach to science in which the parts are emphasized at the expense of …

Medicine, Technology, And Genetic Engineering: Reflections From The Outside, Jeffrey R. Plittman

The Journal of Sociology & Social Welfare

Advances in technology are producing many changes in the ways humans view and manage their lives. The refinement of genetic engineering techniques has created vast opportunities for humankind, along with novel problems and dangers. Accordingly, the questions that must be addressed pertain to the nature of life itself. Yet the scientific community can not be given sole discretion In managing todey's technologies. Instead, all segments of society must be Involved In determining how genetic engineering will be used.

Developing Social Work Interviewing Skills Through A Micro-Video Analysis Training Program, Peter C. Iverson

The Journal of Sociology & Social Welfare

Effective interviewing techniques are required for successful social work practice. Consequently, mastering this relatively complex technology is vital for both social work students and agency professionals. This article will provide a descriptive analysis of the Micro-Video Analysis Training Program which may be operationalized in either an academic classroom or agency. Also discussed are the primary components of the training program and their inter-relationships within the context of the Micro-Video Analysis approach. Hopefully this material will assist those with social work education responsibilities to teach interviewing skills more effectively.

Applying Computers To Clinical Social Work, James Gripton, Paul Licker, Leo De Groot

The Journal of Sociology & Social Welfare

This paper discusses the application of computer technology to clinical social work. It is based on a three-year research and demonstration project on microcomputer applications to clinical social work. The paper reviews the use of computers in social work, contrasting the developments in this field with those that hove occurred in psychiatry and clinical psychology. It then describes the two major components of the integrated software package for supporting clinical social work that has been developed and is currently being tested. The paper concludes with a discussion of the misconceptions and realities of introducing computer technology to a clinical social …

Predictors Of Depressive Symptoms And Unemployed Black Adults, Diane R. Brown, Lawrence E. Gary

The Journal of Sociology & Social Welfare

Using data from a probability based survey of unemployed Black adults residing in an urban area, this study explores factors related to the presence of depressive symptoms. Findings indicate that depressive symptoms are less among unemployed persons with higher levels of income, education, religiosity, age and satisfactory social support. Age, however, is the single best predictor of depressive symptoms among unemployed Blacks. There were no significant differences by gender.

Issues In Assessing Community Resources For The Leisure-Time Needs Of The Elderly, Jordan I. Kosberg, Juanita L. Garcia

The Journal of Sociology & Social Welfare

The growth of leisure-time, following retirement, is potentially problematic for the elderly and can result in such adversities as depression, problem drinking, loneliness, and boredom. Leisure-time resources include recreation, education, volunteerism, training, voluntary associations, familialism, and solitary activities. The use of resources for leisure-time needs of the elderly are influenced by idiosyncratic differences; cultural background, financial resources, geographic variations; and the characteristics of programs and services. There is a need to better prepare individuals for the use of leisure-time. Each community must ensure that leisure-time resources exist and do not exclude any elderly from possible involvement, for either structural, programmatic, …

Understanding A Presented Problem From A Phenomenological Perspective, Anant Jain

The Journal of Sociology & Social Welfare

Social work and other helping professions utilize knowledge generated by social sciences to understand human behavior and human problems. Social sciences follow positivistic and humanistic philosophies. The former claims that methodologies applicable to natural sciences should be applicable to social sciences. The latter believes that positivistic methods are reductionist and social sciences should develop their own methodology because they deal with a unique subject matter--human beings. Phenomenology, a branch of humanistic thinking, has been offered as a perspective to understand the presented problem by the client. Several cases are utilized to highlight the role of a professional in understanding the …

Editor's Introduction To The Special Issue "A Sociology Of Survivors: Post-Traumatic Shock Syndrome", Dennis L. Peck

The Journal of Sociology & Social Welfare

It is estimated that between 500,000 and 1.5 million Vietnam veterans suffer from Post-Traumatic Stress Disorder (PTSD), the nature of which includes sociological and psychological manifestations. However, despite past research efforts, an adequate understanding of the social consequences of PTSD and its effect upon veterans and their families remains largely unexplored.

Coping Strategies Of Female Holocaust Survivors, Marlene Sway

The Journal of Sociology & Social Welfare

This paper describes how Holocaust survivors learned to help themselves and to reestablish their sense of community and self-worth. Sixteen female survivors were interviewed regarding their post-war adjustment. Data from the interviews revealed three themes which the women employed to cope with their post-war stress. These important factors in the adaptation process include establishing a family, building a community, and using work as therapy.

Post-Traumatic Stress And Attributions Among Incest Family Members, Inger J. Sagatun

The Journal of Sociology & Social Welfare

This paper presents a discussion of the relationship between attribution models of self-blame and coping strategies among members of incest families. The findings suggest that incest victims are more likely to experience prolonged post-traumatic stress than are offenders and their spouses. The argument is made that by focusing on individual adjustment, therapy programs may be neglecting the interactive effect of attributions made by other family members, the legal system and outside observers. The author concludes by suggesting that a sociological model in which the relationship between social reactions to incest and attributions is addressed would enhance the effectiveness of self-help …