Clinical and Medical Social Work Commons^™

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 …

Lay Counseling: The Basis Of Prevention In Mental Health, James R. Seaberg

The Journal of Sociology & Social Welfare

The purpose of this paper is to increase the recognition of lay counseling as a basis of mental health prevention and to present a summary of the state of knowledge about it. Lay counseling is cast as one of several components of mental health prevention and treatment, a definition is offered which distinguishes it from paraprofessional and selp-help services, knowledge about it both direct and tangential is summarized, and future research and policy implications are discussed.

Requisites For The Establishment, Implementation, And Evaluation Of Social Work Treatment Programs For Anti-Social Children, John S. Wodarski

The Journal of Sociology & Social Welfare

Requisites for the establishment, implementation and evaluation of social work treatment programs for anti-social children are reviewed. Specific items discussed are: how does one ascertain the level at which change efforts should be directed, i.e., individual, group, organizational, or societal; what is the appropriate context for behavioral change; who should act as the change agent; what characteristics should the worker possess; what are the rationale for service provided; how long should the treatment continue; how does one prepare for the termination of treatment and maintenance of behavior; what organizational factors of treatment contexts are pertinent to the constructive delivery of …

The Principles Of General Systems Theory Applied To The Medical Model: Who Benefits?, James T. Decker, John R. Redhorse

The Journal of Sociology & Social Welfare

The term "Medical Model", though frequently used by professionals, theoreticians and laymen in referring to certain aspects of the medical profession, or of the entire medical system, is rarely used with any degree of precision. The term, indeed, has been used as a shorthand expression, leaving it unnecessary to explicate descriptively the interrelated components of the medical arena. The theories, conceptual constructs, practice, and operating ideologies of the Medical Model, and their association with bi-cultural, economic, political and other concepts are left unspoken. These elements are simply assumed to be implicit in the use of the term. It is our …

The Educational Needs Of Social Work Faculty In Medical Schools, Richard M. Grinnell Jr., Nancy S. Kyte

The Journal of Sociology & Social Welfare

Despite a long-standing association and promise for a closer alliance in the future, considerable ambiguity surrounds the current participation of social workers in medical education. A nationwide study was conducted to obtain a comprehensive, up-todate profile of social work faculty employed by medical schools-- their total number, demographic characteristics, department affiliations, primary specialties, methods and content areas of academic instruction, etc. An accompanying study focused on the opinions of medical school Deans concerning the present and future status of social work faculty in medical education. Attention has been given to social work education in relation to health care practice. Another …

Elements Of The Perpetuation Of Dependency In A Psychiatric Halfway House, David R. Maines, Marilyn A. Markowitz

The Journal of Sociology & Social Welfare

Halfway houses are intended as helping institutions for those who are attempting to make the transition from institutionalized mental health facilities to autonomous living in the community. In spite of the manifest goal to produce independence for its residents, however, the halfway house contributes to patterns of dependency. In addition to the network nature of mental health care, we identify three dependency-perpetuating elements: role commitments, language, and mixed messages. These elements are analyzed as both social organizational and social psychological processes, and their implications are discussed.

Informal Support Systems For The Aged: Limitations And Issues, Marjorie Buckholz

The Journal of Sociology & Social Welfare

The need for community social services to enable older persons to remain in their homes has been well documented (Gold, 1974; Lohman, 1978; Atchley, 1977; Blenkner, 1977). Inspite of a growing service industry and professional corps of helpers, it does not reach the growing numbers of elderly, especially the older-elderly who are most likely to be frail (Gold, 1974; Lohmann, 1978; Heyman and Polansky, 1977). The aged share of the population has grown relative to the younger age group. In 1900, 6.4% of the U. S. population was 60 years or older; in 1975, it had increased to 14.8% (U. …

Differential Aspects Of Assessment And Intervention In Social Work Practice With The Elderly And Their Families, Barbara Silverstone

The Journal of Sociology & Social Welfare

So much in our society separates the rest of us from the old that a discussion of the differential aspects of practice with the elderly and their families (many of whom are aging) runs the risk of being redundant as well as a concealed endorsement of the professional biases which afflict us all. The truth of the matter is that important differences do exist between social work practice with the old and with younger generations, differentials which emanate from a sound gerontological knowledge base. Although the similarities far out-weigh the discrepancies, failure to recognize or delineate these differences has resulted …

Preparing Social Work Practitioners To Work With And In Behalf Of Older Adults, Margaret E. Hartford

The Journal of Sociology & Social Welfare

Practice in the field of social gerontology is one of the developing frontiers in social work. Now and in the foreseeable future, services with a population that is growing older will be a rapidly expanding field of practice. Many of the programs for older adults are multidisciplinary and demand collaboration among several professions and services. In some instances social work is and will be the central organizing force assuming administrative responsibility. In other instances social workers are collateral with several professions, and in still others social work services are an adjunct to another service profession, such as medicine nursing, urban …

Volunteer Support For The Institutionalized Elderly, Harold Zepelin, Janet Stutzman

The Journal of Sociology & Social Welfare

A neglected topic in discussions of services for the institutionalized elderly seems to be the question of whether the residents of nursing homes are receiving adequate support from volunteers. Undoubtedly, voluntarism is playing an important part in the provision of services and emotional support for the aged population, among them the elderly that are institutionalized. But because of the child-centeredness and youth-orientation of American society, it is possible that work with the elderly may not be attracting volunteers in proportion to the needs of this population. This may be especially true of the elderly in institutions because work with this …

A Comparison Of Factors Associated With Past Use, Projected Use, And Perceived Community Need For Health And Social Services, Pat M. Keith

The Journal of Sociology & Social Welfare

Life change, political, and demographic factors associated with past use, projected use, and perceived community needs for services by the aged were examined. Data were derived from interviews conducted with men and women 65 or over in a midwestern community. Life changes were more useful in explaining relationships with health and social services among men than were demographic and political variables. But among women, there was less difference in the amount of variance explained by the three groups of variables. Although men and women differed little in the extent to which they had experienced life changes, discontinuity was differentially associated …

Conflict Theories And Social Work Education, Norman N. Goroff

The Journal of Sociology & Social Welfare

How one defines the world has consequences for one's actions in the world. Sociology has attempted to utilize the scientific method to help human beings understand their social world. However, in the process of its development, sociology has reflected the ideological bias of its practitioners. (Mills, 1943). Irving Zeitlin (1968, pp. vii) claims "Much of classical sociology arose within the context of a debate - first with eighteenth-century thought of the Enlightenment, and later with its true heir of the nineteenth century, Karl Marx."

The central theme of this paper is that social work education makes extensive use of conflict …

Medical Social Work Faculty: Clinicians Or Educators?, Richard M. Grinnell Jr., Nancy S. Kyte

The Journal of Sociology & Social Welfare

Within the health care field, medical social work has expanded rapidly over the past few years. In the United States, medical social workers comprise approximately 1.5 percent of the total medical schools' faculty. And, there is empirical evidence that medical social work faculty will increase substantially over the years to come.

However, we as social work educators know very little about medical social work facultys' opinions on how they perceive their overall function within medical schools. More specifically, if medical social work faculty are to function effectively in medical settings, we as a profession must know: if they perceive themselves …

Interactionist Theory, Human Behavior Social Work And Social Work Education, Ralph Segalman

The Journal of Sociology & Social Welfare

Much explanation of human behavior is based on assumptions about animal behavior. Two major contemporary theories, Behaviorism and Freudianism place major emphasis upon the human being as animal. Many middle-level theories have no reference to man's distinctive social characteristics. However, social explanations of behavior do have a heuristic advantage in the study of human functioning and "social pathology."

Systems Theory, Robert D. Leighninger Jr.

The Journal of Sociology & Social Welfare

Systems Theory has generated a lot of excitement in the last decade. It has also spawned more than its share of pitchmen, enough so that it is in danger of being discredited before its genuine potential in many fields of practice has been fairly tested. Wearing the double halo of Science and Corporate Efficiency conferred by its association with the aerospace industry and the Pentagon, it has been enthusiastically offered to Federal and State governments (Chartrand, 1971; Hoos, 1969 & 1972) as well as private individuals and organizations as a way of solving complex social problems like mass transit, crime, …

Structural Functional Theory, Social Work Practice And Education, Joe Hudson

The Journal of Sociology & Social Welfare

The theoretical framework of structural functionalism in sociological theory does not consist of a single, unified, and consistent exposition. Different writers make different emphases, use somewhat different terminolog, and include different phenomena under a variety of similar terms. Rather than attempt to deal superficially with a wide variety of theorists writing out of this perspective, we will focus primarily on the central concepts in the work of perhaps the most eminent proponent of this approach in current sociological work - Talcott Parsons - and, in turn, discuss the relevance of this framework for social work education and practice.

Living And Acting In An Altered Body: A Phenomenological Description Of Amputation, Mary Jo Deegan

The Journal of Sociology & Social Welfare

Adults with recent amputations are often perceived as suffering from post-operative depression and phantom limbs. These states are frequently seen as failures in "adjustment" since there are often few physiological involvements which curtail daily functioning. This perspective is seen as compatible with major American values of pragmatism, individualism, and a mechanistic medical model. We suggest here that problems in daily living and the phantom limb are not "mental" aberrations but rather reflections of a radically altered lived experience. The performance of the actor is significantly changed and can be discussed as a function of changed experience, and style. This persppctivedraws …

The Application Of Behavior Modification Technology To The Alleviation Of Selected Social Problems, John S. Wodarski

The Journal of Sociology & Social Welfare

The application of behavior modification technology to the alleviation of various social problems is reviewed. Specific items discussed are: energy consumption, pollution control, token economies, architectural control of behavior, welfare, worker performance, social action, crime, and social integration. Where relevant, specific studies are summarized. Future developments and implications for social work practice are reviewed briefly.

Introducing New Approaches Into Social Agencies: The Case Of Behavior Modification, Harvey L. Gochros, Joel Fischer

The Journal of Sociology & Social Welfare

This paper explores the issues involved in introducing behavior modification procedures into social work agencies, sane of the common problems encountered in using this approach, and suggestions for dealing with these problems.

Journal Of Sociology & Social Welfare Vol. 4, No. 7 (September 1977)

The Journal of Sociology & Social Welfare

TABLE OF CONTENTS

• Planning Radical Change at the Grass Roots: The Story of New Communities, Inc. - SHIMON S. GOTTSCHALK - p. 980
• Reactions To The Stigmata Of Inner City Living - JEROME KRASE - p. 997
• Accountability Crises: Consequences of Professionalization - ROBERT W. WEINBACH - p. 1011
• Discourse Management: Key to Policy Development - JOSEPH R. STEINER - p. 1025
• Public Perceptions Of Rural County Social Service Agencies - ROBERT W. BILBY & ROBERT BENSON - p. 1033
• The Application Of Behavior Modification Technology To The Alleviation Of Selected Social Problems - JOHN S. WODARSKI - p. 1055 …

The Role Of The Female Mental Health Professional In A Male Correctional Setting, Cheryl E. Biemer

The Journal of Sociology & Social Welfare

There are increasing numbers of women psychologists and other professionals working within predominately male correctional settings. One finds, however, nothing in the literature on how they are viewed by the system or what it is like to be a woman working within this traditionally male dominated sphere. The dearth of written material on the subject became apparent in a search through the National Clearinghouse of Mental Health and the Criminal Justice Reference Service. The Psychological Abstracts, Social Science Citation Index and the Criminology Index also have no references that shed any light on this issue. There is one particularly good …

A Perspective On The Psychotherapist's Response To The Women's Movement, Harold S. Bernard

The Journal of Sociology & Social Welfare

The women's movement constitutes one of the most powerful sociological phenomena of modern times. Like any important movement, it has elicited reactions from every stratum within our society. The purpose of this paper is to discuss the response to the women's movement on the part of women, men, and man-woman relationships. It will then describe in detail an actual clinical case in which the issues involved were directly related to the concerns addressed by the women's movement, and it will offer a recommended attitudinal stance on the part of the psychotherapist to such concerns.