The electrical discharge of neurons associated with seizure activity stimulates a marked rise in cerebral metabolic activity. Estimates from animal experiments indicate that energy utilization during seizures increases by more than 200", while tissue adenosine triphosphate (ATP) levels remain at more than 95" of control, even during prolonged status epilepticus. The brain generally withstands the metabolic challenge of seizures quite well because enhanced cerebral blood flow delivers additional oxygen and glucose. Mild to moderate degrees of hypoxemia that commonly accompany seizures are usually harmless. However, severe seizures and status epilepticus can sometimes produce an imbalance between metabolic demands and cerebral perfusion, especially if severe hypotension or hypoglycemia is present. A marked increase in glutamate release, which occurs during a prolonged seizure, is likely to result in the activation of all types of glutamate receptors. Although kainic acid produces seizures in the immature brain, it produces little cytotoxicity.
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- Go to chapter: Social Work and the Law: An Overview of Ethics, Social Work, and Civil and Criminal Law
This chapter demonstrates how social work ethics apply to ethical and legal decision making in forensic social work practice. It discusses the context of social work practice in legal systems. The chapter also details the basic structures of the United States (U.S.) civil and criminal legal systems. It lays the foundation for the criminal and civil court processes in the United States and introduces basic terminology and a description of associated activities and progression through these systems. The chapter focuses on providing an introductory, and overarching, picture of both civil and criminal law in the U.S. and introduces the roles social workers play in these systems. It focuses on the ETHICA model of ethical decision making as a resource and tool that can be used to help forensic social workers process difficult and complex situations across multiple systems.
This chapter explains the theoretical basis for motivational interviewing (MI). It reviews the empirical evidence for the use of MI with diverse populations in forensic settings. MI involves attention to the language of change, and is designed to strengthen personal motivation and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion. It is now internationally recognized as an evidence-based practice intervention for alcohol and drug problems. MI involves an underlying spirit made up of partnership, acceptance, compassion, and evocation. The chapter discusses four key processes involved in MI: engaging, focusing, evoking, and planning. It also describes five key communication microskills used throughout MI: asking open-ended questions, providing affirmations, offering summarizing statements, providing information and advice with permission, and reflective statements.
Recent advancements in molecular genetics have expanded our understanding of the etiology of many neurological diseases and neurodevelopmental abnormalities. Having a comprehensive understanding of genetics is essential in treating patients with metabolic epilepsies. Genetic counseling has been defined as a process of helping people understand and adapt to the medical, psychological, and familial implications of genetic contributions to disease. Some of the components of a genetic counseling interaction include interpretation of family and medical histories to assess the chance of disease occurrence or recurrence; education about inheritance, testing, management, prevention, resources, and research; and counseling to promote informed choices and adaptation to the risk or condition. The genetic counselor may also educate patients and their families about the underlying genetics of their epilepsy and the relevance of a genetic cause of epilepsy for family members, including recurrence risk, reproductive options and the possible teratogenic effect of antiepileptic drugs.Source:
This chapter presents a brief review of the enzymes, transporters, and cofactor producers of the urea cycle. Seizures have long been associated with urea cycle disorders (UCDs), thought to be caused by high levels of ammonia. Furthermore, the brain damage obtained during metabolic crisis has been thought to damage critical structures, leading to epilepsy after the conclusion of the crisis. The first and most critical step of successful treatment of UCDs is recognition. Neurologic monitoring is an essential part of the emergency management of UCDs. The neurological abnormalities observed in patients with urea cycle defects are vast. Controlling ammonia levels by dialysis and complementary medication are needed. EEG monitoring should be initiated early, as this may be very useful for clinical management and indication of untreated metabolic crises. Furthermore, aggressive treatment of clinical and subclinical seizure activity may be helpful in optimizing outcomes for these patients.Source:
- Go to chapter: Family Televisiting: An Innovative Psychologist-Directed Program to Increase Resilience and Reduce Trauma Among Children With Incarcerated Parents
Family Televisiting: An Innovative Psychologist-Directed Program to Increase Resilience and Reduce Trauma Among Children With Incarcerated Parents
This chapter identifies how psychological frameworks can be integrated into a cohesive, multigenerational intervention to connect children with their incarcerated parents. It describes scenarios through which televisiting develops resiliency in children. The chapter delineates how geographic, financial, temporal, and intergenerational barriers can be reduced or removed via televisiting. It describes supportive televisiting services as an innovative, psychologist-directed, multidisciplinary program that connects children and teenagers with their incarcerated parents via secure, live, interactive video teleconferencing. The chapter also discusses the seven main pillars that make up the theoretical foundation of the televisiting program: child-focused; the attachment theory; trauma-informed care; resilience and strengths-based perspective; mental health challenges; the developmental, life-span, and intergenerational approach; and yellow flag not red flag policy.
- Go to chapter: Restorative Justice and Community Well-Being: Visualizing Theories, Practices, and Research—Part 1
This chapter introduces the theoretical basis for restorative justice (RJ). It assesses the empirical evidence for RJ programs, and explores the challenges and opportunities associated with applying core competencies. The chapter describes competencies of specific interest which include: engaging diversity and difference in practice, and engaging with individuals, families, groups, organizations, and communities. It also discusses skills essential to the success of RJ which include supporting processes that value the experiences of people associated with a crime or harm. The chapter suggests the importance of practical and context-specific knowledge and skills relevant when individuals, families, groups, organizations, and communities find themselves in conflict and require support. Programs that rely upon restorative principles have been used at a variety of points in the criminal justice process. The chapter discusses a practice, a family group conference, which was first developed in New Zealand involving social workers considerably.
This chapter discusses the concepts, underlying principles, benefits, and challenges of using “whole-family” approaches in social work. It articulates the theory and skills associated with family engagement as part of a human rights and social justice framework for social work practice in forensic settings. The chapter describes the ethical imperatives and evidence base supporting the use of family group decision making (FGDM) in regulatory settings. It engages whole families as partners in the use of FGDM in child protection and youth justice. The chapter also describes the theory, empirical support, and skills in use of FGDM, or family group conferencing (FGC). It concluded with an example of how alert forensic social workers must be to the potential for their best intentions to collide with the tenants of responsive practice and a quote from a child protection social worker who worked closely with the author on a pilot project using FGC.
This chapter presents ways in which forensic social workers respond flexibly, collaboratively, and effectively to situations of domestic violence. It describes ways to engage men who abuse in becoming better fathers and partners. The chapter examines how social workers can foster culturally respectful partnerships with and around families that safeguard all family members. Few services are available for men who abuse to learn how to become responsible parents, and evaluations of these programs are even more limited. Two exceptions are a Canadian program called Caring Dads and a North Carolina program called Strong Fathers. These responsible fatherhood programs seek to raise the men’s awareness of the deleterious impact of children’s exposure to domestic violence and to enhance the men’s skills in communicating and parenting.
- Go to chapter: Thinking Outside the Box: Tackling Health Inequities Through Forensic Social Work Practice
This chapter emphasizes the importance of improving health literacy. It describes the incorporation of cultural competence standards in forensic social work practice perspectives. The chapter also explains how to promote engagement of informal support networks in promoting health and well-being among diverse groups. Disadvantaged racial and ethnic minorities in the United States have long been overrepresented in the criminal justice systems. The elimination of health care disparities and ensuring the health care delivery system is responsive to minority groups is a social justice issue. The roles and function of forensic social workers that provide services to persons with these cultural norms can be expanded using a broader ecological framework and the applied social care model to develop intervention strategies and care plans with incarceration persons. Identifying and incorporating culturally appropriate practice approaches are challenging, yet necessary undertakings for forensic social workers.