This chapter presents an overview of the restorative justice movement in the twenty-first century. Restorative justice, on the other hand, offers a very different way of understanding and responding to crime. Instead of viewing the state as the primary victim of criminal acts and placing victims, offenders, and the community in passive roles, restorative justice recognizes crime as being directed against individual people. The values of restorative justice are also deeply rooted in the ancient principles of Judeo-Christian culture. A small and scattered group of community activists, justice system personnel, and a few scholars began to advocate, often independently of each other, for the implementation of restorative justice principles and a practice called victim-offender reconciliation (VORP) during the mid to late 1970s. Some proponents are hopeful that a restorative justice framework can be used to foster systemic change. Facilitation of restorative justice dialogues rests on the use of humanistic mediation.

This chapter describes some of the recent restorative justice innovations and research that substantiates their usefulness. It explores developments in the conceptualization of restorative justice based on emergence of new practices and reasons for the effectiveness of restorative justice as a movement and restorative dialogue as application. Chaos theory offers a better way to view the coincidental timeliness of the emergence of restorative justice as a deeper way of dealing with human conflict. The chapter reviews restorative justice practices that have opened up areas for future growth. Those practices include the use of restorative practices for student misconduct in institutions of higher education, the establishment of surrogate dialogue programs in prison settings between unrelated crime victims and offenders. They also include the creation of restorative justice initiatives for domestic violence and the development of methods for engagement between crime victims and members of defense teams who represent the accused offender.

This chapter aims to give the behavioral health specialist (BHS) a basic understanding of pain, knowledge about how to effectively evaluate chronic pain, and a description of effective pain management techniques. Knowledge of the biological and psychological basis of pain is important to understanding the experience of chronic pain. A biopsychosocial assessment is the foundation for providing behavioral health treatment to the chronic pain patient. Chronic pain is less responsive to treatments commonly used for acute pain such as opioid analgesia and avoiding physical activity. A multidisciplinary team approach can substantially improve outcomes in chronic pain treatment. Whatever the format of service provision, utilizing multiple interventions such as physical therapy/exercise, emotional management, pacing, and medication, rather than a single modality can substantially improve outcomes for chronic pain. Providing psychoeducation about chronic pain can be an important strategy.

The learning landscape continues to evolve as new technological tools enable teachers to deliver robust learning experiences. It is important to help teachers, administrators, and students know where to begin so that the transition to virtual learning is smooth, without educational loss. This chapter consists of two sections: current trends and issues in technology integration and technological pedagogical content knowledge. The first section briefly reviews the trends in instructional or educational technologies that are causing administrators, teachers, and students to reflect on and modify their thinking about learning and educational content delivery. The second section explores constructivism, the scientific underpinnings of nursing informatics, and ethics. Nurse educators must also address the ethical challenges brought about by this evolving learning landscape. After reading this chapter, one can understand current trends and issues, as well as the influence of nursing informatics and ways to approach new ethical dilemmas.

Healthcare is in a state of rapid change. Although practice environments have become more complex, educational delivery methods have remained stagnant. Innovative technologies provide opportunities to enhance nursing student learning and help nursing programs become more responsive to changes in the practice environment; however, obstacles may hinder successful implementation. With the increasing complexity of today’s health care environment, innovations in nursing curricula are necessary. This chapter explores some of the general challenges associated with the integration of innovative educational technologies, as well as some challenges unique to virtual simulation. It helps the reader to analyze the challenges of integrating educational technologies into nursing education associated with faculty, administrators, and students. It also helps the reader to examine practical and philosophical barriers related to technology integration and explores challenges unique to the adoption of virtual simulation.

Simulation has many advantages for nursing education, some of which include creating safe learning environments for students and reinforcing information learned in the classroom; it also has the advantage of being available in inclement weather as well as 24 hours a day for student access. Simulation in nursing is one of many methods used for teaching students. Teaching and learning in a virtual learning environment has many advantages for administrators, faculty, and students. One of the advantages includes the use of other disciplines to help create or participate in a virtual world learning experience. The virtual learning environment can be created to look similar to real communities, disaster areas, or homes, with avatars populating that environment. The advantage to using virtual reality, rather than a real-life experience, is that in real life, students could be immersed in an environment that could cause them harm.

This chapter describes the relevance of critical thinking and the related process and philosophy of evidence-based practice (EBP) to cognitive behavior therapy and suggests choices that lie ahead in integrating these areas. Critical thinking in the helping professions involves the careful appraisal of beliefs and actions to arrive at well-reasoned ones that maximize the likelihood of helping clients and avoiding harm. Critical-thinking values, skills and knowledge, and evidence-based practice are suggested as guides to making ethical, professional decisions. Sources such as the Cochrane and Campbell Collaborations and other avenues for diffusion, together with helping practitioners and clients to acquire critical appraisal skills, will make it increasingly difficult to mislead people about “what we know”. Values, skills, and knowledge related to both critical thinking and EBP such as valuing honest brokering of knowledge, ignorance and uncertainty is and will be reflected in literature describing cognitive behavior methods to different degrees.

This chapter describes the Coping Skills Program, an innovative, school-based, universal curriculum for elementary-school aged children that is rooted in cognitive behavior theory. Rooted in cognitive behavior theory, the Coping Skills Program consists of carefully constructed metaphorical fables that are designed to teach children about their thinking; about the connections among their thoughts, feelings, and behavior; and about how to change what they are thinking, feeling, and doing when their behavior causes them problems. The chapter provides a thorough description of the Coping Skills Program and how it is implemented through a discussion of relevant research-based literature, and the theoretical underpinnings underlying this cognitive behavior approach with school-aged children. It also includes the results of preliminary testing of the Coping Skills Program. The research-based literature shows that cognitive behavior approaches are among the interventions commonly used by social workers to help young children in school settings.

This chapter describes the current trends toward greater gender equality in couple relationships, what keeps old patterns of gendered power alive, and why equality is so important for successful relationships. Relationship vignettes like the ones just described are common. Sharing family and outside work more equitably is only part of the gender-equality story. Gender ideologies are replicated in the way men and women communicate with each other and influence the kind of emotional and relational symptoms men and women present in therapy. Stereotypic gender patterns and power differences between partners work against the shared worlds and egalitarian ideals that women and men increasingly seek. The concept of relationship equality rests on the ideology of equality articulated in philosophical, legal, psychological, and social standards present today in American and world cultures. The four dimensions of the relationship equality model are relative status, attention to the other, accommodation patterns, and well-being.

Adolescence is a particularly intense stage of development. During the time of life between prepubescence and young adulthood, youth are challenged by accelerated mental, emotional, cognitive, and physical changes. The ordinary biopsycho-social stressors of adolescence, in conjunction with extraordinary environmental conditions, harmful external stimuli, and the dearth of resources that are associated with lower class and ethnic social status, tend to disrupt homeostasis and thwart positive youth development (PYD). Poor, ethnic minority youth are at disproportionate risk of negative social outcomes. The majority of these disparities involve externalizing factors, such as teen pregnancy, academic underachievement, and antisocial peer-group affiliation, as well as violent victimization and offending. The basic mission of F.I.T. an acronym for Focus, Initiative, and Tenacity Camp is to empower disadvantaged, ethnic minority youth by means of fostering positive social and emotional development.

This chapter explores the relationship between gender and power. Gendered power in couple relationships arises from a social context that has given men power over women for centuries. When practitioners fail to take account of social context, however, they may run the risk of inadvertently pathologizing clients for legitimate responses to oppressive experiences. The term gender is a socially created concept that consists of expectations, characteristics, and behaviors that members of a culture consider appropriate for males or females. Consequently, an individual’s ideas about gender may feel deeply personal even though they are a product of social relationships and structures. Strong social forces work to keep social power structures, including gender inequality, in place. The continued presence of gendered power structures in economic, social, and political institutions still limits how far many couples can move toward equality. Today, ideals of equality compete with the institutional practices that maintain gender inequality.

This chapter examines the cultural and relational contexts of postpartum depression. Postpartum depression (PPD) is a debilitating, multidimensional mental health problem that affects 10"-15” of new mothers and has serious consequences for women, children, families, and marriages. Although women’s experience of postpartum depression has been the subject of considerable recent study, nearly all of this work has been interpreted within a medical or psychological frame. The chapter looks at a social constructionist lens to this body of research through a meta-data-analysis of recent qualitative studies of PPD. Though hormonal changes as a result of childbirth are related to depressive symptoms after childbirth, biological explanations alone cannot explain postpartum depression. A social constructionist approach to postpartum depression focuses on how the condition arises in the context of ongoing interpersonal and societal interaction. Climbing out of postpartum depression is an interpersonal experience that requires reconnection with others.

Clinical social workers have an opportunity to position themselves at the forefront of historic, philosophical change in 21st-century medicine. As is so often true for social work, the opportunity is associated with need. For social workers, in their role as advocates and clinicians, this unmet need would seem to create an obligation. This chapter argues that, if choosing to accept the obligation, social workers can become catalysts for vitally needed change within the medical field. While studies using the most advanced medical technology show the impact of emotional suffering on physical disease, other studies using the same technology are demonstrating Cognitive behavior therapy’s (CBT) effectiveness in relieving not just emotional suffering but physical suffering among medically ill patients. While this chapter discusses the clinical benefits and techniques of CBT, it also acknowledges the likelihood that social work will have to campaign for its implementation in many medical settings.

School social workers provide direct treatment for a multitude of problems that affect child and adolescent development and learning; these problems include mood disorders, attention deficit hyperactive disorder (ADHD), disruptive behavior disorders, and learning disorders, as well as child abuse and neglect, foster care, poverty, school drop out, substance abuse, and truancy, to name but a few. This chapter examines four constructs that are important when working with students. These constructs include: assessment and cognitive case conceptualization, the working alliance, self-regulated learning, and social problem solving. The chapter discusses the development of attainable and realistic goals is a critical component both of self-regulated learning and social problem solving. The chapter examines the problem of academic underachievement and four constructs that are critically important when working with children and adolescents in school settings. Academic underachievement is a serious problem affecting the lives of many children.

This chapter offers a review of selective literature on complex childhood trauma. It explains a case study demonstrating the use of meditative dialogue, a collaborative practice through which client and therapist are able to work together to develop empathy and compassion toward self and others during psychotherapy sessions. Thompson and Waltz described an inverse relationship between exposure to trauma and subsequent posttraumatic stress disorder symptom severity, and self-compassion. Recent neuroscience research has begun examining the effects of meditation practices on specific areas of the brain through neuroimaging studies. Clinical trials on the use of meditative dialogue in psychotherapy with survivors of complex childhood trauma, looking at the brains of the clients, and using magnetic resonance imaging (MRI) to measure changes, would help to demonstrate its efficacy and move it into the realm of evidence-based practices.

This chapter explains a set of guidelines to help mental health professionals and clients move away from the gender stereotypes that perpetuate inequality and illness. Identifying dominance requires conscious awareness and understanding of how gender mediates between mental health and relationship issues. An understanding of what limits equality is significantly increased when we examine how gendered power plays out in a particular relationship and consider how it intersects with other social positions such as socioeconomic status, race, ethnicity, and sexual orientation. To contextualize emotion, the therapist draws on knowledge of societal and cultural patterns, such as gendered power structures and ideals for masculinity and femininity that touch all people’s lives in a particular society. Therapists who seek to support women and men equally take an active position that allows the non-neutral aspects of gendered lives to become visible.

One of the emerging approaches to explaining the normative spike in adolescent risk-taking, with delinquent/antisocial behavior as one expression, is based on recent advances in developmental neuroscience. Brain imaging studies have identified two main processes for which co-occurrence in the healthy adolescent brain directly impacts delinquent behavior. The first neuropsychosocial process implicated in heightened risk-taking involves sudden and dramatic changes in activity in the limbic system that coincides with puberty. The second process is associated with a developing ability to self-regulate behavior that continues to mature into the early 20s. Mindfulness meditation may be an effective method for reducing delinquency in juvenile justice involved youth because of its association with increases in self-regulation. The juvenile justice system was built on the argument that children and youth are less culpable for criminal and delinquent behavior than adults, making adolescence a mitigating circumstance in determining the state’s response to youth criminality.

Most Behavioral Group Therapy (BGT) with children and adolescents include aspects of problem solving or social skills training or both. This chapter describes group workers can make an important contribution to children, families, and schools through preventive and remedial approaches. Social skills training grew out of the clinical observation and research that found a relationship between poor peer relationships and later psychological difficulties. The social skills program taught the following four skills: participation, cooperation, communication, and validation/support. The chapter focuses on the unique application of behavioral treatment using groups with an emphasis on assessment, principles of effective treatment, and guidelines for the practitioner. It also focuses on the use of the group in describing these aspects of BGT. The primary goal of using BGT with children is enhancing the socialization process of children, teaching social skills and problem solving, and promoting social competence.

This chapter describes the toxic stress often experienced by young homeless children and the effect that this type of stress can have on brain development, behavior, and lifelong health. Mental health and cognitive challenges are abundant among homeless families. Stress can affect maternal cardiovascular function and restrict blood supply to the placenta, potentially reducing fetal nutritional intake or oxygen supply, and lead to reduced fetal growth, increased risk of placental insufficiency, preeclampsia, and preterm delivery. Trauma in early childhood has clear neurological and developmental consequences, especially with regard to brain development and executive functioning. The chronic release of two stress hormones glucocorticoids and cortisol can have damaging effects on neurological functioning and lifelong health. Similarly, exposure to high levels of cortisol inhibit neurogenesis in the hippocampus, further impacting executive functioning and the ability to distinguish safety from danger, a symptom of posttraumatic stress disorder (PTSD).

The case for major depression being an inflammatory condition has been advanced in the literature on neuroscience as well as in the literature on psychiatry. The correlational data suggested that depressed persons exhibit signs of systemic inflammation. One way to induce inflammation in the blood is to place a piece of the wall of a bacterium in the paw of an animal. There are other ways to induce systemic inflammation besides introducing fragments of a bacterial cell wall. Consistent with the view that behavioral depression involves inflammation, particular alleles for genes involved in the immune system have been identified as risk factors for depression. Mediterranean diets are associated with lower levels of inflammatory factors and lower levels of depression. Parasympathetic nervous system (PNS) releases factors that will inhibit the release of inflammatory factors from white blood cells and from the liver.

This chapter provides insight into the dilemmas couples face when ideals of equality intersect with societal structures that maintain gendered power. It examines how Iranian couples construct gender and negotiate power within their culture, political structure, and Islamic values. Gender equality may express itself differently in a culture such as Iran that not only emphasizes collective goals and achievements, strong feelings of interdependence, and social harmony. Collectivism typically maintains social order through a gender hierarchy. Contemporary Iranian couples draw from diverse cultural legacies. Although some couples seemed to accept the traditional gender hierarchy and a few others appeared to manage relatively equally within it, other couples were quite aware of gendered-power issues and attempted to address them in their personal lives. Some couples describe trying to maintain an equal relationship in their personal lives despite men’s greater legal authority.

This chapter examines how 12 White, middle-class couples negotiated the issue of equality in their relationships during their first year of marriage. The social context both supports and inhibits the development of marital equality. To be included in the present study, complete transcripts with both the husband and wife present had to be available, both members of the couple had to express ideals of gender equality, and both had to express commitment to careers for wives as well as husbands. Most of the couples classified as creating a myth of equality, spoke as though their relationships were equal but described unequal relationship conditions. The other couples classified in the myth-of-equality category described similar contradictions between their ideals of gender equality and their behavior. Gender-equality issues raise political and ethical concerns for all of us who are family practitioners and teachers.

This chapter presents advances in the understanding of adolescent brain development that can inform and improve social work practice with youth leaving foster care. Foster care populations have a high rate of mental health disorders, and the association of types of child maltreatment with elevated risk for such disorders is well known; discussion of specific mental health problems and their treatment can be found elsewhere. Conventional mental health approaches have often targeted the innervated cortical or limbic neural systems, rather than the innervating source of the dysregulation. Psychotherapy, whether psychodynamic or cognitive, acts on and has measurable effects on the brain, its functions, and metabolism in specific brain areas. The ethical response is a sharing of the dilemma, and of information about the neurobiology of the client’s struggle, to enable the client to make as informed a decision as possible. In addition, neuroimaging techniques themselves lead to other ethical dilemmas.

This chapter provides a summary of the social-cognitive neuroscience conceptualization of empathy. It discusses the application of neuroscience research to social work education, practice, and research. Empathy activates neural networks, groups of nerve cells that are connected by synaptic junctions. These three cognitive abilities, self-other awareness, perspective-taking, and emotion regulation, are critical components in the inductive process that results in the experience of affective empathy. Without these three cognitive abilities, people are more likely to be overwhelmed by the effects of the Shared representation System (SRS) and experience emotional contagion rather than affective empathy. Underlying the cognitive empathy appraisal process is the concept known as theory of mind (ToM). The affective empathy induction process relies heavily on a part of the brain known as the limbic system, which is near the center of the brain and evolved first in early mammals.

This chapter focuses on mirror neurons, which were discovered in the 1990s in Italy. It describes the relevance of mirror neurons for social work practice and addresses some research implications of this topic. The chapter explains the functions of the mirror neuron system (MNS), which includes a discussion of imitation, action understanding, intention understanding, theory of mind (ToM), and empathy. It includes sections on the neuroscience contributions to attachment theory, the concept of the social brain, micro-practice and policy implications, and research implications. Mirror neurons are a specialized kind of brain cells that form a network located in the temporal, occipital, and parietal visual areas, and two additional brain regions that are mainly involved with motor actions. The auditory motor neurons found in the high vocal center (HVC) of swamp sparrows are considered to be very similar to the visual motor mirror neurons that have been discovered in primates.

The clinical social worker typically interfaces with older adult clients and their families in a variety of settings, providing diverse services ranging from assessment to clinical treatment to referral. This chapter discusses the ways in which cognitive behavior therapy (CBT) techniques can be used by social workers across different milieu to assist elderly clients who may be suffering from depression. These settings include the client’s home, an inpatient or outpatient mental health facility, a hospital or medical setting, a long-term care facility, or a hospice setting. The chapter provides an overview of how cognitive behavior techniques can be integrated throughout the range of services social workers may provide to elderly clients. Clinical examples demonstrate the use of CBT in a variety of settings. For many older adult clients, issues related to the need for increasing dependence on family, friends, and paid caretakers may become the central focus of counseling.

Community-based epidemiological studies find that when grouped together, anxiety disorders are the most common mental health conditions in the United States apart from substance use disorders. Anxiety disorders are also associated with substantial impairments in overall health and well-being, family functioning, social functioning, and vocational outcomes. This chapter includes a brief description of the anxiety disorders followed by a more detailed review of the cognitive behavior interventions indicated for these conditions. Social phobia is the most common anxiety disorder in the United States. Panic attacks are sudden surges of intense anxiety that reach their peak with 10 minutes and involve at least 4 of a list of 13 symptoms. Another somewhat less common anxiety disorder is obsessive compulsive disorder. The chapter discusses the posttraumatic stress disorder (PTSD). Two anxiety management procedures, breathing retraining and deep muscle relaxation, have been subject to some level of empirical investigation for certain anxiety disorder.

This introduction presents an overview of key concepts discussed in the subsequent chapters of this book. The book serves as a practice resource for social workers by making accessible the vast territory covered by the social, cognitive, and affective neurosciences over the past 20 years, helping the reader actively apply scientific findings to practice settings, populations, and cases. It helps readers gain a deeper understanding of how neuroscience should and can help the design, development, and expansion of therapeutic interventions, social programs, and policies for working with our most vulnerable populations. The book considers the neuroscientific implications for social work practice in child welfare and educational settings across system levels. It highlights the neuroscientific literature that can inform social work practice in health and mental health. The book concludes by discussing the neuroscientific implication of social work practice in the criminal justice system.

This chapter focuses on six maladaptive processes that underlie a wide range of emotional and behavioral problems commonly addressed by social work practitioners in the mental health field. First, it explicates how a focus on transdiagnostic processes differs from traditional views of psychopathology and accords more closely with neuroscientific evidence. Next, the chapter reviews current research in the fields of experimental psychopathology and neuroscience to detail the cognitive, emotional, and neurobiological features of these six core transdiagnostic processes: automaticity, attentional bias, memory bias, interpretation bias, suppression, and stress reactivity. Then it discusses how these processes may be assessed by clinical social workers in the field, and offer six case vignettes that depict how they manifest in human suffering and impaired psychosocial functioning. Finally, the chapter discusses mindfulness-based interventions as a means of targeting transdiagnostic processes in clinical practice.

Cognitive behavioral therapy (CBT) with children addresses four main aims: to decrease behavior, to increase behavior, to remove anxiety, and to facilitate development. Each of these aims targets one of the four main groups of children referred to treatment. This chapter suggests a route for applying effective interventions in the day-to-day work of social workers who are involved in direct interventions with children and their families. An effective intervention is one that links developmental components with evidence-based practice to help enable clients to live with, accept, cope with, resolve, and overcome their distress and to improve their subjective well-being. CBT offers a promising approach to address such needs for treatment efficacy, on the condition that social workers adapt basic CBT to the specific needs of children and design the intervention holistically to foster change in children. Adolescent therapy covers rehabilitative activities and reduces the disability arising from an established disorder.

This chapter discusses the impact of trauma and its treatment through discussion of posttraumatic stress disorder (PTSD) and its neurological components-especially those affecting memory, evidence-based therapies (EBTs) for the treatment of PTSD, and the implications for practice, policy, and research. Two primary predictors exist for a person developing PTSD. The first one is experiencing dissociation during the trauma. The second predictor is the person developing acute stress disorder. Specifically, neuroimaging shows how PTSD affects neurological functioning in the brain. The primary regions of the brain affected by PTSD are the medial prefrontal cortex, the left anterior cingulate cortex, the thalamus, the medial temporal and hippocampal region, and the amygdala. The different regions of the brain associated with memory encoding are: left prefrontal cortex, left temporal/fusiform, anterior cingulate, and hipocampal formation. Cognitive-behavioral therapy (CBT) has been used extensively to treat PTSD.

Social work professionals are in key roles for providing effective education, treatment, training, and services for adult survivors. This chapter helps the social workers to equip with an evidence-based treatment framework to effectively enhance their work with this population of adult survivors. A community study of the long-term impact of the sexual, physical, and emotional abuse of children concluded that a history of any form of abuse was associated with increased rates of psychopathology, sexual difficulties, decreased self-esteem, and interpersonal problems. There is well-established and increasing empirical evidence that cognitive and cognitive behavior therapies are effective for the treatment of disorders that are typical among adult survivors of sexual and physical abuse. The chapter presents some basic cognitive behavior therapy (CBT) strategies that social workers can use in whatever roles they play in working with the multidisordered adult survivor. There are three types of schema avoidance: cognitive, emotional and behavioral.

When Charles, a 46-year-old divorced male with an extensive psychiatric history of depression, substance abuse, and disordered eating resulting in a suicide attempt, erratic employment, and two failed marriages, began treatment with a clinical social worker trained in dialectical behavior therapy (DBT), he was an angry, dysphoric individual beginning yet another cycle of destructive behavior. This chapter provides the reader with an overview of the standard DBT model as developed by Linehan. Dialectical behavior therapy, which engages vulnerable individuals early in its treatment cycle by acknowledging suffering and the intensity of the biosocial forces to be overcome and then attending to resulting symptoms, appears to be the model most congruent with and responsive to the cumulative scientific and theoretical research indicating the need for the development of self-regulatory abilities prior to discussions of traumatic material or deeply held schema.

This chapter offers a brief and focused review of human development, with specific emphasis on cognition and emotion. It is essential that the reader distinguishes between cognitive development, cognitive psychology, and cognitive therapy. Both short-term and long-term memory improve, partly as a result of other cognitive developments such as learning strategies. Adolescents have the cognitive ability to develop hypotheses, or guesses, about how to solve problems. The pattern of cognitive decline varies widely and the differences can be related to environmental factors, lifestyle factors, and heredity. Wisdom is a hypothesized cognitive characteristic of older adults that includes accumulated knowledge and the ability to apply that knowledge to practical problems of living. Cognitive style and format make the mysterious understandable for the individual. Equally, an understanding of an individual’s cognitive style and content help the clinician better understand the client and structure therapeutic experiences that have the greatest likelihood of success.

Social workers are committed to the protection and empowerment of weak populations, of those people who are least powerful. Gradually, social work started to rely more on problem-solving methods, client-focused therapy, family theories, and, more recently, cognitive behavior theories, constructivist theories, and positive psychology developments. Clinical social work today operates in a variety of settings in the statutory, voluntary, and private sectors. Clinical social workers have always been interested in helping clients change effectively. The importance of empirical study, valid information, and intervention effectiveness has always been accentuated by the social work field’s central objectives of increasing accountability, maintaining exemplary ethics and norms, and establishing clear definitions and goals. Cognitive behavior theory emphasizes several components. First and foremost, human learning involves cognitive mediational processes. Social workers need to look for effective methods for change, and CBT methods are very promising in this respect.

Research on brain structure and function in white-collar criminals is a notable gap in the neurolaw literature, a gap that was addressed for the first time in one recent research report. Neuroscience is suggesting a link between brain abnormalities and some types of criminal behavior, but it is not yet clear exactly what those abnormalities are. Research on brain function and criminality focuses primarily on levels of hormones and neurotransmitters involved in neuronal communication. The findings regarding connections between the brain and adult criminal behavior, preliminary as they are, have implications for social work practice, including prevention of criminal behavior as well as intervention with offenders. The consistent finding that the likelihood of antisocial behavior is greatest when genetically based brain abnormalities encounter harsh environments has implications for social policy beyond the criminal justice system.

Progress in neuroscience over the past several decades has led to a greater understanding of how the brain functions as a child or adult learns. This chapter focuses on disorders of the brain as applied to school settings. It explores learning disabilities (LD) as they pertain to practice in schools, as well as policy and research implications, and ethical and legal issues. Social workers must understand how the brain develops during various developmental ages and how this affects the learning of individuals. Research by the National Institutes of Mental Health (NIMH) have detected that the causes of LD are diverse and complex. New brain cells and neural networks continue to be produced for a year or so after the child is born. Electroencephalogram (EEG) can provide accurate timing information but provides little impression of where in the brain a particular activity is occurring.

Over the past 25 years there has been a growing recognition of the importance of working with families of persons with severe mental illnesses such as schizophrenia, bipolar disorder, and treatment-refractory depression. Family intervention can be provided by a wide range of professionals, including social workers, psychologists, nurses, psychiatrists, and counselors. This chapter provides an overview of two empirically supported family intervention models for major mental illness: behavioral family therapy (BFT) and multifamily groups (MFGs), both of which employ a combination of education and cognitive behavior techniques such as problem solving training. Some families have excellent communication skills and need only a brief review, as provided in the psychoeductional stage in the handout “Keys to Good Communication”. One of the main goals of BFT is to teach families a systematic method of solving their own problems.

This chapter discusses the treatment of comorbid chronic depression and personality disorders. It then discusses recent treatment advances in the cognitive behavior field relevant to this population. Recently, research has been done comparing schema therapy to Otto Kernberg’s latest model. Because of severe emotional distress, patient often experience suicidal and/or parasuicidal behaviors. The chapter explores the benefits of mode work with these particular difficulties while maintaining a therapeutic approach of connection and compassion; this alliance is crucial for the approach to be effective. It focuses on the five most common modes for those with chronic depression and personality disorders namely the abandoned/abused mode, the detached protector mode, the angry mode, the punitive mode and the healthy adult mode. The interventions described in schema mode therapy have cognitive, experiential, and behavioral components. Identification of the mode the patient is in when suicidal is essential when managing a crisis.

This chapter reviews the basic tenets of evidence-based practice (EBP), and discusses the potential applications of this model of practice and training for the field of clinical social work. It also presents some actual illustrations of its use. The chapter describes the major forms of clinical outcome studies: Anecdotal Case Reports, Single-System Designs With Weak Internal Validity, Quasi-Experimental Group Outcome Studies, Single, Randomized Controlled Trial, Multisite Randomized Controlled Trials and Metaanalyses that comprise the priority sources of information underpinning EBP. As the human services increasingly develop robust evidence regarding the effectiveness of various psychosocial treatments for various clinical disorders and life problems, it becomes increasingly incumbent upon individual practitioners to become proficient in, and to provide, as first choice treatments, these various forms of evidence-based practice. It is also increasingly evident that cognitive behavior therapy (CBT) and practice represents a strongly supported approach to social work education and practice.

Comparison studies have long found that same-sex partners maintain more equal relationships than their heterosexual counterparts, largely because they do not divide roles and responsibilities based on gender. Thus the study of samesex couples offers the ability to examine the processes that create and maintain equality when gender differences do not organize couple relationships. However, same-sex partners emphasize the satisfaction of intimacy needs, rather than moral obligation or societal expectations, as their reason for maintaining the relationship. This primary focus on the relationship itself, which is also becoming more common among heterosexual couples, tends to be associated with egalitarian ideals that are not necessarily easy to translate into practice. A distinguishing characteristic of couples who were classified as demonstrating attuned inequality is the indebtedness that the benefiting partner feels to the other. Attuned couples describe conscious strategies for managing their relationships.

Over the years, cognitive behavior therapy (CBT) has been applied to a variety of client populations in a range of treatment settings and to the range of clinical problems. This chapter provides a general overview of the cognitive behavior history, model, and techniques and their application to clinical social work practice. It begins with a brief history and description, provides a basic conceptual framework for the approach, highlights the empirical base of the model, and then discusses the use of cognitive, behavior, and emotive/affective interventions. Cognitive behavior therapy is based on several principles namely cognitions affect behavior and emotion; certain experiences can evoke cognitions, explanation, and attributions about that situation; cognitions may be made aware, monitored, and altered; desired emotional and behavioral change can be achieved through cognitive change. CBT employs a number of distinct and unique therapeutic strategies in its practice.

This chapter presents a combined creative-corrective approach to working with the bereaved by emphasizing on cognitive assessment as a tool for social workers. It determines how best to facilitate an adaptive grief process with individuals who experience traumatic loss or complicated grief. Cognitive therapies (CT) and cognitive behavior therapies (CBTs) were found suitable with individuals suffering from posttraumatic stress disorder (PTSD), anxiety, and chronic or traumatic grief. Grief as a process of reorganizing one’s life and searching for a meaning following a loss through death is a painful experience. The Adversity Beliefs Consequences (ABC) model is based on a cognitive theoretical model to be applied in treatment of bereaved individuals. Like other cognitive models, rational emotive behavior therapy (REBT) emphasizes the centrality of cognitive processes in understanding emotional disturbance, distinguishing between two sets of cognitions that people construct, rational and irrational ones and their related emotional and behavioral consequences that differ qualitatively.

The current common combat era casualties have been posttraumatic stress disorder (PTSD), head injuries, hearing loss or impairment, and polytrauma. Common causes of military traumatic brain injuries (TBI) are blasts, falls, vehicular accidents, and penetrating fragments or bullets. Mild TBIs (mTBIs) usually are not detectable by lab tests or scans, which typically show normal results. The most common assessment instrument used for TBI is the Glasgow Coma Scale, which scores eye opening responses, motor responses, and verbal responses. Findings of effectiveness of psychosocial rehabilitation models for civilians with TBI and their families suggest that developing models of supported education and employment for injured veterans may be similarly helpful. Stigma, military stoicism, mTBI-related executive function compromise, and PTSD-related avoidance symptoms are barriers to care for neurological disorders, but disclosure of care is still perceived as possibly leading to loss of career or current employment, both among active duty and veterans.

This chapter discusses some of the critical issues surrounding culture and cognitive behavioral methods in order to better inform the advancement of culturally responsive social work practice. It focuses on one such treatment modality, cognitive behavior therapy (CBT). The chapter reviews relevant theoretical frameworks, existent empirical studies on CBT with diverse cultural groups, strengths and limitations of this modality across cultures, and suggestions for culturally responsive CBT practice, in order to better inform social work practice. While cognitive behavior therapy was developed with universal assumptions and without consideration to the diversity of the cultural contexts of consumers, it is grounded in theory that is likely to have “some universal basis across populations”. Several studies have described the use of cognitive behavior methods with gay and lesbian clients, particularly the use of rational emotive therapy, cognitive restructuring, and behavior experiments.

The treatment of the suicidal individual is perhaps the most weighty and difficult of any of the problems confronted by the clinical social worker. Some frequent comorbid pathology with suicidal behavior includes alcoholism, panic attacks, drug abuse, chronic schizophrenia, conduct disorder in children and adolescents, impulse control deficits, schizophrenia, and problem-solving deficits. Suicidal harmful behavior appears in all ages and characterizes clients in a large spectrum of life. There are four types of suicidal behavior namely rational suicider, psychotic suicider, hopeless suicider and impulsive or histrionic suicider. This chapter presents some primarily cognitive techniques for challenging suicidal automatic thoughts. Recent reports suggest that individuals suffering from alcohol or substance abuse are at an increased risk both for attempting, and for successfully completing, a suicidal act. The therapist must develop an armamentarium of cognitive techniques, and the skills to use these effectively in ways that are appropriate for each individual client.

Attention to the dimensions of culture in restorative justice practices refers to differences among peoples and also to the broader contextual issues including societal prescriptions and the vicissitudes of power, privilege, and oppression that earmark relationships between peoples. The first dimension focuses on issues practitioners must be sensitive to when they are working with people who are different from themselves and different from each other. The second dimension centers on the nature of the crime or wrongdoing, specifically hate crimes and interethnic conflict. The third dimension concentrates on the emerging interest in restorative justice by non-Westernized cultures often located in diverse corners of the world. Paralanguage or other vocal cues, such as hesitations, inflections, silences, loudness of voice, and pace of speaking, also provide ample opportunity for misinterpretation across cultures. Asians and Native Americans will often use many more words to say the same thing as their White colleagues.

This chapter covers the history and development of the practice, the issues involved in implementation of a victim-offender mediation (VOM) program. Experimentation in bringing together victims and offenders with a trained mediator to talk through what happened and to decide together what to do about what happened began in the early 1970s and 1980s. These efforts to humanize the restorative justice process through holding young offenders directly accountable to the victim of their crime were called Victim-Offender Reconciliation Programs (VORPs). A broad base of community support is necessary to counter the predictable initial skepticism that accompanies the start of a new program that allows the victim to meet with the person who victimized them. Securing public funds is one of the most difficult jobs. VOM programs report that 34” of case referrals are true diversion, occurring after an offender has been apprehended but prior to any formal finding of guilt.

This chapter examines the differences in facilitating a settlement-driven versus dialogue-driven mediation. It also examines the concept of introducing a humanistic approach to mediation and dialogue. The chapter presents the characteristics and qualities of an effective mediator in relation to the victim and offender, the facilitator’s responsibilities during preparation, the dialogue itself, and follow-up, including the significance of self-care. Nowhere else in the restorative justice process is the principle of respect and being non-judgmental more critical than in how the facilitator treats victim, offender, and other key stakeholders. Settlement-driven mediation is generally practiced within a conflict resolution context. In contrast, dialogue-driven mediation recognizes that most conflicts develop within a larger emotional and relational context characterized by powerful feelings of disrespect, betrayal, and abuse. Besides the governing values that define humanistic mediation, mediators must cultivate their emotional commitment to and connection with the highest principles they assign to the dialogue work.

This chapter distinguishes between spirituality and religiosity. It reports on a study that begins to deconstruct the elements in restorative justice that might be considered spiritual. Spirituality is defined as a reverence for life. Sacred reverence is defined as being in awe of and deep regard or veneration. Religious leaders are often strong promoters at the forefront of many rehabilitative justice practices including restorative justice. By delineating specific spiritual components, the concept of spirituality is made clearer and more usable by social workers and other mediators of restorative justice practice. Bender and Armour examined texts about restorative justice using a hermeneutic phenomenological approach. Nine components of spirituality emerged from the research on the restorative justice literature such as: internal transformation, connectedness, common human bond, repentance, forgiveness, making right a wrong, balance or harmony, rituals and the spirit or supernatural.

This chapter provides an introduction to the three basic dialogue practices like victim-offender mediation (VOM), family group conferencing (FGC) and peacemaking circles and the expansion of VOM to include severely violent crime. It describes the components of a restorative justice dialogue that are a part of all approaches. The chapter delineates the stages in developing a dialogue including referral, preparation, dialogue meeting, and follow-up. Again these stages demonstrate how restorative justice values, principles, and core concepts are actualized in the process. The chapter describes the conditions necessary for creating the context that enables change during the dialogue. Those conditions include a process orientation, safety establishment, respectful interaction, and the flow of positive energy. Besides embodying restorative justice values, these conditions represent spiritual components. The components include: personal accountability in response to the harm, inclusivity, voluntarism, preparation for the dialogue, and the telling of story as personal truth.

This chapter examines the history and development of circles and delineates the attributes of the circle process. Circles as a restorative justice approach, is distinct from Victim-Offender Mediation (VOM) and Family Group Conferencing (FGC) in its continual attention to the details that must be in place and tended in order for the work of the circle to be productive. Regardless of the context in which circles are used, the purpose of circles is to create a safe, nonjudgmental place to engage in a sharing of authentic personal reactions and feelings that are owned by each individual and acknowledged by others, related to a conflict, crisis, issue, or even to reactions to a speaker or film. The outer supports of a circle process consist of five structural elements: ritual, behavioral guidelines, a talking piece, circle keeping, and consensus decision making. Circles, regardless of type, are often referred to as peacemaking circles.

This chapter reviews the historic relationship between social work and the criminal justice system and the significance of restorative justice to the social work profession. It demonstrates the strong implicit relationship between social work and restorative justice by reviewing the core social work values and how those values are manifest in restorative justice philosophy and practices. As long as rehabilitation was the guiding retributive philosophy, there was a natural affinity between social work and criminal justice. Social work is unique among the mental health professions because it is the only one built on a fundamental set of values. Social workers respect the inherent dignity and worth of the person. Self-determination is an extension of human worth and holds that individuals ought to take part in the decisions that affect their lives. Social workers recognize the central importance of human relationships.

This chapter explains Victim-Offender Dialogue (VOD), its history and development, its characteristics, and its procedures. Concerns about victim forgiveness, are more explicit in VOD because the nature of the crimes involves the taking of human life or other heinous act and the impossibility of ever returning life to the one murdered or restoring a survivor’s life to what it was before the murder. Part of the cautiousness about the use of restorative justice for violent crime was concern that it might revictimize victims. VOD is an outgrowth of victim-offender mediation (VOM) and is similar in its central focus on the relationship between victim and offender. Victims, family members, and offenders describe the process of the meeting as a conversation. Although the dialogue belongs to the victim and offender, the facilitator begins the process, helps with transitions, invites breaks as needed, and remains a constant, readily alert, and cementing presence throughout.

Infectious Keratitis

This chapter examines three different models of family group conferencing (FGC): the New Zealand style model, the Wagga Wagga model from Australia, or the New Zealand Family Group Decision Making model. Besides its focus on youthful offenders, FGC is being applied with increasing frequency to juvenile and adult offenders as part of their reentry process. In New Zealand, FGC grew out of a crisis in the juvenile justice system. The Children, Young Persons, and Their Families Act of 1989 established statutory officials called youth justice coordinators who are responsible for convening and facilitating the FGC, monitoring the Act, recording agreements or plans, and communicating the results to appropriate people and agencies. The coordinator is most often a social worker. The New Zealand model of FGC is unique because it is legislated and administered under the welfare and social sector rather than the criminal justice sector.

This chapter switches gears, away from what leadership means from the view-point of personal qualities to the perspective of what one need to do to achieve the goals of our workplace. Leadership is increasingly defined as the ability to work successfully with others to achieve the organization’s mission and goals. Stereotyped views of nursing stress virtue and busyness but not strength and innovation, thus reinforcing the notion that nurses are helpers, not leaders. The point of naming what one do is for others to see what one does and how one contributes to the organization as a whole. The more others see the contributions of nurses to the organization, the more nurses will be included in key decision-making forums. The more all nurses are expected to be leaders, the more nurse leaders cannot operate from a command-and-control framework but must lead by developing the leadership of others.

Pain remains a common symptom experienced in the palliative care patient population. Despite advances in pain management, patients remain at risk for inadequate relief, especially at end of life (EOL). In order to provide quality pain relief, nurses must possess appropriate knowledge regarding assessment and treatment including pharmacological and nonpharmacological interventions. This chapter provides nurses with a basic overview of the principles of pain assessment and pharmacological management throughout the illness continuum and at EOL. The needs of special populations who have been identified as “at risk” of inadequate pain control are highlighted, including older adults, children, persons with communication impairment, patients with a history of substance abuse, and cancer survivors. These groups represent those in whom pain is often unrecognized, not respected or not believed. Many of the principles of pain assessment and management reviewed can be applied to children.

Obstetrics and Gynecology-Related Infections

Diverticulitis

Infectious Gastritis—Helicobacter pylori

An adult is presumed to have the ability to make his or her own healthcare decisions—including termination of life-sustaining technology—unless he or she is shown to be incapacitated by clinical examination or ruled incompetent by a court of law. Advance care directives are legal vehicles used by people to provide guidance to their healthcare providers concerning the care they would desire in the event they become incapacitated and cannot make their own decisions. Problems with advance directives may arise when they do not seem to apply to the patient’s situation. Nurses roles include educating the patient and family about the patient’s condition and legal end-of-life (EOL) choices, identifying the patient’s and family’s wishes for EOL care, articulating the patient’s and family’s desires to other members of the healthcare team, and assisting the patient and family to obtain necessary and appropriate EOL care.

Infectious Encephalitis

There is no aspect of leadership as gratifying as helping others reach their potential. It is rewarding in a way that other things aren’t because any investment in people pays dividends forevermore. Appreciating others includes giving feedback that is customized to the person. There is growing evidence that indiscriminate praise doesn’t change behavior positively, particularly if the commendation is for something relatively immutable like being smart. Appreciating others includes a broad range of behaviors—valuing the contributions of different kinds of people; respecting what each generation contributes to the mix; developing a community of learning so all continue to grow and develop throughout their careers; understanding that investments in people have a ripple effect because those who have been helped tend to “pay it forward” and providing timely and effective feedback that encourages improvement or advancement. Appreciating others also means valuing what others have done to help your advancement.

Cortes explains that two major university-generated forces can potentially prompt changes in nearby neighborhoods: university-community partnerships and campus economic activities. Rural campuses have different campus-community considerations surrounding infrastructure projects than urban campus, which are housed within a more multifaceted economic ecosystem. University spending, employment, earnings, and student spending have implications for the communities and regions where they are based; these activities often have multiplier effects making quantification challenging. In college towns, student housing tends to be highly concentrated and segregated from the rest of the community. Facing different economic challenges, rural communities are alternative models for campus-led community development. Grounded in the land-grant mission, the Extension model seeks to formalize networks between universities and communities. Historically, many Extension initiatives have focused on agricultural practices and sharing best practices and research with farming communities.

Pneumonia

Medieval universities were structured as urban centers providing technical training in medicine, law, and, most importantly, theology. Colleges and universities are uniquely situated within communities, often influencing many facets of a community’s life, including costs and structure of housing, types of amenities and businesses, and the presence of law enforcement. During the rapid industrialization of Victorian London, urban poverty in the East End became a growing concern. In partnership with Vicar Barnett, Arnold Toynbee conceptualized a model of community engagement whereby students from universities such as Cambridge and Oxford would take up residence in London’s East End to collaborate with residents and address social problems. Understanding the historical rationale for campus-community partnership is critical for determining the future of community engagement. The engaged campus plays an important role in both maintaining and promoting civil society and fostering civic engagement among emerging adults.

Infectious Peritonitis

Introduction to Antimicrobial Stewardship

Historically, service-learning practice and literature have focused more heavily on student experiences rather than those of the community partner. Although research focused on community partners’ experiences has increased, it has generally not taken into account shifting demographics of students in the U.S. higher education system, specifically the rapid internationalization of colleges and universities. Beginning in 1938 with Dewey’s introduction to experiential learning and democratic education, service learning has gained momentum as a pedagogical technique and as a high-impact practice. The number of nonprofit organizations in the U.S. hosting international service-learning students is unknown, but given trends in international exchange programs and the demographic nature of clients served by nonprofit organizations in the U.S., the mutually beneficial possibilities of international service learners in U.S. organizations are vast. Through an analysis of the qualitative data, researchers have identified cultural and linguistic barriers as a consistent theme.

Brain Abscess

Career opportunities are projected to grow faster for nursing than all other occupations through 2026. The advantage of a career framework with multiple stages is that one doesn’t start out expecting to be fully developed at the beginning. Mentoring is needed throughout a career, not just at the start. This chapter provides an overview of the career model that the author has fleshed out over time, greatly influenced by Dalton, Thompson, and Price’s classic article (1977) on stages of a professional career and subsequent work. There are five career stages whereby the individual moves from: (a) becoming prepared, to (b) demonstrating the ability to work independently and interdependently in achieving professional goals, then (c) developing others and the home institution, then (d) advancing the profession and healthcare, and eventually (e) daring to be a truth teller. Exerting leadership presupposes complete career development, going through all five career stages.

Introduction to Antimicrobial Agents

Solid-Organ Transplant Infections

Student learning in college and university settings has changed over the years as more and more emphasis has been placed on learning competencies and learning outcomes. The student learning agenda, sometimes called a learning contract, is the universal tool that all social work students use to integrate the competencies within their field placement. A learning agenda’s main purpose is to provide a framework for student identification of needed learning, and for the evaluation of the demonstrable competencies and behaviors shown by the student at the field site. The learning agenda is a tool to identify what learning experiences the agency has to offer and what skills and abilities the student brings. The CSWE requires field instructors who have degrees from accredited social work programs for at least part of field instruction and supervision because of the unique perspective and educational model of social work education.

Aiming for impact means that one not only thinks that one can transform clinical service, but wants to develop and provide patients and their families with the kind of positive moments that are remembered 20 years later. Leadership presupposes aiming for impact; that is, a determination to address the challenges inherent in the current healthcare system. Impact means always giving some thought to how something good can be parlayed into something better. If one is aiming for impact, developmental learning will inevitably move from focusing on mastery of what today is considered to be best practice to imagining and developing a new and improved version of future practice. Nurses have historically been socialized in the direction of convergent thinking, but leadership requires divergent thinking, experiences that promote creativity and innovation.

According to the Council on Social Work Education (CSWE), the field practicum is the signature pedagogy of the student’s social work education. Students are evaluated on their performance in the field practicum. This chapter focuses on the use of field evaluation measures to characterize the student’s readiness for social work practice, and focuses on the literature review, the purpose of evaluation, the timeline for the practicum and the tasks that students perform at the field agency which serves as evidence of the student’s mastery on the content of the field placement. Studies have named the merits of the fieldwork experience in social work education. Reflective practice is an important skill for any social worker. At all points of all levels of social work practicum experiences, field instructors should ask themselves and their students whether the learning that is happening is appropriate for the specific stage of professional development.

Field education is an integral aspect of every social work student’s training. Whether a student is obtaining a bachelor’s degree in social work (BSW) in the hope of pursuing a career in generalist practice or working toward a master’s degree in social work (MSW) to prepare for advanced or independent work, learning skills and practice techniques in community settings is essential. The work that is performed by students in the field is supervised by social workers in many different organizational and practice settings. The relationship between the field instructor and the social work student provides fertile ground for socialization as a member of a profession and the acquisition of practice skills. Whether we are working in health care, child protection, mental health services, corrections, education, gerontology, or another area of social work practice, we have much important knowledge to share with a student.

Cancer is a devastating diagnosis that many individuals still associate with death. Upon initial diagnosis, individuals embark on a treatment journey that is overwhelming with medical jargon, new healthcare providers, unknown outcomes, and fluctuations of hope amid the distressing effects of the disease and its treatment. The most frequently diagnosed adult cancer types are female breast, prostate, lung, and colorectal cancer. These four most commonly occurring cancers will be the focus of this chapter. The overall incidence and prevalence of cancer has increased with individuals living with cancer as a chronic illness. Treatment options have improved survival rates, decreased toxicity, and provided palliation. Symptoms associated with the disease and the toxicities of treatment require a commitment to an interprofessional model of care across healthcare settings. Palliative care focuses on the physical, psychosocial, and spiritual needs of the cancer patient and family as well as bereavement needs of families.

The main message of this chapter is that a professional career requires sustained development in interpersonal, interprofessional, and communication effectiveness. Undergraduate and graduate courses are full of valuable information about communication—spoken, written, visual, electronic, and social media. Instead of trying to summarize the communication essentials that nurse leaders should have acquired along the way and will need to develop additionally over time, this chapter focuses on some communication skills important to goal achievement that the author learned to appreciate more with experience. They fall under the following headings: courtesies, self-presentation, negotiations, the importance of data arrays and publication, and the value of understanding the viewpoint of others. Self-monitoring, as a leadership ability, means the person seeks to shape how she or he is perceived in order to achieve professional objectives. Measurable outcomes and published results are important in building the image of the profession.

Necrotizing Skin and Soft-Tissue Infections

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States and the leading cause of death due to a respiratory cause. Development of this disease occurs as the result of cigarette smoking and exposure to environmental pollution. In addition, the normal physiologic changes due to the aging process place individuals at an increased risk for the development of complications, such as cor pulmonale and pneumonia. In order to reduce the risk of developing the complications of COPD, smoking cessation is recommended. Pharmacologic modalities focus on improving ventilation, reducing inflammation, and preventing complications. Nonpharmacologic interventions including exercise, rest, and improved nutrition can be valuable complementary therapies in the care of patients with COPD. To provide palliative care for patients at every stage of COPD, from diagnosis to the end of life, the nurse needs to acquire the knowledge and skills for expert nursing care.

Loss and suffering are universal experiences that occur across the life span. How one learns to accept, adapt to, and advance through these experiences determines how the individual will move through life itself. Although culture and ethnicity may influence an individual’s views on living with and dying from life-threatening illness, individuals must be recognized as unique and encouraged to grieve as is most appropriate for them. Traditional grieving theories view the process in stages with closure or resolution; more contemporary theories view the process as nonstaged, individual, and ongoing. Terminal illness can occur over an extended period of time or a brief period of time. The nurse functions as both facilitator and participant in this process. The nurse also can add objectivity while the patient and family resolve many feelings, issues, and decisions related to the living–dying experience.

Child welfare practitioners at all levels play a vital role in shaping outcomes and the well-being of children who reside in kinship care. Child welfare educators will be well served to use innovative approaches to student recruitment and retention in efforts to build a cadre of professionals who have the desire, value orientation, and background to be trained to become competent practitioners. One strategy that child welfare educators can consider is the use of “geodemographic planning”. To ensure an adequate supply of future child welfare professionals, it is imperative that educators and academic leaders implement strategic retention plans. Intensive supervision models, mentoring/coaching, and using youth-and family-representative-informed care are modalities that child welfare educators should consider in workforce development. Field education should incorporate technology-enhanced training resources and methods in order to maximize student supervision. The use of computer-facilitated assessments and standardized screenings could be encouraged with kinship families.

Hepatitis A

Serving as a field instructor is usually a delightful and rewarding experience. Most of our students are bright, motivated, and eager to develop into skilled professionals. However, there are times when a practicum student may be ill-suited to the internship. Field supervision is both a process and a relationship. Several frameworks have been discussed in the social work literature about the nature of the field instructor-student relationship. These include the developmental model, attachment-based approaches to supervision, and the relational approach. Program faculty can also work with you to help in the process of integrating classroom knowledge and theory with interventions in the practicum setting. Some areas where students may particularly struggle are the following: emotional self-care, professionalism, setting appropriate professional boundaries, integrating classroom knowledge with fieldwork, professional writing skills, accepting constructive feedback, and asking for help.

Gastrointestinal (GI) symptomatology is common in patients receiving palliative care. Many patients have described the constant nausea, vomiting, and diarrhea as more disabling and disturbing than pain. Anorexia and subsequent cachexia are common in patients at the end of life with multiple potential and often overlapping causes. GI symptoms affect patients’ activities of daily living and influence their quality of life. Other common GI symptoms in palliative care patients include dysphagia, constipation and bowel obstructions, hiccups, and xerostomia. All of the GI symptoms may be related to the pathology of the diseases as well as treatments. Having an understanding of both is crucial for the nurse caring for patients in this setting. As in all palliative care, ongoing assessment of the patient is necessary to determine what interventions are working and which need modification. Interventions include pharmacological, nonpharmacological, and complementary therapies.

Leukocytosis

Strategic planning involves examining how your professional and/or organizational mission is being affected by changing circumstances, setting goals with concrete actions and a timeline, and then figuring out needed resources and expected outcomes. “The vision thing” at its best involves periodically embarking on a process of strategic planning whereby you examine how your professional or organizational mission is being affected by changing circumstances, and then set short-term and long-term goals with concrete actions and a timeline that moves you in desired new directions. Transformational leaders are deeply committed to the organization and its mission/values, make use of consultants so that they are not limited by the boundaries of their expertise, are willing to try something new knowing that not all good ideas work out, combine vision with practicality in figuring out how to operationalize the change process, and know how to use a range of individuals to the organization’s advantage.

Nearly all social work professionals remember their field instructors. Field instructors clearly play a critical role in social work education. This chapter is for those field instructors who would like to broaden their repertoire of tools for helping students become more adept at integrating theory, models, and skills in a coherent manner. It briefly reviews the literature, then identifies barriers, and makes recommendations about strategies for theory and practice integration. The literature suggests that students have appreciated the systematic integration of theory and practice by field instructors. The literature about how to foster integration in field education has a different focus when comparing academic field faculty and agency-based field instructors. For more experienced field instructors, the literature recommended training centered on topics such as enhancing students’ critical thinking, group work, and communication skills, as well as conflict resolution skills.

Tuberculosis

This chapter discusses several common skin problems including skin tears, pressure injuries formerly known as pressure ulcers, skin tumors, treatment-related skin injuries, peristomal skin, and fistulas. Skin changes, including pressure injuries, are common occurrences during the dying process. The Wound Bed Preparation 2015 model can be used as a clinician guide to develop a care plan for a palliative care patient with an alteration in skin integrity. Focusing on the wound etiology and classifying wounds as healable, maintenance, or palliative (non-healable) can provide realistic expectations for patients, their family unit, and caregivers as well as the healthcare professional team. Wound care should be aimed at improving the patient’s quality of life by providing comfort, relieving pain, controlling odor, and containing exudate. It is paramount that the patient’s preference be prioritized in the decision-making process and the implementation of realistic treatment care plans.

Chronic liver disease and cirrhosis are the 12th leading causes of death in the United States. There are many chronic liver diseases that lead to cirrhosis, such as viral hepatitis, autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis, nonalcoholic steatohepatitis, alcohol, some toxins, and inborn errors of metabolism. Liver cancer is one of the fastest growing cancers in the world. Patients with end-stage liver disease (ESLD) present with malnutrition, muscle wasting, hyperlipidemia, fatigue, jaundice, and renal disease. Nurses need to be aware of the pathophysiology and etiologies of liver disease. Nurses need to explore and acknowledge their assumptions and biases about patients with liver disease and their families. Nurses play a pivotal role in advocating for advance care planning and early palliative care for patients with ESLD and their families. Patients with liver disease benefit from physical, psychosocial, and spiritual interventions offered through palliative care.

Cholecystitis

One of the most important areas of practice that field instructors discuss with their students is teaching and reinforcing the ethics and values of the social work profession. Students are introduced to the Code of Ethics of the National Association of Social Workers (NASW) early in their social work education, but it is up to academic faculty and also field instructors to ensure that social work students can make connections between the content of the ethical code and real-life practice situations. There are a number of topics that frequently arise as ethical challenges in the practicum. These include mandated reporter responsibilities, mental health treatment and involuntary commitment, worker-client boundaries, specific boundary concerns related to self-disclosure, and disclosure of student status. There are a number of other approaches to resolving ethical dilemmas. These include the use of principle-based ethics and virtue ethics.

This chapter focus is on sexual health. Sexual health is a broad concept made up of multiple facets such as sexual desire, self as a sexual being, sexual orientation, sexual lifestyles, and relationships. Intimacy, closeness, communication, and emotional support affect all facets of sexuality. Sexual health within the context of palliative care may be directly impacted by the disease on anatomical structures. However, direct anatomical effect is not the only concern; changes in a person’s sexual interest or desire may also be affected by direct or indirect consequences of medical treatment or in association with being terminally ill. Illness involving sexual organs increases the likelihood of retraumatization for those who have experienced previous sexual trauma. Healthcare practitioners (HCPs) frequently avoid talking about sexuality with cancer patients. HCPs’ barriers to discussing sexuality include embarrassment, misinformed beliefs and assumptions, lack of knowledge, inadequate communication skills, and time constraints.

Neediness cannot be banished, but it’s possible to learn from each shortcoming, determined not to be derailed by either hubris or core anxieties. Taking on new leadership roles, we have to get in touch with warring expectations on the way to a more textured view of leadership and our sense of ourselves as leaders. There are a number of normal-crazy thoughts that get in the way of leadership; for example, wanting to be liked by everyone; believing that if you’re not perfect then you’re no good; thinking things should not go wrong. To succeed, nurses must realize that failure is commonplace. Expect failure, recognize root causes, and then proceed to learn from the experience—this process builds personal resilience. Learning environments that foster a culture of potentiality enable fledgling practitioners to persist in the face of failure because the emphasis is on improving over time.

Anorectal Abscess and Fistula-in-Ano

Urinary Tract Infections

This chapter is titled somewhat provocatively, equating leadership with telling others what to do. One cannot expect others to be mindreaders, so one cannot expect others to do what one wants done without telling them. Being able to be clear with others about expectations, next steps, processes, and direction is integral to leadership, no matter the position held. Leaders have interests, responsibilities, and a purview that span boundaries, making them knowledgeable about how the pieces fit within the organization; therefore, they have a responsibility for making sense of why a course of action is necessary. Providing a context so the work ahead makes sense also means explaining what one do in our leadership position to support the efforts of others and further institutional goals. Successfully functioning teams and committee work are the lifeblood of complex organizations, so all nurses need high-level meeting- management skills.