Cultural beliefs have a tremendous influence on a person’s perception of disability. Viewing culture as a discrete system that encompasses interconnected components should enhance the cultural competence in rehabilitation centers. The manifold layers of culture include the: culture of origin, mainstream culture, brain injury culture, therapists’ culture, and the culture of the neurorehabilitation program. With the increased emphasis on cultural sensitivity, health care training programs have been focusing on enhancing the cultural sensitivity and competency of health care providers. These health care provider aspects also very much apply to the therapists in neurorehabilitation settings. The milieu-oriented neurorehabilitation program creates a unique culture that is different from other cultural influences encountered by an individual. Neuropsychologists in the Center for Transitional NeuroRehabilitation (CTN) milieu program play an important role in fostering a culturally sensitive and competent interdisciplinary team and in translating cultural considerations into concrete treatment approaches and goals.
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- Go to chapter: Layers of Culture: Its Influence in a Milieu-Oriented Holistic Neurorehabilitation Setting
This chapter focuses on eligibility and other rules governing immigrants’ access to federal public benefits programs. The major federal public benefits programs have always prevented some non-US citizens from securing assistance. In determining an immigrant’s eligibility for benefits, it is necessary to understand not only the federal rules but also the rules of the state in which an immigrant resides. However, many federal agencies have not specified which of their programs provide federal public benefits. The confusion stems from the complex interaction of the immigration and welfare laws, differences in eligibility criteria for various state and federal programs, and a lack of adequate training on the rules as clarified by federal agencies. Immigrants’ rights advocates, health care providers, and state and local governments organized to persuade federal agencies to clarify the limits of the laws. Federal agencies have worked to reduce the chilling effect of status-related questions on benefits applications.
There are several misconceptions and assumptions that can reduce the effectiveness of counseling with children and adolescents. New therapists and counselors in training may need to ultimately unlearn assumptions that they carried with them—knowingly or not—before entering professional training programs. This chapter reviews some common misconceptions and assumptions made by counselors at all levels. The field of motivational interviewing has emerged to address the resistance to change and the challenges associated with preparing clients for change. It seems that rational, irrational, positive, and negative thinking are important to untangle when working with children and adolescents. The goal is to help clients to challenge erroneous thinking, distortions, or faulty interpretations that lead them to negative outcomes as well as help them to anchor their academic, interpersonal, and other efforts in an effective understanding of their current abilities, skills, and context.
This book deals with a number of issues and strategies for counseling people with disabilities. It allows counselors and other related health professionals to learn from the writings of 16 people with disabilities across North America. The book provides information on how other professional disciplines perceive and are trained to view disability. It discusses the medical and psychosocial aspects of caregiving in the country and highlights some of the most difficult decisions individuals and families may have to make in this process. The book is organized into four parts containing sixteen chapters. Part I explores disability from a sociological perspective. The topics covered are: the history of how people with disabilities have been viewed and treated in society; attitude formation, societal attitudes, and myths about disabilities; culturally different issues and attitudes toward disability; and attitudes toward disability by specific special interest and occupational groups. Part II focuses on the psychology of disability surrounding the individual and his or her family. The topics address: theories of adjustment to disability by the individual; family adaptation across cultures toward a loved one who is disabled; sexuality and disability; and the psychosocial world of the injured worker. Part III addresses pertinent topics concerning psychosocial issues of disability. The topics include: disability and quality of life over the life span; implications of social support and caregiving of loved ones with a disability; and thriving versus succumbing to disability: psychosocial factors and positive psychology. Part IV addresses counseling strategies and insights for working with persons with disabilities. The topics discuss: which counseling theories and techniques work best with different disability populations and why; social justice, oppression, and disability; counseling families in the community; ethical responsibilities in working with persons with disabilities and our duty to educate; and basic dos and don’ts in counseling persons with disabilities.
This chapter addresses single-system design, an approach to monitor clients’ progress. While reading this chapter, consider the following questions: Which type of single-subject design would be most appropriate for social workers to use with their clients to assess progress? How will social workers integrate different types of measurements in single-system design? Would it be possible for social workers to have more than one client in a design at a time? If yes, what type of design would that be? And what additional resources will social workers need to help accomplish single-system designs? The purpose of this chapter is to present a fundamental tool of the role “clinician–researchers” and a central mechanism through which valid research can be conducted in clinical settings: the single-system design. Single-system designs are quasi-experimental research designs that involve assessing change in a dependent variable on a single research case or subject.
Older adults who are not only living longer, but actually in better health too, could boost the economy by virtue of their longer periods of productivity, their ability to earn and save more income over time, and their purchases and consumption of more goods. Furthermore, because of their accumulated wisdom, skills, and talents, they have much that they can contribute to our social environment. This chapter focuses on the longevity dividend and the importance of mobilizing all sectors of the society to realize the opportunities and address the challenges of an aging society. It includes demographic information related to aging in the United States as compared with that of other countries, as well as a discussion about the detrimental effects of ageism on older adults and on society as a whole. It is especially important for gerontology professionals to understand and avoid ageism.
Health care delivery models increasingly rely on social workers and social worker case managers because of their specialization in identifying and meeting the needs of patients postdischarge. This includes accessing the necessary care and treatment resources in the community, such as elder care services, fraternal/religious organizations, government programs, meal delivery services, and pharmacy assistance programs. This chapter presents a general definition of the role of the health care social worker along with a discussion of the issue of role ambiguity and confusion. It outlines some of the differences between health care social workers and the other related disciplines. The chapter identifies new trends in collaborative teamwork and highlights the role and/or lack of the social worker. Health care social work needs to be viewed as the professional “bridge” that links the patient; the multidisciplinary, interdisciplinary, transdisciplinary, and pandisciplinary teams; and the environment.
Acute care hospitals and ambulatory health care facilities employ more social workers than other settings including individual and family services, schools, and state and local government agencies. The number of practicing health care professionals continues to rise and health care is now the largest employer in the United States. Acute care hospitals often include medical and surgical units, and patients need services that are required to be supervised by licensed medical personnel. Ambulatory settings provide diagnosis, treatment, and care that is not inpatient, and the treatment and care do not require the specialized services. This chapter identifies dialysis social work in nephrology settings as ambulatory care. It provides case exemplars to highlight acute and ambulatory care social work and the processes that are involved in assessment, intervention, and treatment. The chapter explicates areas of strength and concern in the present state of acute and ambulatory care social work practice delivery.
The Changing Face of Health Care Social Work, 4th Edition:Opportunities and Challenges for Professional Practice
This fourth edition of the book covers basic and advanced concepts related to the delivery of social work services in health care settings. When health care is responsive to those in need, the provision of services must be equitable, safe, timely, efficient, effective, evidence-based, and patient-centered while simultaneously exemplifying best practices for all. As pressure for quality services continues to increase, however, the equitable distribution and availability of affordable health care has changed. This has left many providers and patients alike filled with expectation and speculation as to what constitutes essential health care service delivery. The book advocates a proactive stance for health care social workers and is designed to serve as a practical guide for understanding and addressing the philosophy of practice in our current health care environment. Suggestions are made for achieving ethical time-limited, evidence-based social work practice in these settings. At the end of each chapter, a “Summary and Future Directions” section is provided that will help social workers to understand what can be expected and how to prepare for the practice changes needed in order to remain viable clinical practitioners. The book is designed as a practical guide to help social workers understand the roots of social work practice, stressing the importance of the person-in-environment and person-in-situation while utilizing strength’s perspective employing this information as a foundation for embracing the changes to come. As a skilled professional, the incorporation of evidence-based social work practice will need to serve as the cornerstone of all we do while always taking into account the uniqueness and situation-based strategy needed to help each individual patient/client/consumer.
For the health care social worker, flexibility to accommodate federal, state, and local policy changes, as well as adjusting to the changing roles of other health care professionals, has become the state of practice. In addition, predicting future trends and having knowledge of strategic management are required to forecast what changes will need to take place. As health care continues to advance, issues such as living with chronic pain only magnifies the social and emotional pain that people suffer. This makes the psychosocial aspects of self-care and providing services critical regardless of the technology available. If social workers do not respond to these demands, then they will be replaced with other professionals who perform similar functions. This chapter reviews the factors critical to the understanding and further development of health care social work. It highlights professional issues and challenges and highlights suggestions for the future.