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.
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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.
Nursing practice is a symbiotic relationship between the art and science of professional care. One cannot exist in isolation from the other. Nurses are inclined to connect the art of nursing with terms such as compassion, caring attitudes, the therapeutic relationship, presence, professionalism, advocacy, and competence, otherwise known as the “soft or caring side of nursing”. The greatest threat to the disappearance of the art of nursing lies with the perceived “big three”: time, fiscal restraint, and failure of the system to support a full staff of nurses, so those employed are working at full capacity. It is important to recognize that different practice settings have varying needs. One size does not fit all. Yet the requirements for nursing assessments, developing a plan of care, coordinating care with other health care providers, implementing interventions, and evaluating care outcomes are a requirement of all.
This chapter focuses specifically on nursing research program vertical infrastructure. Vertical infrastructure refers to the pillars of the program: the foundation that provides the support to build other services. Three essential components are used to develop a solid nursing research program foundation that advances the scientific foundation of nursing practice and promotes integration of evidence-based practices. The three components are nurse researchers who coach or mentor clinical nurses in nursing research, intranet website resources, and a research departmental database. A successful nursing research program is contingent on having the right nurse researcher personnel who can move research from project inception to dissemination in peer-reviewed literature and translation into practice. Nurse leadership may benefit from educational programs or a business plan that includes the benefits of a nursing research program and information about how a specific nursing research program aligns with strategic goals.
This chapter provides examples of programs and services beyond the foundational elements and global resources that can be used to overcome traditional nursing research barriers. It is assumed that at least one doctorate-prepared nurse researcher is available to facilitate research opportunities and educate nurses about research and evidence-based practice. Many clinical nurses fully understand their clinical roles but are completely unaware of opportunities and resources in nursing research within their hospital. Since contributions of nursing research are vital to the science and art of nursing and provide foundation for evidence-based practices, it is important to overcome the traditional cluster of barriers that include problems with nursing research visibility/priority, time and money, and research education. Nurses need confirmation that nurse leaders support research; when it is visible, it is valued. Moreover, nurses need time, education, and resources to complete rigorous research that leads to discoveries and answers to important clinical problems.
This chapter addresses the need for dissemination of research and focuses on dissemination both inside the hospital organization and outside. Disseminating results of research is often the most exciting phase of the process, as it is the culmination and highlight of countless hours of work. Common areas for dissemination internally include presentations to colleagues on people’s unit, as well as across hospital organization. Internal presentations offer a direct way for people to provide new evidence for practice in their hospital organization. In addition, however, it is important that results of their research reach nurses and other health professionals nationally and internationally. Thus, people want to participate in media dissemination of their research, systematically look for calls for abstracts to present at professional conferences, and disseminate their research through professional publications. Disseminating results, whether internally or externally, by media, poster, oral presentation, or publication, requires effort and attention to detail.
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.
Dorothea Lynde Dix was born into an upper-class, highly educated, intelligent, and politically connected Bostonian family. These opportunities provided the foundation necessary to propel her into a leadership role as national and international advocate for the most vulnerable groups in the mid-1800s. Dorothea utilized her Methodist father’s background to augment the teachings of her adopted religious calling, Unitarianism, which promises salvation through leading a directed life. This chapter explores her leadership role in this period of American history. It also shows how her family background, pursuit of education, personality, and religious commitment to humanitarianism enabled her to confront seemingly insurmountable obstacles to implement national and international reform of care for psychiatrically disabled and imprisoned populations. In the final phase of her career, Dorothea was chosen for a national role to lead nursing during the American Civil War, a role that she considered as within her scope of knowledge and skills.
To think today that health issues in one country are confined to that country indicates a lack of understanding of disease transmission, cultural practices, and migration patterns at the least. This chapter presents health problem or issues and policies that impact populations around the globe. To highlight the worldwide impact, the content is framed within the seven continents. The health issues are not exclusive but selected to reflect the extent of political or governmental impact. It briefly describes government structures, and presents an overview of the policy-making process of Africa, Antarctica, Asia, Australia, Europe, Italy, North America, and South America. The policy process will vary among countries depending on the type of government. Some issues may reflect cultural practices that may not be amenable to government intervention. The reader should determine the extent to which citizens, especially nurses, can be involved in the policy process as advocates and change agents.
This chapter explores how three successful nursing leaders, using different leadership approaches, demonstrate traditional leadership attributes such as strategic vision; risk-taking and creativity; interpersonal and communication effectiveness; and inspiring and leading change. It discusses the opportunities and implications for nursing leaders and those external to the profession to develop collaborative and transformative partnerships to advance quality health care. Pragmatic leaders demonstrate leadership excellence by effectively translating their nursing care assessment skills into the ability to approach organizational problem solving and decision making in a systematic, logical manner. In contrast to the present-needs focus of pragmatic leaders, charismatic leaders are vision-based leaders who predicate their leadership agenda on attaining future goals. Each of the three nursing leaders profiled understands the importance of being politically astute and effectively leveraging power and influence to make value-added contributions. To varying degrees, the various constituents of the nursing leaders profiled view them as socialized leaders.
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.
- Go to chapter: F.I.T. Camp: A Biopsychosocial Model of Positive Youth Development for At-Risk Adolescents
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.
The author, Martin Alpert, presents a method by which individual nurses can be independent, improve patient care, have fun, and earn more money. He proposes that the nursing profession become the leader in a shift to sustainable, least invasive therapies and evaluations (LITE). LITE represents a major profit opportunity for nurses. Many of these new therapies require medical professionals, but not necessarily doctors. They can be administered by dedicated and trained nurses. The impact of LITE on the global society of nursing leading this area of medicine could be transformational for nursing, medicine, and society. Nursing could lead in diagnosis and treatment under the LITE paradigm. Acupuncture is becoming part of conventional therapy. It can be a part of nursing practice. Recently, the World Health Organization estimated that 80” of people worldwide rely on herbal medicines for some part of their primary health care.
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.
Incontinence is a personal challenge that imposes heavy consequences on individual quality of life and a high financial burden on national healthcare costs. Both women and men suffer with incontinence, but more women than men experience it, with a female-to-male ratio of 2.6. Smaller numbers of both sexes suffer from fecal incontinence. This chapter deals with urinary incontinence (UI) in women, but similar factors influence policy affecting UI in men and fecal incontinence. Estimates of the cost of UI include the direct costs of diagnosis, treatment such as medication or surgery, and routine care such as absorbent pads. Stress, urge, and mixed incontinence are the most common types of UI in women. Strong research support has accumulated in favor of choosing conservative approaches as the first-line treatment for all three types of incontinence common in women. These practices include pelvic floor muscle training, bladder training, and the Knack Maneuver.
As a clinical pharmacist, Al Patterson has shared-many experiences with nurses; he reflects on the key dimensions of nursing leadership and describes the similarities between the professions of pharmacy and nursing. He believes that nursing leaders recognize the societal responsibility inherent in their role, and the professional responsibility to provide the most meaningful care to each patient and to structure the environment to ensure safety and quality. There are several things that stand out to me as examples of the transformational nature of nursing leadership: patient advocacy, professional development, and most important, the focus on quality and safety. Initially many department leaders volunteered staff for quality advisor (QA) training, and over 160 teams were formed to address a wide array of problems. Central to the concepts of shared leadership/shared governance is the recognition that the profession must continually improve itself.
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.
- Go to chapter: Use of Meditative Dialogue to Cultivate Compassion and Empathy With Survivors of Complex Childhood Trauma
Use of Meditative Dialogue to Cultivate Compassion and Empathy With Survivors of Complex Childhood Trauma
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 book provides the foundations and training that social workers need to master cognitive behavior therapy (CBT). CBT 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. 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 CBT and practice represents a strongly supported approach to social work education and practice. The book covers the most common disorders encountered when working with adults, children, families, and couples including: anxiety disorders, depression, personality disorder, sexual and physical abuse, substance misuse, grief and bereavement, and eating disorders. Clinical social workers have an opportunity to position themselves at the forefront of historic, philosophical change in 21st-century medicine. 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 CBT’s effectiveness in relieving not just emotional suffering but physical suffering among medically ill patients.
The author, Arthur G. Cosby speaks about his mother, Lillie Mae Mclntire Cosby; a nurse who led him to understand what constitutes leadership, his responsibilities to others, and the role of women in the modern world. In his mother’s mind, discipline was a critical aspect of good health care. As head nurse, she supervised large number of junior nurses, aids and orderlies, many of whom had limited formal health care training. It was very important to him that he had a mother who could do so many things and do them well. Not only was she a mother and nurturer, she was also a woman who was the breadwinner, who could successfully carry out most any job even the most difficult. Over the course of her career, she actively carried out the health care responsibilities of head nurse, hospital administrator, emergency room nurse, obstetrics nurse, public health nurse and nurse practitioner.
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.
This chapter describes, within historical and sociopolitical contexts, a program of research on restraint use with older adults and traces the complex circumstances by which evidence derived from research helped inform policy and change an embedded practice. What over time came to be known as the “restraint-free care movement” was possible because of related social movements that began in the 1950s, including the Civil Rights and the Women’s Movements. Their associated strategies and outcomes may have influenced reform ideology about elder care. The Nursing Home Reform Act included most of the points made in the Institute of Medicine (IOM) report of 1986 and put into motion a mandated change in the use of physical restraints. Providers in nursing homes and hospitals throughout the country struggled to comply with new regulations and standards but found it challenging to change entrenched practice.
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.
This book offers leadership lessons for aspiring nurse leaders from luminaries in business, medicine, philanthropy, government, academia, research, and health care. It offers practical advice, lessons learned, and testimonials as to how nurses can prepare themselves for leadership, which in turn, will help them to provide exceptional patient care. As per the report of the Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF), the heightened roles of the professional nurse allow nurses of all practices to more fully develop their leadership skills. Nurse leaders are moving the interprofessional collaboration agenda forward by serving in key leadership positions. A nurse leader who led public research in the Kent State University and Bowling Green State University challenged the common perception that successful leaders are born, complete with the requisite temperament and talents. Nurses who play leadership roles can fill in research on health care policy formulation and implementation that will change the course of health care payment, delivery, and quality. The book discusses nurse research leadership from an economist’s perspective, hiring leaders to understand leadership, and nursing leadership lessons from an association executive’s perspective, from a physician’s chief executive officer’s perspective, from a nursing friend’s perspective and from a collaborative team’s perspective. The book also highlights nursing leadership’s contributions to safety and quality, how leadership can usher in health reforms and achieve better health for all people, and advancing the cause of transformational nurse leadership.
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.
Karen Gross shares eight lessons learned about leadership that occurred not from leading per se but from the process of hiring an academic nursing leader. The search now successfully concluded gave her an opportunity to reflect on what type of health care leader they were seeking at Southern Vermont College (SVC). Although not a health care professional, she spent more than 15 months thinking about leadership in the context of nursing. The whole search process from creating the job description to identifying a quality candidates’ pool to interviewing and ultimately selecting a divisional chair to helping the successful candidate see the fit with the institution allowed her to consider what qualities are critical to nursing leadership within the academy. In an interesting way, the search for a leader in nursing enabled her to think more effectively about leadership, and in the world of unintended consequences, made her a better leader.
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.
- Go to chapter: The Role of Neurobiology in Social Work Practice With Youth Transitioning From Foster Care
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.
Nurse leaders should be poised for change. One of the common themes across entries was that nurses are central to the changes occurring in health care and that they should seize the opportunities to be in charge of the redesign of the U.S. health care system. There was another strong theme that permeated the entries: that of the knowledge necessary for nurse leaders in health care delivery. To assume leadership roles in a new delivery system, nurse leaders are advised to understand policy and finance and the roles of all team members. Furthermore, leadership must be about the organizational goals, not one’s individual goals. Self-knowledge is essential, including the understanding of how you are reflected in the eyes of others. A high level of self-confidence is essential for leadership. Other important developmental needs for nurse leaders include quantitative skills and technological expertise, including electronic and digital forms of communication.
Interprofessional education (IPE) and collaborative practice are increasingly called upon to improve these domains such as patient care, community health, health care delivery systems respective and overlapping spheres of activity with the larger goal of improving the overall health care system. Nurse leaders are moving the interprofessional collaboration agenda forward by serving in key leadership positions nationally and on local campuses. Nurse leaders, through a combination of their training, professional experiences, and personal preferences, have unique knowledge and skills for which they are enthusiastic champions. Effective leaders apply principles of good communication in their work with individuals and groups. Nurse leaders possess valuable professional knowledge and skills, and when coupled with individual talents and strengths, they offer important assets to the success of a collaborative effort. Nurse leaders should recognize how they can best capitalize on their leadership abilities and confidently apply them.
The increasingly more complex, diverse, and interdisciplinary facets of the health care system prompted the Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF) to join together and assess the current state of health care, thus issuing a “call to action” by the nursing profession. This monumental report challenges nurses to practice to the full extent of their training, transform health care and improve research and information systems. The heightened roles of the professional nurse allow nurses of all practices to more fully develop their leadership skills. The author’s, Greer Glazer, personal and professional life changed when she was notified by the RWJENF Program that she was a finalist for their leadership program. Doctor of Nursing Practice (DNP) programs are designed to prepare nurses for the highest level of leadership in practice that is innovative, evidence based, and reflects application of research.
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.
Steven A. Wartman, the author, provides key advice for potential and aspiring nurse leaders. He advises to let go of the guild mentality, particularly important for nurses who aspire to leadership positions that transcend nursing. Nurse’s perspectives are invaluable in bridging the gap between the technical experience of health care and its meaning in the lives of patients and their families. Nurse leaders are advised to become transformational rather than transactional leaders, and to move beyond the rewards and punishments inherent in transactional leadership styles. Transformational leadership is especially challenging, given the traditional hierarchies in the medical fields and academia. To provide the most effective and “transformational” leadership, potential nurse leaders should focus their efforts on four areas: eliminate the “guild mentality”; change restrictive policies and regulations that weaken the role of nursing; seek to become a “transformational” leader; and learn to take the ego out of the job.
An inadequate nursing workforce will jeopardize the functioning of the healthcare system as increasing evidence shows a relationship between registered nurse (RN) care and patient outcomes. This chapter illustrates how research is shaping health human resources (HHR) strategies for nursing in Ontario and Canada and describes policy responses to alleviate widespread fears about a looming nursing workforce shortage. It discusses the HHR theoretical framework and its application in research and policy. Researchers should understand the nature of the policy cycle in order to promote effective collaboration with policy makers. The chapter explains the policy cycle and conveys how research evidence, using a continuous quality improvement process, is contributing to current strategies aimed at strengthening the nursing workforce in Ontario. It highlights some considerations for the future of nursing that are proposed in current literature.
- Go to chapter: Transitional Care: Improving Health Outcomes and Decreasing Costs for At-Risk Chronically Ill Older Adults
Transitional Care: Improving Health Outcomes and Decreasing Costs for At-Risk Chronically Ill Older Adults
This chapter describes the major shifts in demographic and illness patterns of older adults, the inadequacy of the current healthcare system in responding to the changing healthcare needs of older adults, the rationale and evidence base supporting the need for transitional care, and the implications of adopting the more rigorously tested transitional care models for healthcare policy, clinical practice, and future research. The demographic shifts alone are likely to result in an expanded burden to Medicaid, the state controlled healthcare program for people with low incomes and receiving long-term care. Transitional care is designed to complement high-quality primary care and/or care coordination. In contrast to discharge planning, which involves the development of a follow-up plan of care for older adults prior to leaving the hospital, transitional care services are designed to position the older adult to be in the best possible health condition at the hospital discharge.
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.
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Targeting Transdiagnostic Processes in Clinical Practice Through Mindfulness: Cognitive, Affective, and Neurobiological Perspectives
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.
Health policies that support the uptake and dissemination of effective HIV/AIDS primary and secondary prevention programs and strategies are essential. However, as was true since the beginning of the epidemic, HIV/AIDS research and policy are challenging due to the racism, discrimination, stigma, and homophobia associated with the disease. The effectiveness of HIV/AIDS prevention has been consistently demonstrated in rigorous randomized clinical trials, implemented in practice, and supported through effective policies. This chapter explains how prevention research has been used to support policy in preventing HIV in communities of color. It discusses how the development of evidence-based programs has been disseminated to schools, communities, and practitioners through the development of effective national and local policy. The chapter describes the importance of advocacy organizations in promoting effective programs and policies. It focuses on research conducted with African American and Latino adolescents.
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.
Kate Judge’s first glimpse of nursing leadership in action came the day she arrived at the University of Pennsylvania School of Nursing for an in-person interview to lead Penn Nursing’s development and alumni relations program. During her 8 years at Penn Nursing, she collaborated with a number of faculty members who were gifted in attracting philanthropy. Leadership in philanthropy combines a deep personal moral purpose and the perfect balance between impatience for immediate impact and a desire to achieve long-term outcomes. To be a nurse leader in philanthropy, one must expose oneself to other values, interests, and priorities. Nursing can assume a larger role in tomorrow’s health care delivery if it commands a larger portion of U.S. and global philanthropy. Finally, to be leaders in philanthropy, nurses need to educate themselves about the larger world and the values and issues that resonate with donors.