In this study, we highlight the importance of methodological creativity when researching existential phenomena in caring science. Our intention is to provide epistemological and methodological support that would encourage researchers to be creative when collecting data. One fruitful way to approach creativity involves basing one’s research on the epistemological and methodological ideas of lifeworld research. We will illustrate the usefulness of lifeworld research via examples from empirical caring science research and show how creativity may contribute to a profound understanding of patients’ experiences. Hopefully, this article will help other researchers be creative without losing epistemological foundations and scientific validity.
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- Go to article: Creativity During Data Collection When Researching Existential Phenomena in Caring Science
- Go to article: Interrelatedness of African Care Concept of Ubuntu and Caring in Nursing: The Perceptions of Student-Nurses
Interrelatedness of African Care Concept of Ubuntu and Caring in Nursing: The Perceptions of Student-Nurses
Ubuntu philosophy emphasizes the value of caring for one another. Caring is an integral part of the nursing profession. The purpose of the study was to explore perceptions of student-nurses on the interconnectedness of Ubuntu and caring in nursing. Focus group interviews were conducted on Zoom and Google meeting platforms with 49 fourth-year student-nurses. Data were analyzed thematically using Tesch’s eight-step coding process. Ubuntu and caring in nursing emphasize caring for others. Ubuntu is interrelated to caring through its shared values. The incorporation of Ubuntu into the nursing curriculum has the potential to improve the quality of care in nursing.
Caring is a foundational concept for professional nursing. Because a hospital may be an unfamiliar environment for patients, feeling safe is vital. The purpose of this exploratory study was to examine the importance of caring behaviors for making patients feel safe and their relationship with patient characteristics. Data analysis (n = 324) indicated “being listened to” was the most important caring practice, while having your nurses and doctors demonstrate professional knowledge and skill was the most important behavior for feeling safe. In today’s hospital environment, nurses need to provide patient care that patients consider caring and that helps patients feel safe.
- Go to article: Reflection on Caring, Truth, Bias, Evidence, and Media Literacy During Current Events: An Invited Editorial for the International Journal for Human Caring
Reflection on Caring, Truth, Bias, Evidence, and Media Literacy During Current Events: An Invited Editorial for the International Journal for Human Caring
In the abstract for “Editorial Reflection on Caring, Truth, Bias, Evidence, and Media Literacy During Current Events,” the editorial focuses on the current state of divided truth in issues facing today’s global citizens, such as the coronavirus disease 2019 (COVID-19) vaccination, historical bias, implicit bias, gender identity, and disparity. Recognizing of the challenges faced in addressing truth, bias, and the influence of media literacy raises questions for caring scholars to contemplate advancing of caring science.
- Go to article: “I’m Here for You”: Understanding the Caring Role of Nurse Preceptor in Patient Safety
Nurse preceptors assume many responsibilities, including facilitating the learning experience of novice nurses while ensuring safe practices. Understanding the nurse preceptors’ experience will provide a baseline for raising safety awareness among nurses. Methods: A directed content analysis design was used. The initial categories were based on predetermined categories of Roach’s six C’s. Results: Analysis of the data led to the following six categories: recognizing the uniqueness of others, Building Competence for Patient Safety, establishing relationships, preceptor intentionality, promoting collaboration, and being a role model. Conclusion: The results of the study demonstrate the preceptors’ ability to balance their roles in delivering safe care while precepting new staff. They efficiently used their experience and caring attributes to facilitate the learning process.
- Go to article: The Caring Experience of Fetal Loss and Termination of Pregnancy Through the Eyes of Gynecological Medical and Surgical Nurses
The Caring Experience of Fetal Loss and Termination of Pregnancy Through the Eyes of Gynecological Medical and Surgical Nurses
Nurses care for women experiencing fetal loss as a result of elective or therapeutic termination of pregnancy or unexpected delivery of a nonviable infant. It is an emotional experience for the family and nurses. Investigators aimed to illuminate the experience of nurses caring for women experiencing a fetal loss and/or termination of pregnancy on a gynecological medical/surgical unit. The study used a qualitative, descriptive design approved by the Institutional Review Board. Semi-structured interviews were conducted with nine registered nurses, and transcripts were analyzed using constant comparison methods resulting in codes and themes by three investigators. The experience of nurses caring for women and infants during fetal loss and termination of pregnancy occurs throughout a continuum before, during, and after work. The experience is one of the layers, starting with emotions, sadness, and remorse in the center, followed by layers of attitude (respect and comfort) and action (communication). The foundation for these layers is teamwork, faith, and coping, surrounded by a box of uncomfortableness and distress. Nurses care for both the woman and infant during the termination of pregnancy and fetal loss, treating each with respect and comfort by communicating in both words and physical presence. Support between nurses with similar experiences provides a strong foundation that buffers the uncomfortable and distressing experience.
Phlebotomy collection is one of the most frequently experienced phenomena for patients in the hospital setting universally. Patients transferred from smaller hospitals to tertiary care hospitals are likely to experience repeat laboratory testing at the receiving facility. Unnecessary laboratory blood work can lead to several adverse events. The purpose of this hermeneutic phenomenological study was to discover and understand the lived experience of transferred patients who received repeat laboratory testing. Five essential themes were found through the process of selective thematic analysis. The Conceptual Model of Transferred Patients was designed and offered valuable insight from the patient’s perspective.
- Go to article: Nursing Students’ Perceptions Following an Ostomy Experiential Activity: A Qualitative Study
The study aimed to describe nursing students’ perception after an experiential learning activity of wearing an ostomy device. A qualitative research design to determine themes was used. Students enrolled in a nursing skills course, wore an ostomy appliance for a four-hour lab. After completion of the lab, students submitted a written reflection assignment describing their perception of wearing an ostomy appliance. Results from the thematic analysis revealed three distinct recurring themes: student affective response, student perceptions of the patient experience, and student perceived outcomes. Student comments indicated the affective domain and empathy for the patient was reached.
- Go to article: Reduced Posttraumatic Stress in Mothers Taking Part in Group Interventions for Children Exposed to Intimate Partner Violence
Reduced Posttraumatic Stress in Mothers Taking Part in Group Interventions for Children Exposed to Intimate Partner Violence
This study investigated whether interventions for children exposed to intimate partner violence combining parallel groups for children and mothers contribute to positive outcomes for partaking mothers. The study included 39 mothers in a long-term within-subject design without a control group in a Swedish naturalistic setting. Maternal psychological health was assessed pre- and posttreatment and at 6-month and 12-month follow-up. Mothers reported medium- to large-sized decrease in psychological symptoms, including symptoms of posttraumatic stress, postintervention (p = < .001 d = 0.45–0.96). During the follow-up period, sustained and further decrease of symptoms was reported (p = < .001 d = 0.58–1.60). Mothers also reported decreased exposure to violence. Results indicate that these child-focused programs have major and sustainable positive effects on mothers’ psychological health.
- Go to article: Associations Between Sexual Objectification and Bystander Efficacy: The Mediating Role of Barriers to Bystander Intervention
Associations Between Sexual Objectification and Bystander Efficacy: The Mediating Role of Barriers to Bystander Intervention
This study examined whether sexual objectification (i.e., reducing someone to a sex object via a disproportionate focus on appearance and sexual characteristics) was associated with decreased confidence in future bystander intervention to reduce the risk for sexual violence (i.e., bystander efficacy) through several barriers to intervention: failing to notice the event, failing to identify the situation as risky, and failing to take responsibility. Participants were 1,021 undergraduates (n = 309 men; n = 712 women) who completed self-report measures. Because men frequently perpetrate objectification, whereas women often experience objectification, complementary models were tested with objectification perpetration in men and objectification experiences in women. As expected, for men, each barrier mediated negative associations between objectification perpetration and bystander efficacy. Unexpectedly, for women, each barrier mediated positive associations between objectification experiences and bystander efficacy. Findings underscore important gender differences in associations between sexual objectification and bystander efficacy, as well as potential benefits of helping bystanders recognize the risk for sexual violence and assume responsibility for intervening.
- Go to article: Substance Use and Violence Victimization Among Women: A Review of Relevant Literature
A review of the recent scientific literature on the relationship between substance use and violence victimization among women in the United States is presented. Systematic review methodology adhered to the Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines. In total, 15 studies were identified that met inclusion criteria. There is substantial evidence suggesting substance use (e.g., severity of use, types of substances used) is associated with women’s violent victimization histories. Evidence suggests that women are uniquely situated in illicit drug markets and other illicit economies in a manner that increases their risk for violent victimization. The strengths and shortcomings of current theoretical explanations of substance use and violence victimization are discussed, as well as considerations for future research and interventions.
- Go to article: A Qualitative Investigation of Service Providers’ Experiences Supporting Raped and Sexually Abused Men
A Qualitative Investigation of Service Providers’ Experiences Supporting Raped and Sexually Abused Men
Substantial gaps remain in our understanding of the risks and barriers that exist for men affected by rape and sexual abuse. The present research utilized semi-structured interviews with 12 service providers from specialist organizations in the United Kingdom. An interpretative phenomenological analysis revealed three superordinate themes: (a) survivors’ needs for agency, safety, and control as functions of their masculinity; (b) the impact of rape myths and their challenge to therapeutic intervention; and (c) survivors’ expectations around reporting and the police. The role of masculinity and social stigma permeated participants’ accounts, with negative stereotypes and male rape myths influencing reporting, access to services, and survivors’ coping mechanisms. Results are discussed in relation to current service provision within the United Kingdom, and avenues for improvement are suggested.
- Go to article: Self-Reported Experience of Abuse During the Life Course Among Men Seeking General Psychiatric or Addiction Care—A Prevalence Study in a Swedish Context
Self-Reported Experience of Abuse During the Life Course Among Men Seeking General Psychiatric or Addiction Care—A Prevalence Study in a Swedish Context
A prevalence study was conducted using the NorVold Abuse Questionnaire for men (m-NorAQ) to estimate the prevalence of self-reported experience of life-course abuse and to identify the perpetrators of the abuse. This among men seeking general psychiatric and addiction care in a Swedish context. In total, 210 men completed the questionnaire, and were included in the study. The total prevalence of life-course abuse (i.e., any emotional, physical or sexual abuse during the life course) was 75% (n = 157). The results of this study indicate the importance of identifying experiences of life-course abuse among men in general psychiatric and addiction care settings.
Most research to date has focused on perpetrators of mass murder incidents. Hence, there is little information on victims. We examined 973 mass murders that occurred in the United States between 1900 and 2019 resulting in 5,273 total fatalities and 4,498 nonfatal injuries for a total of 9,771 victims (on average 10 victims per incident). Approximately 64% of victims of mass murder were White individuals, 13% were Black individuals, 6% were Asian individuals, and 14% were Latinx individuals. Given the higher number of nonfatal injuries per non-firearm mass murder event (11.0 vs. 2.8, p < .001), the total number of victims was only 50% higher for mass shootings (5,855 victims) vs. non-firearm mass murder events (3,916 victims). Among the 421 incidents of mass murder in the United States since 2000, Black, Asian, and Native American individuals were overrepresented among victims of mass shootings compared with their representation in the general U.S. population, and White individuals were underrepresented (all p ≤ .002). Findings of racial/ethnic differences were similar among victims of mass murder committed with means other than firearms for Black, Asian, and White individuals. These findings highlight different areas of victimology within the context of these incidents.
- Go to article: International and Domestic College Students: A Comparison of Campus Sexual Assault Victimization
Campus sexual assault (CSA) research predominately focuses on the victimization experiences of domestic college students. Therefore, there is little knowledge on, and understanding of, international student’s CSA victimization experiences. The present study analyzed results from a campus climate survey conducted in 2018 at a midsized Midwestern university. Twenty-three percent of international women and 18% of international men reported being a CSA victim. A series of analyses then compared CSA victimizations in relation to international victims vs. international nonvictims and international victims vs. domestic victims. Results showed international victims vs. international nonvictims were more likely to be a sexual minority and be a member of a sorority or fraternity. Compared with domestic women, international women were more likely to report being non-victims. Compared with domestic men, international men were more likely to report being CSA victims. Results are discussed in relation to research on CSA and propose future directions of study.
- Go to article: “Get Stuck and Can’t Walk Out”: Exploring the Needs for Support Among Chinese Immigrant Women Experiencing Intimate Partner Violence in the United States
“Get Stuck and Can’t Walk Out”: Exploring the Needs for Support Among Chinese Immigrant Women Experiencing Intimate Partner Violence in the United States
Chinese immigrant survivors of intimate partner violence (IPV) in the United States have been overlooked and underserved. The purpose of this study was to explore their perceptions of resources for assistance as well as their priority needs. We conducted phone interviews with 20 Chinese immigrant women who had experienced IPV in the past year. The women expressed their needs for emotional support, culturally specific services, a variety of online resources to meet different demands, being empowered, raising the Chinese community’s awareness about IPV, and batterer intervention programs. These women’s testimonies shows that greater effort should be directed toward addressing those needs in order to reduce IPV and its impacts on health in this vulnerable group of women.
The firearm mortality rate in West Virginia (WV) increased over the past four years and is currently 50% higher than the national rate. These alarming statistics, combined with the urban-to-rural shift in firearm injuries, prompted this 10-year epidemiologic overview. To the best of the authors’ knowledge, the current study stands alone as the only report of its kind on firearm injuries in the rural setting of southern WV. Firearm injuries were common in White males within the age range of 20–49 years. Assault, which is typically identified as an urban problem, was found to be the most common injury in the study population. In our data series, injury severity score was the strongest predictor of mortality, followed by self-inflicted cause of injury and trauma to the neck/head region.
- Go to article: Maximizing Outcomes by Harnessing Patient Values: A Call for Increased Collaboration With Clergy in the Treatment of Scrupulosity-Themed Obsessive-Compulsive Disorder
Objectives: the availability of smartphone-based mindfulness training applications (apps) may circumvent many barriers to receiving in-person help, but little controlled research has been conducted on them. This study sought to evaluate the effectiveness of a widely used mindfulness training app, Headspace, at reducing anxiety and worry. Methods: this study used a randomized-controlled design to examine the app using a 3 (Time; baseline, 4 weeks, 8 weeks) × 2 (Access; immediate, delayed for 4 weeks) design. Participants who reported moderate to high anxiety or worry were randomly assigned to receive either immediate access or delayed access to the app. For null hypothesis significance testing (NHST), analyses of variance were used to test the hypotheses that app access for 4 and 8 weeks would reduce anxiety and worry as compared to waitlist or baseline and that app access for 8 weeks would reduce anxiety and worry as compared to 4 weeks. Bayes estimates were used to determine the level of evidence for the hypothesis that app access reduces anxiety and worry. Results: four weeks of app access significantly reduced anxiety symptoms, as did 8 weeks, but NHST indicated there were no significant difference between 4 and 8 weeks of access. We failed to reject the null for the analysis of variance on worry, but Bayesian estimates indicated substantial evidence for the hypothesis that the mindfulness training app reduces worry. Conclusions: this research shows that using Headspace can reduce anxiety and worry, but that there does not appear to be a consistent dose relation.
- Go to article: The Contribution of Psychological Inflexibility and Metacognitive Processes to Emotional Distress
Process-based cognitive behavior therapy (PB-CBT) may be informed by identifying shared mechanisms of disorder linked to shared processes of therapeutic change. Repetitive negative thinking (RNT) is a molar pathogenic process common to both generalized anxiety disorder and depression. Acceptance and commitment therapy (ACT) and metacognitive therapy (MCT) offer separate models of the relationship between RNT and emotional distress. In a pair of related studies, the relative degree to which processes specific to the two models accounted for variability in levels of generalized anxiety and depression in college student samples was evaluated. Across both studies, processes of cognitive fusion and obstructed valued living within the ACT model and beliefs about the negative consequences of RNT within the MCT model were most predictive of variability in levels of emotional distress. Limitations of this project as well as implications for further research and practice of PB-CBT for disorders of emotional distress are discussed.
- Go to article: Neuroimaging Correlates of Cognitive Behavioral Therapy for Insomnia (CBT-I): A Systematic Literature Review
Neuroimaging Correlates of Cognitive Behavioral Therapy for Insomnia (CBT-I): A Systematic Literature Review
Cognitive behavioral therapy for insomnia (CBT-I) is the gold-standard non-pharmacological treatment for insomnia, a complex disorder that comprises psychological, behavioral, and physiological components. This systematic literature review aimed to evaluate a growing body of exploratory studies that have examined CBT-I treatment effects using neuroimaging assessment. Nine studies met current review selection criteria, of which six studies compared insomnia groups with good sleepers, waitlist, and/or control groups. CBT-I administration varied in treatment length and duration across the studies, as did neuroimaging assessment, which included task-based and resting-state functional magnetic resonance imaging (fMRI), and structural magnetic resonance imaging (MRI). Functional connectivity abnormalities were observed in participants, including reduced engagement in task-related brain regions and apparent difficulties in regulating default mode brain areas that appeared to reverse following CBT-I treatment. Taken together, the neuroimaging results complement behavioral measures of treatment efficacy, indicating support for the effectiveness of CBT-I treatment in the recovery of brain function and structure.
- Go to article: Incremental Validity of Cognitive-Behavioral Therapy and Acceptance and Commitment Therapy Mechanisms for Anxiety and Panic Symptomology
Incremental Validity of Cognitive-Behavioral Therapy and Acceptance and Commitment Therapy Mechanisms for Anxiety and Panic Symptomology
Background: acceptance and commitment therapy (ACT) and cognitive-behavioral therapy (CBT) are empirically supported treatments for anxiety and panic disorder (PD), though they differ in their putative vulnerability and maintenance processes. The present study examined the incremental validity of several of these models’ proposed core processes, including anxiety sensitivity (AS), dispositional avoidance, experiential avoidance (EA), cognitive fusion (CF), and mindfulness, as well as the interaction of the processes within each model, in the prediction of anxiety and panic symptomology. Methods: a sample of US adults (n = 316) completed self-report measures of AS, dispositional avoidance, EA, CF, mindfulness, anxiety, and PD symptoms. A series of hierarchical multiple regression analyses were conducted. Results: hierarchical regression analyses indicated that AS, dispositional avoidance, and EA predicted anxiety and panic symptoms even after controlling for one another, CF, mindfulness, and demographic variables. Although mindfulness and CF was correlated with anxiety and panic at the univariate level, they did not predict either outcome above and beyond AS, dispositional avoidance, and EA. When interaction terms were added to the models, the interaction between AS and dispositional avoidance was a significant predictor of panic and anxiety symptoms, whereas the interaction between EA and CF only predicted panic symptoms. None of the interactions that included mindfulness were significant predictors. Conclusions: these findings provide support the independent and interactive predictive value of traditional CBT (AS, dispositional avoidance, and AS-dispositional avoidance) and ACT (EA) processes for anxiety and panic symptoms, but raise questions about the incremental predictive utility of CF and mindfulness.
- Go to article: Stepping Together in Stepped Care Trauma-Focused Cognitive Behavioral Therapy: Case Report of Core Components
Stepping Together in Stepped Care Trauma-Focused Cognitive Behavioral Therapy: Case Report of Core Components
New service delivery systems are needed to expand the reach of evidence-based practices for childhood trauma. Cognitive behavioral therapy is an effective approach for treating childhood trauma, yet treatment barriers remain. Stepped care models that incorporate parent-led treatment with therapist assistance may be one approach to improve access. This case study highlights the core components of a parent-led therapist-assisted treatment called Stepping Together that serves as a Step 1 treatment within a stepped care model. The components and structure of Stepping Together are described, along with excerpts from therapy sessions to illustrate the therapist’s implementation of the model. Results of the case, in which improvements occurred, are presented. Stepping Together, a parent-led therapist-assisted first-line treatment within stepped care trauma-focused cognitive behavioral therapy, may be an effective treatment for some children after trauma and their caregivers, although more research is needed.
- Go to article: Acceptance-Based Behavioral Therapy: Treating Anxiety and Related Challenges. Lizabeth Roemer and Susan M. Orsillo. The Guilford Press, 2020, 318 pages.
This chapter reviews important contemporary issues, theories, and skills centered on working with underrepresented couples and families. The following family-based contemporary issues are reviewed: discrimination and racism, ethnic microaggression and macroaggressions, racial and ethnic socialization, homophobia, issues relevant to
LGBTQIA+ couples, and key factors related to working with interracial families. This chapter showcases sections entitled Voices From the Field. These sections include quotes from four helping professionals representing a wide range of contextual and cultural backgrounds. The information provided will actualize the multicultural, intersectionality, and sociopolitical information detailed in the chapter and provide emerging systemic therapists with pertinent skills and interventions.
Comprehending the skills, interventions, and assessments for helping families experiencing contemporary issues is a key knowledge for emerging systemically oriented clinicians. This chapter provides theoretical conceptualization, concise skill-based descriptions, relevant assessment measures, and examples so readers have a comprehensive understanding of how to clinically assist families. Contemporary issues that are reviewed include family cohesion and adaptability, blended and stepfamilies, multiracial families, contemporary parenting issues, obesity, the internet, child abuse and neglect, grandparents raising grandchildren, and parental grief after the death of a child. The chapter concludes by reviewing relevant assessment measures related to the contemporary family issues described within the chapter.
Becoming familiar with the nuances of professional issues within couple, marriage, and family therapy is important for practitioners’ growth and understanding. Practitioners who employ a systemic approach to their clinical work understand the similarities and differences between their approach and various theoretical movements in the applied behavioral sciences. In addition to comparing theories, this chapter reviews the major ethical, legal, technological, multicultural, and intersectional issues that are unique to couple and family counseling. The chapter concludes by reviewing the distinctive elements of working with individuals in a systemic manner and the details associated with verbal and nonverbal messages in couple and family counseling.
This chapter is centered on reviewing the contemporary issues related to family therapy. This information will be derived from the recent and classic scholarly literature. Topics explored within this chapter include racism and intersectionality, family cohesion and flexibility, blended and stepfamilies, multiracial families, contemporary parenting practice and issues, obesity, various issues regarding the internet, child abuse and neglect, grandparents raising grandchildren, and parental grief after the death of a child. Throughout the chapter, readers are provided with contemporary examples, key information, and in-depth conceptualizations that accentuate the powerful effect the contemporary issue has on families.
Understanding the professional identity of couple, marriage, and family practitioners is essential knowledge for emerging systemically oriented clinicians. This chapter describes the identity of couple, marriage, and family practitioners; traces the history of couple, marriage, and family professional associations; discusses relevant accreditation organizations and pertinent specializations; explores the nuances of professional practice, including scholarly trends, telebehavioral health and therapeutic technology, understanding wellness, and interventions used during times of crisis, trauma, and disaster; and introduces the concepts of context, diversity, multiculturalism, and intersectionality. This chapter serves as a guide for the remainder of the book. Specifically, every topic introduced within this chapter will set the stage for additional theoretical, skill-based, and contemporary issues covered within the remaining chapters of this textbook.
Understanding the contemporary issues and frequently used skills and interventions for helping children and adolescents is essential knowledge for emerging couple and family practitioners. This chapter provides theoretical conceptualization, concise skill-based descriptions, and examples to provide readers with pertinent information related to treating a variety of child and adolescent contemporary issues. The contemporary issues that are reviewed include child and adolescent resistance to therapy, issues related to childhood attachment, sibling abuse, bullying, and learning disabilities. In addition to contemporary issues and skills, there are four additional sections that highlight important processes and skills related to play therapy, filial therapy, theraplay, sandplay therapy, and sandtray therapy. Lastly, the chapter ends with a concise breakdown of helpful youth-based assessments.
This chapter focuses on contemporary issues that affect people’s lives and motivate them to seek couple and marriage therapy. Topics explored within this chapter include changing views of marriage, rising rates of infertility, delayed motherhood, adult attachment, premarital issues and warning signs, marital and relational distress, effects of crisis and disaster on relationships, substance abuse, financial stress, infidelity, intimate partner violence, conflict during divorce, online issues that affect relationships, and sex addiction and compulsivity. Throughout this chapter, readers are provided with contemporary examples, key information, and in-depth conceptualizations that accentuate the powerful effect each issue has on relationships.
It is important for emerging systemic practitioners to understand the major theories that have influenced the practice of couple, marriage, and family therapy. This chapter explores the methods for creating a clinical theoretical orientation and the theoretical movements that have informed the practice of couple, marriage, and family therapy. Readers will explore the way theories are connected during clinical practice, including the use of a sole theory, integration, eclecticism, and pluralism. Next, readers are provided an overview of feminism, the minority stress model, and racial battle fatigue as they relate to systemic practice and contemporary issues. Through a highly detailed section on first- and second-order cybernetics, readers are given a careful review of the systemic paradigm. The chapter concludes with sections on prominent theories that serve as a foundation for effective systemic practice, including constructionism, constructivism, postmodernism, gestalt, and attachment-oriented therapy.
This chapter focuses on understanding the practice of couple, marriage, and family counseling. The chapter begins with a review of the nuances of session management, cotherapy, and reflection teams. Next, readers review foundational systemic interventions and core counseling skills along with their relevance to systemic practice. The chapter concludes with a concise review of the salient schools of couple, marriage, and family therapy, and a clear breakdown of the major skills and interventions. The theoretical breakdown includes a brief synopsis of the family therapy school, a definition of the core techniques, and applied examples of each skill.
Understanding the frequently used skills, interventions, and assessments related to helping couples who experience the consequences of a variety of pertinent contemporary issues is an important knowledge for emerging systemic therapists. This chapter provides theoretical conceptualization, concise skill-based descriptions, relevant assessment measures, and examples so readers have a comprehensive understanding on how to clinically assist couples. The contemporary issues that are reviewed include infertility, adult attachment, premarital issues and warning signs, marital distress, crisis and disaster, substance abuse, financial stress, infidelity, intimate partner violence, divorce conflict, online addiction, and sex addiction and compulsivity. The chapter concludes by reviewing relevant assessment measures related to the contemporary couple issues described within the chapter.
The Couple, Marriage, and Family Practitioner: Contemporary Issues, Interventions, and Skills delivers the knowledge and skills to help today’s diverse clients in an increasingly complex world. Sweeping in breadth and depth, this is the most comprehensive guide available to examine contemporary issues and interventions in couple, marriage, and family therapy. Designed for master’s- and doctoral-level students, this book helps clinicians examine their professional identity; describes family systems and systems theory; explores current issues facing today’s families, couples, and children; and details how to apply skills, interventions, and assessments to provide optimal service to clients. The book includes key information about multiculturalism, intersectionality, nontraditional families, and other social justice issues, as well as a dedicated chapter centered on working with people of color and underrepresented couples and families. Each chapter provides clear definitions, descriptions, and relevant scholarship along with activities and examples showcasing the use of systemic theory, contextual issues, major interventions, relevant technology, and skills. Voices From the Field sections written by diverse practitioners working with people of color,
LGBTQIA+ clientele, and other underrepresented populations underscore important information and perspectives.
- Go to article: Eye Movement Desensitization and Reprocessing Therapy and Change in Attachment Security: A Pilot Study
Eye Movement Desensitization and Reprocessing Therapy and Change in Attachment Security: A Pilot Study
Eye movement desensitization and reprocessing (EMDR) therapy has a rapidly growing evidence base; however, research into its changes in attachment security during EMDR therapy is limited. This pilot study aimed to explore changes in attachment security in a clinical sample of adults who received EMDR therapy for symptoms of posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (CPTSD). It also explored the quality of the therapeutic alliance in relation to changes in attachment security. A within-subject, repeated-measures design was used. Eighteen participants received fifteen EMDR sessions on average and completed self-report measures of attachment, PTSD, CPTSD, and therapeutic alliance. A decrease in attachment insecurity was observed. Changes in attachment security were partially associated with the quality of the therapeutic alliance and changes in symptomatology. This study contributes to the emerging literature on change in attachment and EMDR therapy.
- Go to article: The Effects of EMDR Therapy on Pregnant Clients With Substance Use Disorders: A Narrative, Scoping Literature Review
The Effects of EMDR Therapy on Pregnant Clients With Substance Use Disorders: A Narrative, Scoping Literature Review
This narrative scoping literature review explores a significant clinical population, pregnant women with co-occurring substance misuse, through the lens of adaptive information processing and the potential for eye movement desensitization and reprocessing (EMDR) therapy intervention. A data search in PubMed, PsychINFO, Web of Knowledge, Science Direct, Cochran, and Scopus databases focusing on literature published within the last 10 years. Due to the distinctiveness of the issue, 10 research articles met the required inclusion criteria. The results confirm that EMDR can deliver effective outcomes for women with co-occurring substance use disorder during pregnancy. However, the rationale for using EMDR as a “sole-treatment” intervention appears insufficient. Instead, there is an argument supporting the utilization of integrative approaches. This review highlights the limited research available for this essential population and discusses the need for further study and investigation.
Most mental health clinicians treating trauma survivors are exposed to repeated details of clients’ traumatic experiences, and some of these clinicians may experience symptoms of indirect trauma through vicarious traumatization (VT), which has the potential of negatively impacting professional quality of life (ProQOL). The ProQOL Scale was developed to measure both negative and positive effects of working with those who have experienced traumatic stress. The purpose of this study was to determine if clinicians who are trained in eye movement desensitization and reprocessing (EMDR) therapy, as compared to trauma-focused cognitive behavioral therapy (TF-CBT) and prolonged exposure (PE), would relate to aspects of their ProQOL differently. Second, it was hypothesized that the ProQOL model would predict VT in TF-CBT and PE clinicians, but not in EMDR therapy clinicians. Fifty-four trauma clinicians who reported their primary modality of treatment as EMDR, PE, and TF-CBT were studied. Participants completed a survey that included demographic information, the ProQOL Scale, and the Vicarious Trauma Scale (VTS). Hierarchical ordinary least squared regression revealed that the empirical ProQOL model did not predict VT scores in EMDR therapy clinicians as it did for non-EMDR therapy clinicians. This study implies that there could be aspects of the EMDR therapy methodology that may support a clinician’s healthy worldview when empathetically bonding with traumatized clients, thereby fostering longevity for both clients and clinicians.
- Go to article: The Effectiveness of EMDR With Individuals Experiencing Substance Use Disorder: A Meta-Analysis
The current meta-analysis aims to synthesize existing studies on the effectiveness of both trauma-focused and addiction-focused eye movement desensitization and reprocessing (EMDR) for people with substance use disorder (SUD). Search and selection procedures involved screening 1,733 references, yielding 10 studies published between 2008 and 2021 from 8 countries with 561 participants. After the removal of one outlier study, the results showed EMDR to be effective on a variety of outcomes for people with SUD (n = 9, d = .654, 95% CI [.332, .985], p < .001). Regarding the effects on SUD outcomes, meta-analysis also showed EMDR to be effective (n = 7, d = .580, 95% CI [.209, .951], p = .002). Specifically, EMDR was effective with SUD treatment engagement and severity, but not necessarily the reduction of cravings, and also effective for reducing comorbid posttraumatic and depressive symptoms. This meta-analysis is limited by the number of studies and participants, heterogeneity in methods of included studies, the quality of studies, and other factors.
- Go to article: The TraumaClinic Model of EMDR Basic Training in Brazil: A Country Case Study for In-Person and Online Training
The TraumaClinic Model of EMDR Basic Training in Brazil: A Country Case Study for In-Person and Online Training
This article utilizes a country case study design to describe the implementation of eye movement desensitization and reprocessing (EMDR) therapy training in Brazil. The primary focus is on the methodology, adaptations, adjustments, and cultural considerations necessary to incorporate in-person and virtual training in this country. Additionally, the article will explore the impact of the Covid-19 pandemic to address National Government Guidance related to social distancing. This guidance required adjustments to training delivery, clinical and self-practice, clinical supervision, and consultation. Finally, the article outlines the advantages and disadvantages of implementing EMDR therapy training in Brazil, expanding to how models of good practice could be implemented in other countries, such as Angola and Mozambique, to include cultural adaptation, sensitivity, and replication.
In this chapter, we discuss the research-informed practice component of Competency 4: Engage in Practice-Informed Research and Research-Informed Practice. Chapter 16 covers the practice-informed research component of Competency 4. This chapter covers critical thinking and critically evaluating existing research. The chapter also reviews evaluating online sources and conducting literature searches.
The chapters in Part II of this edition focus on helping students understand the substantive content of the professional social work competencies and ensure that their field placement provides them opportunities to develop their professional competency. Each chapter focuses on a separate competency and provides descriptions of the competency as well as suggested activities and practice behaviors that can be carried out in student field placements. The goal is to help students develop strategies and activities that allow them to practice and develop each of the nine professional social work competencies in their field placement. In this chapter, we examine what professional social work behavior in communication looks like as it relates to Competency 1: Demonstrate Ethical and Professional Behavior. This competency requires that social workers “demonstrate professional demeanor in behavior; appearance; and oral, written, and electronic communication” (Council on Social Work Education [
CSWE], 2022, p. 9). The chapter also reviews professional electronic communication and the ethical use of technology in social work practice.
In this chapter, we explore the importance of social work supervision. Supervision is an activity that occurs in a variety of professions, but within social work, especially in field, supervision is a dynamic process. Social work supervision partners you as the learning social worker with an experienced social work professional to assist you in applying your social work knowledge and skills in the field setting. It also serves as a tool to improve professional problem-solving while developing your professional self.
- Go to article: Identifying Attitudes Towards Violence in Intimate Partner Relationships People Living in Eastern Turkey: A Cross Sectional Study
Identifying Attitudes Towards Violence in Intimate Partner Relationships People Living in Eastern Turkey: A Cross Sectional Study
Since the rates of violence are high in patriarchal societies, determining the attitudes of people in these societies towards violence and the factors affecting these attitudes are of great importance. The researchers in the present study aimed to determine people’s attitudes towards violence who live in a region where patriarchal values still reign in Turkey and to investigate factors urging people to tend to perpetrate violence. The data was collected from 628 people at five family health centers in a province in the east of Turkey, providing health services to people of different socioeconomic levels. The Participant Information Form and Intimate Partner Violence Attitude Scale were used to collect the study data. In the present study, the participants displayed positive attitudes toward violence. In the present study, the following factors were determined to affect attitudes towards violence: Income status, occupation, sex, family type, alcohol use, and perception that violence cannot be prevented. Male-dominated patriarchal society has very negative effects on people in terms of perpetrating violence. In addition, to reduce the negative effects of living in extended families, people should be enabled to live independently of their families after getting married.
- Go to article: Comparing Abuse Profiles, Contexts, and Outcomes of Help-Seeking Victims of Domestic Violence: Part III—LGBT Clients
Comparing Abuse Profiles, Contexts, and Outcomes of Help-Seeking Victims of Domestic Violence: Part III—LGBT Clients
The present study represents the third part of an exploration into the demographic characteristics, context, and outcomes of abuse and outcomes of service engagement for users of specialist Domestic Violence and Abuse (DVA) services in the United Kingdom (UK; parts I and II respectively). It delivers on a commitment made in those parts to provide an examination of LGBT clients (including in comparison to the cisgender, heterosexual, or “cishet” clients examined in parts I & II, hereby known as “non-LGBT”). The current study utilized a large-scale quantitative data set of 35,882 clients presenting to specialist DVA services within the UK between 2007 and 2017, including 34,815 non-LGBT and 1,067 LGBT clients. Several areas of similarity between the two subsamples were identified, including some of the types of abuse reported, referral routes, and outcomes upon exit from services. Significant differences was also found. For example, the LGBT subsample was found to be significantly more likely to present to services with substance use and mental health issues (including self-harm) and was also more likely to have their case progressed by the Crown Prosecution Service (CPS). The findings are discussed along with recommendations for future research and practice, centered around the provision of gender and sexuality-inclusive provision, which acknowledges differential risks of LGBT clients, and how these reflect their experiences as a “minority” population (i.e., so-called “minority stress”).
- Go to article: Is Methodological Pluralism Improving Our Ability to Uncover the Causal Mechanisms Behind Men’s Violence Against Women?
Is Methodological Pluralism Improving Our Ability to Uncover the Causal Mechanisms Behind Men’s Violence Against Women?
This explorative article aims to take a step in the direction of a realist-oriented scientific design that extends our knowledge of the requirements of a methodology that improves our ability to uncover the causal mechanisms behind men’s violence against women. Despite the great advances that have been made in individual research disciplines, our understanding of the complex causes is still insufficient and suffers from our inability to grasp the larger whole of the collaborative processes. As a first step towards the objective, an integration attempt is implemented that aims to highlight methodological issues that we have to overcome to explain men's violence against women. The integration of psychological, social-psychological, and sociological theories aims to exemplify how contributing, and counteracting factors interact with each other and form a complex mechanism that influences whether violence against women will take place or not. To leave room for the methodological dimension, the depth of each perspective has been reduced. The results of the integration attempt show both opportunities and difficulties in investigating the mechanisms behind men’s violence against women. However, there is still untapped knowledge potential in the explorative integration of theories and the use of realist-oriented pluralistic research methodologies.
- Go to article: Abused and Rejected: The Link Between Intimate Partner Violence and Parental Alienation
Previous studies have demonstrated a connection between intimate partner violence (IPV) and a child’s alienation from the abused parent, but little is known about the relationships between the type of IPV, aspects, and severity of a child’s alienation, and the target parent’s gender. This study assessed the presence of an IPV history (verbal and physical aspects) among parents who identify as targets of their children’s unreasonable rejection. Also investigated were associations between the form of IPV and manifestations of a child’s alienated behavior, parent’s gender and type of IPV, and parents’ gender and degree of the child’s alienation. Self-identified alienated parents (n = 842) completed an online survey that included an IPV screening measurement (Hurts, Insults, Screams, Threatens screening tool) and a measure of the parent’s perception of their child’s alienated behaviors (Rowlands Parental Alienation Scale). The majority identified as IPV victims and reported a higher level of verbal than physical abuse. More mothers than fathers identified themselves as IPV victims. As a group, IPV victims rated their child as more severely alienated than did non-IPV alienated parents. Mothers were more likely than fathers to report physical aggression by the other parent and more likely than fathers to assess their child’s alienated behaviors as more severe. Victims of physical violence reported their children were less likely to withhold positive affection from them. This knowledge may assist in earlier identification of the alienation process and greater recognition, legitimacy, funding, and opportunities for enhanced collaboration among stakeholders. This, in turn, may lead to improvements in prevention, intervention, and accountability, thus helping to interrupt alienation processes.
Police respond to high volumes of domestic violence (DV) calls that can be time-consuming and often deal with repeat involved persons, regardless of whether or not charges are laid. This study extracts and examines three distinct cases of individuals/couples that involved almost 2% of 3,414 domestic violence calls to police that occurred over about a 3-year period for a small-sized urban community and its surrounding rural areas in Ontario, Canada. Most of the calls (86.2%) for these three cases did not result in any charges being laid. Each case represented a unique problem focus common in DV situations, and all three cases involved children. Key issues for one case included substance use and the cycle of violence; in another case, mental health problems and parenting challenges were prominent; and the third case pertained to child custody and access issues. Acceptance of offered support and services by the involved persons was minimal in all three cases. Implications for improved police responses involving collaboration with other service providers in smaller communities with limited resources are discussed.
Across many countries, the use of dating applications and websites (DAWs) has become increasingly popular over recent years; however, research examining the relationship between DAWs use and experience of dating violence and/or other harms is limited. This study aims to explore the use, motivations, and experiences of harm associated with using DAWs and meeting people in person via DAWs. An online convenience sample pilot survey was completed by adults (n = 217) aged 18+ years, living in the UK or the Republic of Ireland, who had used a DAW in the past two years. Differences were found in usage, motivations, and experiences of using DAWs in age and gender. Nearly half, 46.5% of respondents reported having been a victim of at least one harm as a result of meeting someone in person via DAWs in their lifetime; 33.2% reported experiencing sexual violence, 27.2% verbal abuse, 8.3% sexual activity in exchange for goods and 6.5% physical assault. Further to this, 41.9% of respondents reported being “Catfished” in the past two years (i.e., the other person looking different in person compared to their DAWs profile). In multivariate analysis, experiencing at least one harm was significantly associated with female gender (Adjusted odds ratio [AOR] 4.0; p < .001), being aged 40+ years (AOR 3.1; p < .01; reference category, 18–29 years) and being “Catfished” (AOR 3.3; p < .001). In multivariate analysis, sexual violence was significantly associated with being female (AOR 6.9; p < .001), being aged 40+ years (AOR 2.9; p = .013; reference category, 18–29 years) and being “Catfished” (AOR 2.9; p = .001). The study reinforces the importance of understanding the use of DAWs, exposure to harms on and offline, and risks associated with “Catfishing.”
- Go to article: Men’s Exposure to Intimate Partner Violence and Their Experiences With a Crisis Center in Denmark
Many countries are unable to offer men and their children a safe place to stay when exposed to intimate partner violence (IPV). Denmark is an exception by having implemented a coordinated effort in 2016 of meeting the needs of male victims of IPV and their children. This presents an opportunity for in-depth exploration of the experiences of male victims of IPV. In this study we present a review of men’s exposure to IPV in Denmark, the experiences of 58 men who stayed in six crisis centers for men, and present results from a follow-up pilot study working with these men. Men staying in the crisis centers reported having been exposed to psychological, physical, economical, material violence, and stalking perpetrated predominantly by a female partner or ex-partner. In the follow-up, several men reported still being exposed to different types of violence and threats. The men experienced a number of adverse outcomes associated with their experiences but described a positive impact by the combination of help offered at the shelters. This study points to the importance of safe accommodation for male victims of IPV and includes recommendations for practice.
Chapters 1 to 5, which make up Part I of this edition, focus on the field placement experience and strategies to maximize the student learning. The chapters cover the essentials for not only surviving but thriving in an organizationally based field placement. Part II of this edition is devoted to developing your nine Council on Social Work Education’s professional competencies. However, some content on the social work competencies is covered in the Part I chapters. Chapter 1 focuses on beginning your field placement and the expectations for social work interns. It also helps you practice safety in your field placement interactions. The chapter also covers content on values and ethics, ethical decision-making, and ethical behavior.
This chapter addresses Competency 8: Intervene With Individuals, Families, Groups, Organizations, and Communities. It focuses on interventions with organizations and communities. The chapter covers several generalist interventions that include education and training, grant writing, and strategic planning. The generalist interventions with communities include community organizing, coalition building, and community development.
The chapter focuses on understanding the workings of your field placement agency and its community context. It reviews various organizational dimensions that impact the functioning of the agency. It also reviews how to educate yourself about the community context of your field placement experience.
This chapter addresses Competency 8: Intervene With Individuals, Families, Groups, Organizations, and Communities. The chapter review generalist practice and the types of generalist interventions with individuals, families, groups, organizations, and communities. The remainder of the chapter focuses on micro-level interventions with individuals, families, and groups.
In this chapter, we discuss practice-informed research (Competency 4) and practice evaluation (Competency 9). The focus is on applied research. The chapter covers formative and summative program evaluations, developing logic models, and the ethics of applied social work research. It also discusses informal practice evaluation and the use of supervision and client feedback to evaluate the effectiveness of your social work practice. In addition, it presents the use of single-subject designs to formally evaluate practice effectiveness as well as various types of measures that can be used with in formal and formal evaluations.
This chapter focuses on Competency 3: Engage Anti-Racism, Diversity, Equity, and Inclusion (
ADEI) in Practice. It begins with a brief introduction of the ways in which social work values and ethics uniquely support diversity in practice. This is followed by a review of conceptual framework for diversity and bias in social work practice. The chapter then reviews standards for cultural competence, the importance of empathy and humility, and the various ways that individuals and groups are oppressed by the majority culture.
The focus of this chapter is on developing your learning contract, self-assessment, and competency-based social work. The chapter reviews the nine social work competencies and their associated dimensions that are the basis of your social work education. It also reviews competency self-assessment and the use of supervision in developing professional competency.
The focus of this chapter is on the importance of engaging with individuals, families, groups, organizations, and communities (Competency 6). The chapter begins with an exploration of the importance of trust building and collaboration to the engagement at all levels within the helping relationship. This is followed by a deeper dive into interprofessional collaboration—building relationships within the professional realm, the roles and responsibilities of interprofessional relationships, and challenges and benefits of working interprofessionally.
This chapter focuses on Competency 7: Assess Individuals, Families, Groups, Organizations, and Communities. The chapter reviews assessment of the two mezzo-level client systems: organizations and communities. The chapter reviews organizational theories and five methods of organizational assessment. It also reviews community assessment approaches and community asset mapping.
This chapter focuses on Competency 7: Assess Individuals, Families, Groups, Organizations, and Communities. It covers assessment of the three micro-level client systems—individuals, families, and groups. The chapter begins with a brief review of the process of critical thinking, which in our opinion is one of the keys to conducting successful client system assessments. This is followed by a brief review of a strengths-based approach to conducting collaborative assessments. The chapter ends with a section containing tools that be used with strengths-based assessments.
In this chapter, we explore using reflection, self-awareness, and self-regulation to promote well-being through self-care. The potential hazards of vicarious trauma, burnout, and compassion fatigue are reviewed, as are self-care strategies and approaches. Creating a personal self-care plan is reviewed.
This chapter is on Competency 5: Engage in Policy Practice. The chapter begins with a brief introduction of the ways in which the field of social work is inherently political, when viewed through the lens of the
NASWCode of Ethics. This is followed by an overview of organizational policies, theories, and perspectives; how they look within the field; and how they fall into the political framework. The chapter then moves into social welfare policy and its relevance to the field of social work. Finally, a look at advocacy in practice and the unique ways that it is supported by the NASWCode of Ethics is taken.
This chapter focuses on Competency 2: Advance Human Rights and Social, Racial, Economic, and Environmental Justice within your field placement and beyond. The chapter begins with a brief overview of the conceptual theories and frameworks for social justice. This is followed by an exploration of the types and sources of power, social locations, social constructions, social processes, social identities, conflicts, and the ways these concepts interact in relation to the field experience. The chapter then reviews visions and strategies for change.
The Social Work Field Placement is designed to help Bachelor of Social Work and Master of Social Work students structure their field placement learning around the nine Council on Social Work Education (
CSWE) social work competencies to maximize their field placement learning opportunities. The new second edition is completely updated with the 2022 Educational Policy and Accreditation Standards ( EPAS) and threads new content on anti-racism, diversity, equity, inclusion, and rights-based approaches to social work practice throughout. The chapters in Part I focus on helping students have a successful field placement experience. Each chapter in Part II focuses on a specific professional competency with substantive content on the competency. Learning activities in each chapter provide examples of field placement tasks and projects related to chapter topics and competencies. All chapters have field reflection questions, critical thinking questions, a detailed case summary illustrating one or more competencies with discussion questions, and electronic competency resource links to websites and videos.
- Go to article: A Qualitative Analysis of Sex Trafficking Survivor-Advocates’ Barriers to Exiting “The Life”
Despite the recent expansion of sex trafficking awareness, prevention, and aftercare services, knowledge about sex trafficking remains limited by the systemic exclusion of survivors’ voices and strengths from sex trafficking epistemology. Notably, little research examines sex trafficking survivors’ experiences, their critiques of the counter-trafficking movement, nor their recommendations for how the counter-trafficking movement could be improved to better meet survivors’ needs. In this qualitative study, we adhered to an Intersectional-Standpoint Methodology (ISM) to explore sex trafficking survivors’ perceptions of the counter-trafficking movement and their barriers to sex trafficking exit. The results of this study suggest that survivors encounter numerous barriers to sex trafficking exit, including internal barriers, social barriers, and systemic-institutional barriers. Results point towards recommendations for improving service delivery systems by building upon sex trafficking survivors’ strengths and resilience and by reducing their many barriers to exit. By implementing these recommendations, counter-trafficking advocates at all levels of practice can increase sex trafficking survivors’ access to effective, survivor-informed aftercare services.
We embarked on a quality improvement plan to improve culture care in a school of nursing. The nursing workforce is experiencing escalating occupational stress, leading to high turnover. When faculty role model caring, they empower themselves and the future workforce with strategies for self-care and resilience. A faculty self-assessment of caring behaviors and caring relationships was conducted before a caring science workshop. The workshop used Watson’s Caritas Processes to introduce caring micro-practices. Qualitative interviews with faculty after the workshop generated two themes: self-awareness of self-care and caring pedagogy. Themes revealed faculty value this approach for continuous improvement in a caring culture.
- Go to article: Bystander Opportunity, Actions, and Inaction in Suspected Intimate Partner Violence: Differences Between Graduate and Undergraduate Students
Bystander Opportunity, Actions, and Inaction in Suspected Intimate Partner Violence: Differences Between Graduate and Undergraduate Students
Limited research examines graduate student experiences with intimate partner violence (IPV) or bystander intervention. In this exploratory study, we compare the extent of opportunity to intervene in suspected IPV, how students tried to help, and barriers to intervention for undergraduate (n = 698) and graduate students (n = 967) at one university using data from stratified random samples of students. Graduate students indicated significantly less opportunity to intervene than undergraduate students (16.2% vs. 35.5%). Among students with the opportunity, however, similar proportions of undergraduate and graduate students tried to help, with most confronting the situation directly. Among those who did not try to help, graduate students commonly endorsed “not knowing what to do,” suggesting an opportunity to enhance prosocial intervention skills among this population through targeted bystander-based training initiatives.
The present study, conducted in Taiwan, sought to link some elementary and middle school students’ bullying to factors in their social status, social support, direct and indirect bullying victimization, and positive and negative affect. We obtained the secondary dataset from the Survey Research Data Archive, Academia Sinica. Survey data were collected during 2012 from students in grades 5, 7, 8, and 9; of 853 students who filled out the questionnaire, 711 were included in our study’s final sample. Our study found a strong relationship between bullying victimization and bullying perpetration. Therefore, intervention programs seeking to interrupt the implied cycle of bullying could boost their effectiveness by focusing on school children’s capacity to feel empathy for victims of bullying and by developing ways to reduce children’s vengeful feelings toward bullies.
- Go to article: An Analysis of the Relationship Between Self-Compassion, Psychological Inflexibility, Psychological Health, and PTSD Severity in a Partial Hospitalization Program
An Analysis of the Relationship Between Self-Compassion, Psychological Inflexibility, Psychological Health, and PTSD Severity in a Partial Hospitalization Program
PTSD symptoms and psychological inflexibility have been linked to a lack of self-compassion and poor psychological health. Prior work has explored these relationships in a trauma-exposed undergraduate population and found that, while self-compassion was correlated with PTSD symptom severity at the bivariate level, this relationship was no longer significant when accounting for psychological inflexibility. Additionally, self-compassion and psychological inflexibility predicted psychological health. The present study sought to test these findings in PTSD patients enrolled in an exposure-based partial hospitalization program. Acceptance and Commitment Therapy (ACT)-consistent measures (i.e., Valued Living Questionnaire, Behavioral Activation for Depression Scale [Short Form], Quality of Life Enjoyment and Satisfaction Questionnaire [Short Form]) were used to assess psychological health. The PTSD checklist for DSM-5 and the Acceptance and Action Questionnaire (II) were used to measure PTSD symptoms and Psychological Inflexibility, respectively. Our results were largely consistent with previous investigations. We found a negative relationship between psychological inflexibility and psychological health, as well as a positive relationship between psychological inflexibility and PTSD symptom severity. Future research should measure these constructs across different time points to explore the benefit of viewing self-compassion and other related constructs (e.g., courage and love) as values in an ACT model for PTSD treatment.
- Go to article: Mini-Ethnography and Case Studies on Homeless Persons’ Primary Care Needs in an Urban Community
Homeless persons struggle to access healthcare services and obtain resources to meet basic needs. This study used mini-ethnography, case study, and survey to describe primary care needs of homeless persons in two Pennsylvania cities. Data were obtained using participant observation, field notes, surveys, and document analysis. Five homeless persons and four community volunteers were interviewed. Homeless persons had some options for obtaining primary care services. It was difficult to take prescribed medications and acquire preventive services. Their symptoms often went unattended. Dedicated community volunteers and community agencies assisted homeless persons to obtain basic needs and healthcare services.
- Go to article: Sexual Agreements, Substance Use, Binge Drinking, and Bidirectional Physical Intimate Partner Violence Among Male Couples in the United States
Sexual Agreements, Substance Use, Binge Drinking, and Bidirectional Physical Intimate Partner Violence Among Male Couples in the United States
Gay, bisexual and other men who have sex with men (GBMSM) experience intimate partner violence (IPV) at rates comparable to heterosexual women. Previous studies have identified that having a sexual agreement—an explicit agreement around sex permitted outside of the relationship—is associated with reductions in IPV. This article uses data from a sample of 967 partnered GBMSM to examine associations between individual use of substances and alcohol, discordant partner reports of sexual agreements, and the self-reporting of bidirectional IPV. Men who reported different sexual agreements than their partners and recently engaged in substance use or binge drinking had significantly increased odds of IPV. Dyadic interventions are necessary to assist couples in developing the communication skills to successfully navigate both their substance use and discussions around sexual agreements.
- Go to article: Assessing Knowledge and Acceptability of a Trauma-Informed Training Model to Strengthen Response to Conflict and Gender-Based Violence in the Democratic Republic of Congo
Assessing Knowledge and Acceptability of a Trauma-Informed Training Model to Strengthen Response to Conflict and Gender-Based Violence in the Democratic Republic of Congo
Conflict-related sexual and gender-based violence is common in the eastern Democratic Republic of Congo, but there are few evaluations of multisectoral training interventions in conflict settings. We conducted high-quality, trauma-informed medicolegal trainings amongst multisectoral professionals and sought to describe changes in knowledge after training and perceived training acceptability. Participants were health, law enforcement, and legal professionals who completed training at one of four sites from January 2012 to December 2018. Twelve trainings were randomly selected for evaluation. We conducted pre- and post-training assessments and semi-structured interviews of participants within 12 months of index training. Forty-six trainings of 1,060 individuals were conducted during the study period. Of the randomly selected trainings, 368 questionnaires were included in the analysis (36% health, 31% legal, 12% law enforcement, 21% other). The mean knowledge scores (standard deviation) significantly improved after training: 77.9 (22.9) vs. 70.4 (20.8) (p <0.001). Four key benefits were identified: 1) improved cross-sector coordination; 2) enhanced survivor-centered care; 3) increased standardization of forensic practices; and 4) higher quality evidence collection. Participants completing the training had improved knowledge scores and perceived several key benefits, suggesting the multisectoral training was acceptable in this under-resourced, conflict region.
This article is devoted to reflections on how to prevent pre-understanding from influencing the research process and jeopardizing the validity of a study. Influences from preunderstanding are exemplified from empirical lifeworld-led caring science research. Finally, there is a discussion of preunderstanding as a natural attitude and therefore also an important part of the lifeworld. It is concluded that validity requires a self-critical approach. It is suggested that a descriptive analysis, where the findings are fairly close to the data, involves a less problematic approach than research, which requires special attention to pre-understanding in connection with different levels of interpretation.
This quality improvement project describes the initiation of a ceremony at the time of death in a community living center and an acute care setting in a Veterans Administration Health Care facility. The ceremony is a best practice for end-of-life care. Since initiating the ceremony, staff and veterans have expressed a sense of caring, dignity, closure, honor, and connection when performing the ceremony for the deceased. The culture around death has changed due to the ceremony, reflecting Jean Watson’s caring framework where healing can take place in any caring moment where there is an authentic human encounter.
- Go to article: Preferred Self-Care Behaviors of Participants Who Have Completed a Caring Science Online Course
Participant narratives from open discussion boards within a Caring Science, Mindful Practice Massive Open Online Course were analyzed to determine preferred self-care activities, and the degree to which course content supported the creation of self-care goals. Although the course explores different ways to apply Watson's Human Caring Theory, the data collected were focused on self-care activities reported by the course participants. Identifying preferred activities among participants may help facilitate self-care education for those interested in a Caring Science based approach to self-care. The focal points of the data were analyzed to assess whether participants focused on improving work-life or home-life.
- Go to article: A Comprehensive Study of Public, Family, and Felony Mass Shootings in the United States, 2006–2020
This study provides a comprehensive examination of mass shootings in America (2006–2020). Specifically, this work identifies offender, victim, and incident characteristics, incidence rates, and differences between public, family, and felony mass shootings. Findings indicate consistent characteristics across all mass shootings include male offenders and the use of handguns. Family mass shootings had the highest incidence rate. Family and the felony mass shootings largely involved close offender-victim relationships, no victim injuries, and private locations. Oft-considered public mass shootings involving stranger victims, higher victim counts, and public locations do not reflect the overall phenomenon. Implications offer insight for understanding and addressing the mass shooting problem.
Lateral violence or bullying in nursing is the antithesis of caring and a profound, pervasive global concern. Survivors of lateral violence exhibit significant negative emotional and physical effects. Approximately one-third of new nurses leave the profession within the first 3 years of practice, citing lateral violence as a determining factor. This study explored the reasons new nurses decided to remain in the profession despite their experiences. Through one-on-one interviews (N = 9), the lived experiences were explored. Six themes emerged: the patients, needed the experience, I got counseling, there was an end, I cried, and nothing changed.
As nurse educators navigate the realities of racial injustice and deeply polarizing issues in the United States, we must reflect on our own biases, educate ourselves on the impact of inequities, and thoughtfully use our faculty privilege to create change. Purposefully adjusting admissions procedures, hiring diverse faculty, and embedding cultural sensitivity in the curriculum are stepping stones to shaping the future of nursing. Impacting race relations by developing cultural humility and collegial allyship begins with humble inquiry. This article recounts a dialogue and presents the personal reflection of two peers committed to the critical work of diversity, equity, and inclusion.
- Go to article: Community Resident Voices Empowered: Exploring Public Housing Resident Needs and Assets Through a Qualitative Lens
Community Resident Voices Empowered: Exploring Public Housing Resident Needs and Assets Through a Qualitative Lens
Incorporating residents’ voices in needs assessments and decision-making activities affecting public housing initiatives is supported by various research. This approach of increasing communal empowerment and growth informed a needs and assets assessment to support an urban community center servicing ethnically and culturally diverse public housing residents. This study employed qualitative methods to gather insights from focus group participants about their perceived needs of the community. The data gathered from the focus groups provided an opportunity for community voices to expand on understanding the assets and needs of the community. The five themes that emerged in the focus group discussion were: (1) Yearning for home and community; (2) Appreciation for diversity; (3) Conditions supporting human dignity; (4) Continual growth of programs & affordability; and (5) Emphasis on trust. These insights support the importance of including community voice for future programming, policies, and research.
- Go to article: Barriers to the Delivery of Teen Dating Violence Programs in Urban School and After-School Settings Serving Mexican-Heritage Youth
Barriers to the Delivery of Teen Dating Violence Programs in Urban School and After-School Settings Serving Mexican-Heritage Youth
Teen dating violence (TDV) is increasingly recognized as a national health priority, impacting overall well-being and school success. However, there are overlooked barriers to TDV program delivery in schools and youth-serving organizations and these are ideal settings to reach youth universally. In this study, we conducted 10 focus groups with school (e.g., administrators, social workers, nurses) and after-school personnel regarding barriers to TDV programming within a large urban community serving predominantly Mexican-heritage youth. Findings offer practice-driven considerations for the implementation of programs within urban communities. These include attention to limited resources, inhibitive and non-existent policies, competing demands, a lack of training, and demand for culturally competent curricula and wrap-around services.
- Go to article: Helping Older African Americans Thrive in Urban Communities: Empowering Lessons From Detroit
Urban-dwelling African American older adults are disproportionately victimized by systems, which relegate them to disparities in health, education, and economic security as well as inequitable access to resources that support overall wellness (Brown, 2010; Jackson et al., 2004; Kahn & Pearlin, 2006; Zhang et al., 2016). The COVID-19 pandemic of 2020–2021 revealed poorer outcomes and a “double jeopardy” for African American older adults who suffered poor health outcomes (Chatters et al., 2020). As a result, avenues to promote healthy aging through health and wellness literacy, self-empowerment, and social-community connections are critical (Chatters et al., 2020; Pourrazavi et al., 2020; Waites, 2013). A qualitative study was conducted with African American older adults in Detroit to understand how to promote health literacy and overall wellness for those who are aging in place. An empowerment-oriented wellness framework (Dunn, 1961; Dunn, 1977; Hettler, 1976) was employed. Findings indicated that these African American older adults aging in the urban communities strived to maintain their independence while recognizing that they may need some assistance as they age in place. While some elders defined themselves by their disability and expressed feelings of being pushed aside by family and society, many rejected stereotypes associated with aging and reinforced a sense of pride and empowerment. They called for programs to: 1) assist older adults with health literacy and a comprehensive understanding of overall wellness; and, 2) provide activities and tools to support proactive overall wellness; and 3) employ strategies that actively encourage social engagement as well as outreach to their less engaged peers. Participants also suggested that a strategy to enlighten younger generations about the “senior world,” and aging is also crucial.
- Go to article: Justice-Involved Individuals and Admission Into Urban Undergraduate Social Work Programs
Research on the effect of arrests or convictions on college admissions decisions, while limited, suggests that college admission is a major hurdle for applicants with criminal histories. The purpose of this study was to examine admission application policies and practices at undergraduate social work programs in the South for justice-involved individuals or persons with criminal backgrounds. The qualitative study design recruited program directors through professional relationships for interviews and selected programs in urban cities in the South using the Council on Social Work Education’s Accredited Program Directory. The surveys consisted of three questions and the interviews consisted of eleven semi-structured questions focusing on the policies and practices associated with the application process. Study results reveal that slightly more than one half of all programs asked questions about criminal backgrounds, firm policies are not in place, and practices vary from institution to institution.
Negative home equity is due to declines in home values, largely driven by economic factors, and increases in mortgage debt, a decision made by individuals. Yet, empirical research assessing the individual’s role in the occurrence of negative home equity is limited. This study used the 2018 National Financial Capability Study to explore the association between financial literacy, savings, and debt at the individual level on the occurrence of negative home equity. The findings revealed that objective financial knowledge and financial security were negatively associated with the occurrence of negative home equity, while having a home equity loan, using a payday loan, having medical debt, and exceeding credit card limits were positively associated with the occurrence of negative home equity.
Financial literacy scales are often used as a diagnostic tool to assess financial knowledge levels among various populations, although few of them have undergone empirical testing. This study utilized exploratory factor analysis (EFA) with a sample of Chinese rural migrant workers to identify the underlying structure of a financial literacy scale and its psychometric properties. EFA reduced the 23 items to 5 factors that explain for 69.08% of the variance in financial literacy. Five factors are identified that are daily money management, math skills, saving and borrowing, inflation, and long-term investment. Findings suggest that practitioners who work with migrant workers or groups with lower income, lower educational levels can use this instrument to assess financial literacy levels and explore interventions that improve specific areas of financial knowledge.
This study examined attitudes about the relevance of retirement planning and affect associated with it (retirement involvement) of adults (18–65-years-old), taking racial/ethnic status into consideration. Drawing on online survey data, between-group significance testing revealed that racial/ethnic minority (REM; n = 355) and White (n = 543) participants did not differ in mean levels of retirement involvement, but the REM sample perceived retirement involvement as less relevant to their respective racial/ethnic groups. Similar four-profile solutions consisting of Low, Moderate, High, and Mixed-Reactive Retirement Involvement latent subgroups emerged for both samples in Latent Profile Analyses. Findings revealed distinct racial/ethnic variations in demographic and financial capacity predictors of profile subgroup classification. Results signaled a need for more culturally focused financial counseling and planning research and interventions.
The focus of this article is to quantitatively evaluate and compare three of the most popular defined benefit plan types based on various variable assumptions. The decision of when to retire and take a pension, or being given the option to change plans, often happens only once. This makes the evaluation and comparison critical. This paper provides a numerical analysis with a broad perspective so that employees with varying career situations and retirement plans can better evaluate their financial standing. Data sources include standard economic assumptions used in valuing pension plans, as well as a survey of employer sponsored pension plans. Recent pension plans provide more flexibility by paying out pensions as a single lump sum, however, these plans generally provide lower benefits.
- Go to article: Associations Between Financial Stressors and Financial Behaviors: Does Race/Ethnicity Matter?
Using data from the 2018 National Financial Capability Study (NFCS), this study examined the associations between financial stressors and financial behaviors, and how these associations differ by race/ethnicity. The descriptive results showed that Black and Hispanic individuals reported higher financial stressors than White and Asian/Other individuals. The regression results showed that higher financial stressors significantly increased undesirable financial behaviors and decreased desirable financial behaviors. The regression results also revealed that Black individuals engaged in significantly more undesirable financial behaviors, while Hispanic and Asian/Other individuals did not differ significantly from White individuals. Further analyses for racial/ethnic differences in the associations between financial stressors and behaviors suggest that race/ethnicity moderated the relationship between the financial stressors and financial behaviors. Specifically, Black individuals with high financial stressors engaged in fewer undesirable financial behaviors, but they also engaged in fewer desirable financial behaviors as compared to the other racial and ethnic groups. Implications for financial counselors, financial educators, and other financial professionals are discussed.
- Go to article: Are There Racial and Gender Preferences When Hiring a Financial Planner? An Experimental Design on Diversity in Financial Planning
Are There Racial and Gender Preferences When Hiring a Financial Planner? An Experimental Design on Diversity in Financial Planning
The purpose of this study was to examine the likelihood of consumers hiring a financial planner based on race and gender utilizing an experimental design. Using a sample of Black and White MTurk respondents, cumulative logistic regression was employed to determine the effects of race and gender on the likelihood to hire a financial planner. Findings suggested that, overall, consumers did not have racially biased preferences when hiring a financial planner. However, they did express a preference for hiring female planners over male planners. Financial planning firms can use these findings to strengthen their support for and recruitment of women financial planners, as well as address concerns of racial bias amongst consumers.
Although risk preferences and inheritance expectations should affect annuitization decisions, few studies have empirically tested these relations. This study bridges the gap in the prior literature by investigating potential effects that consumer risk aversion and inheritance expectations have on annuitization. Using data from the 2012 wave of the Health and Retirement Study, this study finds that consumers who are more risk averse have a higher likelihood of owning household annuity income compared to consumers who are less risk averse. Consumers with a higher inheritance expectation are more likely to have household annuity income compared to those with a lower inheritance expectation. Finally, when risk aversion is interacted with inheritance expectation, it increases the likelihood of household annuity ownership.
- Go to article: Financial Capability, Financial Education, and Student Loan Debt: Expected and Unexpected Results
This study used the 2015 National Financial Capability Study to investigate the relationships among financial capability, financial education, and student loan debt outcomes. Specifically, this study examines four student loan outcomes: delinquency, stress, preparation, and satisfaction among borrowers who obtained loans for themselves. Three forms of financial capability (objective financial knowledge, subjective financial knowledge, and perceived financial capability) and two forms of financial education (formal school/workplace education and informal parental education) were used as potential predictors in the study. The Probit regression results showed that expectedly, several financial capability and financial education factors were positively associated with desirable financial outcomes such as loan calculation and loan satisfaction, and negatively associated with undesirable outcomes such as loan stress and loan delinquency. However, this study also showed several unexpected results. For example, objective financial knowledge was negatively associated with loan calculation and loan satisfaction, and subjective knowledge and formal financial education were positively associated with loan delinquency.
- Go to article: The Disappointment Dilemma: The Role of Expectation Proclivity and Disappointment Aversion in Describing Financial Risk Aversion and Investing Risk-Taking Behavior
The Disappointment Dilemma: The Role of Expectation Proclivity and Disappointment Aversion in Describing Financial Risk Aversion and Investing Risk-Taking Behavior
This article adds to the existing literature on financial risk aversion and risk taking by testing the possibility that a person’s degree of disappointment aversion, as an anticipatory emotion, may be an antecedent of risk-taking behavior. In this regard, the purpose of this article is to introduce two interrelated measures—the expectation-proclivity scale and the disappointment-aversion scale—and to establish the empirical association between expectation-proclivity and disappointment-aversion scale scores and financial risk aversion and financial risk taking. Results from this study show that disappointment aversion is positively associated with financial risk aversion, whereas establishing high outcome expectations is negatively related with financial risk aversion. Additionally, findings show that disappointment aversion and expectation proclivity are inversely related. Findings from this study provide support for what is termed in this article the disappointment dilemma hypothesis. Specifically, financial decision-makers who are averse to disappointment may be prone to allocating assets and investment dollars in ways that minimize or avoid disappointment in the short-run, but by doing so, may regret risk-avoiding behavior in the future.
- Go to article: Exploring Determinants of Desirable Financial Behaviors Using Decision Tree Analysis Evidence From Four Waves of National Financial Capability Study
Exploring Determinants of Desirable Financial Behaviors Using Decision Tree Analysis Evidence From Four Waves of National Financial Capability Study
The purpose of this article is to utilize decision tree (DT) analysis to examine the relationship between income level, financial satisfaction, financial confidence, financial knowledge, and several demographics with a goal of better understanding desirable financial behavior. The emphasis of this analysis is focused particularly upon better understanding the role of financial knowledge in desirable behavior outcomes. DT analysis is most useful when an analysis includes numerous variables and solving problems where the cumulative learning process is inherent. Our DT analysis of four FINRA National Financial Capability datasets (2009, 2012, 2015, and 2018) suggest that financial knowledge is a relevant variable only under specific circumstances and for respondents with relatively higher income levels. Key variables in the DT analysis included income level and financial satisfaction.
- Go to article: Obsessive-Compulsive Disorder and Illness Anxiety: Examining Commonalities and Comorbidity
Obsessive-compulsive disorder (OCD) and illness anxiety disorder (IAD) often co-occur. Cognitive-behavioral models of both disorders overlap and include maladaptive attentional processes, misinterpretation of thoughts and physical sensations, and engagement in repetitive behaviors in an attempt to reduce associated distress. Given commonalities in their presentation and their common co-occurrence, it is important to understand how illness anxiety affects the presentation and treatment of OCD. In this article, theoretical conceptualizations of OCD and IAD and their comorbid presentation are outlined, and assessment and differential diagnosis of these conditions are discussed. Despite shared cognitive vulnerabilities and behavioral patterns, well-validated symptom measures, along with careful functional analysis, can be used to distinguish between OCD, IAD, and comorbid presentations. Best practices for the cognitive-behavioral treatment of these co-occurring conditions are also presented, with suggestions based on both the empirical literature and detailed case studies. Finally, recommendations for future research on co-occurring OCD and IAD and their treatment are explored.
- Go to article: Co-occurring Obsessive-Compulsive Disorder and Hoarding Disorder: A Review of the Current Literature
Co-occurring Obsessive-Compulsive Disorder and Hoarding Disorder: A Review of the Current Literature
Current research suggests obsessive-compulsive disorder (OCD) co-occurs in around 20% of people with hoarding disorder (HD). The article discusses the theoretical conceptualization of co-occurring HD and OCD (HD+OCD), highlighting similarities between the disorders that may contribute to comorbidity, such as potentially overlapping etiological factors, comorbidity profiles, and phenomenological aspects; and differences that are important to consider in differential diagnosis and conceptualization, such as belief patterns, ego-syntonicty/dystonicity, and trajectory. The combination of HD+OCD versus either disorder alone appears to be associated with a profile characterized by higher nonhoarding OCD symptoms, anxiety symptoms, depression, and tic disorders, and which may be more treatment-refractory. The authors discuss some commonly used measures to assess hoarding that may be relevant in the context of OCD, as differential diagnosis of hoarding behaviors is often difficult, and hoarding may be difficult to detect in patients with OCD, especially in children. The article ends with a discussion on considerations for the treatment of HD+OCD with cognitive-behavioral therapy, as hoarding symptoms are less likely to respond to gold-standard exposure and response prevention, and there are no established treatment protocols that are designed to treat co-occurring HD and OCD.
- Go to article: Co-Occurring Obsessive-Compulsive Disorder and Panic Disorder: A Review of Their Etiology and Treatment
Co-Occurring Obsessive-Compulsive Disorder and Panic Disorder: A Review of Their Etiology and Treatment
Estimated rates of co-occurrence between obsessive and compulsive disorder (OCD) and panic disorder (PD) are notable, but vary considerably, with rates from epidemiological and clinical studies ranging from 1.8% to 22% (Rector et al., 2017). We reviewed the current empirical literature on the etiology, treatment, diagnostic assessment, and differential diagnosis of co-occurring OCD/PD. Best practices for cognitive-behavioral treatment, including identifying and addressing treatment barriers are also addressed. Although it is acknowledged in current literature that co-occurring OCD and PD levels may be clinically significant, there remains a need to thoroughly examine the possible consequences and future research directions of this overlap. Future research must continue to elucidate the biological and environmental causes of OCD/PD co-occurrence.
- Go to article: Obsessive-Compulsive Disorder With Co-Occurring Obsessive-Compulsive Personality Disorder: A Practice Focused Review
Obsessive-Compulsive Disorder With Co-Occurring Obsessive-Compulsive Personality Disorder: A Practice Focused Review
This review article addresses the frequently noted comorbidity between obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD). We begin by reviewing the recent empirical literature on the co-occurrence of these two conditions and the functional consequences of comorbid OCPD on OCD. We describe theoretical conceptualizations of the links between these disorders, including shared mechanisms that may drive the association between these two distinct conditions. We then provide an overview of diagnostic measures for OCPD and differential diagnosis. We also review data on the impact of comorbid OCPD on cognitive-behavioral treatment for OCD, including how to address potential treatment barriers through which OCPD may complicate OCD treatment. Lastly, we conclude with directions for future research.
In this introductory chapter, macro social work and community organizing as a method of practice that emphasizes both task- and process-oriented activities are examined, and different models and approaches to community social work practice are discussed. Cultural competency, cultural humility, ethics, values, and human rights associated with social work and community practice are examined. The Grand Challenges for Social Work and their implications for macro practice and community practice skills are introduced. Specific social work interpersonal skills that are commonly used in community practice are described. A framework is presented that describes how relationship building and engagement are essential for accomplishing common community-organizing tasks such as interviewing prospective community members and constituents, recruiting volunteers, creating group consensus, and conducting participatory needs assessments, planning, and evaluation. In the last section of this chapter, the organization of the book is described.
A number of factors contribute to successful lobbying for legislation, including timing and opportunity, political influence, public or voter support, and election procedures. Social work skills are also important, including the ability build relationships with legislators and interest groups and to communicate issues in a manner that elicits popular support and puts pressure on legislators to take action. In this chapter, the terms legislative advocacy and lobbying are defined and the structure and context of legislative campaigns are examined. A description of the background research necessary to effectively lobby for legislation improvements is also provided. In addition, the skills required for participation in successful lobbying campaigns are described, including written and electronic communication, relationship building with decision makers, components of successful lobbying visits, and the provision of testimony at public hearings. The relationship between legislative and political campaigns is also examined in terms of the types of skills needed for each of these social action approaches, and barriers (such as legal regulations) that limit the engagement of social workers, community practitioners, and community organizers employed by public and nonprofit agencies in these activities are explored. In the last section of the chapter, lobbying campaign procedures used to change laws and social policies in order to achieve social justice are described.