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This book explains how organizational culture and climate affect the quality and outcomes of human services and describes the Availability, Responsiveness, and Continuity (ARC) model of organizational effectiveness that the authors developed for improving social service, behavioral health, health care, and other human service organizations. The authors summarize decades of practice and research experience, including organizational improvement efforts, randomized controlled trials, and nationwide studies with hundreds of human services organizations. The book provides a balance between the use of empirical data and applied examples in explaining how human services can be improved. By combining numerous case examples and experiential knowledge with decades of organizational research, readers learn about empirically proven approaches tested in real organizations that are supported with case examples of organizational change. The book explains that creating the organizational social contexts necessary for providing effective services requires three types of organizational strategies. These strategies include organizational tools for identifying and addressing service barriers, principles for aligning organizational priorities to guide improvement, and the development of shared mental models among organizational members to support the principles and tools.

This book presents an approach to therapeutic contact with clients that capitalizes on people's resilience, strengths, and capacities. The helper works in collaboration with the individual to identify and amplify these capacities to resolve problems and improve quality of life. Clients are empowered to find their own answers and solutions that will fit their particular worldview and their unique strengths (De Jong & Miller, 1995). These principles are operationalized through solution-focused therapy and motivational interviewing. The helper also identifies areas in which clients can use education on how to meet more effectively life's challenges. A focus on coping skills is represented by cognitive-behavioral therapy. These theoretical approaches are woven together for the purpose of maximizing a person's ability to enhance the strengths they bring and also learn new skills that can help them. The resultant strengths- and skills-building model is applied, throughout the book, to various problems and populations that helping practitioners may encounter.

The landmark National Survey of Child and Adolescent Well-Being (NSCAW) study represents the first effort to gather nationally representative data, based on first-hand reports, about the well-being of children and families who encounter the child welfare system. NSCAW's findings offer an unprecedented national source of data that describe the developmental status and functional characteristics of children who come to the attention of child protective services. Much more than a simple history of placements or length of stay in foster care, NSCAW data chart the trajectory of families across service pathways for a multi-dimensional view of their specific needs. The NSCAW survey is longitudinal, contains direct assessments and reports about each child from multiple sources, and is designed to address questions of relations among children's characteristics and experiences, their development, their pathways through the child welfare service system, their service needs, their service receipt, and ultimately, their well-being over time. The topics covered in this book are key to child welfare practice and policy, but are also of compelling interest to other child service sectors such as health, mental health, education, and juvenile justice. The authors of chapters in this volume are esteemed researchers within psychology, social work, economics, and public health. Together they represent the future of child welfare research, showcasing the potential of NSCAW as a valuable resource to the research community, and providing glimpses of how the data can be used to inform practice and policy.

This book reviews the evidence-based treatments relevant to family treatment in human services and social services settings. It addresses some of the main reasons families are seen in mental health and social service settings: child maltreatment, intimate partner violence, attention-deficit hyperactivity disorder, conduct problems, substance use disorders, schizophrenia, depression, and dementia. For each problem area, a detailed case study provides step-by-step guidelines on how the evidence-based theory can be applied in practice. Interventions include psychoeducation, behavioral parent training, solution-focused therapy, cognitive-behavioral treatment, structural family therapy, and multisystemic treatment.

This is a book about how people change their minds and how mental health practitioners can help this process along. It addresses a gap in the literature on cognitive therapy that results from an almost exclusive focus on the constructed aspects of personal meaning, and a lack of attention to the ways in which information that we pick up from life circumstances also influences what we know, feel, and do. Conceptions that ignore the role that current life conditions and interpersonal events play in creating or revising meanings limit the utility of cognitive therapy approaches for clients whose lives are marked by ongoing deprivation, threat, and vulnerability. In laying out a broader perspective, a Cognitive-Integrative perspective, the book expands the internal focus of traditional cognitive therapies to take more account of the role of information generated by environmental events and conditions in impeding or promoting change. It contends that mind draws on organized memories of previous experiences as well as currently available information to generate cognitive, emotional, and behavioral responses. The theoretical grounding for this perspective is drawn from a range of cognitive, neurological, social, psychological, and social work theories. Theoretical explanations are laid out. They are balanced with practice guidelines and grounded in an offering of clinical examples.

This book shows combat from a different perspective by a dozen combat social workers. Written by and for social workers and war veterans, the book is filled with lessons learned that can have significant benefits for students of social work, among others. Combat social work is dangerous work for these highly trained officers. Social work in combat, an oxymoron, focuses on helping the service member seeking mental health services specific to being deployed and in danger. All these practitioners’ clients seek to be at their best in support of their unit as military members. To do so, they must overcome extraordinary obstacles associated with battle and living conditions that may challenge their morale and will to fight. These and other challenges of war require wisdom as much as bravery from combat social workers. The book consists of three sections. The chapters in the first and last sections are about the context and irony of combat and social work and the realities and contexts of combat social workers’ training, education, and life. The middle section includes 11 first-person case studies by combat social workers. They discuss, among other things, the extraordinary lessons they have learned from their deployments into war zones and how social work is both the same as and different from social work outside the war zone and from the work of psychiatrists and psychologists. These chapters vary greatly based on the gender, war context, and military branch and unit.

This book presents innovative interventions for youth with severe emotional and behavioral disorders. The book is designed to fill a gap between the knowledge base and clinical practice through its presentation of theory, practice parameters, training requirements, and research evidence. Featuring community-based and state-of-the-art services for youth with severe emotional and behavioral disorders and their families, this book describes each intervention in depth, along with the supporting evidence for its utility. Most chapters present a single intervention as an alternative to institutional care. Shared characteristics of these interventions include delivery of services in the community (homes, schools, and neighborhoods) provided largely by parents and paraprofessional staff. The interventions are appropriate to use in any of the child human services sectors and have been developed in the field with real-world child and family clients. In addition, they offer a reduced cost in comparison to institutional care. Several chapters address diagnostic-specific psychosocial and psychopharmacological treatments, which are likely to be provided as adjunctive treatment in a clinical setting.

This book describes what happens to human service delivery programs under the impact of unrelenting stress and multiple losses. Never perfect places of safety in the first place, many social services of every size, shape, and variety are collapsing under over thirty years of system fragmentation even while public costs have escalated dramatically. The result is that important places of refuge–of sanctuary–for the children, adults, and families who have been exposed to the greatest amount of adversity and trauma, are struggling to provide even the most minimally adequate services. We believe that at this point, our social service network is functioning as a trauma-organized system still largely unaware of the multiple ways in which adaptation to chronic stress has created a state of dysfunction that in many cases virtually prohibits the recovery of the individual clients who are the source of the underlying and original organizational missions, while damaging many of the people who work within it. Just as the encroachment of trauma into the life of an individual client is an insidious process that turns the past into a nightmare, the present into a repetitive cycle of re-enactment, and the future into a terminal illness, the impact of chronic strain on an organization is insidious. As seemingly logical reactions to difficult situations pile upon each other, no one is able to truly perceive the fundamentally skewed and post-traumatic basic assumptions upon which that logic is built. As an earthquake can cause the foundations of a building to become unstable, even while the building still stands, apparently intact, so too does chronic repetitive stress or sudden traumatic stress destabilize the cognitive and affective foundations of shared meaning that is necessary for a group to function and stay whole. The goal of this book is a practical one: to provide the beginnings of a coherent framework for organizational staff and leaders to more effectively provide trauma-informed care for their clients by becoming trauma-sensitive themselves. This means becoming sensitive to the ways in which all human beings and human systems are impacted by individual and collective exposure to overwhelming stress.

The purpose of this book is to examine the opportunities for, and limitations to, empowerment among adults with severe mental illness who, historically, have lacked power and have been the focus of stigma and discrimination. Its central premise is that despite significant limitations to empowerment, people with severe mental illness can be empowered when certain conditions are met. Building on the work of Joel F. Handler, nine conditions are outlined under which empowerment is likely to occur and be sustained long-term. These conditions are then applied to determine the circumstances under which people with severe mental illness can be empowered through participation in each of seven activities. These including treatment planning; the selection and control of housing; decision making in the organizations from which services are received; planning and policy making; securing and maintaining employment that produces a liveable wage; research and evaluation; and service provision to other people with mental illness. Case studies from a public psychiatric hospital and a community mental health agency illustrate each of the seven areas. Finally, the book identifies the roles that service providers, administrators, policy makers, advocacy groups, researchers, and clients can play in the empowerment process.

Schools have become the default mental health providers for children and adolescents, but they are often poorly equipped to meet the mental health needs of their students. The introduction tackles how to make students eligible for school-based services using the Individuals with Disabilities Education Act or Section 504 of the Rehabilitation Act. Using the new DSM-5 as an organizing principle, this book then addresses the 12 most common mental disorders of childhood and adolescence, ages 3–18. While there are many books that address child and adolescent psychopathology, this book focuses on how to help students with mental disorders in pre-K–12 schools. Each chapter addresses the prevalence of a disorder in school-age populations, appropriate diagnostic criteria, differential diagnosis, comorbid disorders, rapid assessment instruments available, school-based interventions using multitiered systems of support, and easy-to-follow suggestions for progress monitoring. Unique to this book, each chapter has detailed suggestions for how school-based clinicians can collaborate with teachers, parents, and community providers to address the needs of youth with mental health problems so that school, home, and community work together. Each chapter ends with a list of extensive web resources and a real-life case example drawn from the clinical practice of the authors. The final chapter addresses two newly proposed diagnoses for self-harm in the DSM-5 and brings a cautious and sensible approach to assessing and helping students who may be at risk for serious self-injury or suicide.

This book gives an overview of family psychoeducation as an evidence-based psychosocial treatment for schizophrenia and other major psychiatric disorders. Family psychoeducation has produced a robust body of research indicating significant, sustained reductions in patients' relapse and rehospitalization rates and improvements in families' wellbeing. Converging with historical changes in mental health systems, the empirical findings and new theoretical approaches that produced this treatment modality are described. Responsive to research data and expressed informational needs of families of persons with severe mental illness, psychoeducational models were developed by major research centers in the U.S., the U.K., and other European countries, and in China. The book presents theoretical premises and a research overview, together with descriptions of model programs and long-range outcomes. Psychoeducation for prodromal, first-episode, and child and adolescents interventions are discussed as well as for diverse diagnoses and special populations. Cross-cultural and international studies are presented, with a focus on uniformities and cultural variations. Briefer versions of family education, now widely utilized, are then discussed, including research findings of efficacy. Generic components are presented together with a discussion of variations. Training models and issues, and required competencies, are presented. Contemporary applications of family psychoeducation in American and European mental health systems are described, with research on barriers to implementation and suggested solutions. A critical assessment of unresolved issues is followed by a discussion of future trends in families' involvement in the treatment process. An Appendix provides information on family organizations and other selected resources for families in various countries throughout the world, as well as useful materials for service providers.

Doctors are often accused of playing god because they must make life-and-death decisions. Professional ethics and standards of care require physicians to keep secrets; they must live with the memories of split-second decisions often made by instinct; and they can endure the multitude of patients’ pain and suffering every day, day after day. Added to patient-related pressures are the pressures and politics of the House of Medicine, along with a constant drumbeat to train more physicians due to the worldwide shortage of physicians. Yet physicians are human beings who feel pain like everyone else. These demands, and the associated day-to-day challenges of physicianship, can take their toll on doctors, leading to mental health problems, reduced job satisfaction and productivity, and eventually lowered retention. Stress can lead to poor communication between doctors and their colleagues and between doctors and their patients. In the long run, for doctors to avoid harming patients, they must first do no self-harm. First Do No Self-Harm, edited by three medical and mental health educators, offers a clarion call for the improved medical and mental health of physicians across the education continuum by posing and answering five fundamental questions: (1) What are the sources of stress? (2) What are the stress-related consequences for those who work and seek treatment in the House of Medicine? (3) How do they cope with their stressful jobs? (4) What strategies can be used to promote resilience among physicians? (5) How can medical and mental health educators acquire the skills and wisdom to tackle the culture of stoicism and emotional silence in the House of Medicine that encourages physicians’ self-harm?

This volume builds the bridge between books on community practice and on clinical practice, including 33 chapters written by social workers, psychologists, and psychiatrists, for clinicians making the transition to community-based work. This is the first handbook to address this gap and provide guidance for today's community practitioners. Its overarching goal is to support the ongoing development of community-based mental health care, drawing on practical examples. This collection outlines the history and philosophy of community practice, and also illustrates the state of the art, with examples from early intervention and development programs, school-based practice, and community mental health services for children, families, and adults.

The fields of health care, aging, and social work are often treated as discrete entities, while all social workers deal with issues of health and aging on a daily basis, regardless of practice specialization. This is the first reference book to address this reality by compiling the most current thinking on these subjects in a single volume. With the population of older adults increasing as rapidly as new possibilities for their care, professionals need an accessible source of specialized information about how best to serve the elderly and their families. The most experienced and prominent gerontological health care scholars provide social workers with up-to-date knowledge of evidence-based practice guidelines for effectively assessing and treating older adults and supporting their families. The contributing authors paint portraits of a variety of populations that social workers serve and arenas in which they practice, followed by detailed recommendations of best practices for an array of physical and mental health conditions.

In this book, the author relates the stories of 88 families and their 157 children (ages 3 to 17) who participated in a parent-guidance intervention through the terminal illness and death of one of the parents from cancer. The majority of the children successfully reconstituted their lives during the subsequent 8-14 months. Although recent studies of bereaved children have yielded important findings, they have not provided knowledge of how children's development affects their responses either before the death, through the dying experience, or in the later period in which families try to adapt to the new circumstances. Using qualitative analytic methods, The Legacy identifies five developmentally derived age groups that clarify important differences in children's grief and mourning processes, in their understanding of events, their interactions with families, and their varying needs for help and support. The author gives numerous examples of the ways parents and extended family interacted with the children, and also the ways that professionals, friends, and many others helped families to deal with this tragedy.

The question of our research and our book is as follows: What is the experience of African-American elder male caregivers? Research and literature on African-American older males as informal, primary caregivers of demented or impaired family members, particularly spouses, are negligible. Male caregivers in general have been called “hidden” caregivers. Thus, we named the elderly African-American male caregivers we interviewed for this book “the hidden among the hidden.” We asked the experts—a group of 13 African-American male caregivers—to discuss the concrete and nonmaterial aspects of giving care to an impaired loved one. Our book addresses the knowledge gap about African-American male caregivers by revealing, in case-study form, their experiences of caregiving in the context of their personal biography and cohort history. Our focus is the practical and existential meaning of daily life as a caregiver. The men discussed in this book are over 60 years of age, most are long married, and they have been caregivers in their homes for at least 5 years and as long as 25 years. Their loved ones, particularly wives, suffered from a variety of illnesses and debilities that necessitated hands-on care. The book examines varied aspects of the caregiving experience, the unique generativity of men who give care, and the emotions and conflicts about decision making that emerge in day-to-day caregiving.

This book provides the most current theory, research, and practice with regard to preventing HIV in diverse Latino populations and communities in the United States. Chapters share innovative thinking and original research about the many causes of HIV risk in Latinos with overdue attention to social, structural, environmental, and cultural factors that comprise the context of individual-level behavioral risk. As such, this book imagines and researches preventing HIV in LGBT Latinos through community involvement and AIDS activism; in migrant laborers by scaling up community and cultural resources and community-based participatory research; in adolescent Latinas by facilitating communication with their mothers about sex; by decreasing the racism, homophobia, and poverty frequently experienced by Latino men who have sex with men; in transgender Latinas by decreasing familial, peer, and social rejection, and by providing care at local, state, and national levels; and in Latinas by improving their economic autonomy as well as improving gender-equity ideologies among men. This book responds to the diminishing returns of the behavioral model of HIV risk by deconstructing the many social ecological contexts of risk within the Latino experience.

In the wake of disaster, emergency service workers including police officers, firefighters, and paramedics are first on the scene and last to leave. Their heroic actions save lives, provide comfort to and care for the wounded, and inspire onlookers, but at what cost to themselves? We now know that rescue workers who are exposed to mutilated bodies, mass destruction, multiple casualties, and life threatening situations may become the hidden victims of disaster. The sequelea in terms of traumatic stress symptoms and depressive symptoms has the potential to be highly disruptive and long-standing for both the individual worker and their families, and the organizations in which they work. Additionally, emergency workers are exposed to events involving human pain and suffering on a daily basis. While for the most part emergency workers are equipped to deal with these events, on occasion one particular event will have a lasting impact. This book is based on the authors’ combined experience of over forty years of clinical work in emergency departments and with emergency service organizations. It provides an overview of the issue of trauma in the emergency services.

Employment is the highest priority for many people with severe mental illness and it is a central aspect of recovery. Over the past two decades, the Individual Placement and Support (IPS) model of supported employment has emerged as the prominent evidence-based approach to vocational rehabilitation. This book synthesizes the research and experience on IPS supported employment: historical context, core principles, effectiveness, long-term outcomes, non-vocational outcomes, cost-effectiveness, generalizability, fidelity, implementation, policy, and future research. This book relates to areas of work with populations with psychiatric disabilities and in community mental health and social service settings. In tracing the evolution of IPS, readers are equipped with an elegant example of the transition from needs assessment, to model development, to testing, and to dissemination.

High rates of poverty and homelessness, especially among women and children; increasing alcohol and drug abuse problems; escalating teen violence; and inadequate services for the chronically mentally ill are just a few of the problems that human service professionals encounter. Unfortunately, traditional approaches and programs often fail these vulnerable populations, particularly since their multiple needs often require a multidimensional approach. New innovations in practice and service delivery are clearly needed, but the current literature is often idiosyncratic, fragmented, and does not offer a systematic approach to the issues and problems. This book, containing chapters written by leading scholars in social work and related fields in mental health and human services, presents an interdisciplinary approach to the examination of innovations in direct practice and service delivery, synthesizing the development and application of knowledge concerning practice and delivery across both problems and populations. It allows innovations in direct practice and service which have relevance across problem areas or groups to be shared by students and practitioners dealing with a range of problems across the lifespan. The book is divided into four parts, beginning with a conceptual overview of theory developed by the editors for the analysis of innovations in practice and delivery. The remaining sections focus on children and adolescents, adults and the elderly. Each section defines the relevant population; discusses those issues in practice and service delivery where innovation is needed; presents an overview of the types of innovations which are taking place; and outlines the implications for practice, service delivery, policy and research.