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__**Chapter 10: Mental Health Services**__ Statistics
 * 25% of all Americans can be considered as having a mental illness. 1 in 17 of the adult population has a serious mental disorder. Which less than half actually receive treatment.
 * 20% of children and adolescents have experienced mental disorders, and of that 12% have had serious emotional disturbances.
 * Children who have parents that suffer from depression are three times more likely that they suffer from depression and anxiety as well. Only a third of the children that need mental health services actually receive it.
 * 33% of the homeless suffer from severe mental illness.
 * Almost half of people that have one disorder meet the criteria of having another one.
 * Treatments improve symptoms and the quality of life for 70 to 90% of the people who have a serious mental illness.
 * 60% of mental health professionals are clinically trained social workers.

v Social workers provide mental health services by promoting emotional well-being, advocating for parity of mental illness services with physical illness services, and helping to develop affordable and accessible treatment methods and interventions to help people recover from mental disorders. v New discoveries about the function of the brain has increased understanding of what effective treatment is, creating an atmosphere of hope and the possibility of recovery for even those who suffer from the most serious mental disorders. The process that is used to choose and evaluate the most effective treatment available is called **evidence-based practice.**

__**Mental Health and Mental Illness**__
 * Mental Health:** is the successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and providing the ability to adapt to change and cope with adversity.
 * Mental Illness:** refers to collectively to all diagnosable **mental disorders** which are health conditions characterized by alternating in thinking, mood, or behavior associated with distress or impaired functioning.


 * each culture has its own beliefs of what mental illness is according to them.
 * not every person is always mentally ill, sometimes it happens for a short period of time. (after death in the family).

Mental Disorders: ü Mood Disorders affect the individual’s emotional state and thinking.
 * Clinical Depression: serious medical illness with symptom of ongoing sad mood, difficulty in concentration, sleep disturbances, changes in appetite, change in social behavior, and increased risk of suicide. Depression can happen at any age and although it is treatable it is a lifelong condition, Women are at a high risk of getting depression because of the combination of biological, genetic, psychological, and social factors.
 * Bipolar Disorder (maniac depression): a person must have at least one episode of depression and one of mania. The episodes can include hallucinations or delusions, which can lead to a misdiagnosis of schizophrenia. This disorder occurs equally in men and woman, approximately one percent of the population suffers from this disorder. The psychotropic medications help prevent future episodes.
 * Anxiety Disorders: chronic, reoccurring states of tension, worry, fear, and uneasiness arising from unknown or unrecognized perceptions of danger. Panic disorder affects 3-6 million Americans. It occurs twice as much in women than in men and it can happen to anyone at any age. Between the panic attacks the person suffers from persistent and lingering worry that another attack will happen. This disorder can be treated with both medication and psychotherapy. Other examples of anxiety disorders are generalized anxiety disorder, acute stress disorder, post-traumatic stress disorder, obsessive-compulsive disorder, panic disorder, social phobia, and substance induced anxiety disorder.
 * Obsessive-Compulsive Disorder: characterized by thoughts or rituals that the person feels she or he cannot control. The disturbing thoughts are the obsessive part and the rituals performed to make the thoughts go away ate the compulsive part. This can begin at any age and affects both genders. Researchers have discovered a genetic component.
 * Schizophrenia: is one of the most disabling mental disorders. The symptoms are hallucinations and delusions, disorganized thinking or speech, inappropriate mood, flat emotions, and lack of motivation and energy. Researches haven't been able to discover what causes this but they do know that profound changes occur in the brain.

PTSD Brothers Schizophrenia


 * Serious emotional disturbance:** diagnosalble mental health problem in children under the age of 18 which must severely disrupt the ability to function socially, academically, or emotionally.


 * Serious mental illness and serious and persistent mental illness:** groups of mental disorders that interfere with social functioning sufficiently to require ongoing treatment.
 * individuals must meet this criteria in order to be able to receive public mental health services.

Before, mental health and physical health were though to be different. Even insurance did not cover mental illnesses. The U.S. surgeon general's 1999 report emphasized that mental illness and physical illness is inseparable. Successfully diagnosing and treating mental disorders requires a biopsychosocial perspective that focuses on interactions between a person's social environment, medical history, past experiences, psychological variables, and genetic factors. This means that social workers must needs to know about sociology, psychology, psychiatry, anthropology, neurobiology, pharmacology, immunology, and epidemiology. But most important, they need to keep up with the new discoveries in neuroscience and behavioral research that help explain development and successful treatment of mental disorders. For children it is important to be able to distinguish between normal development and warning signs of possible mental disorders. Same goes for adults, social workers need to understand aging as well. For older adults, prevention needs to start in the primary care services because they are the ones that can identify whether the patient is developing a mental disorder.
 * Biological and Psychological Factors**

Gender, race, culture, poverty, and age are important variables when diagnosing and treating mental disorders. The problems must be seen in a social environment and the larger physical and cultural surroundings. Cultural interpretations of symptoms differ, for example in one culture a certain symptom might be normal compared to another's culture. For a child, their biological state and environment have a reciprocal relationship. Perhaps, physiological changes may result from exposure to trauma which effect how the child develops (abuse, violence, separation from parent). Or the child is biologically vulnerable and more at risk to get a disorder when the environment is not meeting their needs in developing.
 * Social Factors**

Sybil


 * Mental Health Care System**: both private and public services that began in the 1800 and today includes social workers.

Five Major Movements in Mental Health (according to Lin in 1997)
NAMI
 * 1) ====Moral Treatment Movement: no government organizations to help the mentally ill, their families took care of them. Mental illness came from violations of physical, mental, and moral laws, enforcing moral behaviors would cure them and was initiated in hospitals. Dix the founder of this movement started a crusade that changed the way people thought, views, and treated the mentally ill. She brought it to the attention of the public the horrible living conditions that the mentally ill were living in and it was because of her that more than 30 public and private institutions were founded. ====
 * 2) ====Mental Hygiene Movement: Recognition of the needs of the people that were mentally ill led to the development of the first psychiatric units in hospitals which was more a medical approach to it. **Psychotropic drugs**, antipsychotics, encouraged the Community Mental Health Centers Act to be passed in 1963. This also encouraged **deinstitutionalization** of people with mental illness a shift of psychiatric care from mental hospitals to the community. The rights of the mentally ill were established, such as self-determination and restrictions of harmful treatment methods. ====
 * 3) ====Community Mental Health Movement ====
 * 4) ====Legal Advocacy Movement ====
 * 5) ====Consumer Movement (1980s-1990s): A **consumer** is a person who has received or is currently receiving services for a psychiatric condition. In this time, organizations such as the National Alliance on Mental Illness were created to educate the public and reduce the stigma of mental illness. Making the public aware of mental illness had mainstreamed medicine and social services. The recovery philosophy was developed to give hope to those who suffer from disorders, it allowed them to live a normal life and gave them more power and responsibility to meet their own goals. ====

====One movement that was not mentioned is the managed care movement. **Managed care** describes a health care delivery system designed to eliminate unnecessary and inappropriate car in order to reduce costs. Health maintenance organizations were created to manage costs and pay only for agreed-on medically necessary treatment rather than following all physician recommendations for care. ====

====** The Current System: ** Social workers can be found through various mental health services ranging from highly structured psychiatric units to informal support groups. ====

U.S. surgeon general refers to four segments within the facto system:

 * 1) ====Specialty mental health services: include private for-profit, private not-for-profit, and public settings. Approx. 6& of adults and 8% of children and adolescents use this service every year. ====
 * 2) ====General medical/primary care services: doctors and nurses in hospitals or clinics. This is where a lot of the education about mental illness lies. The most common reason why they are administered into the hospital is a biological psychiatric condition. Almost 21% of hospital beds are filled with the mentally ill. ====
 * 3) ====Human services: social services, school-based services, counseling, vocational rehab, prison-based services, and religious-based services. The largest provider for children’s mental health services. ====
 * 4) ====Voluntary support network services: self-help groups such as AA (alcohol anonymous) and Recovery Inc., a support for people with mental disorders. There has been an increase in self-help groups since many are seeing that social support is helpful. ====

Recovery International


 * Managed Care **
 * The goal is to reduce costs my emphasizing cheaper brief or group treatment approaches. Providers agree to treat a specified number of consumers for a specified cost, are features of managed behavioral health care service delivery. 89% of US workers have employer-sponsored health insurance with mental health coverage, 74% of those plans are subject to annual outpatient visit limitations, and 64% were subject to limitation on inpatient care. Social workers are advocating for all Americans to be able to afford and access mental health coverage, emphasizing on efforts to creat equality of insurance benefits for physical and mental health. **


 * Deinstitutionalization **
 * <span style="color: black; font-family: Arial,sans-serif; font-size: 8pt;">This was prompted by the need to reduce the cost of psychiatric care. Because of this many became homeless, there was emergency room crowding, and use of jails and prisons are psychiatric hospitals. The community Mental Heath Center Act was never fully funded, and insufficient housing, treatment, rehab and education services were provided for people with serious mental disorders. **


 * <span style="color: black; font-family: Arial,sans-serif; font-size: 8pt;">Criminalization **
 * <span style="color: black; font-family: Arial,sans-serif; font-size: 8pt;">24% of people in state prison and 21% of those in local jails have a recent history of psychiatric disorder. If they aren’t being treated, then their behaviors end up getting them arrested instead of being referred for treatment. **


 * <span style="color: black; font-family: Arial,sans-serif; font-size: 8pt;">Community Treatment **
 * <span style="color: black; font-family: Arial,sans-serif; font-size: 8pt;">Inpatient clients have not always connected with case management services after discharge. Poor coordination between inpatient hospital setting and community mental health clinics is part of the problem on why many get sent back to the hospital. Some are not required to accept treatment and some are scared to accept the treatment because of previous experiences or side effects that they get. This all results in no treatment, and they are set back to the hospital. **


 * <span style="color: black; font-family: Arial,sans-serif; font-size: 8pt;">Multidisciplinary Aspects of Mental Health Care **


 * <span style="color: black; font-family: Arial,sans-serif; font-size: 8pt;">Peer Counselors: paraprofessional workers in the mental health system, consumers who have recovered from psychiatric disorders and who now assist other consumers. **

Social work in mental health settings Social workers with expertise in mental health practice in a variety of settings. · Public community · Mental health centers · Nonprofit and for profit provider agencies to treat public mental health clients · State and country hospitals · Private psychiatric hospitals · Outpatient · Psychiatric rehabilitation
 * <span style="color: black; font-family: Arial,sans-serif; font-size: 8pt;">DSM-IV-TR: the standard for identifying and categorizing symptoms into diagnosed disorders in the American Psychiatric Association’s //Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision.// It lists all currently recognized mental disorders, provides detailed description of each diagnostic category, and specifies the diagnostic criteria practitioners should use to make reliable diagnoses. Last published in 1994. Another full version is expected to be published around 2010. **

Social workers play many roles in the mental health settings · Case manager · Advocate · Administrator · Therapist

Case manager for public mental health system works with people with schizophrenia, bipolar disorder, and borderline personality disorders. They work with these people to determine their strengths, goals, and needs. They find housing, vocational services, services to help them recover. They also will work with families as well. [] []

Clinical social workers will provide individual and family counseling. Those people work in · Mental health centers · Private practice · Drug and treatment centers · School based programs

[]

Treatment Social workers use a lot of evidence based psychosocial treatment approaches. Evidence based they use research as a bias for problem solving and choice of interventions. ACT (Assertive community treatment) community treatment base for people with serious mental illnesses. You have a team which is composed of cross trained psychiatry, social work, nursing, vocational rehabilitation substance abuse staff, and peer specialist. They provide help 24 hours. Psychosocial rehabilitation teaches skills need to function normally in the community. They learn to reduce the ongoing effects of their illness and promote wellness and recovery. There is a range of · Social · Educational · Occupational · Behavioral · Cognitive

Family psycho education educates the family and consumer about the condition, how to deal with symptoms when they occur, helps the family understand what the consumer is experiencing, and to see early warning signs of relapse. Cognitive behavioral approach helps people with serious mental illnesses like depression and bipolar disorders. This is when the person is taught to change his or her reaction to faulty thought s when they occur. Mental health professionals are developing more culturally relevant services and becoming more culturally sensitive and competent. Social workers have to understand cultural beliefs about mental illness and ways of coping with it in order to understand behavior and plan interventions that meet the needs of all groups of consumers. Culture bound syndromes patterns of aberrant of problematic behavior unique to a local culture, may appear more commonly among people who are older or less acculturated. Ethnopyschopharmacology a study that looks at the way ethnic and cultural influences affect a client’s response to medication. Asian Americans and Latinos with schizophrenia may require lower doses of medication than white Americans. This is due because of genetic diet and health behaviors. If you live in lower income you’re more likely to get a mental health problem. Social workers bring on a strengths and capabilities as well as on their symptoms, they can counter the stigma that occurs when the individual diagnosis becomes an enduring label. Strengths perspective allows the social worker to view the whole person and not just the mental illness. []

Only about half of the people with diagnosable mental disorders receive treatment in a given year. Some people are afraid because of family, friends and employers. In 1996 congress passed the Mental health act which prohibits insurers from imposing on physical health care. The Omnibus mental illness recovery act brought a number of important reforms. · Increase in family involvement in planning · Health care coverage · Law enforcement and courts deal with offenders


 * Substance Abuse**

Drugs are any chemical substances taken internally that alter the body’s functioning. Drug use is the general term for drug consumption. Drug misuse is inappropriate use of medications or prescribed drugs. Chemical dependency is addiction to alcohol and other drugs in contrast to nonchemical addictions.
 * Substance abuse** is the continued use of alcohol or other drugs //in spite of adverse consequences.//
 * Addiction** is a compulsion toward a specific behavior, such as the use of alcohol and other drugs, //despite negative consequences,// and //a physical or psychological dependence on the behavior or substance being abused.//
 * Dependence** can be //psychological// (AOD use motivated by emotional reasons) or //physical// (body needs the drug to function normally, as a result when the drug is withdrawn, the person will experience physical symptoms or illness).

Types of Drugs and US Government Drug Classification System -classified on basis of drugs’ //medical use// and //potential for abuse// -politically based, implemented in the early 1970s

[]

Schedule 1: heroin, marijuana, etc. Schedule 2: cocaine, morphine Schedule 3: anabolic steroids, codeine Schedule 4: valium, xanax Schedule 5: over-the-counter medications such as those containing codeine


 * Stimulants** increase alertness, wakefulness, and energy. Psychostimulants/methamphetamines stimulate the nervous system.

Psychoactive drugs are mood-altering hallucinogens that alter sensory perceptions, mood, thought processes, or behavior by acting on the nervous system.
 * Hallucinogens** distort visual and sensory perception.


 * Depressants** are drugs that cause disinhibition, reduce anxiety, and depress the central nervous system; depressants include inhalants and barbiturates.


 * Club Drugs** are usually used by young adults at all-night dance parties such as raves or trances and in dance clubs or bars.


 * Caffeine and Sugar**

Page 361, Table 13.2: Commonly Used Recreational Drugs, Their Effects, Street Names and Health Risks



From a biopsychosocial, or person-in-environment, approach, the origin of alcoholism or addiction includes //environmental, social, psychological, and genetic// variables.
 * Causes of Addiction Summary:**

-**Genetic and Environmental example:** //Fact:// 30% of children with alcoholic parents develop alcoholism themselves, while only 10% of children with nonalcoholic parents develop alcoholism

-**Secondary symptoms of Emotional Pain or Mental Health problems example:** //Fact:// a recent study showed that 69% of the women who reported substance abuse also reported exposure to childhood physical, sexual or emotional abuse; majority reported multiple forms of abuse. -this means that some addicts may use AOD to cope (or avoid coping) with anxiety and other issues such as unemployment, legal conflicts, mental health problems such as bipolar disorder, or family problems. <this theory of addiction is not accepted by groups like Alcoholics Anonymous (AA). Rather AA relies heavily on the disease model, in which blame is placed on the physiological incapacity to control alcohol consumption>.

-**Person-in-environment approach** as base for successful //diagnosis, assessment, and treatment of AOD problems.// -each client viewed as an individual with unique circumstances -in order to use this approach a social worker must be knowledgeable in several areas including: Social Learning Theory, Various Cognitive and Behavioral Treatment approaches, Co-occurring mental health problems (depression, bipolar disorder, psychosis), Cultural and Economic factors, Pharmacology and use of medication (methadone) and Fetal Alcohol Syndrome (FAS or FASD)
 * Social Work and Treatment**

<span style="color: #0000ce; font-family: 'ArialMT','sans-serif'; font-size: 17px;">[]


 * Substance Abuse Treatment and Prevention: Historical Background and Current Context Overview:**

Social Workers have been at the forefront of substance abuse treatment and prevention efforts. However, until recently they were more likely to have used a medical or disease model to plan intervention and prevention programs. More recently social workers have slowly begun to move //away from the disease model in favor of the strengths model//. Strengths model deemphasizes problem areas and emphasizes client strengths.

[] Collection of Alcohol, Prohibition and Temperance Posters and Pamphlets at Brown University

http://www.chestnut.org/LI/cyt/findings/Gov%20Summit.pdf A review of research methods and effectiveness by various models and approaches in adolescent substance abuse (national and Illinois State 1999)

[] Center for Alcohol and Drug Studies provides information of other external databases and collections

NASW statement 1997 affirmed that abuse of alcohol, tobacco and illicit, over-the-counter, and prescription drugs is a significant health problem and that the profession should //focus on prevention efforts in addition to treatment//. The statement also indicated that social, economic, and environmental factors contribute to substance abuse problems and that social workers should therefore //initiate interventions that include strengthening communities and individuals through empowerment and economic development, as well as engage in group, family, and individual treatment.// Noted that AOD problems commonly occur in combination with other mental health challenges, referred to as dual-diagnosis or co-occurring disorders.
 * Current Context**

Substance abuse treatment facilities that employ social workers include: detoxification units, inpatient or residential facilities, and outpatient settings in hospitals, prisons and juvenile justice agencies, schools, courts, welfare agencies, psychiatric facilities, and vocational rehabilitation centers. Social worker often acts as a case manager, networking and monitoring family services, vocational services, mental health services, child-care services, medical and pharmacotherapy services, legal services, and behavioral therapy and counseling services.
 * Role of social workers**

Treatment programs are effective. For every dollar invested in treatment, the government saves four to seven dollars in drug-related health costs, crime, and criminal justice costs.
 * Denial**

Stages of treatment include **stabilization, rehabilitation and maintenance**.
 * Stabilization:** detoxification and abstinence, acceptance of problem and a commitment to permanently overcome the addiction.
 * Rehabilitation:** client learns to identify maladaptive behavior and thought patterns and to replace those patterns with more positive thoughts and actions. Self-monitoring of cravings, triggers and development of coping strategies.
 * Maintenance**: priority to engage client in therapy and skill-building focusing on relapse prevention.

Evidence-based models for **early intervention prevention** programs indicate four important //protective factors:// 1) parental investment in the child-adolescent 2) child-adolescent social competence 3) child-adolescent self-regulation 4) child-adolescent school bonding and academic achievement

//“The war on drugs will not be won by trying to prevent illegal drugs from entering the country or by putting drug users in jails. It can be won through prevention and treatment programs that effectively address the underlying reasons that lead people to abuse drugs”// p.373


 * Diversity Issues and Populations at Risk**

The prevalence of substance abuse among nondominant groups and populations at risk may be explained in part by such societal factors as social isolation, institutionalized racism and poverty.

Traditionally have been double stigmatized by AOD problems, perceived as promiscuous and unfit mothers. As a result, they are less likely to seek treatment.
 * Women:**

Alcohol abuse rates about the same as whites, but more likely to suffer more severe health consequences and higher mortality rate from AOD related problems than whites and African American women. Racism explains many stereotypes that have persisted since colonial America. For instance, African Americans are //six times more likely// than whites to be arrested for AOD-related crimes. Studies and research show that substance abuse among African American population was related to economic deprivation, racism, and stress, emotional pain from cultural depravation and isolation, easy access of alcohol in inner-city areas and the governments war on drugs due to its targeted population and communities. Socio-culturally relevant prevention programs with emphasis on extended community and spirituality engagement are particularly most effective.
 * African Americans:**

Several factors account for early drug use including acculturative stress, language barriers, forced separation from family and poverty. Poverty contributes to low self-esteem, gang involvement, and higher than average teen pregnancy, substance abuse, and dropout rates. Drunk driving is a major problem among Latino men, they are more likely to be arrested for drinking and driving and more likely to die in drunken driving accidents (65 % compared to 46% among whites). For Latino men isolated from their families, group interventions tend to be successful. Family engagement and religious affiliation and support are effective in prevention and intervention of AOD related problems.
 * Latino population:**

Among the First Nation People, alcoholism rates are disproportionately highest in comparison to the rest of population and ethnicities. Racism and other historical, economic, and cultural factors help explain the AOD problems. BIA acknowledged that high rates of alcoholism, suicide, and violence in indigenous communities stem from a legacy of racism and inhumanity toward First Nation Peoples. The stereotype of the drunken Indian has even infiltrated the indigenous community, where some have been influenced to believe that First Nation people have a genetic predisposition toward alcohol consumption and abuse. Any intervention in an indigenous community should take cultural and spiritual traditions and tribal languages into consideration. Indigenous youth who identify with their culture are less likely to use alcohol.
 * Indigenous People:**


 * LGBT Community**: Various studies suggest that rates of AOD problems within the LGBT community range from 20 to 25 percent, compared to 3 to 10 percent of heterosexual population, but more research is needed in this field because it is limited. Internalized homophobia, a degree of self-hatred and shame emerges in a largely homophobic society. Those who do not disclose their sexual orientation experience intense feelings of depression, anxiety, low self-esteem, and suicidal despair. Bars have been a central meeting place in many LGBT communities, largely because there are few other places to congregate without the fear of rejection, ridicule, or violence. Research suggests that that also increases the pressure to use other drugs.

There is not necessarily one “right” answer to ethical dilemmas, but the social work Code of Ethics can provide guidance. Social Workers attempt to ask which course of action would most effectively reduce harm and cause the least harm or produce the most good. They also advocate for actions that reduce harm most effectively. The profession remains open to a definite answer.
 * Social Work and Ethics**

Should drug use during pregnancy be prosecuted? Are needle exchange programs ethical? Should some drugs be legalized?

[]

<span style="color: #269257; display: block; font-family: Tahoma,Geneva,sans-serif; text-align: center;">Chapter 14: Adult and Juvenile Justice Systems National Crime Victimization Survey 2009 Results
 * Violence, Crime, and Punishment in the US**
 * 2.3 million criminals behind bars; 1 in every 100 American adults (2008)
 * Higher levels of violent crime, easy access to guns, laws that require longer sentences, institutional racism, deeply held values of individualism and personal responsibility, the war on drugs
 * Almost half of murder victims are African Americans
 * Gun violence
 * Every day __eight__children and teenagers are killed by gun violence
 * Since 1968 over a million Americans have been killed by firearms in the US


 * The Criminal Justice System**
 * Primary goals are to maintain public safety and punish lawbreakers by confining or controlling them
 * Social Work covers a lot of territory
 * Specialize in juvenile corrections, rehabilitation within the adult correctional system, case management, counseling services in probation and parole, police social work, victim assistance services,
 * Employed by the government, nonprofit victim assistance agencies, or lobbies
 * Advocate for public policies that address poverty, unemployment, and hopelessness

__**Cycle of Violence**__ 1. Retaliatory violence towards the perpetrator 2. Victim lashing out on others due to frustration and anger 3. Victim befriending his or her attackers
 * Victims of crime who live in poor areas sometimes end their victimization by becoming criminals themselves
 * Three pathways:

Individualistic Theories
 * Theories of Criminal Behavior Relevant to Social Work**
 * See criminals not as societal victims but as responsible individuals who must be punished
 * Require society to do little
 * __Deterrence Theory__: People who do not associate certain swift, and severe punishment with criminal activity will choose crime
 * __Biological Determinism__: Criminals inborn, may have low IQs or a biochemical imbalance
 * __Psychological Determinism:__Defects of the mind are the cause of all misbehavior
 * __Behaviorism__: Criminal behaviors are learned responses

Sociological Theories
 * Structural problems, poverty, inequality, constrained residential patterns, and institutional racism are the root causes of criminal behavior
 * Criminal values are passed from one generation to the next
 * __Broken Window Theory__: idea that the level of crime committed in an urban area is correlated with the number of broken windows
 * Encourages that focusing on little things is more effective than trying to fix the problems of institutionalized racism and poverty

Shell Shocked: The New Orleans Youth Story Shell Shocked Home Page


 * Social Workers Support...**
 * Using the political system to eliminate poverty and make society’s rewards accessible to all
 * Making prisons more humane and safe environments where inmates can learn from the modeling behaviors of prison personnel
 * Giving inmates access to effective therapy, educational opportunities, and job skills training
 * More funds to be spent on juvenile prevention and treatment programs

Racial bias in the Criminal Justice System
 * Racial Imbalance in the Criminal Justice System**
 * Police response time is faster, effort exerted stronger, and follow-up more rigorous when the crime victims are white
 * Study done in 2006
 * Black males are less likely that white males/female or black females to be placed on probation rather than sentenced to jail
 * Blacks and Latinos received longer prison sentences than whites for similar crimes
 * Over 60% of prisoners are members of non dominant groups
 * African Americans constitute only 12% of the general population
 * Latinos only 13%
 * Institutional racism and racial bias’ in sentencing
 * Solution: review all federal drug laws and give judges more discretion to decide sentences rather than imposing mandatory minimum prison terms


 * Women in the Criminal Justice System**
 * Women make up about 7 to 8 percent of the prison population
 * Between 1977 and 2004, there was a 574% increase, nearly twice the 388% for men
 * Largely due in part to mandatory drug sentencing, with women (one out of three) more likely than men to be in jail for a drug offense
 * Almost half of female convicts are survivors of physical or sexual abuse
 * Two-thirds are unmarried and have children under the age of 18
 * Women are more likely to test positive for HIV/AIDS
 * The needs of women offenders are different than those of men because of their disproportionate victimization from sexual or physical abuse and their responsibilities to their children
 * They are also more likely to be addicted to drugs or have mental illnesses than male inmates
 * When cut off from their children, families and friends, female inmates are far more likely than male inmates to experience feelings of helplessness, powerlessness, and despair

[|Women in Prison]


 * Inmates with Disabilities**
 * Under the Americans with Disabilities Act (ADA), correctional facilities must provide programs, services, and activities for inmates and employees with disabilities
 * Mental health screening, evaluation, and treatment must be provided to the estimated 30% of offenders who have mental disabilities
 * There are several ways for correctional facilities to accomodate inmates with disabilities
 * Provide specialized housing unites
 * Diverting inmates to more specialized facilities
 * Inmates who are hearing or speech impaired must be provided with
 * Auxiliary aids, including listening devices, taped texts, and other telecommunications devices


 * Inmates with Chronic Health Problems**
 * Almost 3% of all female prison inmates and 1.9% of male inmates are HIV positive
 * An estimated 17% of prison inmates are infected with hepatitis C
 * Many prisons do not provide treatment because it costs about $10,000 a year to treat a person who is infected, only 30% of treated patients get better, and no one knows how long one will stay healthy for
 * About 85% of people who contract hepatitis C suffer from chronic infection and die from liver failure 10 to 40 years later
 * Alabama, Mississippi, and South Carolina prison systems segregate HIV-positive inmates from the general population
 * HIV-positive inmates are excluded from 70 different programs, including job training, educational, and work release programs
 * They're offered alternative programs but these are more limited and appear to be less effective than the programs provided to the general population


 * Undocumented Immigrants and Crime**
 * In 2006 it was estimated that there were 11.5 to 12 million unauthorized people living in the United States, or whom more than half (56%) were thought to be from Mexico and 22% from the rest of Latin America
 * Since 2005, the Department of Homeland Security (DHS) has increased efforts to detain undocumented immigrants and remove them from the United States
 * The difference is not the laws on the books, which have not been changed, but the enforcement of these laws.
 * The DHS detainee population exceeds 261,000 annually. The detention is civil and punitive, yet the vast majority are held in prisons, housed with criminal convicts
 * Immigration detainees are held under civil law, not criminal law. As such, they are legally entitled to better living conditions than convicted prisoners or pretrial detainees
 * One of the rationales for such acts is to combat crime. Do immigrants, particularly undocumented immigrants, cause more crime? Althought there may be public perception as such, studies indicate that may not be true
 * Research indicates that crime decreases with growth in immigrant populations
 * Immigrant communities are often tight knit, and there is an informal system of social control
 * People who are undocumented are fearful of accessing social or public services. Fear of become known to authorities and potentially detained or deported holds people back. This fear includes reluctance to report crimes or make oneself known to school authorities

[|Immigrants and Crime]

**SOCIAL WORK ROLES AND SKILLS**

 * Historical Background**


 * In Great Britain during the 1740s a sheriff named John Howard and an ordinary citizen, Elizabeth Gurney Fry, began to create prisoner assistance programs
 * Sheriff Howard focused on improving prison conditions, while Fry provided direct aid to prisoners
 * By late 1800s, Massachusetts, Maryland, and New York were attempting to duplicate Howard's and Fry's prison reforms
 * In 1841 John Augustus, a Boston philanthropist, because the first unofficial probation officers when he convinced the Boston courts to release people convicted of alcohol-related offenses to his care so that he could help with rehabilitation efforts
 * probation**: is a sentence that does not, at least initially, require incarceration; it may involve a fine, supervision, community service, restitution or home confinement
 * parole**: is the conditional release of a prisoner from incarceration to supervision after part of his or her sentence has been completed
 * Prior to the twentieth century, juveniles were treated in about the same way as adult criminals
 * In 1897 social workers began advocating for **delinquent youth**--children under the age of 18 years who have violated a local, state, or federal law for which an adult can be prosecuted--and began fighting for separate court system to serve them
 * The first juvenile court was established in Chicago in 1899
 * By the early 1900s the entire juvenile court system had acquired a social work emphasis, with a goal of providing treatment and rehabilitation for youth
 * **Due process**--which includes the right to a fair trial, the right to be present at the trial, the right to an impartial jury, and the right to be heard in one's own defense--was introduced into the juvenile system during the 1960s
 * police social work**: originally called women's bureaus, evolved into a specialization that provides social work services to victims and offenders who are referred by the police
 * Police social work experienced a resurgence during the 1980s, when many social workers were hired with funds from a federal grant program, the Law Enforcement Assistance Administration. When the grants ran out in the mid-1980s, many police social workers lost their jobs
 * During the 1960s rehabilitation had become the focus of adult corrections in the U.S. legal system
 * rehabilitation**: is treatment that helps criminal offenders change their antisocial styles of thinking, feeling, and acting
 * In the late 1960s reformers introduced the practice of offering diversion as part of criminal rehabilitation
 * diversion**: involves officially suspending criminal or juvenile proceedings so as to allow defendants to meet specified conditions, such as completing treatment, community service, or an educational program
 * During the 1970s, social workers also began to assist in **reintegration**services, providing a bridge to the community for adults released from prison
 * In 1982, perhaps because of the number of people victimized by crime had reached an all-time high, the federal government organized the first President's Task Force on Victims of Crime
 * The Office for Victims of Crime (OVC) was instituted by the Department of Justice in 1983
 * The Federal Victim of Crime Act (VOCA) was enacted in 1984
 * Both provide federal funds to support victim assistance programs and advocate for the fair treatment of crime victims
 * forensic social work**: is the application of social work to questions and issues relating to law and the legal system, which essentially covers the entire criminal justice system as well as civil family matters such as divorce and custody issues

Social work's effect on the criminal justice system has been uneven. Over time, the system as become increasingly punitive. It has almost never provided criminals with appropriate access to effective treatment and rehabilitation programs.

ü Juvenile and family courts —practice with children, youth, and families. It is put in place to 1) Prevent delinquency 2) Protect society 3) Prevent abuse and neglect 4) Protect children who are being abused and/or neglected 5) Preserve and strengthen families The deal with two types of offenses 1) Delinquent- violation of laws that adults can also be prosecuted for 2) __Status__- illegal for those who are considered minors (ex. missing school or running away) Function of social workers in the court system: psychosocial assessments, court investigations, courtroom testimonies, supervising probation, fulfilling court-assigned social services. They act as agents of the court and those powers allow them to intervene. These powers vary from state to state. Social workers are also important contributors to juvenile delinquency prevention programs which include: 1) Parent training interventions 2) Early intervention 3) Child abuse prevention, violence prevention, substance abuse prevention, gang prevention 4) Conflict resolution 5) Truancy reduction These programs are put in place for families, schools, and in community settings and come from all theories of criminal behavior. 1) Holistic approach in treatment and placement 2) Must be family centered 3) Needs of youth take priority 4) Ethnically and culturally appropriate programs should receive priority funding 5) Think “outside the box” for placement and treatment that are best suited to the individual needs 6) States should determine priorities and hold treatment providers accountable 7) Community based programs are more effective than incarceration [] – different approach to the treatment of youth. Most violent crimes and felonies are committed by male offenders, but now female criminal activity is rising. Females becoming offenders begin with being physically, sexually, and emotionally victimized. The system was developed with that idea that it is boy dominated, so there is a gender gap in services. This is due to processing and the different rate of maturing. Many are still punished instead of treated because of limited access to effective treatment or rehabilitation services. [] - mandated by federal law to examine the juvenile justice system and work to prevent youth being involved with courts. [] youth are different than adults and should be treated differently. ü Adult corrections Social workers evaluate inmate’s behavior, write comprehensive psychosocial histories, prepare reports for parole board, administer treatment programs to sex offenders, alcoholics, and addicts, conduct individual and group therapy, teach life skills, or advocate for prisoners’ rights. After adults are released from prison they usually lack the skills needed to return to the real world, 2/3 eventually return to prison. In 2008 George Bush signed the Second Chance Act (SCA) which is designed to reduce the recidivism rate. __Recidivism__ refers to a criminal offender’s return to criminal behavior after a period of correctional treatment. Newly released inmates have difficulty: 1) Obtaining jobs 2) Education 3) Housing This program helps give information about proven programs, helps reunite families, and broadens access to high quality drug treatments. Prisons that offer these services reduce the recidivism rate by as much as 50%. [] [] we deserve our lives back ü Probation, Parole, and community corrections __Community corrections-__refers to punishments or sanctions that occur outside of secure correctional facilities in half-way houses, treatment programs, work or educational release programs, community service programs, and diversion programs. This allows offenders to work and support their families while still paying back the community. Social worker/case manager who deals with probationers and parolees has 10 primary responsibilities: 1) Engage the client in the helping process 2) Assess the needs of the client 3) Develop a service plan 4) Link the client with appropriate services 5) Coordinate with other case managers and helping professionals involived in the client’s service plan 6) Monitor the progress of the client 7) Intervene with sanctions when necessary 8) Advocate for the client when necessary 9) Provide counseling and informal guidance 10) Evaluate the effectiveness of the service Probation, parole, and community corrections are protection of the community and reintegration of the offenders. Social workers must find a balance between support for the client’s reentry into society and the supervision and protection of the community. [] standard and accreditations [] stay out of prison and reintegrate into society. ü Victim assistance- assists victims of crimes. A __victim__ is not only the person against whom a criminal offense has been committed but also, if that person has been killed or incapacitates, his or her spouse, parent, child, family, or other lawful representative. Victims develop emotional problems including: intense anger, fear isolation, low self-esteem, depression, and helplessness. Social workers are advocates and counselors and are skilled in advocacy, negotiation, mediation, crisis intervention, must know how to prepare victim impact statements, compensation forms, application for emergency monetary assistance, and facilitate victim-offender mediation. Crisis intervention skills are also used when dealing with rape, homicide, suicide, and death notification. After crisis intervention clients need long term counseling and services for ongoing support. Dealing with children is a little different social workers use play therapy, puppets, dolls and drawings to help children tell their stories and emotions. [] play therapy Policy Issues social work goal in dealing with criminal justice is to sever the public interest by developing, advocating for, and implementing effective public policies. [] [|Advances in brain science are calling into question the volition behind many criminal acts. A leading neuroscientist describes how the foundations of our criminal-justice system are beginning to crumble, and proposes a new way forward for law and order.]
 * Forensic social workers** practice in a variety of legal settings where they work to ensure fair treatment. These legal settings include:
 * __Juvenile Corrections__**__:__ encompass a wide range of interventions for young people who have broken the law. Social workers in this field are caseworkers, counselors, administrators, policy analysts, program evaluators, and advocates. __Adjudication__ is the process of formal accusation, trial, and sentencing. Most adjudicated juveniles are sent to training schools (physically similar to maximum-security prisons, but some are secured communities). There are 7 components in making juvenile treatment effective
 * Juvenile Justice and Delinquency Prevention Act of 1974- required states to decriminalize status offenders and to separate juvenile delinquents from adult offenders
 * 1980 it was amended to require states to remove juveniles from adult jails and established the Office of Juvenile Justice and Delinquency Prevention. This provided national leadership, coordination, and resources to prevent and respond to child victimization and juvenile delinquency
 * With the increase in crime rates in 1980, states were forced to change their laws. Between 1985 and 1997 the number of Juveniles sentenced to adult prisons doubled—58% African American, 25% where white, 15% Latino, and 2% Asian American. 61% were convicted of violent crimes (rape, robbery, and murder. Those taken to adult corrections reentered more times and much more quickly than minors tried in Juvenile courts.
 * Juveniles in the adult system are more likely for recidivism, sexual assault, and beatings.
 * Social workers must protect the rights and needs of juveniles placed in the adult criminal justice system.

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 * Domestic Violence **
 * A pattern of assaultive behaviors, including physical, sexual, and psychological attacks and economic coercion, by adults and juveniles against their families or intimate partner.
 * []
 * []
 * __Some Statistics__
 * 9% of all violent crime
 * 389,100 women victimized by intimate partner (2005)
 * 78,180 men victimized by intimate partner (2005)
 * 85% of victims are female
 * 20-24 years of age are at the greatest risk
 * []

[|Legal and Psychological Perspectives on Same-Sex Domestic Violence: A Multisystemic Approach]
 * []
 * http://www.ncjrs.gov/pdffiles1/nij/181867.pdf**


 * __Violence Against Women Act__
 * Enacted in 1994, made available $1.6 billion in support of programs that researched domestic violence and sexual assault. Saw a decline in incidents from 1993 to 2002.
 * []

**//<span style="font-family: 'Trebuchet MS','sans-serif'; font-size: 10px;">John McAdams - Marquette University/Department of Political Science, on deterrence //**
 * Crime and Mental Illness **
 * []
 * Research indicates that as many as 20 percent of inmates in jail or prison are in need of psychiatric care because of mental illness.
 * Women have a higher rate of mental illness than men
 * 70 percent of juvenile offenders suffer from mental illness
 * Conduct disorders
 * Attention deficit disorder
 * Substance abuse problems
 * Social workers advocate for the right of seriously mentally ill prisoners to receive mental health treatment and for them to have access to rehabilitative services.
 * The Death Penalty **
 * Carrying out the death penalty costs tax payers three times more than keeping an offender in a maximum-security prison for 40 years (Logan, 2008).
 * The US is the only industrialized nation that still uses the death penalty.
 * Thirteen states do not have the death penalty and several other states have moratoriums on the death penalty until the fairness of the practice has been reviewed.
 * The death penalty is very controversial in part because there have been so many people released from death row based on new DNA evidence that was not previously available.
 * In April 2008, the Supreme Court decided by a 7 to 2 decision that lethal injection was legal as long as it was administered properly.
 * Person who commit crimes before the age of 18 cannot be given the death penalty
 * Race and class play a significant role in death penalty statistics and in our public response to crime
 * []
 * <span style="font-family: 'Trebuchet MS','sans-serif'; font-size: 10px;">"If we execute murderers and there is in fact no deterrent effect, we have killed a bunch of murderers. If we fail to execute murderers, and doing so would in fact have deterred other murders, we have allowed the killing of a bunch of innocent victims. I would much rather risk the former. This, to me, is not a tough call." **
 * []

> -David Atwood, founder of Texas Coalition Against the Death Penalty > -Ruth Bader Ginsburg, U.S. Supreme Court Justice
 * <span style="font-family: 'Arial','sans-serif'; font-size: 13px;">"When we don't fund Child Protective Services, there are consequences for all of us. Violence manifests itself. Mental health services in Texas are extremely poor. The answer is not to wait until they do something to get them help."
 * <span style="font-family: 'Arial','sans-serif'; font-size: 13px;">"I have yet to see a death case among the dozen coming to the Supreme Court on eve-of-execution stay applications in which the defendant was well represented at trial... People who are well represented at trial do not get the death penalty."
 * []

Perhaps the most important victims’ right is that victims must be given notice of the existence of their participatory rights. Law enforcement officers, prosecutors, and victim service personnel, including social workers, all share notification responsibility. It is essential for social workers to be knowledgable about the victims’ rights in the state they are working so that they can best assist in the helping process. Social workers must continue to advocate for the expansion and more effective enforcement and implementation of victims’ rights.
 * Victim’s Rights **

[] []

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Chapter 8: Gerontology
 * Human Development within the Social Context **


 * Ageism
 * prejudice against people based solely on age
 * generally associated with older people
 * Gerontology
 * The study of the biological, psychological, and social aspects of aging
 * The goal of gerontological social workers is to promote and advance older clients’ social, emotional, and physical well being so that they can live more independent and satisfying lives
 * Four major categories used to analyze elderly clients
 * Biological and physiological aspects of aging
 * Cognitive process and emotional/psychological development
 * Sociological aspects of aging
 * Legal, political, and economic aspects of aging

Biological and Physiological aspects of aging


 * Must understand the basic functions of human physiology such as the circulatory, respiratory, and nervous systems, etc. and how aging affects these body systems
 * Also need to have knowledge about the physical and mental impairments that are related to chronic illnesses as well as the commonly used medications and their side effects

Cognitive Process and Emotional/Psychological Development


 * Can help clients navigate stressful life events such as retirement, widowhood, physical decline, residential relocation, loss, and approaching death.
 * Must know the factors that affect learning, intelligence, and memory as people age.

Sociological Aspects of Aging


 * Understand social roles and expectations such as marital roles, grandparenthood, and sexual behavior
 * Activity theory
 * The more active a person is, the more satisfied that person will be during his/her golden years
 * Disengagement Theory
 * To withdraw and become more introspective as one grows older is normal and healthy

Legal, Economic, and Political Aspects


 * Important legal issues, court cases, legislation, and economic policies that affect and protect the rights of the elderly
 * Examples: age discrimination, guardianship and conservatorship, living wills, power of attorney for healthcare, and Social Security and pension benefits
 * Those who are working in medical facilities need to be aware of the legal rights of chronically and terminally ill elder patients

VOLUNTEER !



[|Elder Friends]

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<span style="font-family: 'Palatino Linotype','Book Antiqua',Palatino,serif; font-size: 140%;">More than 37 million people in the United States are over the age of 65. Individuals over 65 are affected by ageist attitudes or are directly discriminated against. Ageism affects both the youth and the elderly but is primarily directed towards the elderly.

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<span style="font-family: 'Palatino Linotype','Book Antiqua',Palatino,serif; font-size: 140%;">The social work profession is committed to preventing and fighting ageism, negative, stereotypes, myths, and negative practices that affect older people. media type="youtube" key="3Ld6j_uDQ1c" height="349" width="425"

GSWI

= Social Work Practice = <span style="font-family: 'Palatino Linotype','Book Antiqua',Palatino,serif; font-size: 130%;">In 1941, the first professional organization, the Gerontological Society of America, was established to promote age-related issues. <span style="font-family: 'Palatino Linotype','Book Antiqua',Palatino,serif; font-size: 130%;">Gerontological Society of America

<span style="font-family: 'Palatino Linotype','Book Antiqua',Palatino,serif; font-size: 130%;">In 1960, to recognize the needs and contributions of older people, the federal government established the National Council on Aging.

media type="youtube" key="NDcesNXuJ-4" height="349" width="560" National Council on Aging

<span style="font-family: 'Palatino Linotype','Book Antiqua',Palatino,serif; font-size: 130%;">The National Council on Aging has had several White House Conferences. The first conference in 1961 led to the passing of several legislation passages. The Economic Opportunity Act of 1964 funded community-based social services. The 1965 Older Americans Act is a law that established the Federal Administration on Aging as well as the statewide Area Agencies on Aging, both of which were designed to coordinate and fund social services for older people. The second White House Conference on Aging in 1971 focused on housing and adequate income. In 1974 Supplemental Security Income (SSI) was added to the public assistance package which was provided by the federal government. To increase and maintain gains made by and for older people, a non-profit, nonpartisan organization was established during the 1980s. The American Association of Retired Persons (AARP) became dedicated to helping elderly Americans achieve independent, dignified, and a purposeful life. media type="youtube" key="Rs1vsbutvEc" height="349" width="425"

<span style="font-family: 'Palatino Linotype','Book Antiqua',Palatino,serif; font-size: 130%;">The third White House Conference on Aging in 1981 tried to address issues such as ageism, elder abuse, long term health care, and negative stereotyping of the elderly. The fourth White House Conference on Aging in 1995 ended with the idea of saving medicare and social security. The fifths White House Conference on Aging in 2005 aimed for providing transportation for the elderly.

<span style="font-family: 'Palatino Linotype','Book Antiqua',Palatino,serif; font-size: 130%;">Social Security

<span style="font-family: 'Palatino Linotype','Book Antiqua',Palatino,serif; font-size: 130%;">Older people are persons 65 years old and older. They are categorized into three groups: the young-old (ages 65-74), the old-old (ages 75-84), and the oldest-old (age 85 and older). Services to help the elderly differ among gerontological social workers due to various settings. Adult protective services, which help the abused elderly; institutional placement services for the elderly, adult day care, and even social workers in a health care or a psychogeriatric settings, which is a combination of psychiatric and mental health care. In these settings psychosocial and comprehensive assessments are used to determine conditions for the given setting. Serving as liaisons to community agencies, working as policymakers or administrators, and participating in development of new programs are roles a gerontological social worker must play to become a successful advocate for the elderly.

<span style="font-family: 'Palatino Linotype','Book Antiqua',Palatino,serif; font-size: 130%;">__Critical Public Policies__ <span style="font-family: 'Palatino Linotype','Book Antiqua',Palatino,serif; font-size: 130%;">Social Security Acr of 1935 was the first major legislation that included programs to aid the elderly. Social Security was never intended to by a retired person's only source of income, but instead to supplement pension funds and savings. Medicare was added to the Social Security Act in 1965. Medicare is a universal, federally funded health insurance program for older people. It has four parts: Part A (hospital insurance) helps pay for inpatient hospital care and certain follow-up services, Part B (medical insurance) optional monthly premium that pays for up to 80% of allowable services, Part C (medicare advantage) provides an expanded set of options for delivery health care, and Part D (prescription drugs) provides subsidized access to prescription drug insurance.

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<span style="font-family: 'Palatino Linotype','Book Antiqua',Palatino,serif; font-size: 140%;">In 1974 the Supplemental Security Income (SSI) was added to the Social Security Act. This program includes cash assistance to people who are poor and elderly or poor with disabilities. The amoint an older person receives depends on other income and where the person lives. The Social Services Block Grant program provides federal funds for adult foster care and day car programs. The Older Americans Act of 1965 funds social services like senior centers and nutrition programs. The Family and Medical Leave Act of 1993 allows men and women time off from work to care for dependent parents and newborn children, with the guarantee of no job loss.

The Roles of Social Workers


 * ====Explores and identifies one’s own attitudes and fears on aging====


 * ====is trained in interpersonal relationships====


 * ====interdisciplinary or multidisciplinary team skills====


 * ====Doctors====
 * ====Nurses====
 * ====Psychiatrists====
 * ====Physical therapists====
 * ====Occupational therapists====
 * ====Dieticians====


 * ====Community====
 * ====adult day care, Adult Protective Services====
 * ====Health Care- Hospitals, Home Health, and Hospice====
 * ====Geriatrics, home health care agencies, outpatient rehabilitation====
 * ====Nursing Homes====


 * ====Social work at the Alzheimer’s association====
 * ====Social work in rural geriatric mental health====
 * ====Working with homeless older adults====


 * Diagnosis/Assessment- the goal of a psycho-social needs assessment is to identify the strengths and limitations of both the family and the patient and to assist them with a treatment plan. The assessment takes into consideration how well a patient functions in six different categories.
 * Physical, psychological, social, cultural, environmental, spiritual


 * Care management- or case management, this aspect of social work can include problem identification (for example, lack of financial resources, or a mental health intervention) as well as a linkage to community resources such as transportation services, household care assistance, or medical specialists.

Case management is the primary tool for social service agencies that help older people remain in their homes. They are also the primary tool for cases that involve long term care.

Long-term care provides health and social service over a long period of time. The goal of the social worker as a case manager will be to make sure the services are appropriate to the needs of the client, and improve client access to long term care. They also provide counseling and serve as a bridge between institutional and community-based care services.


 * Individual Counseling- Psycho-social counseling includes treatment of mental health problems such as depression and anxiety through many techniques. A patient's ability to adjust to an illness has a profound impact on the quality of life as well as upon the patient's willingness/ability to comply with the prescribed treatment.


 * Group work- Group therapy and supportive educational groups are designed to help patients, caregivers, and patient’s families cope with a specific illness, e.g., depression, Alzheimer's disease, cancer or diabetes. The social worker brings skills in group development and facilitates the group.


 * Liaison- Most commonly, the social worker is the principle liaison among team members, other staff, and the caregivers or patients families.


 * Advocacy- Social workers’ training, including knowledge of ethics, patient confidentiality, cultural and ethnic factors, and patient and family rights serve to help teams face the challenge of balancing their patient’s needs with the demands of the system. Often, the most important service that social workers provide is to assist in negotiating an overwhelming bureaucratic system.


 * Community resource expertise- Knowledge of community resources and how to access them is an important piece of the social work profession. This involves
 * Negotiation and bargaining in order to become a broker for appropriate resources
 * A working knowledge of financial systems, including federal, state and county programs.

(Developed by the GITT - Social Work Interest Group of the John A. Hartford Foundation Geriatric Interdisciplinary Team Training Program)

==== Social workers need to be aware of the older people at risk. Women; African Americans, Latino, and Indigenous older people; older persons living alone; the oldest-old; and older people in rural areas are the most at risk. These people are much more likely to live in poverty, have an early onset of chronic health problems, and have a shorter life expectancy. Life-long racism and discrimination cause a chain reaction of unemployment and underemployment which result in a lack of pensions and lower Social Security benefits. Living in poverty, there is a lack of knowledge for services that are provided which helps account for the added vulnerability. ====

==== The long-term effects of gender discrimination are still not completely understood, due to the fact that they have not been included in research until recently. According to our text, our society gives women a great deal of praise for beauty and giving birth, but there is little value that is placed on the older women. There is evidence that the combined effects of being female and being old negatively affects a woman’s mental health. ====

==== Social workers need to advocate for services available in racial or ethnic communities of older people. The service should be culturally appropriate. Social workers should strive to be bi-cultural as well as bilingual. Outreach services are critical within these communities. ====

Resources

[]

[|The growing need for gerontological social workers]

[|Geriatric Social Work Initiative]

**Values and Ethical Issues**
Gerontological social workers often encounter difficult professional situations. These situations involve ethical aspects.

Physician-Assisted Suicide- The most difficult question is whether physician-assisted suicide is considered a controlled passion for patients who are terminally ill and in severe pain, or if it is considered murder. Dr. Jack Kevorkian is well known for his efforts in both passive and active euthanasia. He was arrested three times for providing means of death to patients and in 1998, he was sentenced 10-25 years in prison. In 2007, he was released from jail. The majority of the public favors the idea of doctors assisting a patient’s request for suicide. However, only in Oregon, have voters approved the Death with Dignity Act in 1994. It allows doctors to prescribe lethal prescriptions to their patients. There was no correlation found between elderly, poor, or minorities and likeliness or pressure to use the lethal medications.


 * ==== Social workers need to be aware of all legal and ethical issues surrounding physician-assisted suicide and recognize their own feelings as to not impose their beliefs onto their clients. ====


 * ==== Many health care facilities have created ethics committees in dealing with ethical concerns. These committees are made up of doctors, clergy, social workers, care providers, lawyers, and family representatives. ====


 * ==== Social workers are there to encourage elderly clients to have a full on discussion with their doctor, family members, and friends about their wishes should they become incapacitated. ====


 * ==== They should also encourage clients to have a living will. This consists of how a person’s wishes to have their death handled in the event that the person cannot participate in the decision making. ====


 * ==== An Advance Directive is also a document that outlines the medical options to be used or not used to prolong life. Social Workers help to facilitate this process. ====


 * ==== Who should receive vaccines if there is a limited supply available ====
 * ==== Who should be placed higher on an organ transplant list ====

Social workers should be involved in discussions on how age and other factors are considered when negotiating limited resources for their clients.

Resources﻿[][|Powerpoint on ethical dilemmas][|"You Don't Know Jack" trailor]

** Critical Issues and Emerging Concerns ** **__ Medicare __** <span style="color: black; display: block; font-family: Arial; font-size: 13px; line-height: normal; margin-bottom: 0pt; text-align: justify;">Medicare is the primary insurance for many elderly and disabled people, and it had no prescription drug coverage. In 2003, the Medicare Prescription Drug Improvement and Modernization Act took effect. It was designed to help with the cost of prescription drugs, which many had monthly expense over $500. <span style="color: black; display: block; font-family: Arial; font-size: 13px; line-height: normal; margin-bottom: 0pt; text-align: justify;">Many people had Medicaid as a secondary insurance, when this Act went into effect, Medicaid no longer picked up the increasing cost of prescriptions. <span style="color: black; display: block; font-family: Arial; font-size: 13px; line-height: normal; margin-bottom: 0pt; text-align: justify;">Under the Medicare D Prescription Drug Plan the enrollee have <span style="color: black; display: block; font-family: Arial; font-size: 13px; line-height: normal; margin-bottom: 0pt; text-align: justify;">- an average $ 37 monthly premium <span style="color: black; display: block; font-family: Arial; font-size: 13px; line-height: normal; margin-bottom: 0pt; text-align: justify;">- a $250 deductible <span style="color: black; display: block; font-family: Arial; font-size: 13px; line-height: normal; margin-bottom: 0pt; text-align: justify;">- between $250 and $2,250 the enrollee pays 25% <span style="color: black; display: block; font-family: Arial; font-size: 13px; line-height: normal; margin-bottom: 0pt; text-align: justify;">- between $2,250 and $5,100 the enrollee pays 100% of the drug cost. This is called "the donut hole" - after $3600 the enrollee has a copay for $2-5 per drug media type="youtube" key="uKDteTBUJG4" height="349" width="425" **__ Elder Abuse and Neglect __**

<span style="color: black; display: block; font-family: Arial; font-size: 13px; line-height: normal; margin-bottom: 0pt; text-align: justify;">Forms of Elderly Abuse

<span style="color: black; display: block; font-family: Arial; font-size: 13px; line-height: normal; margin-bottom: 0pt; text-align: justify;">Advocates or Resources for help would be Adult Protective Sevices as well as the National Longterm Care Ombudsman Resource Center
 * 1) Physical Abuse- any willful infliction of injury, forced confinement, or cruel punishment.
 * 2) Sexual Abuse – non consensual sexual contact of any kind
 * 3) Emotional Abuse- humiliation, harassment or social isolation
 * 4) Neglect- with holding basic necessities
 * 5) Financial Exploitation- stealing, with holding or mismanaging money.

**__ National Center for Victims of Crimes __**[]

**__ National __****__ Center __****__ for Elderly Abuse __** [] media type="youtube" key="WUajNHejtyc" height="349" width="425" [] [] [] **__Alzheimer’s Disease and Dementia__** Dementia is an irreversble loss of brain function. It affects your intellectual and social abilities enough to intefere with daily functioning. <span style="color: #343637; display: block; font-family: Verdana; font-size: 13px; line-height: 115%; text-align: justify;">Alzheimer's disease accounts for 50 to 80 percent of dementia cases. [|http://www.alz.org] (symptoms, stages, warnig signs, related dementias, treatments etc…) [] media type="youtube" key="q1BkfV2h09g" height="349" width="560" **__Mental Health & Depression__** - Depression affects as many as 2 million elderly aduts a year - Increase as the individual experience changes associated with aging. (physical, social and psychological) - The most under diagnosed condition of the elderly, especially in Nursing Homes - Test used to measure depression in elderly

- Psychogeriatric Social workers work more closely with client and physician because many mental conditions go undiagnosed. - [] **__Caregivers for Aging Parents__** Social Workers may educate families and caregivers on resources and assistance to either keep the client home or moving to a facility. **National Family Caregivers Association** [] **__GrandParents Caring for Grandchildren__** More grandparents are now raising grandchildren because the parents can not due to: - This may be hard on the grandparent causing http://youtu.be/MS6AOzkk9Os
 * Geriatric Depression scale
 * Beck Depression Inventory (w/o dementia)
 * Cornell Scale for Depression (w/ dementia)
 * Anxiety
 * Paranoid disorders
 * Substance abuse
 * || ** Caregiving Population ** ||  ||   ||   ||
 * ||  ||   || <span style="color: #333333; font-family: Verdana; font-size: 13px; line-height: normal; margin-bottom: 0pt;">More than **65 million people,** 29% of the U.S. population, provide care for a chronically ill, disabled or aged family member or friend during any given year and spend an average of 20 hours per week providing care for their loved one. ||
 * // Caregiving in the United States; //// National Alliance for Caregiving in collaboration with AARP; November 2009 // ||
 * <span style="color: #333333; font-family: Verdana; font-size: 13px; line-height: normal; margin-bottom: 0pt;">The value of the services family caregivers provide for "free," when caring for older adults, is estimated to be **$375 billion** a year. That is almost **twice as much** as is actually spent on homecare and nursing home services combined ($158 billion). ||
 * // Evercare Survey of the Economic Downturn and Its Impact on Family Caregiving; //// National Alliance for Caregiving and Evercare. March 2009 // ||
 * // Evercare Survey of the Economic Downturn and Its Impact on Family Caregiving; //// National Alliance for Caregiving and Evercare. March 2009 // ||
 * Divorce
 * Abuse (physical or substance)
 * Disease
 * Dissertion
 * Death
 * Deployment
 * Incareration
 * More illnesses
 * Depression
 * Marital problems
 * Poverty.

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<span style="color: #0000ff; display: block; font-family: Arial,Helvetica,sans-serif; font-size: 190%; text-align: center;">Chapter 7: __Child Welfare://Working with Children and Their Families//__

<span style="color: #000080; font-family: Arial,Helvetica,sans-serif;">__//﻿//__
__Child Welfare Systems__ == The Child Welfare System is a network of federal and state mandates that advertise for the welfare of children and facilitate permanency by providing services to prevent the unnecessary seperation of families and to reunite children with their parents if they have been seperated. ==

== Child Protective services is the state system, department, or agency responsible for the investigation of allegations of abuse or neglect, the protection of children at risk of abuse or neglect, service delivery and the placement of children who have been maltreated. Social workers serve as caseworkers, supervisors, and administrators. == == Foster Care is a organization that takes in and take care of outside of the family. The purpose is for a child to be placed in a foster care while the family receives counciling. The main objective is to return the child back into the home with their family. == == In this profession, Social Workers follow guidelines. This is known as permanency planning. In some cases, it still may not be safe for the child to return home. If that fails, then the the next alternative is adoption. ==

Limited Conceptions
== More and more social workers are being told to locate a area of focused responsibility and help their patient on soley that. However, most patients have more than one problem, but social workers are told to just focus on one. == == This can leave social workers dissapointed, because they are not fully able to help the client. The fact is that the social worker is instructed to do follow orders and has to go by them. In this system, social workers are limited to a extent to what they can do to help a patient. ==

=The Child Welfare League of America=

=[|www.cwla].org=

==The Child Welfare League of America or CWLA is the oldest child welfare organization in the United States. The organization's primary objective is to "Make Children a National Priority. The CWLA is the trusted authority for professionals who work with children and the only national organization with members from both public and private agencies, providing unique access and influence to all sectors of the children’s services field.==

__ History __
=Founded in 1921 as a federation of approximately 70 service-providing organizations, the first director of the CWLA, C. C. Carstens, was a well established national child welfare leader and opponent of institutional care for children. Originally located in New York City, the CWLA moved to Washington, D.C. in 1985. In 2008 the organization introduced a bill in the U.S. Congress that would host the White House Conference on Children and Youth by 2010.= = =

= The Roles of Social Workers #|Social Workers =

__CASE MANAGEMENT__
== Case management with children includes assessing a child's problems and needs and determining what steps are necessary to provide services for the child and their family. Case management is involved when a social worker tries to find low-income housing for a family in need, works with a foster family to provide counseling services for a child placed in the home, and works in a hospital to help a family find aftercare services for a child. ==

__ DIRECT PRACTICE __
== Direct practice with children and their families can be varied depending on the clients needs and the environment in which a social worker is based. Generally, direct practice involves face-to-face contact with children and family members to form a therapeutic relationship and work through issues. Relationships may formed for only one day, as in the case of a crisis intervention specialist, or for a longer period of time, such as with a therapist at a behavioral center. ==

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= __ADVOCACY AND POLICY BUILDING__ = ==== Advocacy and Policy Building is working to protect children's basic rights. Theses rights are protected by either expanding current policies or creating new ones. Many groups work as advocators for this cause. One example is the Children's Defense Fund. ==== =[|www.childrensdefense.org/about-us/]=

__CRITICAL ISSUES F__﻿__ACING CHILDREN AND FAMILIES__ == A number of areas critical to children and families present challenges to social workers, program planners, and policymakers. Some of the issues are child maltreatment, foster care, substance abuse, sexual behavior, delinquency, divorce, poverty and immigration. ==

= __Child Maltreatment__ = == The effect of child maltreatment reach beyond physical damagement. Children who endure maltreatment also develop other social and psycholoigcal problems that often effect them well into adulthood. Child maltreament encompasses all of the ways chldren are hurt by the people who are expected to care for them. This can be in the form of physical,sexual and emotional abuse or neglect. Maltreatment occur anywhere including the child's home, outside of the home in the neighborhood, school, or in the home of relatives or friends. == = = = __media type="youtube" key="ojLXmeqd_HI" height="390" width="480"﻿﻿__ = =[|www.texprotects.org]= = = = __Foster Care__ = = When a child is need of a safe place to live, foster care can be a good option. Many foster families are nuturing and supportive of the children in their care, but there are also problems with the foster care system, including too few qualtiy placements, growing numbers of children needing care, high costs and increasing length of time spent in foster care. The foster care population stands at over half a million children in 2004. At least one-third of the children in foster care never return home to there families and some may never be adopted. Often, the children in foster care have been severly affected by the maltreatment they experienced, are emotionally and phyiscally troubled, and can be difficult to manage. The challenges of needing temporary help while finding permanent solutions for children is the task of social workers in the child welfare system. = = = = media type="youtube" key="tVUq51VyyNU" height="390" width="640" =

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=<span style="color: #0000ff; font-family: Arial,Helvetica,sans-serif; font-size: 110%;">__Alcohol and Drug Abuse__ = ==<span style="color: #000000; font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Another critical issue for children and families is the presence of alcohol or drug abuse. Families and children are deeply affected by parental alcoholism and drug addiction. Having parents that abuses alcohol and drugs can lead to conflict, violence, financial stress, neglect, or emotional abuse. In addition, alcohol abusing parents results in decreased connection and difficulty expressing emotion, limiting the family's potential for healthy relationships and effective communication. == ==<span style="color: #000000; font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Families can also be seriously affected when a child is involved with illegal drugs and alcohol. Heavy drug or alcohol use can result in problems at school, conflicts with parents, legal system, negative health consequences, theft, unsafe sexual practice and other bad implusive choices. Social workers that are involved in the school system, child welfare agencies, police departments, hospital and in family service agencies often see situations of alcohol and drug abuse daily by child and parents. Social workers refer parents and children to prevention programs, group coundeling or inpatient substance abuse programs like the ones that I have listed below:﻿ ==

= __Decision About Sexual Behavior﻿__ = == Due to the risks of contracting HIV/AIDS, sexual transmitted diseases and the risk of pregnancy, it is critical for social workers to educate teens about the dangers of nsafe sex. Current studies show that most teens engaged in sexual activity, much of it high-risk sexual behaviors often occur with alcohol and drug use. Many turn to oral sex to prevent pregnancy, but is not aware of the STD's they can come incontact with. The use of condoms is very controversial, leaving many of young adults uninterested in the role of condoms in the preventing the spread of STDs and pregnancy. Although adolescents represent about quarter of the sexual active population, they account for almost half of all new STDs. This type of issue is very important for teens to know the knowledge about their sexual choices.== media type="youtube" key="7N2U4L1an7Y" height="510" width="640"

[] [] http://www.vdh.virginia.gov/epidemiology/DiseasePrevention/DAta/2010_ProfileUpdates/Scope%20of%20HIVAIDS_2010.pdf http://www.vdh.virginia.gov/epidemiology/DiseasePrevention/DAta/Annual/2008/table_1_a_annual.pdf

= __Delinquency__ = =The term __delinquency__ refers to any behavior that is illegal and could involve a child with the juvenile justice system. The behavior may be illegal only for minors, such as running away, using alcohol, being truant, or violating curfew. It may involve offenses that are illegal regardless of age, such as theft, assault, violence, and the use of illegal substances. Social workers involved in schools, police departments and those that deal with child and family counseling see alot of problems like the ones listed above. The social workers that are involved with childrens that are considered delinquents must seek to understand and intervene with the children in a way that helps the children respect themselves as well as those around them.= =Runaway and homeless youth are often listed in this category of delinquency. Living on the streets and in shelters are the only place they can call home. Majority of the time, they may have thrown out of their home or fought with family member and do not think that they are welcome back home. Famliy financial situations may have cause the family to loss their home, being victims of violence or sexual abuse may leave the children feeling like the home is not safe to return. So, youth that live out on the street lives and social needs are at greater risk than most. Intervention is required for most delinquents.= http://www.ncjrs.gov/pdffiles1/ojjdp/186162.pdf = = = __﻿__ = = __Divorce__ = =Divorce can have a negative effect on children who are unable to process the loss of their intact family. Others suggests that the first year after a divorce can be traumatic for both child and adults. Social workers commonly see clients who are affected by the stress of single parenthood and complications resulting from remarriage and blended families. Family counselors and school social workers commonly work to help children and families achieve emotional adjustment needed in such situations.= =In this video you have children and divorce parents in counselor meetings discussing the problems that they are faced with each day.= = media type="youtube" key="h_KjkseplbE" height="510" width="640" = = = = = = __﻿__ = = = = __Poverty__ = =This can be a critical problem for millions of children. It can have negative effects on their health, development, and overall well-being. Economic deprivation leads to poorer health, dangerous living conditions, and lack of opportunities for social, economic and educational advancement.= =media type="custom" key="9701372"= http://www.dss.virginia.gov/geninfo/reports/agency_wide/poverty_short.pdf = = = __﻿__ = = __Immigration__ = == Stricted immigration enforcement and new laws aimed at removing people who ae undocumented has led to a rising concern among child welfare service providers. As undocumented parents are detained for deportation, their children are left behind because they were born here in the U.S. and are legal citizens. Hundreds of children are left without one or both parents due to them being targeted for deportation. Due to stricting laws the immigrates are not being release for pending deportation hearings rather they are sent straight to prison. == = __﻿__ = =media type="youtube" key="X2z7x0WyiQM" height="510" width="853"﻿ __﻿__ = == Many cases like the story above are on the raise here in the U.S., because no one knows for sure how man children are being raised here with undocumented parents. The children are forced to live on their own here in the U.S. or live in a country they know nothing about if they go with their parents. == [] http://www.aecf.org/~/media/Pubs/Topics/Special%20Interest%20Areas/Immigrants%20and%20Refugees/FactSheetImmigrationandChildWelfare/Immigration.pdf

Theory of Child Development

Our goal as child welfare social workers is to promote and enforce the health, safety and overall well-being for all children.

__Children__, as most of us already know, are defined in the United States as anyone under the age of eighteen; this means that they are legally dependent. Children are viewed as a vulnerable population among our society. This is because children’s cognitive and social functioning is not fully developed and children are reliant on others (adults, parents etc.) to advocate for their needs.

A __family__ is defined in our text as a system of individuals who are interrelated and have significant relationships. As social workers we must be able to accept all types of families such as gay and lesbian couples with children, single mothers, single fathers, and grandparents that are legal guardians.

Ecological Approach

First step is to identify the child’s environment.

Must recognize: The second step is to make a correlation between the child and the systems, resources and environment which affect them.
 * Family members
 * School
 * Peer groups
 * Neighborhood
 * Larger systems
 * Public policies
 * Surrounding communities
 * Federal system (resources and barriers)

The book gives a great example of the ecological approach on page 176.

Human Development

It is very important to understand theories about how human beings develop throughout their lives, especially when referring to children. Human development follows fairly predictable patterns. These patterns have been studied and organized into categories that can assist social workers to assess a child. These patterns help describe abilities and skills that are expected to be accomplished at each stage of childhood, but we have to remember that these are guidelines and not every child will fit the description perfectly. These guidelines don’t take into account cultural or religious diversity or the norms of non-dominant populations.

__Prenatal__ is defined in the text as the time during which a fetus develops within a mother’s womb prior to birth. This stage is assessed medically. Prenatal care usually emphasizes a healthy lifestyle, which fosters a healthy development of the fetus. Prenatal care allows doctors to detect problems such as genetic disorders, symptoms related to drug and alcohol use, or transmission of a virus, such as HIV, from mother to child.

__Infancy__ is the first three years of a child’s life.

Normal Development: Abnormal Development:
 * Attachment to primary caregiver
 * Coordination
 * Locomotor and sensorimotor skills
 * Language
 * Begins as babbling and leads to recognizable words
 * Child lacks a healthy attachment to a caregiver
 * No recognizable progress of language developing
 * Physical development is not progressing

__Preschool Years__ are from the age of three to five years old.

Normal Development: Abnormal Development:
 * Height and weight progressing
 * Language becomes more complex
 * Increase in questioning and desire for understanding
 * Peer relations are forming
 * Asserting self
 * Able to resolve conflicts is increased significantly
 * Lacks social reaction
 * Fails to imitate others
 * Refusal to eat
 * Refusal to talk
 * Withdrawn behavior
 * Poor muscle control
 * Fails to follow simple instructions

__Middle Childhood__ is from age six to twelve years old.

Normal Development: Abnormal Development: __Adolescence__ is from age thirteen to eighteen.
 * Cognitive abilities are increasing rapidly
 * Memory, conceptual thinking, deductive reasoning and problem solving.
 * Relationships expand to peers, teachers and extended family.
 * Anxiety disorders
 * Obsessive compulsive disorder and or phobias
 * Mood issues
 * Depression
 * Behavior problems
 * Non compliance
 * Educational issues
 * Learning disabilities

Normal Development:
 * Growth spurts
 * Hormone changes
 * Maturity of reproductive system
 * Cognitive advancements
 * Able to master abstract thinking and complex problem solving
 * Seek social acceptance from peers
 * Begin to separate themselves from parents and family
 * Learning to express and manage emotions
 * Moral development
 * Able to recognize standards and able to behave in a way that complies with them.

Abnormal Development:
 * Drug abuse
 * Alcohol abuse
 * At-risk sexual behaviors
 * Pregnancy
 * Noncompliance with authority
 * Delinquency
 * Eating disorders
 * Problems in school
 * Dropping out of school
 * Running away
 * Depression
 * Violent reactions

Other Theories

__Cognitive Development__: A belief that cognitive processes start out basic and concrete in infancy and become more abstract and complicated with moral development.

__Social Learning Theory__: The idea that behavior is learned through socialization. It utilizes behavioral methods such as modeling and positive reinforcement for bringing about learned behavior. This theory is often used in parent training programs, residential and group homes for children. Big Brother Big Sister is an example of an organization that uses social learning theory by modeling.

__Psychosocial Theory__: An idea that children progress through clear stages of development and are presented with a series of psychosocial crises. In order for normal development to precede one must resolve each of these crises. If one fails to do so, it will lead to problems in the later stages. All of the theories covered today aid in determining the best intervention strategies that are appropriate.

Statistics and Resources

[|www.childhelp.org/pages/statistics#gen-stats]

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The Spirit Catches You and You Fall Down: [] [|www.casaforchildren.org] [|www.marchofdimes.com] [|www.fns.usda.gov/wic/]

__**Chapter 4: Poverty and Economic Disparity**__

= Two approaches to defining poverty: =

=(1) __Absolute Poverty__- utilizes an exact dollar amount to designate who is impovershed and who is not living in poverty. For example, if the abosolute poverty threshold (or poverty line) is set at $35,000 for an individual annual income, and the individual makes $35,191, that individual is not considered poor. However, if an individual earns $34,497, that individual is considered poor.= = = =(2) __Relative Poverty__- uses comparisons to determine whether or not a particular individual is considered poor. In essence, the relative poverty standard seeks to determine the amount of economic resources that an average person (or family) should possess. Once this standard is established, those who lack or are deficient of that given resource are considered to be living in poverty. For example, if the median price for a house in 2006 was $250,000, then any family that owns a home worth less than that amount is considered relatively poor.= = = == Definition conclusions: The absolute poverty threshold is much easier to use and modify than the relative poverty standard (because absolute poverty figure is a fixed value). There are several reasons for this: first of all, the relative poverty standard is in a constant state of flux. Home and food prices, transportation and gas costs, and other living expenses are influenced and shaped by a wide range of factors, including the fluctuating levels of supply and demand within our economy's free-market system. Consequently, determining the cost or value of resources to a given individual may be a difficult task. For example, age or phase of life may determine the level of necessity of a particular item. Students who live on campus may view the ownership of a vehicle as a luxury, while a parent of four may view a car as a vital resource necessary for the proper functioning of his or her family. ==

The official definition of poverty (according to the text) and poverty-related agencies:
== The definition of poverty used by federal and state governments is the absolute poverty measure. This measure is used to determine eligibility for social service and welfare assistance programs. The Social Security Administation ([|SSA]) is responsible for overseeing social service programs designed to alleviate and combat poverty. Originally, the SSA determined the minimum amount of income that was necessary for a single individual or an individual family. Today, the poverty threshold is determined by Census Bureau*, and the [|U.S. Department of Health and Human Services] sets poverty guidlines based on the Census Bureau's thresholds. In 2008, the poverty guidline was $21,200 for a family of four (the same purchasing power, adjusted for inflation, as $3,100 did in 1963). Critics of the poverty threshold argue that, because it only takes income into account, ignoring benefits like medeical care and food vouches, it presents an exaggerated view of the poor in the United States. Others, conversely, claim that the poverty threshold is too low because it only takes into the account the minimum amount of nutrition needed for survival, not a balanced way of life. The threshold seems to assume that families are preparing meals from scratch, have adequate time to prepare meals from scratch, and that parents or gaudians are aware of how to prepare balanced and nutritious meals both for both young and adoloscent children. == ====**// *For census information related to poverty, see the Census Bureau's web page ( [|located here]) or, for global stastitics regarding poverty, go [|here.] Finally for additional facts and statistics, visit [|the Global Issues page.] //**====

//__ **Who are the poor in the world?** __//

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//__Starving Poor in the World__//



**Percentage of Population living on less than $1 a day (2007-2008)**

** //__Who are the poor in the U.S.? __// **

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[|SOURCE: U.S. Bureau of the Census, __Income, Poverty, and Health Insurance Coverage in the United__]
 * **[|Children Under 18 Living in Poverty, 2008]** ||
 * [|Category] || [|Number (in thousands)] || [|Percent] ||
 * [|All children under 18] || [|15,451] || [|20.7] ||
 * [|White only, non-Hispanic] || [|4,850] || [|11.9] ||
 * [|Black] || [|4,480] || [|35.4] ||
 * [|Hispanic] || [|5,610] || [|33.1] ||
 * [|Asian] || [|531] || [|13.3] ||

//Figure 1// **Poverty Rates by Race/Ethnicity, 1980 to 2006**



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__** Causes of Poverty **__
 * __Culture of Poverty__- People learn to be poor from growing up in impoverished areas.
 * Environment is a powerful influence
 * Does not explain how some poor people grow up and become economically self-sufficient
 * __Functionality of Poverty__- Poverty plays an important role in the economic structure and there is little incentive to rid the nation of it
 * This means maintaining a group of people who are poor for workers that are needed for undesirable lower paying but necessary jobs
 * Poverty keeps wages from increasing too much too fast
 * **Values and Blaming the Victim**
 * People that are poor are viewed as being responsible for their poverty
 * Poverty carries a major social stigma: that the poor person is not participating in society the right way (Blaming the Victim)
 * The responsibility of poverty is blamed on the individual so that society does not have to reevaluate economic conditions, and whether all people have equal opportunity to acquire wealth
 * Social stigma and internalized blame enter deeply into the personal being of people that are poor. This is a challenge social workers often address when working with clients.
 * __John Powell- Does Race Drive Opportunity?__
 * Executive Director, Kirwin Institutefor the study of Race and Ethnicity

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 * Race**
 * Race is one of the most significant factors that influence income and wealth in the United States
 * Median Income-
 * White households- $52,423
 * African American households- $31,969
 * Latino households- $37,781 (DeNavas-Walt, Proctor, & Smith, 2007)
 * Families of color earned less than two thirds of what white families earned
 * #|Employmentrates for people of color have also been lower than those of the white population
 * In 2008, the unemployment rate was…
 * 4.4% for whites
 * 8.8% for African Americans
 * 6.5% for Latinos (U.S. Department of Labor, 2008)
 * This clearly illustrates how prejudice and discrimination can limit a person’s opportunities


 * Income levels, Jobs, and Income Distribution**

According to the textbook, poverty is due to several different factors. One possibility would be because of limited job availabilities. Statistics prove that unemployment rates have steadily increased throughout time. The text states that in July 2005, 5 percent of adults were counted as unemployed, which calculated into approximately 7.5 million people in the United States were unable to find work. As of May, 2011 the statistic rate of unemployed people have risen to 9.1 percent which translates into 13.9 million persons left unemployed in the United States. __ [|(http://www.tradingeconomics.com/united-states/unemployment-rate)] __

The text also explains that people who may have jobs does not necessarily mean that they are not poor, but they may be underemployed or considered the working poor, as their jobs may not pay enough to meet their basic needs, such as shelter, food, electricity, and running water. Even though the government does set a minimum wage, increasing the minimum wage would more likely cause a controversy as many employers would prefer to get as much as they can with the smallest amount possible. The text shows the minimum wage to be $5.15 an hour, which would make an annual income of $10,712 for someone who worked 40 hours for 52 weeks a year. In 2006, this would be considered below the poverty line for a family of two. As of June, 2011, the minimum wage is 7.25 an hour. For someone who again, worked 40 hours a week for 52 weeks a year, he would earn $15,080 a year. The national poverty line is $14,570 for a family of two people. __ [|(http://www.minimum-wage.org/states.asp?state=Virginia] __). This means that many people are not recognized as being in poverty, because they don’t meet the income requirements or criteria.

Another factor we should consider is that income is not equally distributed throughout households. The text explains that there is a range of people in America that earn different incomes. There is the “top half” and the “bottom half” of employed persons. In the bottom half, income distribution has decreased from 1970 to 2003. Perhaps, meager minimum wages are given to people with limited experience, and perhaps even taken for granted for labor while people who have college degrees and longer work experience receive an increase in salary while others may take what they can to put food on the table.

A three minute clip I think, would make you think. Something to allow you to change your point of view, for money goes by so fast, and it is so very difficult to prioritize budgets when one is living in poverty.

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__Homelessness: Beyond Poverty__

Homelessness is attributed to а number in interrelated and interconnected triggers. Anything from the lack of affordable housing, to unemployment, to the unavailability of government programmes can (even single-handedly) cause the landslide from poverty to homelessness. Those of us that are unlucky to transcend poverty to this stage are faced with а number of different obstacles that appear far more complex than the obstacles that those with housing face. Particular Challenges of Homelessness: - More difficult means of communication (no address, mobile, internet, etc.) - No clothing, food, etc. (needed to prepare for job interviews, work) - Many homeless are youths, are often not documented in any legal system due to age Links of interest:


 * [|Housing & Urban Development]
 * [|United Press International]
 * [|Homeward VA]
 * [|Project Hope](Administered by the College of William and Mary )
 * [|Virginia Supportive Housing]

__ Social Welfare Programs __
 * Social Welfare-** refers to any government program that provides help or support for those in need. Included but not limited to family cash aid, welfare to work, aid to dependent children, food stamps, unemployment insurance, disability, Medicare and Medicaid. The goal of social welfare programs is to reduce poverty to the maximum extent possible.

There are two major types of social welfare programs also known as public assistance; they are in-kind benefits and cash assistance programs.
 * In-kind benefits: Give people commodities or coupons that they can exchange for goods or services. Some in-kind benefits include public health care clinics, housing subsidies, Medicaid, WIC, school breakfast and lunch and food stamps.
 * Cash assistance programs: Provide people with monthly payments that can be used as needed. Supplemental Security Income (SSI) and Temporary Assistance for Needy Families (TANF) are two examples.


 * Food Stamps –** Run by the Department of Agriculture, the food stamp program now known as SNAP (supplemental nutrition assistance program) assists low- and no-income individuals/families by providing credit that can be used for food at commercial grocery stores. Funded by general tax revenue, eligibility for the program is set by the federal government and is standard across the nation. Food stamps formally came as stamps or coupons, but now are distributed as an EBT card. As of May 2011, 44 million Americans received food stamps, the highest number since the program began in 1939.

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 * Supplemental Security Income (SSI)** – The program provides cash assistance to individuals who are poor and in need and are age 65 years or older, blind or disabled. There are certain guidelines that have to be met before a person is eligible for SSI. They have to be in poverty and their benefit amount is adjusted based on any other income the individual is receiving. As of 2006 the maximum benefit a person could receive with another income was $603 a month.


 * Temporary Assistance for Needy Families (TANF)** - Under this program cash assistance is provided to families that are poor. Families are eligible to receive benefits for no more than 24 consecutive months and a lifetime total of five years. To be eligible for TANF all adult participants must spend 20 hours per week in a job or job-related activity. The typical TANF family is usually a single mother with two young children. Through TANF families can receive up to $4,440 annually ($370 month). Most families who use TANF also receive in-kind benefits such as food stamps and are eligible to use Medicaid.


 * Other types of Social Welfare programs****-** Child and #|Adult CareFood Programs (CACFP), Federal Pell Grant, Headstart and Section 8 Housing.

=Some social justice links we talked about in class on the 1st.=

=White Privilege: Unpacking the Invisible Knapsack= = = =A cool page about diversity resources= = = =H8 map ~ from class=

=This is a very interesting website with graphs showing what Americans pay for healthcare vs. the quality of services. Compared to other countries, we are not looking very good.= = = = = =5.25.11= =Chapters 1&2 Social Work "A Helping Profession" & A History of Social Welfare=



= Evolution of social work timeline = = = =United States Social Welfare timeline=

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Dept. of Labor Occupational Outlook Handbook - Social Work
=cultural competence self assessments=

=website on paradigms and gender role ideation= =[|NASW full code of ethics]= =[|Should I be a social worker quiz]= = = = = = = = = = = = = = = = = = = = = = VCU SSW - __Introduction to Social Work__ - Summer 2011 =

Welcome to the class wiki site. This will be the board where we share (as a group) class notes, media, and anything else we find along the summer that can help us conceptualize what social work is, how it fits in our society, what it means to us, and what it can be. Im looking forward to starting class with you. Posted below are a few videos pertaining to different social work roles in general. Over the course of the semester we will all be adding content to this page to share with one another. The content we add should be AS CREATIVE AS POSSIBLE, and with good reason! No matter what role a social worker finds themselves in, some of the most important skills involve being willing to search out a better understanding (assessment) of where people are coming from and what their experience is. Also of remarkable importance is the need to be creative problem solvers. In this course curiosity and creativity will be highly rewarded!

Wikispaces help
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Some videos claiming to be about social work
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=<span style="font-size: 1.1em; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 5px;">__Discussion for the first session-__ =
 * What is "social justice?"


 * What is "advocacy?"

=Excerpt from a recent SSW graduation speech=

<span style="font-family: arial,sans-serif; font-size: 13px; line-height: normal;">I want to respond to the parents, friends, and family members out there who said, “Why are you going into social work? You won’t make much? Why do it? Well…Social workers don't make much. Or do they? Hmmm….What do they make? They make an infertile couple celebrate a lifetime of Mother's Days and Father's Days by helping them adopt a crack baby no one else wanted. They make a child fall asleep every night without fear of his father's fists. They make a homeless veteran feel at home in the world. They make a teenager decide to stop cutting herself. They make a beaten woman find the courage to leave her abuser for good. They make a boy with Down syndrome feel like the smartest kid on the bus. What do they make? They make a 10-year-old believe that he is loved and wanted, regardless of how long he lasts in the next foster home. They make a teen father count to 10 and leave the room so he won't shake his newborn son. They make a man with schizophrenia see past his demons. They make a rape victim talk about it for the first time in years. They make an ex-convict put down the bottle and hold down a job. What do they make? They make a dying cancer patient make peace with her past, with her brief future, with her God. They make the old man whose wife has Alzheimer's cherish the good times, when she still remembered him. They make forgotten people feel cherished, ugly people feel beautiful, confused people feel understood, broken people feel whole. What do they make? They make more than most people will ever make. They make a difference.

~Unknown Author