What mental health settings do social workers treat in?
address mental illnesses at the micro, mezzo and macro levels
Social workers at the micro level
provide case management, counseling, and intensive psychotherapy for chronically mentally ill people
Social workers at the mezzo level
conduct group therapy, and provide various kinds of family treatment
social workers at the macro level
initiate changes in organizational and public policy to improve service provision to large groups of clients. also may assume administrative or supervisory responsibilities in agencies providing any level of service.
group therapy (treatment groups)
help individuals solve personal problems, change unwanted behaviors, cope with stress, and improve their quality of life.
types of treatment groups
therapy, support, educational, growth, and socialization
therapy group:
group of people diagnosed with schizophrenia who live in the community and meet at a local community health center
support group:
group of adults caring for their parents who have Alzheimer’s disease
educational group:
group of parents learning about effective child management techniques
growth group:
group of gay men focusing on gay pride issues
socialization group:
current events group at a nursing home that gets together to discuss their opinions
Social workers role in mental health
inpatient mental and psychiatric hospitals. psychiatric units in general hospitals, residential treatment centers for children and adolescents, outpatient treatment agencies, employee assistance programs, and community mental health centers.
Inpatient treatment
means that clients reside in the facility for some period
residential treatment centers for children and adolescents
agency that provides children who have serious emotional and behavioral problems with residential round-the-clock care, education, interpersonal kills training, and individual group and sometimes family therapy
Empathy
the act of not only understanding how another person feels but also conveying to that person and awareness of how they feel
positive reinforcement
a procedure or consequence that increases the frequency of the behavior immediately preceding it
feedback
process of giving people information, positive or negative, about their performance or behavior
token or point systems
in which tokens or points on a chart are used in a coordinated systems to control poor behavior, develop good behavior, and monitor progress
psychiatric units in general hospitals
emergency psychiatric care on a temporary inpatient basis for people in crisis
outpatient treatment agenices
agencies and clinics provide individual, group, and family counseling for a wide range of mental health and substance abuse problems
employee assistance programs
services provided by organizations that focus on workers’ mental health and on adjustment problems that interfere with their work performance
community mental health centers
versatile local organizations that provide a range of services, from mental health treatment to education about and prevention of mental illness
person centered therapy
takes a positive view of individuals, believing that they tend to move toward becoming fully functioning
Carl Rogers (techniques for doing therapy_ person centered)
congruence, unconditional positive regard and accurate empathic understanding
How many social workers work in the mental health field?
60% of all mental health service providers are social workers. 10% are psychiatrists, 23% are psychologists, and 5% are psychiatric nurses
deinstitutionalization
process of providing services and care for people within their own communities rather than in institutional settings
cultural awareness (competence)
mastery of a particular set of knowledge, skills, policies, and programs used by a social worker that address the cultural needs of individuals, families, groups, and communities
substance abuse
use of a mind-altering substance with the resulting behavior having negative consequences or not being socially acceptable
substance dependence
reliance on the use of a substance to the extent that withdrawal occurs when the substance is not used
alcoholism
chronic disorder characterized by repeated excessive use of alcoholic beverages and decreased ability to function socially and vocationally
intoxication
development of a series of symptoms, often involving psychological or behavioral changes, directly related to intake of the substance and its influence on the central nervous system
withdrawal
array of symptoms that develop as a result of discontinued use of the substance or the compulsion to absorb the substance to avert these symptoms
withdrawal symptoms
severe abdominal pain, convulsions, anxiety attacks, depression, and uncontrollable trembling
tolerance
need to use increased amounts of the substance to reach the same level of mood alteration initially achieved
substance
commonly used to refer to mind-altering drugs, including alcohol
drug
refers to a wide range of materials that alter mood or consciousness when ingested, including amphetamines, cannabis, cocaine, and hallucinogens
substance use disorder
a cluster of cognitive, behavioral, and psychological symptoms resulting from continued use of a substance despite significant resulting difficulties and problematic issues
The diagnostic and statistical manual of mental disorders (DSM-5) cites four categories of pathological behaviors concerning how the substance is used
impaired control, social impairment, risky use, and pharmacological criteria
the four categories of pathological patterns of behaviors have how many criterion listed?
11
what criterion is found in impaired control?
one through four
criterion 1
concerns an individuals multiple failed attempts to decrease or halt use of the drug
criterion 2
entails the individual spending significant amount of time either trying to acquire the substance, using it, or recuperating from its negative consequences
criterion 3
involves how an individual with a sever disorder may spend essentially all of their time in actions and pursuits concerning substance use
criterion 4
entails intense cravings for the substance
what criterion is found in social impairment?
five through seven
criterion 5
concerns inability to fulfill responsibilities at work, school, or home
criterion 6
entails experiencing problems in interpersonal relationships that are intensified by the use of a substance
criterion 7
involves decreasing or stopping participation in activities involving social interaction that had been part of regular daily life in the past
what criterion is found in risky use?
eight and nine
criterion 8
entails the use of the substance in situations that may involve physical danger
criterion 9
concerns persistent use of the substance despite experiencing acknowledged physical or psychological difficulties
what criterion is found in pharmacological issues?
ten and eleven
criterion 10
involves increased tolerance to the substance
criterion 11
entails the occurrence of withdrawal
types of mind-altering substances
stimulants and depressants s
stimulants
psychoactive substances that boost the functioning of the central nervous system
types of stimulants
amphetamines, caffeine, and nicotine
amphetamines (+methamphetamines and cocaine)
are “top of the line” stimulants c
caffeine and nictoine
“bottom shelf” stimulants.
How many deaths by tobacco?
more the 400,000 the US each year
Depressants
psychoactive substances that suppress, slow, or relax the central nervouse system
most commonly used depressant:
alcohol… the sedatives and hypnotics such as prescription painkillers
Date rape drugs
GHB and Rohpynol (roofies)
other commonly used addictive drugs that don’t fit into stimulants or depressants:
cannabinoids, dissociative anesthetics, hallucinogens, opioids and morphine derivatives
cannabinoids
including hashish and marijuana, produce euphoria, slowed thinking, impaired coordination, confusion, and sometimes anxiety
dissociative anesthetics
including ketamine and PCP, can caused increased heart rate and blood pressure, slowed motor functioning, memory loss, and potentially nausea. PCP can cause aggression and depression
hallucinogens
including LSD, mescaline, and psilocybin, result in unpredictably altered mental states, distorted perception, hallucinations and sometimes flashbacks
opioids and morphine derivatives
including heroine, morphine and opium, can cause euphoria, pain relief, drowsiness, and potentially, coma and death
psychoactive substances
molly, spice, krokodil, and bath salts
bath salts
stimulants producing effects resembling those of amphetamines, consumed orally, inhaled, or injected
cathinone( found in bath salts)
chemical substance derived from that of the khat plant.
krokodil
homemade replacement for heroine. consumed by injection with a hypodermic needle
spice
synthetic marijuana, consumed by smoking (inhalation)
molly
(MDMA) synthetic drug that has characteristics resembling stimulant amphetamines and hallucinogen mescaline, typically consumed orally by capsule or tablet
methods of ingesting substances
oral, inhalation, injection, and mucous membranes
orally
drinking or swallowing
inhalation
smoking, more efficient
injection
directly into the bloodstream
mucous membranes
“snorting,” slower than smoking and injection but quicker than oral.
treatment process’s four features
engagement, assessment, intervention, and development of continuing care plan
engagement
process of building and maintaining a productive relationship with the client
assessment
act of determining the nature and causes of a client’s problem
intervention
multiple-system approach to individualized treatment: a plan should be developed to address the client’s unique needs, issues, and strengths
development of a continuing care plan
formed after the primary treatment has ceased
resources for the treatment approaches for substance abuse
detoxification, outpatient treatment, inpatient treatment, therapeutic communities, and halfway houses
halfway houses
temporary residences to assist in the transition from an inpatient program to the the real-life community
therapeutic communities
residential programs where clients remain for one to three years. immersing clients in an environment aimed at global change in lifestyle
inpatient treatment (substance abuse)
offers a more intensive focus on the individual’s recovery…than outpatient treatment programs
outpatient treatment
received by clients who participate in a program without staying over-night at a treatment facility
detoxification
short-term treatment designed to oversee the client’s withdrawal from the substance to which he or she is addicted
four stage recovery model
abstinence, confrontation, growth and transformation
abstinence
major focus on avoiding mind-altering substances
confrontation
clients begin confronting and changing personal, family, and social issues that contributed to their chemically dependent lifestyle
growth
the beginning of a new lifestyle not involving substance use
transformation
true change in life orientation from theformer substance-using days
people who abuse alcohol or other drugs typically adopt a series of defense mechanisms to protect themselves from having to deal with problems caused by substance dependence.
minimization, rationalization, and denial m
minimization
assigning little importance to drug use or its consequences (“oh its just a little bit”)
rationalization
involves making excuses for the problems caused by the dependence on the substance (“i did bad cause it was hard, not cause i was hungover”)
denial
most prevalent defense used by substance dependent people, involves insisting that nothing is wrong (“i can stop whenever I want”)
School social worker role
consultant, counselor, facilitator, educator, advocate, broker, case manager, community intervention collaborator, and policy initiator and developer