Clinical Social Work Journal最新文献

This study explores how social work professionals at women's shelters in Sweden experience, understand, and are responding to domestic violence under the impact of the COVID-19 pandemic. A qualitative longitudinal research design was employed, and multiple semi-structured interviews were conducted with 14 professionals at women's shelters over a period of one year. The results are presented in three overall themes; (a) professional challenges due to increased needs, (b) professionals' adjustments to new circumstances, and (c) professionals' attributions regarding client barriers to help seeking. The results show diverse and changing experiences among the professionals as the pandemic progressed. Clients and professionals have shared the same collective trauma associated with the pandemic, which has affected the professionals' understanding of and response to domestic violence. The professionals understand both clients and themselves as being more vulnerable and susceptible to risk under these new circumstances. Social work adjustments focused on maintaining contact, reducing risk and prioritizing safety, which had both positive and negative consequences for both clients and professionals. The study concludes that the professionals coped with the uncertainty they experienced during the pandemic by relying on both their previous knowledge and work experience of domestic violence and their experience of sharing trauma with clients.

Due to the COVID-19 pandemic, many social work students and educators had to switch gears quickly and replace face-to-face courses with online delivery. While most had had experience with remote learning, the unexpected and immediate transition was challenging. Students and educators who had chosen in-person instruction had to adapt quickly to a learning paradigm for which they had not planned, while simultaneously coping with the anxieties brought on by the pandemic, such as economic hardships, threat of illness, and new family responsibilities. The pandemic has engendered fear, trauma, grief, and loss, all of which negatively affect instruction and learning. This reflection paper identifies special challenges and issues with regard to teaching and learning in social work clinical practice courses brought on by the pandemic. Utilizing the theoretical frameworks of ambiguous loss, interpersonal neurobiology, and the here and now approach, this paper suggests effective teaching methods and collaborative learning strategies to inform social work education during academic disruption in this and future emergencies (e.g., natural disasters). It is suggested that social presence, as well as group cohesion among students and between students and instructors, can serve as a protective factor to ensure continued productive motivation for teaching and learning while facing the challenges that are experienced during such times.

In March of 2021, as the world marked the first anniversary since COVID-19 altered our reality, graduate social work students in Dr. Carol Tosone's Evidence-Based Trauma class at NYU considered the challenges of learning about trauma treatment while simultaneously living through a global trauma. Students reflected on their home lives, school experiences, field placements, mental health challenges, feelings of burnout, and the added complexities of racial disparities and injustices. Students also shared their coping mechanisms and hope for the future. This paper aims to provide insight into their varied experiences while relating their struggles and demonstrating their pathways toward resiliency.

System enactments are co-created phenomena characterized by confounding and emotionally charged multi-person interactions that emerge through the convergence of patients' complex psychopathology, staff vulnerabilities, and the organizational dynamics of the clinical system in which all are embedded. There is ample literature about the psychoanalytic construct of enactment in the therapeutic dyad. Though systems-based clinicians often experience system enactments which transcend the dyad and occur within the projective field of the system, there is no comparable literature that discusses this phenomenon. This paper describes a qualitative study that investigated how psychodynamic clinicians understood the phenomenology and impact of system enactments on clinicians, treatment processes and organizational climate. Major themes were identified through qualitative analysis of the data. The following four key findings were distilled from the resulting themes of the study's two research questions: (1) Clinicians conceptualize system enactments from a classical perspective; (2) System enactments have an experiential impact on clinicians in the domains of affect, cognition, behavior, and physiological arousal, which may be related to secondary traumatic stress responses; (3) Clinicians demonstrate a collapse of mentalizing associated with ruptures in the patient's treatment, conflict in the working relationships between staff, and problematic organizational dynamics; and (4) Interconnected and reciprocal interactions among all levels of the system including patient subsystem, individual staff subsystem, intra-staff subsystem and organizational subsystem, are shaped by the impact of system enactments. A conceptual understanding of system enactmentis outlined, and implications for clinical social work education and practice, organizational policy-making and research are addressed.

The COVID-19 pandemic necessitated an abrupt conclusion of field placement for social work interns at a comprehensive cancer center. In response to social distancing requirements, social workers, but not interns, were granted access to work remotely. Virtual programming became necessary to meet the interns' remaining educational requirements and provided an opportunity for proper termination from the program. This article will delineate the program redesign for oncology social work interns using remote/virtual modalities. This melded approach involved creating simulated clinical interactions, based on selected points along the illness trajectory targeting specific clinical competencies, which were presented to interns by phone and/or videoconference. Examples will be provided related to developing clinical skills and critical thinking and preparing for professional responsibilities within a broad range of healthcare settings. Guidelines for working with individuals, couples/families, and groups will be included. Issues of individual and group supervision will be explored, with sensitivity to the parallel experience of existential uncertainty and mortality awareness among the interns in the context of the pandemic. Although in-person training is preferable, there are advantages to virtual learning for both supervisors and interns. This creative adaptation of field education provides an innovative programming model that can be used to enhance the experience for social work interns moving forward in various healthcare settings during ordinary or extraordinary circumstances.

The COVID-19 pandemic prompted a radical shift in social work practice. Overnight, social work intervention models provided in-person gave way to the utilization of Information and Communication Technologies to facilitate direct practice in virtual environments (e-therapy). Social work's slow acceptance of e-therapy prior to the pandemic resulted in a lack of training for many social work practitioners and MSW student interns, who were required to make rapid transitions to using and operating in online environments. It appears likely that e-therapy will continue after the COVID-19 pandemic subsides, so integrating education about effective e-therapy techniques into social work curricula seems like a logical next step. A social worker's ability to establish the therapeutic alliance, which is at the heart of all helping relationships, will be central to this curricula. Understanding social work students' perceptions of e-therapy and the therapeutic alliance can help shape the development of this new curriculum. Using internal student email, students at two Research I universities were invited to participate in a fully online anonymous survey dealing with attitudes towards e-therapy and the therapeutic alliance. Surveys were conducted in 2018 and April-May 2020. Survey questions were based on the only prior comprehensive study of student attitudes towards e-therapy (Finn in J Soc Work Educ 38(3), 403-419. 10.1080/10437797.2002.10779107, 2002). Study results indicate that students have e-therapy experience, believe that a practitioner can build a good therapeutic alliance, and think that some form of e-therapy will continue after the pandemic. These results confirm that further exploration about the inclusion of e-therapy education and its efficacy in social work curricula requires urgent attention.

Preliminary results of a qualitative study of the lived experience of teaching and learning during the Covid-19 pandemic are presented. An instructor, a program director and five doctoral students in different stages of their coursework and dissertation proposal development, wrote a reflective journal. Participants varied in their levels of familiarity with technology-assisted education, personal backgrounds and circumstances including work and family responsibilities. Participants' journals documenting their reactions, struggles and coping since the abrupt move of the university from face to face to online classes were content analyzed. The analysis was co-conducted by five participants to identify themes and generate understanding of the experience. Two main themes emerged from the analysis: a developmental process of participants' reactions, perceptions and meaning making of the experience and factors that shaped it. Lessons learned are discussed and recommendations for professional education and directions for future research are suggested.

In this preliminary study, social workers' experiences of adjustment and loss during the coronavirus disease (COVID-19) pandemic were explored as they, along with their clients, coped with the resulting emotional and psychological impacts. As death and illness rates increased alarmingly, masters-level social work students' discourses and feedback in a course on grief and loss revealed a knowledge gap surrounding counseling in face of shared loss that led to a pilot study. Subsequently, a qualitative research study (n = 7) of video self-reports from clinical social workers was conducted to further explore their losses and their consequent professional impact. They responded to the question, "What losses have you felt in this pandemic that have impacted you professionally?" Participants listed multiple losses related to work (e.g., loss of professional therapeutic space, loss of the work/life divide) and recognized the challenges to maintaining a personal sense of well-being. In consideration of the pandemic's impact when counseling others, participants identified the following themes: greater emphasis on one's own well-being, greater focus on maintaining strong therapeutic rapport, the value of creativity in the new therapeutic space, and a continual assessment of dynamic shifts. For society to process-which means, largely, to grieve-the losses related to COVID-19 and adjust to the world as is, there is a need for counselors to do so as well. This paper explains how some counselors have experienced loss through their work and coped with it; thus, they have been able to support their clients through the pandemic.

Many parents experience grief and loss in response to their child receiving an autism diagnosis in early childhood. However, there is a dearth of research that considers if grief and loss are experienced by parents throughout their child's adolescence and young adulthood. Further, there is a small but growing body of evidence suggesting that parents of autistic children may be living with ambiguous loss in particular, that is, a loss for which there is no closure or resolution. This case study introduces a peer group intervention utilizing an ambiguous loss framework that school social workers and other clinicians can adopt to support mothers of autistic adolescents who are struggling with ambiguous loss. Through the group process, the mothers developed deeper understanding, self-compassion, and effective coping strategies, resulting in a more resilient approach to the transition process and an enhanced capacity to plan for a meaningful adult life with their autistic child.

As the number of older adults grows exponentially, social work and psychology practice must embrace a more nuanced appreciation of the aging process. Family life is evolving in unprecedented ways, leaving adults with new challenges and choices for how best to live out their lives. Adults may face difficult decisions and increased anxieties regarding their own health, concern for loved ones, and uncertainties about the future. The noteworthy trends associated with the "new adulthood" holds clinical significance and raises important questions for contemporary practice. Our collective clinical and research experience with older adults suggests a re-envisioning of the threshold from midlife to older adulthood as well as an expansion of clinical sensitivity to issues raised by clients. We conceptualize this transition period as Emerging Elderhood (EE) and propose key tasks, developmental opportunities, and suggestions for clinicians to guide clients toward adaptation and change.