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1.
Abstract

The American health care system is in the midst of unprecedented changes under the name of “managed care,” including preauthorizations for care, cost and outcome accountability, formulary regulations and restrictions, and corporation of multi-professional collaboration. How to prepare practitioners for new responsibilities in such a time of exponential change while preserving professional values and priorities is the rightful concern of mental health educators. This paper identifies and examines some fundamental professional skills as essential criteria for assessing the preparation of social work professionals for the new mental health care environment. They are (1) communication skills, (2) cultural competency, and (3) state-of-the-art treatment. The paper also discusses the manner in which rapid scientific advance, managed-care environments, and changing patterns of practice might test, extend and alter traditional pillars of professional competence. Finally, it is stressed that social work education should prepare professionals to distinguish between constructive and destructive aspects of managed care and should teach the moral imperative to confront harmful practices.  相似文献   

2.
ABSTRACT

This paper presents the findings of a study conducted on the social work values systems of social work students in the City University of Hong Kong. A social work values scale composed of six dimensions, namely human worth, potential for change, mutual care, societal responsibility, social participation and freedom to make choice, was constructed. The findings in this study indicated that all batches of students had a common pattern in the ranking of the order of the value dimensions. Not all the value dimensions had an increase in scores with the increase in training and practice experiences. The fieldwork placement was considered by the students as the most important formal channel during trainingin the acquisition of social work values. It is suggested that social work educators need to have a thorough review of the relationship between curriculum design and the inculcation of professional values.  相似文献   

3.
Abstract

An enormous challenge faces social work educators as we prepare for the twenty-first century. Most significant is the scramble to understand and respond to contemporary challenges, notably managed health care and welfare reform. The authors present the conceptualization and implementation of an advanced generalist concentration curriculum. Teaching strategies and assignments in a MSW academic and field curriculum are used to illustrate the integration of knowledge necessary to a three-tiered model of practice at the micro, mezzo and macro levels. Finally, results of an alumni survey are presented that lend credence to our contention that graduates are well-prepared to function effectively in today's practice environment.  相似文献   

4.
abstract

This article outlines the evaluation of student‐led group work as the major vehicle for a professional course in education (PGCE whole school studies) which relies heavily on work‐based learning. Group work is found to be an effective means of enhancing reflective practice. Problems of engaging whole group responsibility for the tasks and activities can be effectively managed through appropriate structuring of the learning experiences, induction programmes in team work, review and tutor facilitation. Two issues are identified as problematical in longer‐term work of this kind. The first is that of the social cohesion of the groups; where this works well the learning experience is enhanced, where not students are deprived of an effective learning experience. The other is that of the appropriateness of this form of learning for all preferred learning styles. A flexibility of approach is recommended.  相似文献   

5.
Abstract

This article presents an evaluation of an innovative, three-year graduate program to prepare workers from educationally disadvan-taged backgrounds for professional careers in social work in an urban health care system. It analyzes the contributions to the Social Work Health Careers Opportunity Program (SWHCOP) of a course designed to provide: an overview of health care issues and policies; beginning knowledge, values and skills for social work practice in health care; and an opportunity to acquire or strengthen skills for graduate education, including oral and written communications, problem-solving, and critical thinking. This article considers the practice, policy and teaching implications of such an educational program for increasing access to professional careers in social work for members of educationally disadvantaged communities.  相似文献   

6.
BackgroundLooked after children and care leavers (LACCL) are some of the most vulnerable and marginalized young people in our communities. Existing research demonstrates that this group often interprets care in terms of genuineness and tends to feel uncared for. Less work exists from the perspective of social workers and formal carers.ObjectiveThis study aims to explore how care is perceived and practiced among LACCL and those with a duty of care for them. We use a theoretical lens of care ethics to compare and contrast understandings in order to explore how they affect the delivery and receipt of care.Participants & settingThere were 44 participants from four local authorities in north-east England including nineteen LACCL aged 12–20, eight social workers, and nineteen formal carers.MethodTwenty-eight semi-structured 1:1 interviews, four dyad interviews and three focus group interviews.ResultsLACCL desired care that felt familial, went beyond minimum standards and involved understanding. Social workers had to manage LACCL expectations and build relationships by both rationing care according to role constraints whilst sometimes going ‘above and beyond’ statutory care. Carers conceptualized care in terms of dedication and discipline but felt limited in their ability to achieve care in this way.ConclusionBridging different conceptualizations of care is necessary to achieve integrated support for these vulnerable young people whilst also helping them to develop key skills for later adult life. A deeper understanding of frameworks of care has implications for social worker and formal carer training and practice.  相似文献   

7.
ABSTRACT

Over the last decade, there has been increased momentum to bring the worlds of physical and behavioral health care together. Instead of social work education simply reacting to this change, it is imperative that we be proactive and prepare students to be “multilingual,” that is, be able to speak and function in both the worlds of health and mental health so they can move seamlessly into the new world of integrated care. The purpose of this article is to explore curricular and pedagogical strategies needed to prepare graduate social work students for the coming shift in practice toward integrated health and mental health care.  相似文献   

8.
ABSTRACT

During the past 15 years managed care has greatly influenced all forms of health services, including at colleges and universities which have long functioned like health maintenance organizations but without commercialism. This article discusses managed care's rise to power, the new forces countering it, and its influence on psychotherapy practice. The article suggests that preventive and developmental ideals are better served generally within institutions of higher education than by external, commercial managed care companies.  相似文献   

9.
Abstract

Problem-based learning has been described for use in medical education and is thought to be a superior approach to traditional didactic methods. We describe the use of PBL as an innovative approach to the education and training of social workers on an interdisciplinary health care team. An actual PBL case is described, and a discussion of the advantages and disadvantages to this approach is presented. The use of PBL on interdisciplinary teams helps educate social workers to work effectively on teams, and educates other professionals about the social work role and how to utilize social work services effectively.  相似文献   

10.
ABSTRACT

Knowledge of sexual and reproductive health and rights (SRHR) by health care, police, legal and social work professionals has been shown to be insufficient. This lack of competence is likely to affect the quality of services. The aim of this study was to describe SRHR indicators in educational programmes in health care, police, legal and social work higher education in Sweden. A text-based analysis was conducted of written material from all educational programmes in law, midwifery, nursing, occupational therapy, physiotherapy, police work, psychology, social work and undergraduate medicine (93 educational programmes at 27 universities and university colleges). Representation of different SRHR indicators varied, but most were poorly covered in the educational programmes. Existing educational programmes lack comprehensiveness in their coverage of SRHR and are unequal both within and between the professions and universities. This situation creates the risk of inequalities in SRHR competence and suggests that needs within this field may be unmet. There is an urgent need therefore to enhance the presence of SRHR in health care, social work and law enforcement education in Sweden.  相似文献   

11.
Abstract

This paper describes the revision of a curriculum that was initiated to engage and sustain students' interest in the macro dimension of social work practice. Specifically, we describe how two junior policy courses, a seniormacro practice course, and a research methods course were revised to include a service learning approach. This article provides a review of the literature and focuses on the development of service learning in two social work courses. Results of subsequent research are discussed, indicating service learning provides successful opportunities to engage students in macro social work practice.  相似文献   

12.
Abstract

The increase in violence in our society has been well documented in the media as well as in professional journals. Social workers experience a particularly high incidence of physical and verbal violence. This article presents a current review of the literature on violence, describes a Risk Reduction Model for social work practicum education, and discusses implications for further study. The literature review includes reported incidence, the professional response, and the impact on social work education. The Risk Reduction Model addresses school policy and procedures, a school based teaching module, training for field work instructors, and consultation to agencies regarding their safety policies, procedures and training.  相似文献   

13.

This study examined the role of managed mental health care in the counseling of gifted children and families. When gifted children and their families experience difficulties resulting from giftedness, they have the option of choosing a private provider, although cost is often prohibitive. Moreover, when insurance is used to offset the cost, most mental health insurance policies have a managed care component. One requirement of managed care is that services be medically necessary to alleviate a recognized mental illness diagnosis. Problems resulting from giftedness may not be recognized as a mental illness. As a result, insurance may not pay for these counseling costs. However, this does not have to be the case because of the flexibility managed care case managers have to make judgments. 40 managed care case managers were surveyed to address this issue. 14 of the case managers consented to individual interviews. The results indicate that some case managers would approve reimbursement and others would not. The study describes criteria and conditions that need to be met for reimbursement.  相似文献   

14.
ObjectiveThis study assessed infant disposition and health outcomes among offspring born to mothers without prenatal care, based on maternal characteristics and the reason for lack of prenatal care (i.e., denial of pregnancy, concealment of pregnancy, primary substance use, financial barriers and multiparity).MethodsA retrospective record review was completed at an urban academic medical center. Subjects were women who presented at delivery or immediately postpartum with no history of prenatal care (N = 211), and their infants.ResultsInfants of mothers with substance use problems had the highest rates of referral to child protective services and out-of-home placement at discharge, though mothers with other reasons for no prenatal care also experienced both referral and placement. Infants born to mothers using substances experienced the highest rates of neonatal intensive care unit admission, and the lowest mean birth weight.ConclusionsThough those without prenatal care experienced a variety of adverse outcomes, substance use problems were most frequently correlated with adverse infant outcomes. Mothers who either had lost custody of other children or with substance use problems were at highest risk of losing custody of their infants. Those who denied or concealed their pregnancy still frequently retained custody.Practice implicationsAmong mothers without prenatal care, those with substance use problems were least likely to retain custody of their infant at hospital discharge. Custody status of the mother's other children was also independently associated with infant custody. Mothers who denied or concealed their pregnancy still often retained custody. Referrals of mothers with no prenatal care for psychiatric evaluation were rare, though referrals to social work were frequent. Child protective services occasionally did not investigate referrals in the denial and concealment groups. Healthcare providers should be aware of the medical and psychological needs of this vulnerable population of infants and mothers.  相似文献   

15.
Abstract

This paper describes the use of a participatory action research model to teach undergraduate social work research and statistics. Strategies of the model include (1) integration with social work education, (2) policy analysis, (3) literature review, (4) collaboration with practitioners, (5) collaboration with the target population through qualitative research, (6) quantitative study, (7) ongoing social action efforts, and (8) evaluation. An example is used of a project addressing a community problem with increased domestic violence during recovery from natural disaster.  相似文献   

16.
Abstract

The aim of the present study was to gather information within a specific college population about the general prevalence of anti-depressant use and psychotherapy for depression, which treatments people tend to prefer, people's perceptions of the helpfulness of treatments, and if this information was consistent with the research and the current status of the managed health care system. The results demonstrate a high prevalence rate, that people tend to prefer psychotherapy, and that the managed health care system is not providing the best or equal coverage of treatments for depression.  相似文献   

17.
ABSTRACT

This paper suggests that, while there is a wealth of work on the economic benefits of training, relatively little attention is being given to relationships between vocational training and broader social structures and trends. The focus here is on social processes within vocational training. The paper is based on ethnographic research into training for employment in the field of institutional care. This study documented dramatic adjustments in young people's attitudes towards work which occurred in the course of training. The paper explores ways in which training contributed to these adjustments. Two fundamental inter‐related processes are identified, which may also have wider relevance: screening for social and cultural attributes and discipline. The analysis of the discipline of training draws upon the work of Foucault in order to highlight the importance of current trends towards increased ‘surveillance’ and accountability at work. Through such processes, it is suggested, training may both serve to reinforce links between class, gender and occupational destinations and may also reinforce the control of labour within occupations.  相似文献   

18.
Abstract

Through a study of field tasks performed by MSW foundation students, the authors show an empirical relationship to the Gener-alist model of practice. Secondarily, the paper explores whether practice under managed care should be used to inform curriculum or whether standards embedded in curriculum should be used to influence current practice. Implications for student learning in field and classroom are discussed.  相似文献   

19.
BackgroundInstitutional rearing is associated with increased risk for reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED). Disorders of attachment involve disturbances in children’s primary caregiving relationships, and are likely to disturb multiple domains of social functioning.ObjectiveTo examine associations between signs of RAD and DSED and social functioning in early adolescence.Participants and settingOur participants were 110 children with a history of institutional rearing and 50 community comparison adolescents from the Bucharest Early Intervention Project, based in Bucharest, Romania. Participants were assessed at age 12 years (M age in years = 12.80, SD = 0.71).MethodSigns of RAD and DSED were obtained through caregiver report. Reports of social functioning were provided by caregivers and teachers. General and specific domains of social functioning were identified using bi-factor modeling. A general social functioning factor and four specific factors were revealed: peer conflict, caregiver views as victim, teacher views as victim, and social competence.ResultsSigns of RAD predicted poorer general social functioning (β=-0.36, p < .01, 95% confidence interval [CI] [-.33, -.09]) and poorer social competence (β=-0.38, p < .01, 95% CI[-0.05, -.01]) above and beyond time spent in institutional care and placement disruptions. Signs of DSED (β=-0.38, p < .001, 95% CI[-0.49, -.16]) along with placement disruptions (β=-0.22, p < .05, 95% CI[-.29, -.01]) predicted poorer general social functioning above and beyond time spent in institutional care. Signs of DSED predicted higher scores on caregiver views as victim (β = 0.29, p < .05, 95% CI[0.02, 0.14]) and lower scores on social competence (β=-0.29, p < .01, 95% CI[-.06, -.01]) above and beyond time spent in institutional care and placement disruptions.ConclusionsAttachment disorder signs in early adolescence are problematic for social functioning, although the manifestation of these social difficulties differs based on whether RAD or DSED signs are present.  相似文献   

20.
BackgroundTemporal dynamics during the early adulthood transition among children in out-of-home care is a neglected research area, leaving the possibility of coping with childhood adversity over time a poorly understood topic.ObjectiveTo explore early adulthood education and employment trajectories among young adults who experienced out-of-home care during childhood and to examine how various care history factors predict these trajectories.ParticipantsWe use longitudinal birth cohort data comprising individual-level information from national registers of all children born in Finland in 1987 (N = 59,476, of whom 1893 were in care).Setting and methodsWe use trajectory clustering from a previous study on the 1987 birth cohort to compare trajectories between children in care and a propensity score–matched group of peers never in care. We investigated the association between care history factors and trajectories with multinomial logistic regression modeling.ResultsCompared with the matched peer group, children in care were less likely to enter trajectories characterized by education and employment (38%) and more likely to enter trajectories involving early parenthood (14%) or long periods of fragmented social assistance benefit receipt and unemployment (21%). Those on early parenthood trajectories were almost exclusively women, whereas those receiving social assistance benefits and experiencing unemployment for lengthy periods were mostly men. Entering disadvantaged trajectories was associated with, inter alia, placement as an adolescent, residential care, and aging out of care.ConclusionThe study demonstrates the relevance of examining longitudinal trajectories in children in care’s early adulthood. Many young adults with care experience need support in education and employment beyond young adult age.  相似文献   

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