Being in a DBT Support Group


Being in a DBT Support Group

Being in a DBT Support Group

Individuals and their families who experience a  medical/physical illness often find the use of psychoeducational or support groups helpful as they navigate the illness/disease process.  This assignment provides students the opportunity to visit a  support group of your choosing (DBT skills group for patients with Bipolar,depression and anxiety and other personality disorders). Your observations will serve as the basis for a paper that will critically consider clinical practice concepts pertinent to health care social work presented in this course and related to the specific diagnosis of your chosen support group. That is,  the support group serves as your clinical   “observation”   and should focus on the medical/physical diagnosis and its impact on patients and families,  and notion any particular attendees of the support group. For the purpose of this assignment, any analysis of patients’ and family members’ experiences (e.g., adjustment to diagnosis, coping, etc.) should be discussed in aggregate form and not in terms of unique individuals.



  1. Preliminary Tasks:
  2. Select a patient/family support group. (Outpatient open to the public is most feasible, however, Inpatient is also acceptable)
  3. Contact the group facilitator for permission to attend one meeting.
  4. Submit “Support Group Prospectus” to the instructor for approval
  5. Attend One Meeting. (If the group facilitator expects an introduction,  then state the following: “My name is ___, and I am a graduate student at Rutgers University’s School of  Social  Work.  I  am taking a  course in health care,  and need to attend a  support group for one of my assignments. I am interested in understanding more about____ (diagnosis) and I am grateful to you and to ____ (group facilitator) for allowing me to attend.”
  6. Write an analysis that explicitly integrates course concepts as instructed below.


  • Papers will comprise no more than 4 total pages, with 3 “analysis” pages:-

Cover page (page 1)-

Analysis (pages 2-4): four pages typed, double-spaced, 12 pt font, one-inch margins. *

Content should include:

Cover Page (Page 1):

~ Your name, course, and date due.

~  Diagnosis, (outpatient)  and  purpose  of  the  group (DBT SKILLS FOR PATIENTS WITH BIPOLAR AND PERSONALITY DISORDERS) DBT skills group for patient’s at an outpatient and intensive outpatient program; Outpatient Behavioral Health at Overlook Medical Center

.~ To promote a strong culture of academic integrity, Rutgers has adopted the following honor pledge to be written and signed on examinations and major course assignments submitted for grading. Please type and sign on your cover page the following: On my honor, I have neither received nor given any unauthorized assistance on this assignment. Signed by ________. (the typed name is acceptable for electronic papers)

~ Anonymity/confidentiality footnote/acknowledgement

Analysis Pages (Pages 2-4):

~ This paper will view your chosen diagnosis and the experience of patients and families through the lens of course concepts only from our Gehlert & Browne textbook Chapter 13 “Families, Health and Illness” by John S. Rolland. Explicitly integrate (cite) course concepts throughout your analysis.

That is, avoid merely “telling the story” of what happened during the support group session, but link information observed at a group to specific Ch. 13 concepts.

*Note: Include the patient in the “Family Illness Model” (p. 319) and other chapter concepts.

Use concepts from the entire Chapter 13 in your discussion/analysis of the following:

** Psychosocial Types of Illness (p. 320)

A .Onset

  1. Course
  2. Outcome

d .Incapacitation

** Phases of Illness Developmental Tasks (p. 322; Table 13.1)

–Note: Explicitly connect your analysis to the three specific phases and the numeric tasks and as relevant to your group/diagnosis (i.e., identify which phase and which numbers within each phase that your case examples/analysis links to).

For the paper: It is essential that you protect the anonymity of others (e.g., use pseudonyms in place of actual names of persons and organizations and geographic locations); protect the confidentiality of others (omit any identifying or highly sensitive information that could link individuals and agencies with the content of this paper). [Modify and cut/paste this verbiage onto the cover page, which acknowledges you have done so]

Excellent papers address relevant course concepts and are well-written, well-organized, informal English, demonstrate a masterful ability to analyze the participants in terms of clinical practice concepts learned in Ch. 13, use of verbatim quotes and paraphrasing participant (including group facilitator) statements that serve as “case material” and “information” to support your analysis, and show evidence of critical thinking and client strengths. [Analytic depth: state/identify concepts, define & cite, provide an example, discuss/analyze how example illustrates the concept, integrate/cite course materials—yet, avoid stringing together quotes from the literature. I want to hear your voice, your analysis. Being in a DBT Support Group

Because this paper draws only from Chapter 13, use only page numbers for in-text citations (only for the purpose of this paper, and to save space). However, be sure to use quotation marks when quoting the textbook verbatim (which should be kept to a minimum).

~ First-person voice is preferred.


Book pdf is attached so you can use the appropriate pages listed above

  • attachment


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    Praise for Handbook of Health Social Work, Second Edition

    “The major strength is the organization and comprehensive content of the book. This is a book that can serve as a reference book in any social worker’s library, regardless of whether they are practic- ing in a health-care setting. There are no other books on this topic that are as comprehensive in scope as the Handbook of Health Social Work, Second Edition.”

    — Deborah Collinsworth, LAPSW, NSW-C, Director of Nephrology Social Work Services, Dialysis Clinics, Inc., West Tennessee

    “I’m quite impressed by the comprehensive nature of this revision. It’s the enduring kind of text that serves an immediate purpose for social work instruction while also providing a reference for future practice. This is a book that you’ll want to keep on your shelf.” Being in a DBT Support Group

    — Kevin Lindamood, Vice President for External Affairs at Health Care for the Homeless, Adjunct Professor of Health Policy at the University of Maryland SSW

    “Sarah Gehlert and Teri Browne have thoughtfully covered the topics. The readers of this book will be empowered to deal with the daily challenges. It’s simple but far reaching, a rich knowledge bank of social workers’ interventions, and will benefi t even policy makers in planning strategies to improve patients’ quality of life.”

    — Sujata Mohan Rajapurkar, PhD, Medical Social Worker and Transplant Coordinator, Muljibhai Patel Urological Hospital, Gujarat, India

    “The book’s strengths include the high quality of writing and the expertise of its contributors. It covers the fi eld of health social work in signifi cant depth and is sure to leave readers well informed.”

    — Mary Sormanti, PhD, MSW, Associate Professor of Professional Practice, Columbia University School of Social Work

    “Quite simply, this is the defi nitive volume for Health and Social Work. The fi rst edition was well- executed, well-written, and comprehensive. In this second edition, Gehlert and Browne and their expert contributors have confi dently managed to keep pace with current theory and empirical re- search across a wide range of subject matter that will be of interest to practitioners, educators, and researchers.”

    — Michael Vaughn, PhD, Assistant Professor, School of Social Work, School of Public Health, and Department of Public Policy Studies, Saint Louis University

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    fmatter.indd iifmatter.indd ii 9/21/11 7:56 PM9/21/11 7:56 PM





    Edited by


    John Wiley & Sons, Inc.

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    This book is printed on acid-free paper. o

    Copyright © 2012 by John Wiley & Sons, Inc. All rights reserved.

    Published by John Wiley & Sons, Inc., Hoboken, New Jersey. Published simultaneously in Canada.

    No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400, fax (978) 646-8600, or on the Web at Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, (201) 748-6011, fax (201) 748-6008. Being in a DBT Support Group

    Limit of Liability/Disclaimer of Warranty: While the publisher and author have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifi cally disclaim any implied warranties of merchantability or fi tness for a particular purpose. No warranty may be created or extended by sales representatives or written sales materials. The advice and strategies contained herein may not be suitable for your situation. You should consult with a professional where appropriate. Neither the publisher nor author shall be liable for any loss of profi t or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

    This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering professional services. If legal, accounting, medical, psychological or any other expert assistance is required, the services of a competent professional person should be sought.

    Designations used by companies to distinguish their products are often claimed as trademarks. In all instances where John Wiley & Sons, Inc. is aware of a claim, the product names appear in initial capital or all capital letters. Readers, however, should contact the appropriate companies for more complete information regarding trademarks and registration. Being in a DBT Support Group

    For general information on our other products and services, please contact our Customer Care Department within the U.S. at (800) 762-2974, outside the United States at (317) 572-3993 or fax (317) 572-4002.

    Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. For more information about Wiley products, visit our Web site at

    Library of Congress Cataloging-in-Publication Data:

    Handbook of health social work / edited by Sarah Gehlert and Teri Browne. — 2nd ed. p. cm. Includes bibliographical references and index. ISBNs 978-0-470-64365-5; 978-1-118-11589-3; 978-1-118-11591-6; 978-118-11590-9 1. Medical social work—Handbooks, manuals, etc. I. Gehlert, Sarah, 1948- II. Browne, Teri. HV687.A2H36 2012 362.1‘0425—dc22 2011010997

    Printed in the United States of America

    10 9 8 7 6 5 4 3 2 1

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    Foreword viii Suzanne Heurtin-Roberts

    Acknowledgments x

    List of Contributors xi

    Introduction xiii


    1 ⏐ Conceptual Underpinnings of Social Work in Health Care 3 Sarah Gehlert

    2 ⏐ Social Work Roles and Health-Care Settings 20 Teri Browne

    3 ⏐ Ethics and Social Work in Health Care 41 Jared Sparks

    4 ⏐ Public Health and Social Work 64 Marjorie R. Sable, Deborah R. Schild, and J. Aaron Hipp

    5 ⏐ Health Policy and Social Work 100 Julie S. Darnell and Edward F. Lawlor

    6 ⏐ Theories of Health Behavior 125 Sarah Gehlert and Sarah E. Bollinger

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    vi Contents


    7 ⏐ Community and Health 143 Christopher Masi

    8 ⏐ Physical and Mental Health: Interactions, Assessment, and Interventions 164 Malitta Engstrom

    9 ⏐ Social Work Practice and Disability Issues 219 Rebecca Brashler

    10 ⏐ Communication in Health Care 237 Sarah Gehlert

    11 ⏐ Religion, Spirituality, Health, and Social Work 263 Terry A. Wolfer

    12 ⏐ Developing a Shared Understanding: When Medical Patients Use Complementary and Alternative Approaches 291 Penny B. Block

    13 ⏐ Families, Health, and Illness 318 John S. Rolland

    14 ⏐ Human Sexual Health 343 Les Gallo-Silver and David S. Bimbi


    15 ⏐ Social Work With Children and Adolescents With Medical Conditions 373 Nancy Boyd Webb and Rose A. Bartone

    16 ⏐ Social Work With Older Adults in Health-Care Settings 392 Sadhna Diwan, Shantha Balaswamy, and Sang E. Lee

    17 ⏐ Substance Use Problems in Health Social Work Practice 426 Malitta Engstrom, Colleen A. Mahoney, and Jeanne C. Marsh

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    Contents vii

    18 ⏐ Nephrology Social Work 468 Teri Browne

    19 ⏐ Oncology Social Work 498 Daniel S. Gardner and Allison Werner-Lin

    20 ⏐ Adherence and Mental Health Issues in Chronic Disease: Diabetes, Heart Disease, and HIV/AIDS 526 Wendy Auslander and Stacey Freedenthal

    21 ⏐ Social Work and Genetics 557 Allison Werner-Lin and Kate Reed

    22 ⏐ Pain Management and Palliative Care 590 Terry Altilio, Shirley Otis-Green, Susan Hedlund, and Iris Cohen Fineberg

    23 ⏐ End-of-Life Care 627 Yvette Colón

    Afterword 643 Candyce S. Berger

    About the Editors 649

    Author Index 651

    Subject Index 677

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    It is both an exciting and a challenging time to be a social worker in the fi eld of health. A diversity of roles is available for social work- ers. Areas of practice and opportunities for inter- and transdisciplinary collaborations are unprecedented in the history of the profession. Social workers along with other professionals are on the cutting edge of new health-relevant programs and practices, with social workers frequently in top leadership roles in these ef- forts. To note just a very few examples, social workers are providing genetic counseling and mental health treatment, coordinating hospice and palliative care, working with communities to develop better access to cancer care and clini- cal trials, advocating for and writing improved health-relevant policies, developing health pro- grams and practices, and conducting research that provides an evidence base for effective practice in social work and other professions. Being in a DBT Support Group

    A number of events and trends have come to bear on this blossoming of social work in health. The Patient Protection and Affordable Care Act of 2010 (PPACA), itself the result of decades of advocacy and study on the part of many, including social workers, will radically change the context in which health care is de- livered in the United States. This change will require profound and unsurpassed expertise in complex systems and their relationships to users of health care that is the domain of so- cial workers. Effective implementation of the PPACA will require social work expertise at all levels, from front-line practitioner to policy maker and executive. Being in a DBT Support Group

    The evidence-based practice movement in social work and other health professions also has been integral to the rising importance of social work in health. From fi rst-level, or T1, translation of research fi ndings to cultural and community tailoring and dissemination and diffusion, social work has a principal role to play in getting health knowledge and knowl- edge-based practice to the populations that most can use it. Indeed, social work has been and will continue to be a key source of research producing such knowledge. As the profession is focused on improving people’s well-being through practice that targets interrelationships among systems and people, social work re- search is of great consequence for knowledge production on which to base health-care re- form and other efforts to improve health care in the United States. Thanks to the concerted and strategic efforts of academic social work and professional social work organizations, health social work research is growing and be- ginning to fl ourish.

    The growth of the social determinants per- spective on health has fostered a crucial place for social work in health. As a profession, so- cial work has long understood the importance of multiple life dimensions and experiences as they affect human well-being across the life cycle and has built its practice on such a per- spective. As other health professions catch up in this area, social work’s contributions can be very infl uential in helping to prevent reinven- tion of the wheel in both health care and dis- ease prevention.


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    Foreword ix

    I have noted just a few of the phenomena leading to social work’s rich contributions to health and great potential for even more. As a postdoctoral fellow in applied anthropology, I once worked in a hospital setting on a geriatric consult team. Repeatedly I went to social work staff for information and advice. Indeed, my team (which included physicians, a nurse, and a pharmacologist) held to the mantra of “go ask a social worker, they know everything!” The breadth and depth of social work exper- tise in health is refl ected in and supported by the material in the current work. Being in a DBT Support Group

    This volume is a crucial addition to the libraries of seasoned practitioners as well as an essential foundation for fl edgling social workers ready to enter health as a practice and research area. Both editors are respected leaders in the fi eld of health and social work with an abundance of experience, knowledge, and passion for their work. They have brought together a multiplicity of impressive contribu- tors, all authorities in their respective areas, who share their knowledge and wisdom. The Handbook’s contributors address multiple theoretical foundations, models, issues, and dilemmas for the social worker in health.

    Included are descriptions of skill sets and other expertise needed for direct practice clinicians, community workers, planners, policy makers, researchers, advocates, and administrators. The volume covers practice and research areas ranging from chronic disorders to infectious disease, from physical to mental disorders, and all the gray areas in between.

    However, the book is not simply a how-to manual. Rather, it assesses the current state of the fi eld while suggesting important new directions and developments for the future of social work in health. The ideas in this vol- ume suggest that, perhaps, there is some truth to the sentiment that “social workers know everything.” Certainly they know a great deal about working to improve health and about what will be needed in the future to improve the nation’s health. At a time of great change in the United States in regard to facilitating the production of better health for populations and individuals, a ny social worker engaged in this area would be well advised to have this out- standing resource at hand. Being in a DBT Support Group

    Suzanne Heurtin-Roberts Bethesda, Maryland

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    The preparation of the second edition of this Handbook involved the efforts of a number of people. First and foremost was Jerrod Live- oak, a very talented young man who again helped us organize and edit the Handbook. We could not have done it without his as- sistance. Rachel Livsey and Kara Borbely of John Wiley & Sons’ behavioral science divi- sion were supportive throughout the process. We join them in mourning the loss of Lisa Gebo, a gifted member of the John Wiley & Sons team who worked with us on the fi rst edition and lost her life to breast can- cer on June 14, 2010. We also would like to thank these colleagues who reviewed the

    book and provided valuable feedback: Gary Rosenberg, Mount Sinai School of Medicine; Mary Sormanti, Columbia University; Judy Howe, Mount Sinai School of Medicine; Kevin Lindamood, University of Maryland; Deborah Collinsworth, Union University; and Michael Vaughn, St. Louis University. The 36 contributors to the Handbook, some of whom were friends and others known to us only by reputation prior to the collabora- tion, worked hard and were patient with this revision. Finally, we would like to thank our spouses, Roy Wilson and Lyle Browne, who were always willing to listen to our ideas and to provide feedback and support. Being in a DBT Support Group


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    List of Contributors

    Terry Altilio, MSW, ACSW Beth Israel Medical Center New York, New York

    Wendy Auslander, PhD Washington University St. Louis, Missouri

    Shantha Balaswamy, PhD Ohio State University Columbus, Ohio

    Rose A. Bartone, MSW, LCSW-R New York Medical College Valhalla, New York

    Candyce S. Berger, PhD Stony Brook University Stony Brook, New York

    David S. Bimbi, PhD LaGuardia Community College Long Island City, New York

    Penny B. Block, PhD Block Center for Integrative Cancer Care Evanston, Illinois

    Sarah E. Bollinger, MSW, LCSW Washington University St. Louis, Missouri

    Rebecca Brashler, MSW, LCSW Rehabilitation Institute of Chicago Chicago, Illinois

    Teri Browne, PhD University of South Carolina Columbia, South Carolina

    Yvette Colón, PhD, ACSW, BCD American Pain Foundation Baltimore, Maryland

    Julie S. Darnell, PhD University of Illinois at Chicago Chicago, Illinois

    Sadhna Diwan, PhD San Jose State University San Jose, California

    Malitta Engstrom, PhD University of Chicago Chicago, Illinois

    Iris Cohen Fineberg, PhD Lancaster University Lancaster, United Kingdom

    Stacey Freedenthal, PhD University of Denver Denver, Colorado

    Les Gallo-Silver, MSW, ACSW, CSW-R LaGuardia Community College Long Island City, New York

    Daniel S. Gardner, PhD New York University New York, New York

    Sarah Gehlert, PhD Washington University St. Louis, Missouri

    Susan Hedlund, MSW, LCSW Hospice of Washington County Portland, Oregon

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    xii List of Contributors

    Suzanne Heurtin-Roberts, PhD, MSW United States Department of Health and

    Human Services Bethesda, Maryland

    J. Aaron Hipp, PhD Washington University St. Louis, Missouri

    Edward F. Lawlor, PhD Washington University St. Louis, Missouri

    Sang E. Lee, PhD San Jose State University San Jose, California

    Colleen A. Mahoney, PhD University of Wisconsin Madison, Wisconsin

    Jeanne C. Marsh, PhD University of Chicago Chicago, Illinois

    Christopher Masi, MD, PhD University of Chicago Chicago, Illinois

    Shirley Otis-Green, MSW, ACSW, LCSW City of Hope National Medical Center Duarte, California

    Kate Reed, MPH, ScM National Coalition for Health Professional

    Education in Genetics Lutherville, Maryland

    John S. Rolland, MD Chicago Center for Family Health Chicago, Illinois

    Marjorie R. Sable, DrPH University of Missouri Columbia, Missouri

    Deborah R. Schild, PhD Public Health Social Worker Ann Arbor, Michigan

    Jared Sparks, PhD Ozark Guidance Springdale, Arkansas

    Nancy Boyd Webb, DSW, LICSW, RPT-S Fordham University (retired) New York, New York

    Allison Werner-Lin, PhD New York University New York, New York

    Terry A. Wolfer, PhD University of South Carolina Columbia, South Carolina

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    In a faculty meeting a few years ago, a col- league from another profession referred to the “lower-level skills” of social workers in health care. She distinguished these skills from the “higher-level skills” of social workers in men- tal health settings. I addressed her comment by citing the broad array of information that social workers in health care must possess and be able to access quickly in order to assess cli- ent situations and devise optimal plans in the limited time available to them in health-care settings. I characterized the process as highly challenging, requiring skills at least as well developed as those of social workers in other arenas. This exchange between my colleague and me made me realize two things. First of all, health social work is not well understood by those working in other subfi elds of social work and other disciplines. Second, it would behoove health social work scholars to better defi ne and represent the subfi eld.

    As health care becomes increasingly more complex, social workers have much to know. We have yet to fully understand what the Pa- tient Protection and Affordable Care Act that was enacted in March 2010 means for the health of the nation or what it means for so- cial work practice and research. We do know that current federal approaches to addressing complicated health conditions like HIV/AIDS and cancer argue strongly for simultaneous attention to factors operating at the social, psychological, and biological levels (see, e.g., Warnecke et al., 2008). As members of health- care teams that take these approaches, social

    workers must possess suffi cient knowledge at the social, psychological, and biological lev- els to converse productively with other team members and to work in concert with them constructively. In addition, to be effective, so- cial workers must be aware of how these fac- tors operate with individuals, families, groups, communities, and societies. This awareness is best accomplished by engaging community stakeholders at many levels in research. Being in a DBT Support Group

    The Handbook of Health Social Work was developed to prepare students to work in the current health-care environment in which providers from a number of disciplines work more closely together than was ever the case in the past. Health care in the United States has moved from being multidisciplinary to being interdisciplinary, with the ultimate goal of being transdisciplinary. In multidisci- plinary environments, professionals from dif- ferent disciplines work on the same projects but speak their own languages, view health care through their own disciplinary lens, and often share knowledge with one another after the fact. Interdisciplinary teams interact more closely, but each discipline continues to op- erate within its own boundaries. Because an interdisciplinary approach almost never pro- vides a broad enough view of health-care conditions to capture their inherent complexi- ties, transdisciplinary teamwork has become the exemplar. Here health-care professionals work so closely together that they must de- velop a shared language and pool the best of their separate disciplinary theories. Absent this

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    xiv Introduction

    new, more interdependent approach, the team is reminiscent of the old cartoon of a roomful of blindfolded people touching different parts of an elephant, with each describing the beast based only on the part that she is touching. One might base his description on the trunk, another on the ears, and a third on the tail. To address complex health conditions like HIV/ AIDS effectively, we must recognize the el- ephant in the room.

    In 2009, my coeditor, Teri Browne, and I were asked by John Wiley & Sons if we would be interested in revising the Handbook. A good deal has changed on both the national and in- ternational fronts in the 4 years since the fi rst edition was published. The mapping of the human genome in 2004 continues to change how we view and approach the treatment of disease. Our ability to treat some disorders has increased markedly. Over the four years be- tween the fi rst and second editions, increasing numbers of people lost their health-care cov- erage. Although health-care reform holds the potential to ensure that citizens have cover- age, this is not true for those who are undocu- mented immigrants, and exactly how reform will impact the nation’s steadily increasing health disparities remains a question.

    These changes will continue, and require a great deal of fl exibility on the part of health so- cial workers. As was the case with the fi rst edi- tion of the Handbook of Health Social Work, the second edition considers social workers in health care to be active problem solvers who must draw from a variety of germane bodies of information to address the issues and prob- lems faced by individuals, families, groups, communities, and societies. We believe that this approach allows fl exibility and thus posi- tions health social workers to deal optimally with a changing health-care environment. The authors and layout of the second edition re- fl ect this approach. Learning exercises at the end of each chapter are designed to stimulate discussion and help readers process the infor- mation provided and consider it analytically. The book’s chapters are sandwiched between a foreword by Suzanne Heurtin-Roberts and an afterword by Candyce Berger, both of whom

    have broken ground as social work leaders in health-care practice and research and done much to raise the profi le of the profession.

    The book is divided into three sections. Part I, Foundations of Social Work in Health Care, provides information that we consider basic and central to the operations of social workers in health care. In Chapter 1, “Conceptual Un- derpinnings of Social Work in Health Care,” Sarah Gehlert again discusses the principles that underlie the development of social work in health care and follows its course through time to discover any changes in principles and activities that may have occurred. Chapter 2, “Social Work Roles and Health-Care Set- tings,” by Teri Browne, carefully outlines the wide array of roles performed by social work- ers in health-care settings today. After provid- ing a framework for ethical decision making, Chapter 3, “Ethics and Social Work in Health Care,” by Jared Sparks, again considers some key issues confronting social workers in health care in a variety of arenas, from practice with individuals to policy development. All three chapters take into account the unique chal- lenges facing health care in the United States. Being in a DBT Support Group

    Public health social work recently was named as one of the top 50 professions by U.S. News & World Report, and training programs that combine the two continue to grow. Be- cause of this, and because social work has for a long time played an integral role in the pub- lic health of the United States and other parts of the world, Chapter 4, titled “Public Health and Social Work,” is an essential component of the Handbook, to orient readers to the pub- lic health perspective. J. Aaron Hipp, a com- munity psychologist who works in a school of public health, joined health social workers Marjorie R. Sable and Deborah R. Schild in revising the chapter. The chapter introduces readers to the concepts of primary, secondary, and tertiary health care and considers health from a wider lens than is often used, including global patterns of health and disease. Chapter 5, “Health Policy and Social Work,” written by Julie S. Darnell and Edward F. Lawlor, is almost totally revised from the fi rst edition. It presents basic information on the interplay

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    Introduction xv

    among clinical, administrative, and policy is- sues in health care. Although it is beyond the scope of this book to cover all possible health policies and considerations, an overview of the most pertinent policies and issues is pro- vided. The authors address the likely sequelae of health care reform. Chapter 6, “Theories of Health Behavior,” by Sarah Gehlert and Sarah E. Bollinger, outlines fi ve key theories and meth- ods that can help guide social work practice and research in health care. Empirical evidence for their use in certain situations is provided. Being in a DBT Support Group

    Part II is titled Health Social Work Prac- tice: A Spectrum of Critical Considerations. Although cases and questions confronted by social workers in health care vary widely, certain critical issues should always be con- sidered. The eight chapters in this part repre- sent critical issues that should be considered in approaching cases or pursuing the answers to health-care questions, even though in time they may not prove to be germane to those cases or questions. Failing to consider issues such as religion, sexuality, or substance use may lead to incomplete understandings of cases or consideration of health-care ques- tions. It was only after considering health beliefs, for instance, that Matsunaga and col- leagues (1996) were able to understand why native Hawaiian women did not participate in breast cancer screening despite their high rates of breast cancer. Being in a DBT Support Group

    Because individuals and families do not operate independently but rather as parts of communities, an overview of the relationships between health and community factors is in- cluded in Part II. In Chapter 7, “Community and Health,” Christopher Masi again reviews signifi cant evidence-based data and provides information about how knowledge about com- munity factors can be accessed and included in social work activities in health care. The complex interplay of physical and mental health is addressed in Chapter 8, “Physical and Mental Health: Interactions, Assessment, and Interventions.” The chapter, again prepared by Malitta Engstrom, carefully outlines how to assess for mental health concerns and re- views a variety of interventions. In Chapter 9,

    “Social Work Practice and Disability Issues,” Rebecca Brashler again carefully frames so- cial work practice with individuals and groups with disabilities and provides suggestions for practice. Because communication is central to the effective provision of heath care as it changes through time, the revised chapter titled “Communication in Health Care” is in- cluded as Chapter 10 in Part II of this Hand- book. The chapter provides a basic framework for understanding the dynamics of health-care communication; reviews interventions for im- proving communication; considers the effect of culture, gender, race, and other salient factors on patient and provider communication; and provides guidelines for the use of interpreters. It also addresses the dynamics of health-care teams and social workers’ positions on teams. Being in a DBT Support Group

    In Chapter 11, “Religion, Spirituality, Health, and Social Work,” author Terry A. Wolfer, who is new to the Handbook, reviews the ways in which religion and spirituality af- fect health and individual and group responses to health care. Ways of incorporating religious and spiritual considerations into practice and policy are reviewed. Complementary and al- ternative treatments are reviewed in Chapter 12, “Developing a Shared Understanding: When Medical Patients Use Complementary and Alternative Approaches.” Author Penny B. Block provides information on the extent of al- ternative and complementary treatments in the United States and reasons for their use. She reviews a number of treatments and their his- tories and addresses the importance for social workers of being familiar with complementary and alternative techniques. Chapter 13, “Fami- lies, Health, and Illness,” again written by John S. Rolland, presents a framework for under- standing the interplay between family struc- ture and dynamics and health and addresses its implications for social work practice and policy in health care. Chapter 14, “Human Sexual Health,” addresses the relationship be- tween sexuality and health and discusses ways to incorporate sexual and other intimate con- siderations into practice and policy. Authors Les Gallo-Silver and David S. Bimbi make the point that sexual and other intimate issues are

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    xvi Introduction

    more likely to be faced by social workers in health care than in other areas of practice.

    Part III, Health Social Work: Selected Areas of Practice, contains nine chapters by social workers with extensive practice and academic experience. Selecting the areas to include was diffi cult, and the list is not meant to be exhaus- tive. Our aim was to present a range of examples of good social work practice in suffi cient detail to provide a reasonable overview of social work practice in health care. The second edition of the Handbook includes a new chapter devoted to health social work practice with young pa- tients: Chapter 15, “Social Work With Children and Adolescents With Medical Conditions,” by seasoned authors Nancy Boyd Webb and Rose A. Bartone. Chapter 16, “Social Work With Older Adults in Health-Care Settings,” outlines the issues central to practice with older adults and the challenges faced by social workers. Sang E. Lee joins Sadhna Diwan and Shantha Balaswamy as an author of the revised chap- ter. Because substance use is widespread today and can negatively affect health and response to treatment, it is important that social workers consider the topic in practice and policy. The revised Chapter 17, titled “Substance Use Prob- lems in Health Social Work Practice,” again written by Malitta Engstrom, Colleen A. Mahoney, and Jeanne C. Marsh, carefully out- lines the importance of considering substance use and abuse and provides guidelines for in- corporation into practice and policy.

    After providing background on end-stage renal disease and its psychosocial sequelae, in Chapter 18, “Nephrology Social Work,” Teri Browne reviews evidence-based social work interventions, policies and programs, and resources and organizations available to ne- phrology social workers. In Chapter 19, “On- cology Social Work,” Daniel S. Gardner joins Allison Werner-Lin as an author in the revised chapter. The chapter reviews psychosocial is- sues faced by patients with cancer and their families. Practice considerations are outlined and suggestions for interventions provided.

    Issues of chronic illness are addressed by Wendy Auslander and Stacey Freedenthal in the revised and retitled Chapter 20, “Adher-

    ence and Mental Health Issues in Chronic Disease: Diabetes, Heart Disease, and HIV/ AIDS.” Chronic conditions present a number of unique challenges to social workers, such as how to improve adherence to treatment recommendations. The authors outline these challenges and make suggestions for practice. Chapter 21, “Social Work and Genetics,” has been revised in light of myriad advances in our understanding of genetics and health that have occurred in the last several years. Kate Reed, from the National Coalition for Health Pro- fessional Education in Genetics, joins Allison Werner-Lin as an author of the chapter, which considers the role of social workers in helping patients and families learn and make decisions about genetic testing and cope with its results. Being in a DBT Support Group

    The management of pain in acute and chronic illness increasingly has become the domain of social workers in health care. Chapter 22, “Pain Management and Palliative Care,” orients readers to the effect of pain on behavior and functioning and reviews roles for social workers in pain management and palliative care teams. Terry Altilio, Shirley Otis-Green, Susan Hedlund, and Iris Cohen Fineberg are authors of the chapter. Finally, Chapter 23, “End-of-Life Care,” again by Yvette Colón, discusses how social workers can assist patients and families in dealing with these end-of-life issues effectively. Being in a DBT Support Group

    Our aim in preparing the Handbook of Health Social Work has been to provide a source of information that would help social workers to be active problem solvers rather than followers of routines and existing proto- cols. The book enables social work students to learn the foundations of practice and policy in health care (Part I), critical considerations in implementing practice and policy (Part II), and the ways in which social work is practiced in a number of arenas and with a number of health conditions (Part III).

    We hope that the book will continue to be useful in professional education, allowing those already in practice to learn about issues such as pain management and alternative and comple- mentary medicine that they might not have been exposed to while in school or had the opportunity

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    Introduction xvii

    to learn after graduation. It also is a valuable source of information on evidence-based prac- tice in a variety of areas of health care.

    Social workers in health care today face a number of challenges, some new and some that have always been with the profession. We hope that readers will use the 23 chapters of the Handbook of Health Social Work as a set of tools to help them better address the health-care needs of the individuals, families, groups, com- munities, and societies with whom they work. Being in a DBT Support Group

    Sarah Gehlert St. Louis, Missouri

    Teri Browne Columbia, South Carolina


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