Traumatic brain injury and the Americans with Disabilities Act: implications for the social work profession.

The practice of social work has been greatly affected by the Americans with Disabilities Act of 1990 (ADA). Title I of the statute prohibits discrimination against people with disabilities, including the increasing number of workers who are returning to work after a traumatic brain injury (TBI). This article examines the extent to which the ADA protects those with TBI from being harassed, being denied reasonable workplace accommodations, or suffering other adverse actions related to perceived discrimination. To do so, it relies on judicial decisions from U.S. federal courts involving alleged workplace discrimination of this population. Implications for social work practice are noted with the intent of increasing ADA awareness among professionals providing services to people who meet the criteria for disability under the ADA as well as to those persons who do not. The authors hope to encourage social workers to rely on case law analysis as a mechanism to provide further evidence of the systematic problems faced by people with TBI and thus increase their visibility.

Tailoring work-life interventions for culturally diverse caregivers of patients with traumatic brain injury.

With the increasing incidence of traumatic brain injury among culturally diverse families, there has also been increased attention to the dual demands of employment and caregiving. In this article, we contend that culturally diverse caregivers are an understudied group of workers. We examine literature to assist in conceptualizing the relationship between cultural orientation and caregiving, work-life stress, and organizational responses. Implications for strengthening the cultural responsiveness of work-life initiatives are discussed.

Factors associated with work-family conflict stress among African American women.

Job demands and workplace culture variables associated with work-family conflict stress, in addition to workplace racial bias, were examined for a national sample of 607 African American women in 16 Fortune 1000 companies. Similar to other studies, women in this sample who had dependents were younger, had supervisory responsibilities, and experienced a less positive workplace culture, and those in professional job positions with high job demand were most likely to experience work-family stress. Married women who experienced a more subtle form of workplace racial bias reported more work-family conflict stress. Implications for social work policy, practice, and research are considered.

The role of catastrophizing in sickle cell disease--the PiSCES project.

In several types of chronic pain, catastrophizing has been related to higher pain intensity, and health care utilization but it has not been explored extensively in sickle cell disease (SCD). The objective of the study was to identify the role of catastrophizing in SCD, specifically in relation to painful crises, non-crisis pain, and responses to pain. Two hundred and twenty SCD adults were enrolled in a prospective cohort study of pain and completed between 30 and 188 daily diaries in 6 months. The Catastrophizing subscale (CAT) of the Coping Strategy Questionnaire (CSQ) was administered at baseline and at study exit. Depression and quality of life were measured by the Patient Health Questionnaire and SF-36, respectively, at baseline. The CAT mean was 13.6 (SD=8.4) and higher CAT was correlated with greater depression severity (r=0.48; p<0.001) and poorer quality of life in all domains (r=-0.24 to -0.47; p<0.001). There was no significance difference between CAT mean baseline and exit scores, and the measures were strongly correlated within patients (r=0.69; p<0.001). No difference was found between higher and lower catastrophizers in intensity of pain, distress, interference, and health service utilization, both on crisis or non-crisis SCD-related pain days, after controlling for depression. Adults with SCD had a higher mean catastrophizing score than found in studies of other chronic pain conditions that are not lifelong and life-threatening. CAT scores were not correlated with pain parameters or utilization. The role of catastrophizing in other conditions cannot be generalized to SCD.