The Human-Animal Bond and Older Adults: The Role of a Community-Based Organization's "Heart to Heart" Program.

In the field of gerontological social work, there is growing interest in further exploring and understanding human-animal bonds and relationships, a trend that accelerated significantly during the early years of the COVID-19 pandemic. Community-based organizations are promising partners as they provide acknowledgment and support for older adults' relationships with their pets and the strengthening of the human-animal bond. This brief report discusses the history, impact, and potential of one community-based organization's annual Valentine's Day event, Heart to Heart. Initiated at the height of the COVID-19 pandemic by Animal Advocates of Greater Lafayette (AAGL), an Indiana-based community organization, Heart to Heart recognizes, celebrates, and supports older adults' bonds with their pets through delivering pet presents directly to older adults' homes. Despite the mounting evidence that pets provide support and comfort for people of all ages, but particularly older adults, social service agencies and programs that serve older adults are often reluctant to recognize the power of the human-animal bond. Heart to Heart allows our community to see and appreciate the strength of these relationships, contributing to new conversations and possibilities for keeping pets and people together through the lifespan.

Effect of a peer-led emergency department behavioral intervention on non-fatal opioid overdose: 18-month outcome in the Navigator randomized controlled trial.

BACKGROUND AND AIMS: Emergency departments (EDs) provide an opportunity to identify people at risk of overdose and reduce the risk. We evaluated the effect of an ED behavioral intervention delivered by peer recovery support specialists (PRSSs) on non-fatal opioid overdose. DESIGN: Two-arm, randomized trial. SETTING: Two EDs in Rhode Island, USA. PARTICIPANTS: ED patients presenting with an opioid overdose, complications of opioid use disorder or a recent history of opioid overdose (November 2018-May 2021). Among 648 participants, the mean age was 36.9 years, 68.2% were male and 68.5% were White. INTERVENTION AND COMPARATOR: Participants were randomized to receive a behavioral intervention from a PRSS (n = 323) or a licensed clinical social worker (LICSW) (n = 325). PRSS and LICSW used evidence-based interviewing and intervention techniques, informed by their lived experience (PRSS) or clinical theory and practice (LICSW). MEASUREMENTS: We identified non-fatal opioid overdoses in the 18 months following the ED visit through linkage to statewide emergency medical services data using a validated case definition. The primary outcome was any non-fatal opioid overdose during the 18-month follow-up period. FINDINGS: Among 323 participants randomized to the PRSS arm, 81 (25.1%) had a non-fatal opioid overdose during follow-up, compared with 95 (29.2%) of 325 participants randomized to the LICSW arm (P = 0.24). There was no statistically significant difference in the effectiveness of randomization to the PRSS arm versus the LICSW arm on the risk of non-fatal opioid overdose, adjusting for the history of previous overdose (relative risk = 0.86, 95% confidence interval = 0.67-1.11). CONCLUSIONS: In Rhode Island, USA, over one-in-four emergency department patients at high risk of overdose experience a non-fatal opioid overdose in the 18 months post-discharge. We found no evidence that the risk of non-fatal opioid overdose differs for emergency department patients receiving a behavioral intervention from a peer recovery support specialist versus a licensed clinical social worker.

Implicit Biases and Racial Microaggressions: Examining the Impact on Black Social Work Students' Well-Being.

This paper explores the concept of racial microaggressions, everyday slights and offensive behaviors experienced by people of color, particularly focusing on their manifestation within social work education programs. Black social work students, in particular, frequently encounter instances tied to stereotypes about their intellectual abilities, perpetuating historical prejudices and contributing to mental health challenges such as anxiety and impostor phenomenon (IP). The historical trauma endured by Black individuals adds a distinct layer to the struggles faced by Black, Indigenous, and People of Color (BIPOC) students in social work education. Despite the evident impact, there exists a significant gap in scholarship addressing these issues, emphasizing the urgent need for the social work profession to confront and comprehend how implicit biases and racial microaggressions impede the success of Black social work students. This theoretical exploration aims to spark vital dialogue on the manifestations of implicit biases and racial microaggressions, probing their link to feelings of IP and historical trauma. Central to this inquiry is the examination of the critical consciousness framework's efficacy in social work education, uncovering its role in raising awareness among professionals regarding their inadvertent perpetuation of oppressive systems. By leveraging this framework, the paper seeks to unearth structures of oppression and privilege, promoting awareness of unintentional complicity in upholding these structures. Recommendations align with the critical consciousness framework, advocating for future dialogues and the implementation of effective microaggression scales to incorporate and analyze frequencies and the impact of racism in social work research.

Addressing Psychosocial Disabilities Through Social Interventions for Individuals With Severe Mental Disorders.

Mental disorders are prevalent worldwide, often causing significant distress and impairment across various life domains. Furthermore, they may lead to psychosocial disabilities exacerbated by stigma, discrimination, and social exclusion that hinder full societal participation and frequently result in human rights violations denying access to education, work, high-quality health, and reproductive rights. Therefore, a comprehensive and coordinated response to mental health requires a biopsychosocial approach and the integration of holistic promotion, prevention, support, care, and rehabilitation. Effective interventions need to be recovery-focused and should include social interventions. This editorial discusses the social interventions that can be utilized to address psychosocial disabilities in individuals with severe mental disorders. There is a need for developing innovative strategies, tools, and digital solutions, the provision of psychoeducation and caregiver support, along with conducting recovery-oriented research and provider training. Furthermore, the focus should be more on strengths instead of pathology and on cultivating a mental health-promoting environment. This requires inclusive policies, increased advocacy to decrease stigma and promote human rights, redirecting funds to community-based services from long-stay mental hospitals, and a multisectoral collaboration between different sectors such as employment, education, health, housing, social, and judicial sectors to provide support across different life stages, facilitate access to human rights, and attain equal opportunities to help individuals with severe mental disorders reach their full potential and live a meaningful life.

Revisiting longitudinal qualitative studies in social work: considerations for design and methodological insights.

This paper undertakes an analysis and discussion of the methodological challenges and insights derived from three longitudinal qualitative studies, all conducted in Chile during the COVID-19 pandemic and subject to comprehensive theoretical-methodological reflection processes centred on their respective designs. This analysis makes a significant contribution to interdisciplinary discussions within social research, with a particular emphasis on longitudinal trajectories. First, we present a comparative analysis of three studies in social work, utilising Saldaña's questions addressing changes and learning in longitudinal studies. The first study explores the labour trajectories of researchers, the second focuses on the educational trajectories of students, and the last examines therapeutic alliance trajectories between social workers and families within the child protection system. Following this, we delve into the methodological decisions made by the research group during the execution of these longitudinal studies. This encompasses an examination of participant involvement, temporal definitions of the adopted designs, and the most suitable methodological tools for analysing change processes over time. The outcomes of this comparative analysis reveal the distinctive characteristics of the three longitudinal studies, providing insights into how the time dimension is explored within them. We highlight key criteria essential for consideration in longitudinal qualitative research, particularly regarding participants and methodology. In conclusion, we advocate for an expanded reflection within the realm of longitudinal qualitative methodology, encompassing aspects such as design choices, approaches to data analysis, integration of technology in information processing, and strategies for maintaining participant engagement.

Social Workers and Black Barbers: A Collaboration to Address Mental Health Stigma.

Black men need safe spaces to express emotions free from bias and stigma. They have been underserved in emotional support due to systemic inequalities. Creating nurturing environments can empower Black men to heal from trauma. Stigma plays a crucial role in their reluctance to seek mental health treatment. This research uses a qualitative approach, combining an action research methodology with a generic qualitative inquiry. This study was conducted to answer the following research question: How can social workers and barbers collaborate to address the stigma of mental health treatment among Black men better? In this study, five social workers, five barbers, and five social work supervisors were interviewed to collect data for the study. Audio recordings were transcribed, and thematic analysis was used to analyze the interview data. Several key themes emerged: (a) collaboration strategies, (b) barbershops as safe spaces, (c) overcoming stigma, (d) cultural competence, and (e) challenges and barriers. The research study produced a pamphlet aimed at raising awareness of mental health stigma's impact on Black men. The implications for the study highlight that partnerships between social workers and barbers can play a pivotal role in dismantling stereotypes and barriers associated with mental health issues among Black men, fostering a cultural shift toward greater mental well-being, acceptance, and understanding.

Differential effects of a social work staffing intervention on social work access among rural and highly rural Veterans: A cohort study.

OBJECTIVE: To evaluate the impact on rural Veterans' access to social work services of a Department of Veterans Affairs (VA) national program to increase social work staffing, by Veterans' rurality, race, and complex care needs. DATA SOURCES AND STUDY SETTING: Data obtained from VA Corporate Data Warehouse, including sites that participated in the social work program between October 1, 2016 and September 30, 2021. STUDY DESIGN: The study outcome was monthly number of Veterans per 1000 individuals with 1+ social work encounters. We used difference-in-differences to estimate the program effect on urban, rural, and highly rural Veterans. Among rural and highly rural Veterans, we stratified by race (American Indian or Alaskan Native, Asian, Black, Native Hawaiian or Other Pacific Islander, and White) and complex care needs (homelessness, high hospitalization risk, and dementia). DATA COLLECTION: We defined a cohort of 740,669 Veterans (32,434,001 monthly observations) who received primary care at a participating site. PRINCIPAL FINDINGS: Average monthly social work use was 8.7 Veterans per 1000 individuals. The program increased access by 49% (4.3 per 1000; 95% confidence interval, 2.2-6.3). Rural Veterans' social work access increased by 57% (5.0; 3.6-6.3). Among rural/highly rural Veterans, the program increased social work access for those with high hospitalization risk by 63% (24.5; 18.2-30.9), and for Veterans experiencing homelessness, 35% (13.4; 5.2-21.7). By race, the program increased access for Black Veterans by 53% (6.1; 2.1-10.2) and for Asian Veterans by 82% (5.1; 2.2-7.9). CONCLUSIONS: At rural VA primary care sites with social work staffing below recommended levels, Black and Asian Veterans and those experiencing homelessness and high hospitalization risk may have unmet needs warranting social work services.

Varying Estimates of Social Workers in the United States: Which Data Source to Use?

Behavioral health needs continue rise in the United States and constitute a key driver of health care utilization, costs, and outcomes. Social workers provide a wide range of services across health, behavioral health, and community settings, and while this heterogeneity in practice benefits care delivery, it complicates health workforce analyses. This analysis compares five commonly used national data sources and details similarities and differences in their estimates of the number, type, and practice characteristics of social workers. The analysis suggests that estimates vary significantly between data sets ranging from 282,425 to 1,022,859 social workers; as well as yield different findings of types of social workers in the United States, depending on the data set used. These differences have the potential to shape how researchers and policy makers assess the adequacy of the social work workforce and identify solutions to address the nation's behavioral health and social care needs.

Beyond Victim Identification: A Practitioner's Guide to Designing a Youth Anti-Sex Trafficking Advocacy Program.

Thousands of youth are sexually trafficked each year in the United States. In order to address this concern, anti-trafficking advocates often emphasize the importance of uniform screening protocols to assist with the identification of survivors. Unfortunately, an oft-overlooked component of sex trafficking identification is what to do once a victim has been identified, and how to best meet survivors' complex needs. In this article, the authors provide social work practitioners and other advocates with best practice guidelines for how to design and evaluate anti-sex trafficking advocacy programs for children and youth. These guidelines include considerations related to direct services with clients, community partnerships, and organizational capacity, as well as recommendations for how to begin and then evaluate programming. Regardless of the form selected for the program, all anti-sex trafficking programs should be designed to provide effective, client-centered follow-up and advocacy once a positive identification is made in the community. The recommendations included in this paper are based upon extant literature, the authors' practice experience with survivors, and insights from anti-sex trafficking program evaluations.

Compassionate Release: A Call to Social Workers.

An increase in the number of older people incarcerated in prisons has given rise to increased costs of correctional health care. Despite the many benefits of compassionate release, it is rarely used. Citing barriers at the micro, mezzo, and macro levels, we contend that social workers are uniquely suited to increase the number of people released through this mechanism owing to a unique knowledge and skill set. We offer eight specific strategies for how social workers can increase the use of compassionate release by working with individuals, conducting and disseminating research, and engaging in advocacy as shaped by core professional principles and values and related curricula.

Silent suffering: The hidden challenges confronting unaccompanied refugee children through the eyes of social workers.

BACKGROUND: Unaccompanied refugee children are one of the most vulnerable categories within the refugee population. They face inexhaustible risks from the start of their journey until its conclusion; being exposed to various forms of violence, assault, and exploitation during the transit phase. OBJECTIVE: This study was aimed to discern the challenges faced by unaccompanied refugee children in Jordan, as perceived by social workers. Additionally, to uncover the role of the social work profession in helping these children in confronting and alleviating these challenges. PARTICIPANTS AND SETTING: Ten social workers working with unaccompanied refugee children in the International Medical Corps in Jordan were selected to take part in the study. METHODS: The study adopted a qualitative research approach to achieve its aims. Semi-structured interviews served as the primary method for data collection. Data analysis used inductive thematic analysis, and ethical considerations were consistently observed throughout the study process. RESULTS: The study revealed significant social challenges, including strained alternative familial relationships and difficulties in social integration. Psychological struggles were clear in enduring loss, separation, and suicidal thoughts. Economic hardships manifested in meeting basic needs and child labor. School dropouts appeared as a prominent educational issue. Social workers are primarily engaged in case management, providing psychosocial support, and easing referrals. CONCLUSIONS: Adverse living conditions profoundly affect children, affecting their psychological, physical, and social development. This leads to the emergence of deep psychological traits such as sadness, hostility, anxiety, and behavioral disintegration. Consequently, many children experience social disconnection and struggle to adapt to their environment effectively.

Visible damp in a child's bedroom is associated with increased respiratory morbidity in early life: a multicentre cohort study.

OBJECTIVE: Household damp exposure is an important public health issue. We aimed to assess the impact of the location of household damp on respiratory outcomes during early life. METHODS: Household damp exposure was ascertained in children recruited to the GO-CHILD multicentre birth cohort study. The frequency of respiratory symptoms, infections, healthcare utilisation and medication prescription for wheezing were collected by postal questionnaires at 12 and 24 months. Log binomial and ordered logistic regression models were fitted to the data. RESULTS: Follow-up was obtained in 1344 children between August 2010 and January 2016. Visible damp was present in a quarter of households (25.3%) with 1 in 12 children's bedrooms affected (8.3%). Damp in the bathroom, kitchen or living room was not associated with any respiratory or infection-related outcomes. Damp in the child's bedroom was associated with an increased risk of dry cough (8.7% vs 5.7%) (adjusted relative risk 1.56, 95% CI 1.07 to 2.27; p=0.021) and odds of primary care attendance for cough and wheeze (7.6% vs 4.4%) (adjusted OR 1.37, 95% CI 1.07 to 1.76; p=0.009). There were also increased risk of inhaled corticosteroid (13.3% vs 5.9%) (adjusted RR 2.22, 95% CI 1.04 to 4.74; p=0.038) and reliever inhaler (8.3% vs 5.8%) (adjusted RR 2.01, 95% CI 1.21 to 2.79; p=0.018) prescription. CONCLUSION: Damp in the child's bedroom was associated with increased respiratory morbidity. In children presenting with recurrent respiratory symptoms, clinicians should enquire about both the existence and location of damp, the presence of which can help prioritise those families requiring urgent household damp assessment and remediation works.

The relationship between chronic disease variety and quantity and suicidal ideation: A cross-sectional study of NHANES.

BACKGROUND: This cross-sectional study examines the link between chronic diseases and suicidal thoughts in U.S. adults using 2013-2018 National Health and Nutrition Examination Survey (NHANES) data, aiming to identify potential risk factors for suicidal ideation. METHODS: Using NHANES data, we analyzed the association between various chronic conditions (hypertension, diabetes, asthma, etc.) and suicidal thoughts, employing logistic regression models adjusted for demographics and lifestyle factors. RESULTS: The analysis of 8891 participants revealed a significant association between suicidal thoughts and chronic diseases such as liver disease, diabetes, and asthma. The risk of suicidal ideation is higher with the number of chronic conditions. CONCLUSION: Our findings suggest a strong link between the presence and number of chronic diseases and the risk of suicidal thoughts, emphasizing the importance of integrated care approaches that address both physical and mental health needs.

Perceived Readiness for Gerontological Social Work: Insights from Recent Graduates During COVID-19.

An online qualitative survey explored perceived training, readiness, and needs of recent SW graduates serving older adults. Over half (N = 14) held a master's in social work, with 70% having taken an introductory aging course. Nearly halfcompleted other aging-specific coursework, and 80% did fieldwork with older adults. Participants indicated moderate proficiency in assessing issues like lossestransitions (46.7%), and physical health (53.3%), and advanced expertise in cognitive assessments (60.0%) and caregiver stress management (53.3%). Training deficiencies were noted in disaster readiness, telehealth, and resource coordination. Findings underscore the need for educationfor early-career social workers, ensuring their effective support to older adults.

Adverse Childhood Experiences and Their Relationships with Perceived Stress and Self-Care Behaviors in African American Social Work Students: Insights from a Latent Class Analysis.

Based on stress sensitization theory and stress proliferation theory, this study was designed to identify adverse childhood experience (ACE) classes and their relationships with perceived stress and self-care behaviors. Hypotheses were that (a) there would be diverse ACE classes among African American social work students; (b) the identified classes embedded in high/multiple ACEs would have greater levels of perceived stress than those in low ACEs; and (c) the identified classes embedded in high/multiple ACEs would have lower levels of self-care behaviors than those in low ACEs. Recruited from one of the South's historically Black colleges and universities, 186 African American social work students completed an online survey. Latent class analysis found three classes fit the data best: low ACEs, high divorce/abuse/neglect, and high/multiple ACEs. Students in the high divorce/abuse/neglect class had the greatest levels of perceived stress and significantly greater perceived stress levels than the low ACEs class. The low ACEs class had greater self-care behaviors than students in the other two ACEs classes. The study revealed diverse ACE classes and the effect of more ACEs on greater perceived stress and lower self-care behaviors, supporting the importance of using a range of approaches to support African American social work students with different ACEs.

Challenges perceived by social workers to prevent FGM/C in Bavaria: a prospective, cross-sectional survey.

BACKGROUND: Worldwide, at least 230 million girls and women are affected by female genital mutilation/ cutting (FGM/C). FGM/C violates human rights and can cause irreparable harm and even lead to death. In 2022, more than 100,000 survivors of FGM/C lived in Germany, and more than 17,000 girls were considered at risk. Due to the increasing number, there is a need to improve the skills of professionals not only to treat FGM/C but also to prevent it, aiming to maintain or improve women's physical and mental health. However, previous studies mostly focused on health care providers, even though other professionals such as social workers, play an important role in the provision of sexual and reproductive health (SRH) care and are often the first point of contact. Therefore, the study's main objective was to understand challenges perceived by social workers in pregnancy counselling centres in the provision of good quality of SRH care for girls and women suffering from or endangered by FGM/C. METHODS: A quantitative self-administered cross-sectional online survey was sent by e-mail in 2021 to all pregnancy counselling centers in the German federal state of Bavaria. RESULTS: Among the 141 participants, 82% reported no or insufficient FGM/C knowledge and barriers to provide the best quality of care. The main findings were language obstacles (82.7%), perceived client's fear or shame (67.9%) and cultural difficulties (45.7%). Furthermore, participants also reported a lack of competence on the professional side (29.6%). Importantly, most participants (129 of 141; 92%) expressed interest in training. CONCLUSION: Providing comprehensive good quality sexual and reproductive health care to women and girls affected from or endangered by FGM/C is challenging. The study revealed the importance of strengthening the skills of social workers and suggested the following strategies: (1) enhancing FGM/C knowledge and skills (including specialized competences e.g., in mental health) by improving training and information material for the target group, (2) improving referral pathways and addressing deficits in the existing care system (e.g. with health or legal institutions), and (3) developing trusting relationships with cultural (or traditional) mediators to build strong community networks.

Sitting with you in uncertainty: a reflective essay on the contribution of social work to end-of-life care.

Death may be the only certainty in life, but for palliative care patients and their carers, it is anything but. How long is there left? Will a hospice bed be available? What new loss (big or small), will tomorrow bring? Research suggests that the poor management of uncertainty in palliative care can significantly impact patient outcomes as well as the experience of bereaved families. Social workers cannot mitigate this uncertainty, but they can support individuals to recognise and engage with it. Often, this can create tensions with their personal instinct to remove distress, as well as their professional drive to 'fix things'. By overcoming these challenges and embracing their ability to find ways forward 'in the midst of the messy stuff', they model a constructive mode of behaviour that patients and other multidisciplinary professionals can then mirror.

How Social Workers Can Be Deployed to Assist with the Ongoing Opioid Crisis.

The opioid epidemic has claimed more than 1 million lives in the United States over the past two decades. The persistent increase in deaths indicates that current strategies intended to decrease the negative consequences of opioid use are inadequate. Harm reduction strategies are designed to promote safer substance usage and reduce overdose mortality rates, yet the implementation of harm reduction programs is inhibited by community- and provider-level stigma against people who use opioids, coupled with limited understanding and insufficient education about harm reduction approaches. Despite ongoing research, engagement in opioid treatment programs remains a challenge, and the opioid crisis continues to disproportionately harm marginalized populations. This article describes how social workers are prepared to play a larger role in opioid use treatment because they are trained with the skill set and values necessary to facilitate access to harm reduction programs, promote engagement in substance use treatment, and create and advocate for interventions to address problematic substance use, especially in high-need communities.

Adverse Childhood Experiences, Women Who Are Sex Trafficked, and Social Service Utilization: Implications for Social Work.

The aim of this study was to examine the associations between adverse childhood experiences (ACEs) and the high levels of social service usage by women who are sex trafficked. Fifty (N = 50) women who were sex trafficked were surveyed using purposive and snowball sampling methods. The ACEs score for respondents ranged from 2 to 10 with an average score of 7.4 (SD = 2.3). Emotional and sexual abuse tied at 88 percent as the most frequently cited ACEs among the women in this sample. The prevalence of ACEs was significantly higher in this sample compared with known estimates in similar populations, ranging from 20 percent to 54 percent (p < .001). Considering the well-established link between ACEs and poor health outcomes, these findings point to the need for innovative and targeted social service provisions to women who were formerly sex trafficked that take into consideration the high level of ACEs of the women. Given the sociodemographic diversity of this sample, there is a need for services that are trauma-informed, innovative, and culturally sensitive in a variety of social service settings.

Harnessing Resilience in the Healthy Ageing Discourse: Insights from Attappadi Indigenous Older Adults, Kerala, India.

In this "Decade of Healthy Ageing," the integration of resilience into the healthy aging discourse becomes paramount, particularly in the context of indigenous communities grappling with the enduring effects of historical oppression, persistent poverty, and health disparities in their aging journey. Employing a phenomenological lens, this study seeks to derive the resilient characteristics exhibited by the Attappadi indigenous older adults of Kerala, aiming to explore the role of resilience in their pursuit of healthy aging. In-depth phenomenological interviews (n = 34), observation, and document analysis have revealed four key themes: A life course marked by adversities, Embracing the unyielding strength within, Personal resilience catalysts, and Extrinsic resilience catalysts. The participants exhibited a reasonably well-functioning collective, given their persistent adversities in their life course. Narratives illuminated a notable connection between the presence of resilience characteristics and the overall functioning of older adults. From a social work standpoint on resilience, this article underscores the vital interplay between individual agency and environmental factors in addressing adversity. The article advocates culturally sensitive, asset-based strategies to strengthen indigenous older adults' intrinsic and extrinsic resilience to ensure that they are not left behind in the global pursuit of healthy aging.