Social Work Care in Traumatic Brain Injury and Substance Use Disorder Treatment: A Capacity-Building Model.

Co-occurring traumatic brain injury (TBI) and substance use disorders (SUD) are a major public health concern, yet TBI is often underrecognized within SUD treatment organizations. Social workers in these organizations are well positioned to deliver tailored treatment, but little is known about what social workers are doing to address the needs of these clients. The purpose of this study was to examine current social work practices in providing care to clients with co-occurring TBI and SUD. Using grounded theory methodology, authors conducted semistructured interviews with 17 licensed social workers employed in various SUD treatment settings. Transcript coding was conducted through an iterative process and data were analyzed using NVivo (version 12.0). Results demonstrated that social workers lack basic knowledge on the relationship between TBI and SUD. Additional barriers to providing care included lack of skills to identify history of TBI, lack of community resources, poor agency collaboration, and access-to-care restrictions. Social workers identified their primary roles as advocacy, care coordination, and serving on multidisciplinary teams. These results informed development of a capacity-building model, with recommendations for social work situated in each level of the socioecological framework. This study has important implications for building workforce capacity and collaborative care systems to improve client outcomes.

Individual and Community Engagement in Response to Environmental Challenges Experienced in Four Low-Income Urban Neighborhoods.

Low-income urban communities, and the individuals that live within them, continue to face disproportionate interconnected social, economic, and environmental challenges related to their built, natural, and social environments. The aim of our phenomenological research study was to elevate the experiences of residents living in low-income urban neighborhoods in terms of their communities' environmental challenges. Our objectives were to (1) identify challenges across neighborhoods, (2) identify ways individuals and communities are addressing those challenges, and (3) assess the individual and collective efficacy and engagement of communities to lead environmental improvements in neighborhoods. This study brings forward the voices that are often ignored or misunderstood in these communities and uses an ecological-social perspective. We conducted focus groups (N = 68) in four low-income urban neighborhoods across two Ohio cities in the United States. Participants described five key challenges in their communities: Pollution, abandoned buildings with associated crime, low food access and health concerns, trash and illegal dumping, and lack of trees. We assessed engagement and efficacy using two frameworks focused on individual and community readiness to engage in and lead community change. Policymakers should acknowledge the valuable contributions and leadership capacity of residents in low-income communities to implement environmental initiatives.