Family Centred Brief Solution-focused Therapy with Chronic Schizophrenia: a Pilot Study

The purpose of the study was to pilot a family centred brief solution-focused therapy model (BSFT) with families and clients diagnosed with schizophrenia. A control group of clients and their families received traditional outpatient therapy, while an experimental group of clients and their families were treated with a BSFT model. All participants were pre-tested and then post-tested with the Family Environment Scale after five therapy sessions over a ten-week period. Significant differences between the groups were found on expressiveness, active-recreational orientation, moral-religious emphasis and family incongruence. The participation of families and clients with schizophrenia in family centred brief solution-focused therapy produced encouraging results and demonstrated the need for expanded studies using BSFT with other chronically mentally ill clients and their families.     

Applying the principles and techniques of solution-focused therapy to career counselling

Career counselling aims to help clients become more effective agents in solving problems in their vocational aspects of life. To achieve this goal, theorists and practitioners are called upon to form useful helping approaches that can help clients in a more efficient and effective manner. This article proposes an alternative model toward this end by considering and adopting principles and techniques from the solution-focused therapy in career counselling practice. After a very brief introduction of the basic features of the solution-focused counselling, the paper reviews some key theoretical principles of the solution-focused therapy, and connects these principles to career counselling context. It then illustrates several solution-focused counselling techniques that are particularly applicable to career counselling intervention.     

Emotions in solution-focused therapy: a re-examination

This article re-examines whether and how emotions are an aspect of solution-focused therapy. A major theme in the article focuses on the usual ways that therapists define and discuss emotions in solution-focused and other therapies. We argue that these discussions are a source of much confusion about emotions and about solution-focused therapy, including the confusing idea that emotions are neglected in solution-focused therapy. The second major theme describes an alternative approach to these issues, one that we believe better fits with the assumptions and concerns of solution-focused therapy. The approach is based on Wittgenstein's writings about language games, private experience, and how emotions are rule-following activities. Viewed from this perspective, solution-focused therapists take account of their clients' emotions by helping clients to create new emotion rules to follow.     

Psychotropic Medication Practices for Youth in Systems of Care

Concerns have been raised about the quality and appropriateness of psychiatric medication treatment for youth treated in the child welfare or juvenile justice systems. Unfortunately there is a lack of empirical research to indicate whether there are indeed widespread problems related to psychopharmacologic treatment for youth served by public sector systems. This exploratory study utilized data from a national survey of social workers to examine differences in reports on medication type, processes, and perceived outcomes for adolescent clients in the juvenile justice and/or child welfare system (n = 90) versus non-systems clients (n = 305). Relevant clinical and demographic factors were controlled in hierarchical binary logistic and linear regression analyses. The results indicated that social workers referring to systems cases were more likely to report the use of highly potent medication (antipsychotics, mood-stabilizers, and poly-pharmacy), less likely to report that clients were receptive to or involved in the decision to utilize medication, and less likely to report beneficial medication outcomes. However, these reported differences, suggesting that medication treatment for systems youth tends to be less participatory and beneficial, were largely accounted for by differences in clients’ level of functional impairment and rate of disruptive behavior disorders. Implications for further research are discussed.     

Job Satisfaction of Child Welfare Workers in an Urban Setting: Status and Predictors

Large urban areas present many challenges to those children and adults who reside in those settings. The social service workers in urban areas have clients with complex, multiple needs. Reliable and consistent workers are essential to successfully working with these families. In the current study, the job satisfaction of 29 social service workers in an urban child welfare agency was assessed using the Job Satisfaction Scale (JSS). The JSS measures satisfaction in 7 areas of one's job (i.e., work, supervision, coworkers, pay and promotion, work environment, training, and position). Data indicated that the staff were relatively satisfied, that satisfaction did not vary by staff position (family worker vs. social worker/supervisor), and that neither demographic factors nor prior experiences were predictors of job satisfaction. Implications for agency management and the provision of social services to urban families are discussed.     

Social identification effects in social dilemmas: a transformation of motives

Three experimental studies were conducted to examine two alternative explanations for the widely established positive effect of social identification in promoting cooperation in social dilemmas. We hypothesised that social identification effects could be either ascribed to (1) an increase in the value assigned to the collective good (i.e. goal‐transformation hypothesis) or (2) an enhancement of trust in the cooperation of other group members (i.e. goal‐amplification hypothesis). To disentangle these two explanations, we examined the effects of social identification on the contributions to a public good of people with a different social value orientation (i.e. pre‐existing differences in preferred outcome distribution between self and others). Following the goal transformation hypothesis, we predicted that an increased group identification would raise contributions, in particular for people essentially concerned with their personal welfare (i.e. pro‐self value orientation). Alternatively, following the goal amplification hypothesis it was expected that increased group identification would primarily affect decisions of people concerned with the collective welfare (i.e. prosocial value orientation). The results of all three studies provided support for the goal‐transformation rather than goal‐amplification hypothesis, suggesting that ‘selfish’ individuals can be encouraged to cooperate by increasing the salience of their group membership. Copyright © 1999 John Wiley & Sons, Ltd.     

A solution-focused approach to working with clients who are suicidal

Self-harm and suicide are amongst the most challenging and frightening problems that therapists and counsellors can encounter in the course of their work. The risk of clients harming themselves in the course of treatment can debilitate the therapists from acting creatively and collaboratively, and make their actions defensive, focused solely on risk assessment rather than therapeutic change.Yet it is precisely a creative and collaborative response, such as that engendered by solution-focused therapy and other models, that is the most likely to facilitate change and re-empower clients to take back charge of their lives. This article describes a solution-focused approach to working with suicidal clients that can be used in conjunction with traditional approaches and which focus on establishing safety as well as assessing risk.Working from this model the clinician shifts to identifying client strengths and coping skills, to collaborating with the client to establish meaningful goals and to helping the client envision a positive future. Arguably, such an approach can increase collaboration between therapist and client and lead to a more client-centred safety plan.     

Reciprocating Desires: The Pursuit of Desirable East Asian Femininity in China’s Commercial Sex Industry

ABSTRACT

This article examines how socioeconomic conditions impact heteronormative sexual desires between high-tier sex workers and their non-Chinese clients in urban South China. Drawing from Hoang’s interpretation of ‘dealing in desires’, Rofel’s ‘Desiring China’, and cultural capital, the article considers how desire circulates in high-end bars and its impact on how workers and clients negotiate their relationships. I move beyond Hoang’s and Rofel’s framework to include cultural capital that help sex workers perform an East Asia femininity and develop their image as cosmopolitan tempting girls to practice ‘reciprocating desires’ with their non-Chinese clients. The article unfolds as a theoretical exercise in unearthing and understanding the underpinnings of how socioeconomic context impacts our understanding of what qualifies as desirable East Asian femininity. Drawing upon ethnographic research conducted in a high-end bar in South China from the summer of 2015 to the summer of 2017, this article first examines desire and the meanings attached to sex workers’ body capital, and cultural capital that exemplify desirable East Asian femininity. Second, cultural capital explains how desire operates within high-tier heteronormative sex work spaces to construct social identity, which can help sex workers achieve professional success and become a source of personal satisfaction.     

Brief therapy in adult psychiatry: results from fifteen years of practice

We report the outcomes from our solution-focused brief therapy outpatient clinic in adult mental health. A questionnaire was sent to clients and their family doctors one year after they ceased to attend. Seventy-five clients were referred, of whom fifty-three were seen and forty-one traced at follow-up. Thirty-one (76%) reported a good outcome, with an overall average of 5.02 sessions, 20% attending only one session. Combining these data with our previous studies, 170 referrals were received of whom 136 attended and 118 were traced. Good outcome was reported by eighty-three clients (70%) with a mean of 4.03 sessions per case. There was no significant difference between the groups in solving additional problems or seeking further professional help. New problems were significantly less common in the 'good outcome' group. Long-standing problems did less well. In all three studies there were no significant differences in outcome between socioeconomic groups.     

Gender-sensitive training for substance use disorder treatment: Results and implications of a pilot health professionals needs assessment

This study explored mental health practitioner training needs in gender-sensitive substance use disorder (SUD) counselling genderqueer populations. Informants were health professionals in SUD practices and from the Eastern Cape, South Africa (females = 75%; black = 90%, 10% = white, clinical and counselling psychologists = 10%, social workers = 65%, auxiliary health workers = 25%). They completed focus group interviews regarding their needs for gender-sensitive (GS) training in SUD treatment. Thematic analysis of the data indicated training needs in how to deal with their own bias and prejudice beliefs about the genderqueer population. Furthermore, results indicated that they needed training on how to manage the treatment setting once genderqueer clients were integrated in treatment with cisgender clients. Training for SUD treatment and care with genderqueer clients should prioritise gender sensitisation. Health professionals’ need gender equality awareness training for health care equity with the genderqueer community.     

The Contradictions of Caring: Social Workers,Teachers, and Attributions for Poverty and Welfare Reform

This paper examines the attitudes toward poverty and welfare reform of a sample of social workers and inner‐city school teachers. More specifically, it focuses on the impact of poverty attributions on attitudes toward welfare reform among members of this sample. There is a mystery about attitudes toward welfare reform that the paper attempts to explain. These social workers and teachers rejected most of the 1996 changes to welfare, but they were surprisingly positive about the impact these reforms have on the families with whom they work. This contradictory set of beliefs is explained as a function of the family‐oriented view of poverty that is peculiar to this group.     

Being a Social Worker as an Existential Commitment: From Vulnerability to Meaningful Purpose

One's personal and professional dimensions complement each other in the practice of social work. In plying their trade, social workers construct a personal narrative that gives a sense of meaning to their commitment to clients who face suffering and distress. The study is based on in-depth interviews of twenty-five experienced female social workers. Two themes were identified: The first theme focuses on the construction of an existential vulnerability in the family-of-origin, which drives the choice of a helping profession. The interviewees perceived these difficulties as contributing to their sensitivity toward the suffering and turmoil of others, connecting them with clients, and giving them a sense of purpose, commitment, and meaning in their work. The second theme relates to the special meaning assigned to social values, such as giving and committing to others, in the family-of-origin and the profound effect of this socialization process on professional choices and practice. The discussion of the findings is from an existential perspective and has implications for the professional development of social workers and other helping professionals.     

Solution-focused Couples Therapy Groups: An Empirical Study

The professional literature contains numerous theoretical and case study articles regarding the development and use of solution-focused therapy. However, as with many models of systems-oriented therapy in use with couples, very little has been subjected to empirical investigation. This project was designed to make a contribution to the empirical literature regarding the effectiveness of solution-focused therapy in use with couples' groups. This study utilized pre-test comparisons of treatment and comparison groups, and examined pre- to post-test changes in the scores of the treatment group couples. Twenty-three treatment group couples participated in a six-week solution-focused couples therapy (SFCT) group. A separate group of thirteen couples served as a comparison group. The Dyadic Adjustment Scale (DAS) was used to assess changes in the couples' relationships. Scores on the Marital Status Inventory (MSI), as a pre-test measure indicating the couples' likelihood of divorce, indicated no significant differences between groups. The remaining analyses revealed significant improvement in DAS scores. Self-reports from the couples involved indicate improvement in a variety of areas after completing the six-week solution-focused couples group therapy process.     

Helping the Helper Heal:

Social workers who have their own problems with alcohol or other substances may be ineffective or harmful to chemically dependent clients. This article discusses the nature of co-dependency as it affects those who try to help alcoholic or addicted clients. It provides information about the possible extent of co-dependent social workers, the consequences of their activities, and the precautions to be taken to vitiate any harm.     

The Scope of Client Aggression Toward Social Workers in Israel

The phenomenon of client violence toward social workers has been documented in various parts of the world. The goal of this study is to describe the phenomenon and explore the relationship pattern between contextual variables and clients’ aggression. The study encompassed a sample of 645 workers in 34 municipal social service agencies. Of the entire sample, 80% reported being exposed to some form of aggression at least once over the last 3 months. The findings highlight 2 broad axes related to client aggressiveness: frequency and level of aggression. With respect to frequency, we can discern a continuum running from common types of aggressive behaviors to rare ones. The other axis focuses on the level of aggressiveness used, from minor types of client aggression, such as verbal assaults and threats, increasing to more severe ones, such as property damage, and, finally, to physical injury. The routineness of aggression in the work environment lends it the appearance of being normal, and functioning in such an environment desensitizes social workers to clients’ aggressiveness. Also examined and discussed are organizational and personal factors that contribute to the aggressive behavior of clients, including seniority, gender, workload, inadequate service conditions, and coworkers’ aggressive behavior.     

The Love that Binds: Transnational Relationships in Sex Work

The maintenance of long-term relationships between sex workers and their clients involves the management and balance of intimacy and a business relationship and requires both parties to constantly negotiate their roles and expectations. In this study, I focus on how they interpret these relationships. The data used are from in-depth interviews and participant observation collected from August 2004 through August 2007. I identify three factors affecting these relationships: distance apart, affairs and social bond. While older lovers yield a certain amount of control and power over their younger partners, the latter can convert older lovers’ emotional attachment, sense of responsibility, familial involvement, and sense of pride to currencies used to increase their bargaining power.     

Perceptions of health care social workers in Ontario: challenges and facilitators to reflective practice

Background: Reflective practice in health care social work ensures that social workers provide effective and efficient services to clients as well as maintaining their mental and physical health. In this study, we aim to determine how health care social workers engage in and describe reflective practice and challenges related to their reflective practice in their work in the health care system.

Methods: We used the Reflective Dialogue Rating Scale (RDRS) developed by Marion Bogo et al. to structure qualitative face-to-face interviews with 23 health care social workers employed in a hospital in a large urban area in Ontario, Canada.

Results: Findings illustrated that all participants regularly engaged in reflective practice in order to carry out everyday social work activities, promote ethical practice, and to enhance the provision of services to their clients. The social worker participants consistently agreed that as a profession they faced challenges maintaining their knowledge of current research due to few opportunities for professional development, workload competing with educational opportunities, and a work climate that is not conducive to gaining professional development, thereby challenging reflective practice. Supportive working environments include: peer supervision, safe and private spaces to talk to colleagues, a supportive supervisor, and an overall positive organizational culture.

Discussion and conclusion: Reflective practice is a key component in health care social work. All 23 social workers stated that they used reflective techniques (such as peer supervision and debriefing) to deal with their own reactions and operated in a purposeful and intentional manner to form therapeutic relationships with clients. As such, participants stated that lifelong learning was paramount in providing quality care to clients.     

Nonsexual relationships between psychotherapists and their former clients: obligations of psychologists

This article examines the issue of nonsexual relationships between psychologists and their former therapy clients. What little research is available concerning nonsexual relationships with former clients suggests that psychologists have clear reservations about some of these relationships, especially personal ones and intentional social interactions. Relationships immediately following termination are seen as particularly suspect. Drawing on the literature dealing with multiple relationships in general, and sexual relationships with former clients in particular, a number of arguments are made outlining why psychologists should avoid significant nonsexual relationships with former clients for at least some period of time following termination.     

From the front lines of welfare reform: an analysis of social worker and welfare recipient attitudes

Social workers and welfare recipients operate within the same institutional framework and share a working and/or lived knowledge of poverty, but they occupy different social and economic positions. To gain a better understanding of intergroup attitudes, the author compared how social workers and welfare recipients explain poverty and perceive the welfare system. The results highlight important similarities and differences between the two groups. Although the author did not find differences for individualistic attributions, welfare recipients regarded prejudice as playing a greater role in causing poverty than did social workers. Welfare recipients also expressed stronger support for increased welfare funding and progressive welfare policies than did social workers. The author discussed implications for strengthening interclass alliances, particularly the relationship between social service providers and welfare recipients.