The inevitability of infidelity: sexual reputation, social geographies, and marital HIV risk in rural Mexico

Marriage presents the single greatest risk for HIV infection among women in rural Mexico. We drew on 6 months of participant observation, 20 marital case studies, 37 key informant interviews, and archival research to explore the factors that shape HIV risk among married women in one of the country's rural communities. We found that culturally constructed notions of reputation in this community lead to sexual behavior designed to minimize men's social risk (threats to one's social status or relationships), rather than viral risk and that men's desire for companionate intimacy may actually increase women's risk for HIV infection. We also describe the intertwining of reputation-based sexual identities with structurally patterned sexual geographies (i.e. the social spaces that shape sexual behavior). We propose that, because of the structural nature of men's extramarital sexual behavior, intervention development should concentrate on sexual geographies and risky spaces rather than risky behaviors or identities.     

Children's rights and social work practice

This paper looks at the impact that the increasing focus on Children's Rights is having on Social Work Practice. It is divided into four main parts and begins by looking at how we have initially responded to the Children Order, to highlight some of the fears and anxieties that exist and to identify the central myths that feed these. The second section moves beyond the myths to look at the reality of Children's Rights and, in particular, how they have come to be defined and understood in theory and practice. This will provide the basis from which, in the third section, consideration is given to the detail of the Children Order and how the notion of Children's Rights have come to be both enshrined in law and implemented here in Northern Ireland. The final section draws upon my personal experience as a Senior Social Worker and examines some of the current dilemmas that have emerged in practice in relation to Children's Rights.     

Bipolar disorder and social work practice

With the introduction of lithium and increasing evidence that bipolar disorder is a biogenetic condition, changes have occurred in the diagnosis and treatment of bipolar disorder. Cross-cultural studies indicate that in the United States there is a tendency to overuse the diagnosis of schizophrenia when bipolar may be indicated. Both disorders have psychotic symptoms, rendering diagnostic confusion possible. This paper describes the characteristics of bipolar disorder, explanatory theories and treatment. A medical model of treatment is preferred. Issues of concern to social workers are addressed.     

Discharge planning and social work practice

Current health care practice discharge planning has emerged as a major professional function in hospital settings. To examine the tasks involved in discharge planning and how frequently they are being performed, 124 Alabama hospitals were contacted with a 72% rcsponse rate. Of the 178 surveys returned by discharge planners the core tasks were identified and ranked in terms of performance frequency. The results revealed that the tasks performed typically resembled that of generalist social workers. When specialization occurred, it was related to the populations served and not the specialized tasks or methods utilized. From this data recommendations are made for linking advanced generalist social work practice to discharge planning activities.     

Family practice and social and political change

Reform in US medicine has been a longstanding process, and it has always been intertwined with politics and social issues. So-called organized medicine has often resisted reform, but despite this resistance, many changes took place in the US medical system in the 1960s. The establishment of the specialty of family practice coincided with these changes. Although family practice was established with many goals in mind, many of the goals did not match the public's perceived needs, and there is still much unfinished business. One of family practice 's current tasks is to examine its accountability to the public and decide what it can provide for the public good.     

Women's social space and the reference for breastfeeding practice

This study aimed to identify agents or institutions taken as reference by women when breastfeeding. A qualitative study was carried out on 20 primiparous who were assisted, for reasons not related to breastfeeding, in the five health services selected by this study. Data were collected by semi-structured interviews carried out in the participants' households and were analyzed by content analysis in the thematic mode. We identified that health professionals play a standardize role of breastfeeding based on scientific knowledge. In the daily breastfeeding routine, the family is the first reference for women, transmitting beliefs, habits and behaviors. We believe in the valorization of the family context by the health professional, in which actions and interactions in the breastfeeding issue are developed in order to constitute the foundations for a new care model in breastfeeding. This model should, therefore, consider the practice diversity, adapting actions to the multiple roles of being mother/fortress/wife/worker in the social context.     

Harm reduction: a social work practice model and social justice agenda

Efforts in the United States to eradicate drug use through supply reduction (that is, the War on Drugs) have increasingly violated the principles of social justice and human rights, both locally and globally. This has created ethical conflicts for social workers in policy making, practice, and research. Harm reduction has been conceptualized as a peace movement and is aligned with the humanistic values around which social work is organized. The authors examine how social workers may reduce the ethical conflicts associated with efforts to address substance abuse by adopting a harm reduction approach to policy, practice, and research. They examine current drug policies, the consequences of the policies, and, in particular, how the policies affect social workers as practitioners, agents of social control, and guardians of social justice.     

Health care social work treatment of patient and family emotion: a synthesis and comparison across patient populations and practice settings

Health care practitioners and researchers alike are beginning to acknowledge the importance of emotion in health. Nevertheless, health care social workers continue to assume most of the responsibility for actually dealing with the emotions of patients and families. Literature exploring social work interventions with emotion are restricted to a single patient population and practice setting. This study conducted a content analysis of pertinent literature, systematically codifying strategies across patient populations and practice settings according to a pragmatic conceptual foundation of the professional emotion treatment process. Analysis yielded a comprehensive conceptually clustered matrix of 45 strategies, establishing an objective and systematic basis for identifying and understanding this professional emotion treatment process for social work educators, practitioners, and researchers alike.     

Between social and somatic disorders: the promotion of health as part of general social work practice

The population of the highly industrialized countries have access to an increasing range of possibilities for influencing their own state of health in both positive and negative ways. Health maintenance behavior is part of a general 'way of life' which is determined by chosen life styles. While the clients of professional social work may have a more restricted range of options, the interdependence of their individual life situations and health disposition remains a factor in their case as well, usually with negative results. There is a constant mediation of social disorders in somatic disorders (and vice versa, especially in cases of chronic illness, disability and addiction). This paper discusses aspects of assessment, coping styles and social support along the socio-psycho-somatic axis. There are many arguments for a conscious integration of health promotion into social work practice in general.     

Constructing resilience: social workers' understandings and practice

Concepts and constructions of resilience have assumed a significant position in contributing to understandings of the psychosocial development of children and young people. This paper examines how concepts of resilience are constructed within the literature, and then explores social workers' perceptions and use of resilience with young people who were 'looked after' or at risk of becoming 'looked after'. It addresses the interface between social workers' views and understandings of the emotional health needs of their clients, and the responsiveness of accompanying service interventions. Using the Framework for Assessment as a platform for discussion, 32 semistructured interviews were conducted with 19 social workers relating to a purposive sample of 52 children and young people (31 boys and 21 girls). Social workers experienced difficulty in conceptualizing resilience, often providing cursory, general or non-expert explanations. Furthermore, social workers described all children and young people within the sample as being resilient, drawing only upon face-value observations to evidence this. Related to this was the low frequency of social workers' reports of children and young people's mental health difficulties and the concomitant low referral rate to secondary tier services. The authors argue that social workers' optimistic perceptions of the resilience of children and young people within this sample, alongside their positive appraisal of their emotional needs, impact on the interventions that are put in place. The paper concludes that the tendency of social workers to project optimism onto their client base calls our attention to a possible transference of the collective need for the social work department itself to be resilient within that local authority.     

Medical social work practice and SARS in Singapore

This article reports on the findings of a qualitative study exploring the impact of SARS on social work practice in five different hospitals in Singapore. The study sought to examine the range of interventions adopted by 28 medical social workers and the theoretical orientations underpinning them. The findings discussed include the impact of infection control practices on social work intervention, the range of interventions undertaken, respondents' reflections and self-awareness, the role of values and ethics, creativity and training, and their recommendations for future emergencies. While the findings of the study relate specifically to hospital social work practice, the crisis and trauma nature of the work makes it applicable to a broader range of practice in these areas and a range of populations. The findings from this study could also inform the development of training programs for social work and other clinical health workers, and emergency management planning.     

Crisis intervention and social work practice in hospitals

Crisis intervention, with its emphasis on focused treatment in a limited time frame, is adaptable to social work practice in hospitals. The author discusses the crisis intervention model in relation to the hospitalized patient and his or her family and examines three kinds of crises: those caused by illness or injuries, by hospitalization itself, and by treatment procedures.