Marcia Spira

Adolescent Daughters of Mothers with Breast Cancer: Impact and Implications

While the literature supports the view that a parents illness will have an impact on a child, less specific attention has been given to the impact of a mothers breast cancer on her adolescent daughter. In this paper, clinical vignettes derived from interviews with adolescent daughters (ages 12–19) living with mothers who have breast cancer are presented to illustrate some of the concerns daughters have about themselves and their mothers illness. The daughters express anxiety about changes in family roles, but seem more concerned about the potential loss of the mother/daughter relationship. They describe their fears of recurrence of the disease as well as getting the disease themselves. The girls also demonstrate great strength; resilience and hope in the face of the challenges presented by the changes in their lives. Girls who had mothers die of the disease are not included in this article. Implications for treatment are discussed.

Mothers and their adolescent daughters: Transitions and transformations

Throughout adolescence the mother-daughter relationship reflects the tension between the tasks of separation and the need to renegotiate connection. This dilemma may be at the source of frustration in the mother-daughter relationship during adolescence. Theoretical perspectives, with emphasis on feminist theories, and clinical vignettes will be highlighted to illustrate the interface between individual development and the transformations in the mother-daughter pair.

Cancer as a Life Transition: A Relational Approach to Cancer Wellness in Women

Receiving a diagnosis of cancer is a traumatic event and changes ones life forever. The period of initial diagnosis and treatment is indeed a life transition, regardless of the prognosis. It precipitates a change in self-perception, physically, emotionally, and interpersonally. It changes how a woman sees herself, her family, and her world. Simultaneously the woman is confronted with many decisions to make regarding treatment options and the management of personal, familial, and work related responsibilities. People have the opportunity to reflect on old decisions and to make new decisions. Inevitably one is confronted by mortality. The management of this illness is done in the context of a complex network of relationships with family, friends, coworkers, doctors, other medical personnel, and clergy. Often it is the clinical social worker who is in the position of facilitating access to and participation in resources for care. Many women join healing communities or wellness centers to find a model of care and achieve a state of well-being that utilizes and encourages the support of these relationships. Understanding the importance and impact of these relationships can help clinical social workers facilitate cancer wellness in their clients and advocate better on their behalf. The intent of this paper is to understand the concept of cancer wellness as a relational approach and to promote its place in integrative clinical social work practice.

Examining cohort differences and resilience among the aging LGBT community: Implications for education and practice among an expansively diverse population

The aging lesbian, gay, bisexual, and transgender (LGBT) community continues to grow considerably while often being faced with unique and unmet needs separate from younger LGBT cohorts or their non-LGBT counterparts. This article explores some of the differences in attitudes among generational cohort groups regarding coming out decisions; sexual risk and safety; the impact of evolving policies within systems and society; as well as the demonstrated strengths and resiliencies of the aging LGBT community. Implications and suggestions for education, training, and best practices among this expansive and diverse population are considered as well as continued research in the field of LGBT aging.

Domestic Violence or Elder Abuse? Why it Matters for Older Women:

Law enforcement and legal services are 2 systems that respond to reports of abuse against women through programs such as adult protective services (APS) and domestic violence (DV). APS and DV systems operate independently and define the cause of the abuse differently. The designation of a woman as having suffered domestic violence or having been abused often depends on which system she enters. This designation can lead to different options for women to obtain services. Aging may further complicate access and usability of these systems to respond to the needs of abused elderly. Using vignettes, this article explores the definitions of abuse and highlights specific concerns of aging that impact usefulness of services.

A Conceptual Framework for Differential Use of Mediation and Family Therapy Interventions With Older Adults and Their Families

The purpose of this article is to present a family-centered approach to working with older adults. This framework utilizes a differential use of family therapy and therapeutic mediation theoretical concepts and skills. This provides an effective approach to conceptualizing and intervening with these often complex situations regarding the decision-making processes related to care of older members. Family-centered mediators/clinicians must be skilled in both models to understand and intervene in the challenging issues presented by families. A case example is included in the article to illustrate the framework.

The Evolution of Understanding Menopause in Clinical Treatment

This paper integrates the meanings created about menopause through a biopsychosocial perpective. Once understood only as a biological illness creating affective disorders, new paradigms provide understanding based on the psychological and social constructions of the process. History emphasizes a view of women experiencing increasing deficiency and loss, while modern interpretations view women as gaining new freedoms. Case material is presented to direct attention to the meanings of menopause as it emerges in the treatment process.

Voices of Three Generations: Families and the Declining Health of Older Adults

The declining health of an older family member impacts family members in many ways. This article describes the effects of coping with the needs of older members among three generations. The systemic effects result in challenges to each generation along physical, psychological, and social dimensions. Discussion focuses on the experiences of the respective generations as they each attempt to voice their needs and negotiate their individual and interpersonal development in the context of the older persons’ decline. Multiple theories and intervention strategies, including developmental, narrative, and family systems, will be applied to case material. Helping families to articulate the stress, renegotiate the issues of care, and reframing old patterns of behavior may be crucial to assisting families navigate through this time of life.

The Penultimate: Understanding Adult Women Beyond Menopause

Abstract As the expected life span of women increases, women live more years in the postmenopausal phase. This extended period of the life cycle deserves a dynamic description with a focus on the unique biological, psychological, social and cultural issues. A developmental model will be combined with a psychodynamic theory in order to create a comprehensive understanding about the physical and mental health concerns. The goal of this paper is to redefine through case examples this important phase of adult development and to recognize it, not as prolongation of earlier phases, but as a phase with its own idiosyncratic features.

Class participation as a pedagogical tool in social work education

Abstract Class participation is an essential part of the social work pedagogy. However, active student engagement in classes is inconsistent and varies based on factors such as social backgrounds, educational background, and individual characteristics. Instructors often evaluate participation based on frequency of verbal contributions. Evaluation criteria are often unarticulated or difficult to measure, presenting numerous challenges for instructors and students alike. A model of reflective self-assessment of participation by students, paired with timely instructor feedback is put forth in this paper to mitigate these concerns. The steps in this model include initial self-assessment, goal setting, midterm review, and a final review. The process of continuous self-evaluation and problem-solving is discussed as strategies that aid the process of class participation. Three instructor touch points are suggested: at the goal-setting stage, the midterm review, and the final grade. Throughout the paper, connections to social work practice and social work pedagogy are highlighted. This model has yet to be implemented in a social work school’s curriculum. Challenges in the implementation and resolution of those challenges are also presented. This model suggests ways to enhance opportunities for student engagement and integration into graduate programs, in addition to fostering valuable skills for future practice in the field.