Marlene Cooper

The Effects of Suicide on the Private Practitioner: A Professional and Personal Perspective

A patients suicide has a profound effect on the therapist and psychotherapy with a chronically suicidal patient is particularly troubling. Guilt over ones failure to recognize the warning signs, fear of ones incompetence or irresponsibility, shame that one has failed, and fear of being blamed by the patients loved ones and by colleagues are feelings that frequently surface and that can result in isolating a practitioner from the very sources of peer support that are necessary in order to resolve the trauma. This article explores the effects of suicide on the private practitioner. It discusses how burnout and vicarious traumatization impact upon the therapist who treats the chronically suicidal patient. Two clinical examples illustrate the impact of working with imminent suicide and the aftermath of a patients death from a personal perspective. Recommendations are made to help private practitioners maintain equilibrium when working with these overwhelming case situations.

Social work in primary care: a demonstration student unit utilizing practice research.

ABSTRACT A neighborhood primary health care program serving a socially and economically oppressed community, and a graduate school of social work have collaborated to create a social work student field work unit in a primary health care setting, to demonstrate emerging and innovative social work roles in an ever-increasing managed care environment. Patients with high levels of psychosocial stress make large demands on the primary care system and consume considerable laboratory and diagnostic treatment resources. Development of social services in primary care settings is a relatively new concept, however it has been clearly demonstrated that primary care physicians need the skills of social workers to handle the psychosocial and environmental aspects of illness. The principal goal was to demonstrate social work practice in a primary care health setting, utilizing practice research approaches. Validation of effectiveness was noted, as depression, anxiety, adjustment reactions (to name a few) were decreased, resulting in fewer physician visits, less somatization and improved compliance with medical and diet/nutrition regimens. The case examples and single subject data presented provide qualitative evidence, in the context of a natural experiment, for the profession to pursue this model further in both program development and research.

A Group for Families of Obsessive–Compulsive Persons

Obsessive–compulsive disorder places formidable burdens on the affected persons family members, who not only experience the pain of seeing their loved one deteriorate but are frequently called upon to participate in strange behaviors in order to keep the peace. Help for these families has been negligible. The author discusses a psychoeducational support group that attempts to meet the needs of this population. Clinical examples illustrate some of the psychosocial issues that confront these families as they struggle to understand and cope with this devastating disorder.

Assessment and Treatment of Sexual Compulsivity

Abstract Sexual addiction represents a life-threatening obsession-a pattern of out-of-control sexual behavior with serious physical, emotional, and legal consequences. This paper discusses the concept, etiology and characteristics of sexual addiction. It offers information that will help mental health professionals accurately assess the problem and provide appropriate treatment. Case material illustrates a multi-modal treatment process with a young gay male who was addicted to anonymous sex. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678.

How Race Affects the Helping Process: A Case of Cross Racial Therapy

This paper explores several relevant themes in a cross-racial counseling situation between a white female worker and an African-American professional woman. Issues of racial identity development, bi-culturalism, and the effects of cross-racial counseling are discussed in detail and illustrated with case material.

LIFE-THREATENING DISABILITY IN ADOLESCENCE: ADJUSTING TO A LIMITED FUTURE

This paper describes a medical social workers efforts over one and a half years to help a client adjust to a neurological disorder. Prior to social work services, the young woman had never discussed her disability, which began in adolescence, with anyone outside the family, and communication within the family was seriously compromised by their perception of disability as a stigma. Lacking the opportunity to mourn the loss of her physical abilities, she became isolated and depressed, and acted out aggressive thoughts and fantasies within the family system. Social work intervention helped the client to re-work the original trauma of diagnosis, which led to the development of a healthier defensive structure and new coping mechanisms.