Rachelle Ashcroft

Health and Wellbeing: Starting with a Critical Pedagogical Model

There are many views on what constitutes health and wellbeing. What emerge are varying—and at times competing—discourses and recommended approaches for practice. Knowledge of these varying perspectives and the skills to critically assess their compatibility with social work values provides tools to social workers to assist in determining how to shape practice in a way that best focuses on health and wellbeing. A pedagogical model is reviewed that includes an overview of the six most dominant health paradigms: biomedicine, public health, biopsychosocial, social determinants of health, political economy, and holism.

An Evaluation of the Public Health Paradigm: A View of Social Work

This article engages in a critical review of the public health paradigm to determine the compatibility with social works guiding value of social justice. This critical examination explores the history, epistemology, and view of health underlying the public health paradigm. Implications of the public health paradigms view of health on social work practice and discourse is examined.

An Examination of the Biomedical Paradigm: A View of Social Work

The biomedical paradigm provides foundational assumptions that shape the context within which social workers in health care settings practice. By providing social workers with a greater understanding of the history, epistemology, and key assumptions, this article aims to promote critical awareness and critical reflection on how the biomedical paradigm may be influencing health care environments. The analysis of this article raises important questions for social workers within health care environments, questions about how social workers are able to retain their disciplinary identity as agents of change in the pursuit of social justice.

The Emerging Role of Social Work in Primary Health Care: A Survey of Social Workers in Ontario Family Health Teams

Primary health care systems are increasingly integrating interprofessional team-based approaches to care delivery. As members of these interprofessional primary health care teams, it is important for social workers to explore our experiences of integration into these newly emerging teams to help strengthen patient care. Despite the expansion of social work within primary health care settings, few studies have examined the integration of social works role into this expanding area of the health care system. A survey was conducted with Canadian social work practitioners who were employed within Family Health Teams (FHTs), an interprofessional model of primary health care in Ontario emerging from a period of health care reform. One hundred and twenty-eight (N = 128) respondents completed the online survey. Key barriers to social work integration in FHTs included difficulties associated with a medical model environment, confusion about social work role, and organizational barriers. Facilitators for integration of social work in FHTs included adequate education and competencies, collaborative engagement, and organizational structures.

Health Promotion and Primary Health Care: Examining the Discourse

The health promotion discourse is comprised of assumptions about health and health care that are compatible with primary health care. An examination of the health promotion discourse illustrates how assumptions of health can help to inform primary health care. Despite health promotion being a good fit for primary health care, this analysis demonstrates that the scope in which it is being implemented in primary health care settings is limited. The health promotion discourse appears largely compatible with primary health care—in theory and in the health care practices that follow. The aim of this article is to contribute to the advancement of theoretical understanding of the health promotion discourse, and the relevance of health promotion to primary health care.

Family-focused practices in addictions: a scoping review protocol

Introduction Families are significantly impacted by addictions and family involvement in treatment can reduce the harms and can also improve treatment entry, treatment completion and treatment outcomes for the individual coping with an addiction. Although the benefits of family-focused practices in addictions have been documented, services continue to have an individual focus and research on this topic is also limited. The objective of this study is to map the extent, range and nature of evidence available examining family interventions in addictions and identify gaps to guide future research, policy and practice. Methods and analysis This is a scoping review using the five-stage framework developed by Arksey and O’Malley. We will include published and unpublished empirical studies focusing on any type of family interventions in addiction treatment between 2000 and the present in English or French. A reviewer will search for literature that meets the inclusion criteria through the following electronic databases: MEDLINE, PsycINFO and Social Services Abstracts. For a comprehensive search, we will also hand-search reference lists, web sites and key journals. Data will be charted and sorted using a thematic analysis approach. Ethics and dissemination This review will be the first to examine all forms of family-focused practices for both substance use and problem gambling treatment for adults. It will provide information about existing service provisions and gaps in practice. This review can be used to start moving towards the development of best practices for families in addiction treatment. The results will be disseminated through a peer-reviewed journal and at mental health and addiction conferences.

An Examination of the Holism Paradigm: A View of Social Work

ABSTRACT This article examines the holism paradigm, implications on social work practice in healthcare, and how social work practice can help promote the value of social justice. Examining the holistic health paradigm fosters a critical reflection that assists to better understand beliefs and assumptions that guide social work practice, thus leading to critical action.

Social work’s scope of practice in the provision of primary mental health care: protocol for a scoping review

Introduction Social work is a key member of interprofessional primary healthcare teams and foundational to primary healthcare reforms that aim to improve the provision of mental healthcare. Little is known, however, about social work’s scope of practice within primary healthcare settings, particularly in the provision of mental healthcare. The objective of this study is to identify and describe social work’s scope of practice as it relates to mental healthcare in primary healthcare settings. Methods and analysis A scoping review will be conducted using the methodology established by Arksey and O’Malley. We will search electronic databases (MEDLINE, Embase, PsycINFO, CINAHL, Social Services Abstracts and Social Work Abstracts) to identify studies appropriate for inclusion. One reviewer will independently screen all abstracts and full-text studies for inclusion, with supervision by lead investigator. We will include any study that focuses on social work and mental healthcare within primary healthcare settings. All bibliographic data, study characteristics and range of social work practice activities will be collected and analysed using a tool developed by the research team. Ethics and dissemination The scoping review will synthesise social work’s scope of practice in the provision of mental healthcare within primary healthcare settings. This review will be the first step to formally develop guidelines for social work practice in primary healthcare. The results will be disseminated through a peer-reviewed publication and conference presentations.

Using Participatory Action Research to Access Social Work Voices: Acknowledging the Fit

ABSTRACT This article presents Participatory Action Research (PAR) as a critical methodology that fills a gap in health research, and describes the importance of using PAR with a group of social workers about their conceptualizations of health. While social work practice, knowledge and contributions extend beyond the traditional positivist framework that dominates health research, the profession’s unique understanding of health is frequently subsumed within work contexts that are dominated by bio-physiological conceptualizations of health. PAR provides a means of engaging the knowledge of social workers, which, in turn, helps in the pursuit of wide-reaching social justice and change.

Incentives and disincentives for treating of depression and anxiety in Ontario Family Health Teams: protocol for a grounded theory study

Introduction There is strong consensus that prevention and management of common mental disorders (CMDs) should occur in primary care and evidence suggests that treatment of CMDs in these settings can be effective. New interprofessional team-based models of primary care have emerged that are intended to address problems of quality and access to mental health services, yet many people continue to struggle to access care for CMDs in these settings. Insufficient attention directed towards the incentives and disincentives that influence care for CMDs in primary care, and especially in interprofessional team-based settings, may have resulted in missed opportunities to improve care quality and control healthcare costs. Our research is driven by the hypothesis that a stronger understanding of the full range of incentives and disincentives at play and their relationships with performance and other contextual factors will help stakeholders identify the critical levers of change needed to enhance prevention and management of CMDs in interprofessional primary care contexts. Participant recruitment began in May 2016. Methods and analysis An explanatory qualitative design, based on a constructivist grounded theory methodology, will be used. Our study will be conducted in the Canadian province of Ontario, a province that features a widely implemented interprofessional team-based model of primary care. Semistructured interviews will be conducted with a diverse range of healthcare professionals and stakeholders that can help us understand how various incentives and disincentives influence the provision of evidence-based collaborative care for CMDs. A final sample size of 100 is anticipated. The protocol was peer reviewed by experts who were nominated by the funding organisation. Ethics and dissemination The model we generate will shed light on the incentives and disincentives that are and should be in place to support high-quality CMD care and help stimulate more targeted, coordinated stakeholder responses to improving primary mental healthcare quality.