Stéphanie Wahab

Feminist Voices on Sex Work: Implications for Social Work

Sex work and prostitution are the focus of debate among feminists. This article explores the long history of the debate on sex work and presents recommendations for a policy statement for the profession.

Creating Knowledge Collaboratively with Female Sex Workers: Insights from a Qualitative, Feminist, and Participatory Study:

This article reflexively engages substantive, epistemological, methodological, and ethical issues that surfaced during a feminist, qualitative, and participatory research project with 6 adult female sex workers in Seattle, Washington. Given the intersubjective researcher-participant relationship within participatory forms of inquiry, personal and professional roles and boundaries were often obscure, fluid, and minimally defined. Consequently, issues of power, those personal and institutional, facilitated intriguing tensions that captured this researchers attention. Central to the issues explored in this article are significant tensions between collaborative, reflexive, community research and academic modes and structures. In-depth individual dialogue sessions provided opportunities to both explore and create knowledge collaboratively with sex workers about their experiences from their perspectives. A spontaneous interpretive focus group created an opportunity for the participants, working in diverse arenas of the sex industry, to meet and exchange thoughts, feelings, and experiences, as well as inform the inquiry process and the authenticity of the findings.

Intimate partner violence and sexual assault in Native American communities

Previous studies indicate that Native American women experience the highest rate of violence of any ethnic or racial group in the United States. This article addresses the prevalence of intimate partner violence and sexual assault among Native Americans. We present significant substantive and methodological issues that inform research on violence in the lives of Native Americans, as well as existing interventions. Interventions discussed in this article fall within three major categories including those that are community based, those grounded in the public health and health care systems, and those grounded in federal and national organizations. We provide some examples of interventions from each of these three levels of direct service, including a brief discussion of barriers to service accessibility. We conclude with substantive and methodological recommendations for research and practice.

The Design, Implementation, and Acceptance of a Primary Care-Based Intervention to Prevent Depression Relapse

Objective: This article describes the conceptual underpinnings, implementation, and participation rates of a twelve-month low-intensity primary care-based intervention to prevent depression relapse. The intervention was designed to address the inherent problems in delivery of effective maintenance treatment in a population based sample of primary care patients. Methods: Patients at high risk of relapse based on psychiatric history who recovered from depression six to eight weeks after initiation of pharmacotherapy by their primary care physician were eligible; 194 were randomized to receive the intervention. The intervention combined education about depression, motivation-enhancing shared decision-making regarding the use of maintenance pharmacotherapy, and cognitive-behavioral strategies. The program included two visits with a Depression Prevention Specialist working in tandem with the primary care physician at the primary care clinic, with supervision and back up from a consulting psychiatrist, proactive follow-up telephone calls and mailed personalized feedback. Results: Ninety-three percent of patients attended both in-person visits; 97 percent attended one visit. Eighty percent of patients completed all three follow-up telephone calls, and 85 percent returned at least one mailed feedback form; 48 percent returned all four forms. Offered a menu of options for self-management, most patients chose medication as well as a variety of behavioral strategies. At six months, 72 percent of patients and at twelve months 62 percent of patients remained on antidepressant medication. Conclusions: We conclude that it is feasible to integrate a low intensity, twelve-month relapse prevention intervention for depression into a primary care clinic.

Motivational Interviewing and Social Work Practice

• Summary: Motivational interviewing was proposed as an alternative model to direct persuasion for facilitating behavior change. Social work behavior change interventions have traditionally focused on increasing skills and reducing barriers. More recent recommendations tend to encourage practitioners to explore a broad range of issues, including but not limited to skills and barriers. The article defines and explains motivational interviewing by presenting its essential spirit and techniques, and provides a brief case example within a domestic violence context. • Findings: This article proposes motivational interviewing as an intervention appropriate for social work practice concerned with behavior change by arguing that motivational interviewing is an exciting intervention model for numerous social work settings due to its consistency with core social work values, ethics, resources, and evidence-based practice. • Applications: Social workers may strive to practice and test motivational interviewing in addictions settings, as well as within other critical social work arenas including but not limited to health, domestic violence, batterer treatment, gambling, HIV/AIDS prevention, dual disorders, eating disorders, and child welfare.

A Randomized Trial Comparing the Effect of Two Phone-Based Interventions on Colorectal Cancer Screening Adherence

BackgroundEarly-stage diagnosis of colorectal cancer is associated with high survival rates; screening prevalence, however, remains suboptimal.PurposeThis study seeks to test the hypothesis that participants receiving telephone-based tailored education or motivational interviewing had higher colorectal cancer screening completion rates compared to usual care.MethodsPrimary care patients not adherent with colorectal cancer screening and with no personal or family history of cancer (n = 515) were assigned by block randomization to control (n = 169), tailored education (n = 168), or motivational interview (n = 178). The response rate was 70%; attrition was 24%.ResultsHighest screening occurred in the tailored education group (23.8%, p < .02); participants had 2.2 times the odds of completing a post-intervention colorectal cancer screening than did the control group (AOR = 2.2, CI = 1.2−4.0). Motivational interviewing was not associated with significant increase in post-intervention screening.ConclusionsTailored education showed promise as a feasible strategy to increase colorectal cancer screening.

What Makes it Feminist?: Mapping the Landscape of Feminist Social Work Research:

Social work as an academic discipline has long included women and gender as central categories of analysis; the social work profession, started and maintained largely by women, has been home to several generations of feminists. Yet, social work is curiously and strikingly absent from broader multidisciplinary discussions of feminist research. This article explores contemporary feminist social work research by examining 50 randomly selected research-based articles that claimed feminism within their work. The analysis focused on the authors’ treatment of the gender binary, their grounding in theory, their treatment of methodology, and their feminist claims. Feminist social work researchers are invited to reconceptualize feminisms to include third-wave feminist thought and more explicitly engage theory and reflexivity in their work.

Motivational Interviewing and Colorectal Cancer Screening: A Peek from the Inside Out

OBJECTIVE This article focuses on design, training, and delivery of motivational interview (MI) in a longitudinal randomized controlled trial intended to assess the efficacy of two separate interventions designed to increase colorectal screening when compared to a usual care, control group. One intervention was a single-session, telephone-based MI, created to increase colorectal cancer screening within primary care populations. The other was tailored health counseling. We present the rationale, design, and process discussions of the one-time motivational interviewing telephone intervention. We discuss in this paper the training and supervision of study interventionists, in order to enhance practice and research knowledge concerned with fidelity issues in motivational interview interventions. METHODS To improve motivational interviewing proficiency and effectiveness, we developed a prescribed training program adapting MI to a telephone counseling session. RESULTS The three interventionists trained in MI demonstrate some MI proficiency assessed by the motivational interviewing treatment integrity scale. In the post-intervention interview, 20.5% of the MI participants reported having had a CRC screening test, and another 19.75% (n=16) had scheduled a screening test. Almost half of the participants (43%) indicated that the phone conversation helped them to overcome the reasons why they had not had a screening test. CONCLUSIONS Ongoing supervision and training (post-MI workshop) are crucial to supporting MI fidelity. The trajectory of learning MI demonstrated by the interventionists is consistent with the eight stages of learning MI. The MI road map created for the interventionists has shown to be more of a distraction than a facilitator in the delivery of the telephone intervention. MI can, however, be considered a useful tool for health education and warrants further study. PRACTICE IMPLICATIONS MI training should include consistent training and process evaluation. MI can, however, be considered a useful tool for health education and warrants further study. MI can also be adapted to diverse health promotion scenarios.

Evaluating the Usefulness of a Prostitution Diversion Project

As social workers are increasingly collaborating with the criminal justice system through diversion programs to create and provide alternative approaches to working with legal offenders, practitioners and researchers must consider evaluating such projects. While there exist numerous prostitution diversion programs for both sex workers and clients of commercial sex workers, often referred to as ‘John Schools’, throughout the USA and Canada, there have been no published evaluations, until now, of any of the programs for commercial sex workers. This article presents the research methods and discussions concerning some of the study findings of a qualitative evaluation of Salt Lake Citys Prostitution Diversion Project (PDP). This article explores the usefulness of the PDP by discussing the programs objectives, its strengths and limitations as perceived by the stakeholders. The author discusses how the various stakeholders perceived and experienced the PDP. Discussions in this article pay particular attention to the stakeholders’ experiences of working with and across significant theoretical and practical differences.

Ethical and Human Rights Issues in Coercive Interventions With Sex Workers

Sex work reemerged as a spotlight issue within feminist arenas in the 1960s. The interest in ‘‘prostitution’’ reform during the 1960s came about in much the same way it had in the past, that is, it rode on the coattails of other social movements (Hobson, 1987). As the civil rights movement led a heightened awareness of all human rights, individuals began to protest governmental interference in private sexual acts. Civil libertarian lawyers and feminist activists contested prostitution laws and social injustices against sex workers. The relationship between some strands of feminism and sex work is often polarized and rocky at best. In fact, the contemporary feminist debates on sex work, which began in the 1960s related to pornography and prostitution, have often been referred to as the feminist sex wars (Hollibaugh, 2000; Lerum, 1998; Sloan & Wahab, 2000; Zatz, 1997). On one side of the debate are sex workers and feminists who emphasize the importance of sex workers’ rights and understand sex work as potentially liberating and empowering. On the other side are those who believe sex work is exploitive, casting sex workers as coerced victims. Whether social workers think that sex work is a form of violence, legitimate work, or something much more complicated that cannot be reduced to the rhetoric of the feminist sex wars, it is time to seriously grapple with the ethical considerations involved with social work practice focused on people in the sex industry. Social workers should be deeply troubled by social work interventions that target individuals for arrest as a means of providing services. Specifically, we call attention to social work collaborations with law enforcement that target or end in the arrest of sex workers. While specific events in Arizona during the week of May 16, 2013, sparked the writing of this editorial, the issues discussed below bring into question ethical social work practice with sex workers including practice with oppressed and marginalized individuals and groups. Specifically, we challenge the assumption that arresting (or participating