Terry L. Koenig

The Cultivation of Social Workers' Hope in Personal Life and Professional Practice

Abstract Hope writings within the social sciences literature assume that social work professionals already possess hope that they can readily draw upon to evoke change in clients. The purpose of this article is to challenge this assumption and in response, to put forth ways of assessing hope within the social workers personal life and in educational and agency-based practice contexts. Implications for developing and nurturing professional hope through the use of the strengths perspective within social work education (i.e., using models that assert hope and client growth as normative) and within agencies (i.e., using inverted organizational hierarchies and group supervision) are discussed. doi:10.1300/J377v26n03_03

Reclaiming Joy: Pilot Evaluation of a Mental Health Peer Support Program for Older Adults Who Receive Medicaid

PURPOSE Stigma and lack of access to providers create barriers to mental health treatment for older adults living in the community. In order to address these barriers, we developed and evaluated a peer support intervention for older adults receiving Medicaid services. DESIGN AND METHODS Reclaiming Joy is a mental health intervention that pairs an older adult volunteer with a participant (older adult who receives peer support). Volunteers receive training on the strengths-based approach, mental health and aging, goal setting and attainment, community resources, and safety. Participant-volunteer pairs meet once a week for 10 weeks. Participants establish and work toward goals (e.g., better self-care, social engagement) that they feel would improve their mental health and well-being. Aging services agencies provide a part time person to manage the program, match volunteers and participants, and provide ongoing support. Outcomes evaluation for this pilot study included pre/postintervention assessments of participants. RESULTS Thirty-two participants completed the intervention. Pre/postassessment group means showed statistically significant improvement for depression but not for symptoms of anxiety. Quality-of-life indicators for health and functioning also improved for participants with symptoms of both depression and anxiety. IMPLICATIONS The Reclaiming Joy peer support intervention has potential for reducing depression and increasing quality of life in low-income older adults who have physical health conditions. It is feasible to administer and sustain the intervention through collaborative efforts with minimal program resources and a small amount of technical assistance.

Hospital to Community Transitions for Adults: Discharge Planners and Community Service Providers’ Perspectives

Discharges from the hospital to community-based settings are more difficult for older adults when there is lack of communication, resource sharing, and viable partnerships among service providers in these settings. The researchers captured the perspectives of three different groups of participants from hospitals, independent living centers, and Area Agencies on Aging, which has rarely been done in studies on discharge planning. Findings include identification of barriers in the assessment and referral process (e.g., timing of discharge, inattention to client goals, lack of communication and partnerships between hospital discharge planners and community providers), and strategies for overcoming these barriers. Implications are discussed including potential for Medicaid and Medicare cost reductions due to fewer re-hospitalizations.

Hoarding Cases Involving Older Adults: The Transition From a Private Matter to the Public Sector

Hoarding interventions with older adults require significant resources from multiple public agencies, yet recidivism occurs frequently. To improve services through better coordination, some communities have formed multiagency hoarding teams (MAHT), which include aging services. MAHTs requested this mixed methods study to understand the progression of cases through the public sector. Quantitative data collected on 52 cases involving adults ages 60+ identified steps in this process. Qualitative data collected from MAHT members were the basis for case studies illustrating the progression of cases through the public sector. Findings have implications for social workers involved in local service coordination, training, and policy.

Taoism and the strengths perspective

Summary. This article attempts to expand the contemporary strengths perspective in social work by moving beyond its reliance on Western science and philosophy. The authors suggest that Eastern philosophy may provide broader and richer underpinnings for understanding the strengths perspective. The article examines the basic tenets of the strengths perspective which include: (1) an emphasis on reality as constructed out of lived experience; (2) a redefinition of expertise in the helping relationship; (3) a challenge to expand our understanding of knowledge; and (4) a focus on supporting clients’ strengths. All of these tenets are then examined in the light of the Chinese philosophical tradition of Taoism. Five themes from the Taoist tradition are explored and applied to the strengths perspective: (1) reality is a process of constant flow and change; (2) holistic dualism or the blending of two aspects into one whole; (3) nonaction or wu wei as a way of acting that keeps us in harmony with an ever‐changing un...

Using multidisciplinary teams to address ethical dilemmas with older adults who hoard.

Multidisciplinary teams, representing professionals from diverse disciplines, are often involved in addressing difficult ethical dilemmas as they work with older adults who hoard (e.g., resolving conflicts between the older adults freedom to engage in hoarding behaviors versus individual or public safety). The purpose of this article is threefold: (a) to explore the current use of hoarding task force or team interventions to address ethical dilemmas that occur within hoarding cases; (b) to propose an ethical decision making framework for use by teams and others; and (c) to discuss practice implications for hoarding teams in implementing this ethical decision making framework.

Ethical Issues in Practice With Older Women Who Misuse Substances

Older women who misuse substances represent a growing population within the United States. Yet, helping professionals lack guidance in addressing ethical issues that arise in working with these older women. The purpose of this article is to (a) examine what we know about older women who misuse substances, (b) address professional ethical dilemmas and other ethical issues that emerge in treating and delivering services to older women, (c) identify barriers for treatment, and (d) propose practice recommendations. Specifically, the authors examine the overarching professional ethical dilemma or tension between client autonomy and professional beneficence that emerges in treating and delivering services to older women. Implications are delineated for professional education, gender-and age-sensitive substance misuse services, and research and policy efforts.

An Examination of the Adult Day Services Industry Using the Resource Dependence Model within a Values Context

ABSTRACT The adult day services (ADS) industry continues to grow and develop in providing care to larger numbers of older adults and their caregivers. Despite the growth in the number of programs and the changes in the way services are delivered, a systematic examination of the development of the ADS industry from a policy perspective has not been published since the mid-1990s. This article provides an analysis of the development of the ADS industry using the resource dependence model within a values-based context to determine whether public reimbursement opportunities are congruent with the needs of older adults and caregivers. Potential directions for the future development of the industry are presented through analysis of the collaborations of adult day providers with the providers of other services for older adults and the effort by public and private funders to connect quality outcomes and resources.

Older adult and family member perspectives of the decision-making process involved in moving to assisted living

The decision to move into assisted living (AL) can be viewed as a life-changing process for older adults and their families; and each may possess differing views of this process. This qualitative study examined the AL decision-making process as described by twenty-two older adult and family member dyads. Participants described emotional and logistical components related to the AL moving decision. Further, fifteen of twenty-two dyads expressed conflicting or differing views of the AL moving decision. Our discussion examines the need for future studies to explore the impact of family and older adult disagreements on the older adult’s AL adjustment; the necessity for community-based agencies and AL settings to provide social services over the duration of the decision-making process; and the importance of employing social workers skilled in family practice in the AL setting.

Ethical Dilemmas Faced by Hospice Social Workers

Ethical decision making is critically important in hospice social work. Through in-depth interviews, researchers explored ethical dilemmas faced by 14 hospice social workers and the processes they used to move toward resolution. The dilemmas were integrated into a framework focused on the sources of ethical conflict: the client system, the agency, and the profession. Processes involved in resolving ethical dilemmas included consulting with other professionals, weighing the pros and cons of options, and bringing about desired outcomes. Findings suggest that hospice teams should be provided with opportunities to meaningfully discuss ethical decision making. Further, the involvement of social workers in administrative leadership is recommended to increase the likelihood that discipline-specific perspectives are incorporated into formal policies and procedures that shape practice in ethically complex situations.