Friday, March 31, 2017

Handy List of Words for Social Workers

The word Health surrounded by a collage of words related to heal

As a social worker, you are required to keep case notes. It’s important to maintain detailed records through case documentation. It allows you to create successful outcomes for your clients. Always make sure your case notes are useful. Do your best to make sure they provide insight and value. Analyze your notes and see if they would be useful to another case worker. You want to make sure you give an accurate picture of the client’s history, as well as their current situation.

It’s important to use language that is non-judgmental. Neutral language is the most common form of case notes in social work. It’s also helpful if you avoid making assumptions and remember to stick to the concrete facts. You should always indicate clearly when a comment is an observation. It is imperative you make it clear when you are recording the client’s own words by using quotation marks.
Notes are important in this type of work because the courts can subpoena records and other reports; you have to be careful about what you say about your respective client. Write your case notes immediately after you have spoken with a client. Here’s a handy list of words that many social workers use while writing up their case notes:
  • Acknowledged
    Actively Listened
    Checked In
    Crisis Intervention
    Goal (setting)
    Development/Goal Setting
    Information Giving/Gathering
    Physical Activity
    Problem Solving
    Reflective Listening
    Social Skills Practice

Monday, February 13, 2017

Is Love Enough To Make A Marriage Succeed?

Is Love Enough To Make A Marriage Succeed?

By Dr. James Dobson

Is Love Enough To Make A Marriage Succeed?

Love can be defined in myriad ways, but in marriage “I love you” really means “I promise to be there for you all of my days.” It is a promise that says, “I’ll be there when you lose your job, your health, your parents, your looks, your confidence, your friends.” It’s a promise that tells your partner, “I’ll build you up; I’ll overlook your weaknesses; I’ll forgive your mistakes; I’ll put your needs above my own; I’ll stick by you even when the going gets tough.”

This kind of assurance will hold you steady through all of life’s ups and downs, through all the “better or worse” conditions.

Many couples assume that the excitement of their courtship will continue for the rest of their lives. That virtually never occurs! It is naive to expect two unique individuals to mesh together and to remain exhilarated throughout life.

Gears have rough edges that must be honed before they will work in concert. That honing process usually occurs in the first year or two of marriage. The foundation for all that is to follow is laid in those critical months. What often occurs at this time is a dramatic struggle for power in the relationship. Who will lead? Who will follow? Who will determine how the money is spent? Who will get his or her way in times of disagreement? Everything is up for grabs in the beginning, and the way these early decisions are made will set the stage for the future. If both partners come into the relationship prepared for battle, the foundation will begin to crumble.

The apostle Paul gave us the divine perspective on human relationships--not only in marriage, but in every dimension of life. He wrote, "Do nothing out of selfish ambition or vain conceit, but in humility consider others better than yourselves" (Philippians 2:3).

That one verse contains more wisdom than most marriage manuals combined. If heeded, it could virtually eliminate divorce from the catalog of human experience—no small achievement, considering that more than one million marriages break apart in the United States every year. If you want yours to be different, I urge you to commit now to “sticking in there” during the newlywed phase, the middle years, and your golden age together.

Will your commitment hold you steady? If you want your marriage to last a lifetime, you must set your jaw and clench your fists. Make up your mind that nothing short of death will ever be permitted to come between the two of you. Nothing!

Premarital counseling is a must and can literally be a marriage saver. These sessions can help young men and women overcome the cultural tendency to marry virtual strangers. Let me explain.

The typical couple spends much time talking. Still, they don't know each other as well as they think they do. That is because a dating relationship is designed to conceal information, not reveal it. Each partner puts his or her best foot forward, hiding embarrassing facts, habits, flaws, and temperaments.

Consequently, the bride and groom often enter into marriage with an array of private assumptions. Then major conflict occurs a few weeks later when they discover they have radically different views on nonnegotiable issues. The stage is then set for arguments and hurt feelings that were never anticipated during the courtship period.

That's why I strongly believe in the value of solid, biblical premarital counseling. Each engaged couple, even those who seem perfectly suited for one another, should participate in at least six to ten meetings with someone who is trained to help them prepare for marriage. The primary purpose of these encounters is to identify the assumptions each partner holds and to work through the areas of potential conflict.

The following questions are typical of the issues that a competent counselor will help the couple address together:

• Where will you live after getting married?
• Are children planned? How many? How soon?
• Will the wife return to work after babies arrive? How quickly?
• How will the kids be disciplined?
• Are there theological differences to be reckoned with?
• Where will you spend Thanksgiving and Christmas holidays?
• How will financial decisions be made?

This is only a partial list of questions to be discussed and considered. Then a battery of compatibility tests is administered to identify patterns of temperament and personality. Some couples decide to postpone or call off the wedding after discovering areas of likely conflict down the road. Others work through their differences and proceed toward marriage with increased confidence. In either case, men and women benefit from knowing each other better.

Someone has said: The key to healthy marriage is to keep your eyes wide open before you wed and half-closed thereafter. I agree. Premarital counseling is designed to help couples accomplish that.

From Dr. Dobson’s book, The Complete Marriage and Family Home Reference Guide

Wednesday, November 16, 2016

ABA Therapy and Autism Resources

Image result for ABA Therapy
What is ABA? Applied Behavior Analysis is the process of systematically applying interventions based upon the principles of learning theory to improve socially significant behaviors to a meaningful degree, and to demonstrate that the interventions employed are responsible for the improvement in behavior

Getting Services in Texas

I will tell you how we got services for my own child, and that only 30% of autistic children will ever have access to ABA therapy. First and foremost I think the BEST resource for families and providers in the Autism community is Autism Live. Jump on YouTube and start watching their biweekly show. Speaking of Autism live, they partner with CARD who have a home based program called Skillz. CARD offers full scholarships for the SKILlz program which is an online ABA program parents do themselves.

There are a few grants out there for services but they a few and far between. The first place to go is to the employer, ask the insurance person in HR to have a single policy inclusion for ABA if it's not already covered. Ask for a single policy copay waiver, this is almost unheard of as not collecting copays can be considered insurance fraud, but some insurance companies will drop copays if appealed.

If they make less than 50k they can get SSI. That money should be used to pay copays. Medicaid that comes with SSI can be used to pay speech and OT copays, but not ABA, as it is not a service covered by Medicaid.

Depending on the age of the child either ECI or special ED can provide therapy , although the services are too infrequent and not adequate to make meaningful change, however some therapy is better than no therapy.

Go to Families for Effective Autism Treatment support meetings in North Richland Hills. Parents are a wonderful resource to each other and can tell each other tips and tricks they used to get services.

Assure them that unless rich, every single autism parent has been there. Sadly it's been my experience that 90% of parents just throw their hands in the air and give up. No matter how severe the autism the child can improve their level of functioning! So encourage them not to give up, and keep watching Autism Live. That program has been invaluable to me.

Good luck.

Also as a side note i would encourage them if they are willing and able to move to another state. Colorado is the closest state that offers much better access to care than Texas. In fact Texas is one of the worst states to live in if you have a disability.

Monday, July 25, 2016

Introductory Guide to Hospice and Palliative Care Social Work

Introductory Guide to Hospice and Palliative Care Social Work

Friday, July 22, 2016

How Social Workers Help Struggling Teens

By Frederic Reamer, PhDand Deborah Siegel, PhD, LISCSW

Introduction Special Schools and Programs
Warning Signs Substance Abuse and Truancy Courts
How to Find Help How Social Workers Help
Cost of Programs and Services Resources
Crisis Intervention

The adolescent years can be very challenging for some teenagers and their families. While adolescence can be an emotionally intense, stormy phase for virtually all teenagers, sometimes a teen’s struggles require special intervention. Many teens struggle with issues related to mental health, family relationships, friends, school performance, substance abuse, sexuality, and other high-risk behaviors.
Warning Signs
Struggling teens usually show signs of distress. Common warning signs include:
  • Low self-esteem
  • School failure and truancy
  • Defiance towards authority (such as parents, teachers, police)
  • Running away from home
  • Choosing the “wrong” friends
  • Impulsive behavior (such as speeding, taking other unsafe risks)
  • Getting in trouble with the law
  • Depression
  • Abusing alcohol or drugs
  • Social isolation
  • Eating disorders (overeating, not eating, self-induced vomiting)
  • Self injury (such as cutting)
There is help for these youngsters and their families through many avenues.
How to Find Help
There are many ways to locate and access programs and services for struggling teens. Initially parents can seek help by contacting school personnel (guidance counselors, social workers, administrators), family service agencies, community mental health centers, other community-based social service programs designed specifically for at-risk youngsters and their families, public child welfare agencies, family and juvenile courts, and specialty courts (such as truancy and drug courts).
Social workers can help parents and struggling teens identify and explore difficult and challenging family issues. Individual, family, and group counseling provided by clinical social workers may help parents and teens improve their communication skills and relationships, resolve conflicts, and address important mental health issues.
Professionals called “educational advocates” and “educational consultants” may be able to help parents and teens obtain needed services. Educational advocates, who are often attorneys, help people obtain specialized educational services. Educational advocates charge parents a fee and work with local, state, and federal education officials to ensure that students receive the services and “special accommodations” to which they are entitled by law. Advocates may file claims in court to force school districts to provide or pay for special-needs services and programs outside the school district.
Educational consultants help parents locate programs and services designed to meet their child’s needs. Educational consultants charge parents a fee, assess each teen’s unique strengths and needs, and help the family find the most appropriate schools or programs for their teen. Many educational consultants monitor students’ progress in the new program or school and, when necessary, advocate for the teen with that program or school when challenging issues arise.
Cost of Programs and Services
Programs and services for struggling teens can be very expensive. Some families are able to pay for these programs and services “out of pocket.” Some families have health insurance that pays for all or part of the program, or the public school system may pay the cost.
Many families cannot afford needed programs and services, do not have adequate insurance, and are unable to obtain funding from their public school department. In some instances families that cannot afford needed services agree to give legal custody of their teen to the local public child welfare agency, which then funds the services or programs (in several states the public child welfare agency will fund services without requiring that parents hand over legal custody). In still other circumstances, desperate parents may turn to the juvenile or family court and formally request that the teen be declared “wayward,” thus enabling the court to require the child to accept intervention. In these cases the state typically pays for needed services and programs. Some parents may be reluctant to use this route to services because the court, not they, determine where the child goes for help.
There is a wide range of services and programs run by private and public agencies for struggling teens and their families. Some programs may be available locally; however, some programs may be in other communities or states, which means that the teen must live away from home in order to receive needed services.
Crisis Intervention
A broad range of professionals and agencies offer crisis intervention and follow-up counseling services to teens and families. These services may be available through family service agencies, community mental health centers, hospital outpatient clinics, public child welfare departments, and psychotherapists in private practice (such as clinical social workers, clinical and counseling psychologists, mental health counselors, pastoral counselors, psychiatric nurses, and psychiatrists).
Many communities offer comprehensive counseling and family-intervention programs specifically for teens and families in crisis. These programs – known by names such as “comprehensive emergency services” or “comprehensive intensive services” – provide home-based assessment, emergency counseling, information, and referrals for longer term help.
Special Schools and Programs
A variety of alternative schools, therapeutic schools, and treatment programs serve teens who struggle with significant behavioral, emotional, mental health, and substance abuse issues. Some programs, such as alternative high schools, focus primarily on education while being sensitive to students’ mental health and behavioral challenges. Other programs, such as residential treatment programs, therapeutic boarding schools, and wilderness therapy programs, focus primarily on mental health, emotional and behavioral issues, while including an educational component. “Emotional growth” boarding schools address mental health, emotional, behavioral, and educational issues simultaneously. Other boarding schools focus on specific learning disabilities while also paying attention to the whole student. In short, different programs give different degrees of emphasis to personal and academic issues.
Parents of struggling teens – particularly teens who are oppositional and defiant – may be tempted to place their child in a school or program that promises to impose needed discipline and structure. Often these schools and programs – such as some military boarding schools and those that advertise their mission as “character education” – do not provide the mental health services many struggling teens need. These schools and programs can cause more harm than good for struggling teens who have personal and mental health issues that contribute to their challenges.
Prominent program options include:
  • Alternative high schools provide education, including special education services to teens who have floundered academically or socially in traditional high schools. These schools may be freestanding or sponsored by a community mental health center, family service agency, school district, or a “collaborative” composed of several social service and educational programs.
  • Youth diversion programs typically attempt to help struggling teens who have had contact with the police avoid more formal involvement in the juvenile justice system (juvenile courts and correctional facilities). Typical youth diversion programs offer first offenders individual and family counseling, links to other needed services (such as psychiatric medication), and education.
  • Independent living programs are designed to help adolescents develop the skills they need to live independently. These programs primarily serve teens who do not have stable families and are in the state’s custody. Some independent living programs also serve teens whose families are able to pay for these services privately. Typical services include practice in daily living skills, money management, career and educational planning, mental health services, housing assistance, recreational, and social activities and case management.
  • Wilderness therapy programs offer highly structured intensive short-term (three to six weeks) therapy in remote locations that remove adolescents from the distractions available in their home communities (such as television, music, computers, cars, drugs and alcohol, movies, delinquent peer groups). The challenges of living full-time outdoors and developing wilderness survival skills help teens develop self-confidence and pro-social behaviors. Often, families are advised to send their struggling teen first to a wilderness therapy program and then to a therapeutic or emotional growth boarding school, rather than return the teen to their home community environment.
  • Boarding schools for teens with significant learning disabilities offer structured academic programs that focus on education and learning while addressing relevant emotional and behavioral issues.
  • Emotional growth boarding schools offer structured academic programs and focus on emotional development and personal growth but do not provide the intensive treatment services offered by therapeutic boarding schools.
  • Therapeutic boarding schools focus intensively on students’ mental health, substance abuse, and behavioral needs while also providing an academic educational program.
  • Residential treatment centers offer highly structured treatment addressing substance abuse, family, and other mental health issues. In contrast with therapeutic boarding schools, residential treatment centers are more like a psychiatric hospital than a school, although they may have an academic/educational component in their program.
Substance Abuse and Truancy Courts
Many communities run substance abuse courts (sometimes known as drug courts) and truancy courts. These specialty courts use a supportive and nurturing approach rather than a punitive one to help struggling teens. Using case management, counseling, tutoring, mentoring, and parent education, the courts’ goal is to prevent future problems and more formal involvement with the juvenile justice system.
How Social Workers Help
Social workers can provide struggling teens and their families with:
  • Assessment of the teenager’s and family’s needs and strengths
  • Information about and referral to needed programs and services
  • Information about financial and legal issues and resources
  • Names of reputable educational advocates and educational consultants
  • Crisis intervention counseling services
  • On-going psychotherapy for the teen, the parents, and the family as a whole
  • Case management (helping staff from multiple agencies coordinate and communicate on behalf of the teen, and advocating for the family with these providers)
  • Information about important “warning signs” of teens who are on a downward spiral and the steps needed to get help
  • The National Association of Social Workers provides a listing of social workers in your area who can help you with these issues. Please click here to find a social worker.
Information about services and programs for struggling teens and families is available from social workers, schools, public child welfare agencies, juvenile and family courts, family service agencies, community mental health centers, educational advocates, educational consultants, and lawyers. Useful Web sites include:

Frederic G. Reamer, PhD, is the author of The Pocket Guide to Essential Human Services which contains diverse resources compiled into a user-friendly guidebook appropriate for use by professionals, volunteers, and consumers.
The opinions expressed in this article are those of the writer, and do not necessarily reflect those of the National Association of Social Workers or its members.

Common Myths and Why They are Wrong

Domestic violence only happens to poor women and women of color.

  • Domestic violence happens in all kinds of families and relationships. Persons of any class, culture, religion, sexual orientation, marital status, age, and sex can be victims or perpetrators of domestic violence.
Some people deserve to be hit.
  • No one deserves to be abused. Period. The only person responsible for the abuse is the abuser.
  • Physical violence, even among family members, is wrong and against the law.
Alcohol, drug abuse, stress, and mental illness cause domestic violence.
  • Alcohol use, drug use, and stress do not cause domestic violence; they may go along with domestic violence, but they do not cause the violence. Abusers often say they use these excuses for their violence. (Michigan Judicial Institute, Domestic Violence Benchbook, 1998, p. 1.6 - 1.7)
  • Generally, domestic violence happens when an abuser has learned and chooses to abuse. (Michigan Judicial Institute, Domestic Violence Benchbook, 1998, p. 1 - 5)
  • Domestic violence is rarely caused by mental illness, but it is often used as an excuse for domestic violence. (Michigan Judicial Institute, Domestic Violence Benchbook, 1998, p. 1 - 8)
Domestic violence is a personal problem between a husband and a wife.
  • Domestic violence affects everyone.
  • About 1 in 3 American women have been physically or sexually abused by a husband or boyfriend at some point in their lives. (Commonwealth Fund, Health Concerns Across a Woman's Lifespan: the Commonwealth Fund 1998 Survey of Women's Health, 1999)
  • In 1996, 30% of all female murder victims were killed by their husbands or boyfriends. (Federal Bureau of Investigation, 1997)
  • 40% to 60% of men who abuse women also abuse children. (American Psychological Association, Violence and the Family, 1996)
If it were that bad, she would just leave.
  • There are many reasons why women may not leave. Not leaving does not mean that the situation is okay or that the victim want to be abused.
  • Leaving can be dangerous. The most dangerous time for a woman who is being abused is when she tries to leave. (United States Department of Justice, National Crime Victim Survey, 1995)


Thursday, July 21, 2016

So Why Do They Stay?

By Linda A. Osmundson

Slapping, hair-pulling, kicking, biting…battered women relate a litany of abuse experienced at the hand of our intimate partners. The results are bruises, broken bones, black eyes, internal injuries, sometimes and death. Always there are broken hearts.
Yet, most battered women really do not want to leave their abusive partners. Many of the women who call shelter crisis lines tell the staff and volunteers that they just want the abuse to end. We hope for fantasy TV endings like the lives of Claire and Heathcliff Huxtable or Ward and June Cleaver.
So why do we stay? When the person who had promised to love and cherish us beats us, what makes us stay for the second and third beating? When I speak to community groups about domestic violence, I am nearly always asked this question. Often women in the audience would exclaim, "if my partner laid a hand on me, I would be out the door!"
Imagine, for a moment, your own family. Would you really be able to walk out the door? Could you leave your home, neighborhood and friends? Where would you go? Could you, your two lively children, plus the dog, stay at your brother’s apartment on his couch for an indefinite period of time? What would his two roommates have to say about that? Could you stay with your parents who live in one of those adults-only condos?
I would not be surprised if the first time it happened you would help your partner rationalize why it happened. Your partner was (tired, stressed, angry, drinking, jealous, upset about losing a job or worried about expenses). Any excuse will fill the blank! YOU (made a mistake, came home late, disagreed with your partner, bought lunch at the mall….) fill this blank with the reason your partner says you caused the abuse.
But abuse is not about reason. It is about power. It is about control of one’s partner. And it works. The physical abuse is only the most obvious. It is reinforced by a whole spectrum of other kinds of abuse. We’ve already mentioned the excuses, the minimizing and blaming, saying it was her fault or it really wasn’t that serious. Abusers isolate their victims and keep them from having friends or family around. They control what we do, who we see, what we read and where we go.
Abusers abuse our psyche and emotions by calling us unprintable names, humiliating us, constantly criticizing us.
Abusers are intimidating. I knew an abuser who left a single bullet on the kitchen counter! It takes only a look, a threat, to instill fear. Abusers are coercive, threatening to leave, forcing us to participate in illegal activities. Abusers make sure we have no money, keep us from getting a job, making us put our check in to their account. Abusers treat their partners like servants, acting like "master of the castle," making all the important decisions.
Finally, abusers use the children by making us feel guilty about them, threatening to take the children, using the children to relay messages to their mother.
Abuse works because many of us continue to pretend it does not happen to "good" women. So anyone who is abused must be "bad"! We blame the victim for her own abuse by calling her codependent. We expect her to prevent the abuse instead of why the abuser chose to abuse. In short, we collude with the abuser.
Abusers succeed because they are not abusive all the time. In fact, sometimes they are fun and charming. They are almost always charming around other people.
Battered women stay because we are afraid. We are afraid no one will believe the truth. We fear we will lose our children. We are afraid we will have nowhere to go. We are fearful we will not be able to support the children. We are afraid our church or family will condemn us. We are terrified the abuser will hurt our friends or family. Ultimately, we fear we will be killed trying to leave.
All these fears are legitimate. Most battered women, killed by their abusers, have tried to leave. Some die in the process of leaving and many are killed trying to start over. The blood of millions of battered women is on the hands of friends and families, social workers, clergy, doctors, police, attorneys, judges and anyone else who failed to believe them, failed to heed their pleas for help.
Maybe we should reverse that question, "why does she stay?" and ask, "So why does the abuser abuse?" With all the obstacles in our path the real question is, "How can we possibly leave?"