New on HelpStartsHere.org - A Celebration of African American  Social Workers who tell us why they joined the profession and what they believe are the greatest challenges in the African American community.

Also on HelpStartsHere…

Profiles of Native American Social Workers

Profiles of Hispanic Social Workers

Introduction

Intimate partner violence is all too common throughout the world and takes many forms. The most serious of these is homicide by an intimate partner. The fear of being killed, in fact, is a major dynamic in male-on-female violence and sometimes in motivating women to kill the perpetrator of abuse out of fear or desperation.

Facts on Domestic Homicide

In the U.S., estimates from the Bureau of Justice Statistics (BJS) are that more than three women a day are killed by their intimate partners. Women are killed by intimate partners more often than by another acquaintance of stranger. Most of these murders involved were preceded by physical and psychological abuse.

Outside the domestic realm, males are killed much more often than females; they are killed most often in fights with other men.

According to the FBI’s Uniform Crime Reports, 1,055 women and 287 men were murdered by their intimate partners in 2005. These figures are striking, because in the past, in the 1970s and earlier, the numbers of men and women so victimized were about even. In other words, there has been a significant decline in the numbers of men killed by their partners but not for women.

The number of men who were murdered by intimates dropped by 75% between 1976 and 2005 (BJS). The number of black females murdered in this time has declined but the number of white females murdered has dropped only by 6%. Statistics Canada (1998, 2005), similarly, reveals a sharp decline in the numbers of male domestic homicide victims but not of female victims of homicide.

The reason that women are resorting less to murder of their partners is most likely because many of these women were battered women who felt trapped in a dangerous situation. Today, the presence of violence prevention programming and the availability of shelters are paving the way to other options. The fact that domestic violence services apparently are saving the lives of more men than women is a positive, though unintended consequence of the women’s shelter movement (see van Wormer and Bartollas, 2007).

Situations of Domestic Murder Suicide

The National Violent Death Reporting System (NVDRS) is a recently developed state-based surveillance system that includes data from 17 states as of 2007. Now for the first time, a national data base exists that reveals the numbers of homicides that end in suicide. The goal is to collect data on homicide for all 50 states. Results so far reveal that over 90% of the perpetrators of murder-suicide are male. About one third of these male perpetuated homicides end in suicide. (Data available at www.nvdrs.com.)

These results are consistent with those of the Violence Policy Center (VPC). The VPC bases their findings on an Internet search of media accounts of deaths by murder-suicide. VPC reports that a total of 591 murder-suicide deaths took place nationwide in the six months between Jan. 1 and June 30, 2005.

As reported by the Violence Policy Center (2005), the pattern of the murder-suicide is predictable: the pattern involves a male perpetrator, female victim, a decision by the woman to leave the man, and a gun. A handgun was used in 92% of the incidents. The offender was 6.3 years older on average than the victim. Texas had the highest number of cases; the typical Florida pattern involved an elderly male caregiver overwhelmed by his inability to care for an infirmed wife.

Some researchers argue that murder is the primary motive in such cases; others point to the double and multiple killings as a form of extended suicide (van Wormer and Bartollas, 2007). The urge to kill can be described as an urge toward total self-destruction including the destruction of the person who rejected him.

The pattern that emerges in these cases involves intimate partners in the 20 to 35-year-old range: The man is abusive, psychologically and/or physically. Obsessed with the woman to the extent that he feels he can’t live without her, he is fiercely jealous and determined to isolate her.

Characteristically, suicidal murderers have little regard for the lives of other people; they would be considered, in mental health jargon, to be antisocial. Yet they are so emotionally dependent on their wives or girlfriends that they would sooner be dead than to live without them. When the girlfriend/wife makes a move to leave, her partner is absolutely distraught in the belief that he can’t live without her.

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Ever since the 1970’s, divorce has become commonplace. In fact, the definition of family has changed dramatically. Less than fifty percent of families are intact families with the original mother and father. Families now include single heads of households—with women as the head of household, couples living together and step-families that become “blended” through divorce and re-marriage.

Included in the rising divorce rates are long-term marriages. Why, we ask, would someone get divorced after more than twenty years of marriage? Before we take a look at the top reasons for why some long-term marriages end in divorce, let’s first see why some long-term marriages succeed or just “go along to get along.” “Success” means that BOTH partners report being happy.

Good Reasons Why Some People Stay in Long-Term Marriages—What Makes These Good, Happy Marriages Work?

Good, happy marriages consist of people who:

1. Are both truly happy, optimistic people who know how to problem-solve.
2. Tended to get married when older and more settled in their careers/education and more mature.
3. Are financially comfortable.
4. Have college degrees or technical training.
5. Find ways to “renew” the marriage spark. Some couples do this by traveling, taking classes of some kind together, doing a large project together (building a dream house, etc.), volunteering together and basically finding a new shared interest etc.
6. Are happily involved with their grandchildren and/or adult children.
7. Have good health.
8. Don’t criticize and reject each other.
9. Respect and like each other.
10. Have more than “weathered or gotten through” major stresses such as affairs, financial or emotional problems. Instead, they triumph over these issues and grow.
11. Have a wildcard factor—a highly personalized reason for being happy and together!

Make a checklist of which ones are part of your marriage. Now let’s take a look at why some unhappy, long-term marriages continue.

Why Some Unhappy, Long-Term Marriages Continue

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Note: All names have been changed to protect confidentiality.

By L.B. (LeslieBeth) Wish, Ed.D, MSS

Introduction

Sally had been a soldier’s wife for all twelve years of their marriage. She endured separations while her husband, Tom, was called to duty, and she toughed out raising twin boys alone. Sally said Tom loved her because, in his words, she was a “team player.” But ever since Sally learned that Tom was killed in a roadside bomb in Iraq, Sally doubts whether she can be a team of one. “I’m really not that strong,” Sally said. “It’s just a good act.”

When Rolanda was shot out of her helicopter, her husband Ray said he had no choice but to “pull himself together.” He had to focus on his job and raising his stepdaughter. “I only cry at night, and then only for a second or two. We were practically newlyweds. I don’t even know what I’ll be missing.”

“At least the kids are grown.” It was the first thing that came to Linda’s mind when she heard that her husband was killed in an ambush. But the relief was short—depression set in, and Linda felt “ashamed” for falling apart.

These stories provide a glimpse into the plight of many of the American families of downed warriors in Iraq. Each family’s grief is unique, but most share issues that are familiar to mental health professionals–adjustment, loss, grief, and anger.

Some families rely on friends, the Armed Forces community, and supportive family for help. But one of the issues that many (certainly not all) of these families also share is their reluctance to use the mental health services available to them.

Why? What makes providing counseling to these families so different from non-military families in mourning? And how can mental health professionals serve these families’ needs?

Let’s start with learning a little more about some of these families. Bear in mind, that there are many reactions to the loss of a family member and that not all families of downed warriors react the same. Yet, a constellation of beliefs, fears and adjustment issues does exist amongst many of these families, and it is important to become familiar with them.

Current Issues of Some American Military Families

At first, it seems that the most common issues of military families do not differ from the problems of families not in the military. People are people, as some say. After all, humans share common problems. Yet, military families often add elements to these issues that are unique to them.

Fear of Being “Found Out”

Many families worry about being seen in counselors’ halls and waiting rooms and about being judged and “found out.” They also worry about confidentiality. They believe that no matter what the organization, if it’s affiliated with the armed forces, it will keep records that could easily be shared with other branches and departments.

Non-military families may have similar feelings, but military families carry with them an extra dose of shame of being “found flawed.” They also say they “have had it” with the power of military and government rules. They long for privacy, and they have far higher doubts that their insurance can protect them.
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If you find that your child does, indeed have ADHD, it’s important to educate yourself as much as possible. There are numerous books on the subject. Consulting with a mental health professional to help you with the many challenges ADHD can present, is invaluable. Finding support by attending local groups such as CHADD (Children and Adults with Attention Deficit Disorder) also are immensely helpful in not only learning more about ADHD, but also to connect with other families who are struggling.

Since the treatment of ADHD often includes parenting strategies, it is imperative that you work with a professional to help you learn new techniques to not only help manage your child’s behavior, but to also help him learn organizing strategies, homework management, social skills and more.

Treatment also often includes medication to help quiet the hyperactivity and impulsivity and/or improve attention. Many parents are reluctant to give their child medications, but stimulants (the most common and beneficial medication for ADHD) are safe when given as directed. Still, all parents have concerns. Here are some questions to ask your doctor to help you in making the decision as to whether medication is right for your child:

• What are the risks vs benefits?
• What side effects might I observe?
• Which medications will work best for my child?
• What options do I have if I don’t want to use medications for my child?
• How will I know if the medications are working?

For more information visit www.helpstartshere.org.

Reprinted with permission of the organization People Living With Cancer

Introduction

For people diagnosed with cancer, an oncology social worker is an important member of the health-care team. An oncology social worker provides services, such as counseling, education, and information and referrals to community resources, including support groups. An oncology social worker often acts as a liaison between people with cancer and the medical team, and helps people find ways to navigate the health-care system. He or she works with the medical team to make sure people with cancer get the information they need to make informed choices about their care, and the support needed to manage the day-to-day challenges of living with cancer.

Taking Care of the Whole Person

An oncology social worker is a professional who has specialized training in how a diagnosis of cancer affects a person and his or her family and friends. An oncology social worker understands that there are many aspects of a person’s life outside of cancer, and that cancer affects each person in a different way. The oncology social worker’s expertise is a comprehensive view of the person living with cancer that is respectful of each individual’s ethnicity, spirituality, family situation, unique strengths and challenges, and it is his or her job to represent a person’s interests and needs to the medical team.

For most people, a cancer diagnosis brings with it new feelings and experiences. Talking to a professional who has helped other people manage similar situations may help a person find ways to improve quality of life, manage fears, and find hope. A social worker talks to people about the different aspects of adjusting to the cancer, and helps find strategies to adapt to, and manage health-care concerns. This can happen through individual, couples, and family counseling; support groups; and referrals to community agencies that have additional support programs.

A Bridge to the Medical Care Team

An oncology social worker has advanced training in cancer treatment, as well as in how treatments affect people living with cancer. Many people with cancer find that information that may have been easy to read and absorb in a textbook is much more difficult to understand when it pertains to their own health. A social worker helps gather the information people need to make decisions about their care. He or she may arrange a family meeting with the medical team, at which people’s care and treatment options may be discussed. A social worker can also refer people to additional educational resources and to community organizations that have information about cancer and treatment.

New Roles and Responsibilities

People may wonder how their parents, children, friends, and coworkers will react to their cancer, and how they will feel about that reaction. People may also wonder if there will be changes in their ability and desire to keep up with the many responsibilities of their life, such as a demanding job, taking care of young children, or helping an older parent. A social worker can arrange a meeting to talk about how those roles and responsibilities might change, and about what kind of support he or she wants and needs while going through treatment…Click here for the rest of this article

Army National Guard Specialist Chuck Ross

The Veteran’s Administration employs more than 4,400 MSWs to assist veterans and their families with individual and family counseling, patient education, end of life planning, substance abuse treatment, crisis intervention, and other services.

Please click here to read the article Leaving the War Half a World Away which is the story of Army National Guard Specialist Chuch Ross pictured above. When Mr. Ross returned home from the Iraq war experiencing symptoms of post traumatic stress disorder, he turned to social worker Dr. Rick Selig for help.

Below are links to additional articles about veterans affairs and social work.

• - About Post Traumatic Stress Disorder (PTSD) and Brain Injury in Iraq’s War Veterans
• - Help for Spouses of Combat Vets With Post Traumatic Stress Disorder From People Who Know
• - When the Soldier Doesn’t Return: The Needs of American Families of Down Warriors in Iraq
• - What It’s Like to Help Disabled Veterans as a Veterans Health Administration Social Worker
• - Love, Honor, & Obey: Working With Military Men and Their Families
• - How Social Workers Help Veterans and Their Families
• - Help for World War II POWs: The Former POW Living History Project
• - Retired Army Colonel and Dean of the University of Maryland, Baltimore School of Social Work, Jesse J. Harris, PhD, Honored by the Maryland Legislature

By LeslieBeth Wish, Ed.D, MSS

Introduction

Few of us are immune to holiday stress. It doesn’t help that Thanksgiving and Christmas are so close together. For many people, it’s like getting a second wham of anxiety and disappointment before you recover from the first one at Thanksgiving.

Because our American culture still promotes the image of the happy family with the white picket fence, we often assume the ideal family exists–even if we know that these families, too, have holiday difficulties. Holiday movies increase our disappointment. Oh, they might start out with family feuds, misunderstood children and unacceptable mates, but all these issues get resolved by the end of the film.

In reality, most families have a few issues that are unresolved. What may be stressful to one family may not be to another, yet despite the differences, the top holiday stresses are familiar to most of us. What can you do to make the holidays a happier time? Everyone’s situation is unique, but here are the top problems and solutions. (All names and identities cited below have been changed.)

Unrealistic Expectations of Happiness, Joy and Acceptance

The holidays are supposed to be a joyous time. If you have unresolved issues, hopes run high that the festivities will propel family members to act with greater kindness and emotional responsibility. Unfortunately, holiday time is not necessarily the best time to try to settle grievances or have one of those long, heart to heart talks with a family member. In fact, you might end up with nothing more than a lot of words and raised hopes—with little followup after the holidays are over.

The first thing to do is to lay the groundwork for a renewed relationship long before the holidays. Start by sending e-mails or birthday and anniversary cards. You want to send the message that you care about them and that you have changed.

It’s usually not a good idea to play a game of history where you review your past complaints. A long family meeting where you air your past anger won’t necessarily result in changing other family members’ behavior or attitudes about you. More effective change usually comes from your acting differently—and surprising them with the new you. Acting unpredictable in a positive way is a potent strategy for shaking up family members’ old views and treatment of you.

For example, if you’ve been regarded as the wayward child, you can demonstrate your maturity by telling the family about your life changes and speaking to each relative about things that are important to each of them. Even though it can take months for attitudes and behavior to change, when you act in a different and positive way, the family is more likely to notice you’ve changed.

Of course, if there is a timely hot topic that has to be addressed, then speak to other family members about ways to coordinate a strategy. For example, a common issue is how to care for a close relative who has dementia or Alzheimer’s disease. Some families divide up the tasks of researching doctors, nursing homes and other care facilities in the area. Family members then use e-mails to remain in touch.

Rigid Rituals

Rituals sustain the family emotional glue. They provide an easy format to recall and chart family growth, connection and cooperative decision-making. In addition, the holidays give families an opportunity to celebrate “who we are and why we matter.”

Later, as you mature, these family events provide a forum for testing your maturity, feelings and assumptions about yourself and others. You can assess family members with your own eyes and come to different or refined conclusions about how your family operates. You can forge your own identity and role as well as establish resources in the family through selected people.

However, rituals are often unresponsive to change. Family ruts are easy to get into. For example, mother always sits here, father there. It’s amazing to see the power of even these simple acts. Yet, not everything can stay the same. Family members are lost and added through death, marriage, birth and feuds. Life demands flexibility. Rather than complain about a ritual, recruit the key person in the solution. Be prepared to provide a reason and ideas.

For example, no one wants to hurt Cousin Dee’s expectations about hosting the Thanksgiving feast. However, now the family is too large to fit into her dining room. If you have a better idea, discuss it with other members, including the person whom Cousin Dee responds to with the least defensiveness. Then, have this person seek Dee’s advice about some related issue such as how to arrange the seating order or what chairs to use.

If you are that designated person, act perplexed about the best way to accommodate the growing family. You might mumble about moving chairs or using the kitchen. You might even say things such as: “Gee, it’s too bad Cousin Tina hasn’t offered to have the Thanksgiving meal at her house. Then we could have the next day brunch all day at your house, where it’s more fun and casual. Do you think Cousin Tina would want us messing up her new carpet?” Of course, you’ve already cleared it with Cousin Tina. The goals are to get creative and positive and to turn the key family members into key players in the solution.

Finally, take advantage of changes in the family to forge new traditions. Use events such as births, marriages, remarriages or college graduations as springboards for new gift giving, different homes for the celebration or more flexible seating arrangements around the dining table. These changes might prompt innovative ways of sharing the holiday. For example, you can divide up Christmas into Christmas Eve, Christmas morning and Christmas dinner. (more…)

College Student AnxietiesSocial workers in college counseling centers see increasing numbers of students each year for problems ranging from homesickness and test anxiety to eating disorders and suicidal thoughts.

While many people think of college as an ideal time of life when young adults are meeting academic challenges, experiencing personal growth and enjoying social activities like football games and parties; college can also be a time of depression and overwhelming anxiety, confusion about identity and dealing with losses and traumas such as parental divorce or date rape.

Life can feel complicated and lonely as students move into a new and shifting environment without the emotional skills or support to deal with many of the changes they are facing. For returning adult students there may be additional financial and caretaking issues with which to contend.

How Social Workers Help

An effective social work therapist in the college counseling center setting is able to evaluate, diagnose, and provide treatment for a range of life and emotional issues. Clinical social workers engage in assessment of student problems and emotional status, provide crisis intervention, individual and group counseling, make referrals for medical and psychiatric services and engage in consultation with friends, family and other caregivers on campus.

Working with young adults requires openness to changes in cultural trends and surface presentations of students while also connecting with them about timeless issues such as understanding life events, developing coping strategies and finding meaning in their struggles. In the case of suicidal or high risk behaviors, a social worker’s role may involve developing a safety plan to prevent harm.

In addition to counseling services, social workers also engage in education and prevention activities as well as activities designed to create a more caring and emotionally responsive environment. Social workers present workshops and classroom presentations for students on topics such as stress management, depression, and relationship communication. Faculty, staff, and peer helpers are also trained to identify and refer students experiencing emotional distress.

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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.

Reviewed by NASW Office of Social Work Specialty Practice Staff

What Are Assisted Living Residences?

Generally, assisted living residences provide a combination of housing and supportive services for seniors who do not require round-the-clock skilled nursing or medical care but do require more personal care and health services than independent living provides.

Assisted living facility settings vary widely — from small homes to big apartment buildings. Many are stand-alone assisted living residences, while others are connected to independent housing and/or a nursing home on the same campus.

Accommodations and services also vary. Some residences provide apartments with kitchenettes, while others offer private or shared rooms. In one residence, services may be limited to housekeeping and personal care, such as help with bathing and dressing; meanwhile, another may also offer other services such as physical therapy or transportation. Typical services include meals that are served in a common dining room, personal care, housekeeping, and activities.

Explore Your Options

We encourage you to explore the whole spectrum of long-term care options. Do you still live at home? If so, before deciding on assisted living, find out whether you could get home care, housekeeping, or other services — and what they would cost. These services could help you stay in your own house or apartment. Your own home is familiar, and it’s where you have the most freedom to lead your life as you want.

Maybe you are still able to live independently but want the companionship that communities offer. If so, here’s another option to consider: independent living, also called retirement communities, congregate living, or senior apartments. Independent living typically provides seniors with recreational, educational, and social activities. Although such residences may also provide laundry, linen, meal service, and transportation, they almost never offer any personal care of health services. (more…)