Tracking Study on the Relapse and Aftercare Effect of Drug Patients Released From a Compulsory Isolated Detoxification Center

Background and AimsThere are no accurate statistical data on the relapse rate of drug abstainers after compulsory detoxification in China. This study aimed to collect relapse data for drug abstainers through follow-up visits, verify the effectiveness of professional social worker services and explore significant factors affecting relapse.Design and SettingThe drug abstainers released from Guangzhou T Compulsory Isolated Detoxification Center were randomly divided into two groups. The difference between the experimental group and the control group is that assistance services were provided by social workers to the former.ParticipantsThe study included 510 drug abstainers released from T Center, including 153 in the experimental group and 357 in the control group.MeasurementsDemographic information, history of drug abuse, and motivation for drug rehabilitation (SOCRATES) were collected 1 month prior to drug abstainer release from compulsory detoxification. Then, the relapse situation after their release was tracked according to fixed time points.FindingsThe overall relapse rate of 510 drug abstainers after their release from compulsory detoxification was 47.6%. The average survival time to relapse based on survival analysis was 220 days (N = 486), as calculated with Bayesian estimation by the MCMC method. The average survival times to relapse of the experimental group and control group were 393 and 175 days, respectively. By taking the specific survival time as the dependent variable and the group as the control variable (OR = 25.362), logistic regression analysis showed that marital status (OR = 2.666), previous compulsory detoxification experience (OR = 2.329) and location of household registration (OR = 1.557) had a significant impact on the survival time to relapse.ConclusionsThe occurrence of relapse among drug patients released from compulsory detoxification can be delayed effectively through the intervention of professional social worker services. Regardless of whether patients receive aftercare after compulsory detoxification, drug-using patients who are single, have multiple detoxification experiences and whose households are registered in other provinces deserve special attention. Relevant suggestions to avoid relapse are provided.

Optimizing care coordination to address social determinants of health needs for dual-use veterans

Background Veterans increasingly utilize both the Veteran’s Health Administration (VA) and non-VA hospitals (dual-users). Dual-users are at increased risk of fragmented care and adverse outcomes and often do not receive necessary follow-up care addressing social determinants of health (SDOH). We developed a Veteran-informed social worker-led Advanced Care Coordination (ACC) program to decrease fragmented care and provide longitudinal care coordination addressing SDOH for dual-users accessing non-VA emergency departments (EDs) in two communities. Methods ACC had four core components: 1. Notification from non-VA ED providers of Veterans’ ED visit; 2. ACC social worker completed a comprehensive assessment with the Veteran to identify SDOH needs; 3. Clinical intervention addressing SDOH up to 90 days post-ED discharge; and 4. Warm hand-off to Veteran’s VA primary care team. Data was documented in our program database. We performed propensity matching between a control group and ACC participants between 4/10/2018 – 4/1/2020 (N- = 161). A joint survival model using Markov Chain Monte Carlo technique was employed for 30-day outcomes. We performed Difference-In-Difference analyses on number of ED visits, admissions, and primary care physician (PCP) visits 120-day pre/post discharge. Results When compared to a matched control group ACC had significantly lower risk of 30-day ED visits (Hazard Ratio (HR) = 0.61, 95% Confidence Interval (CI) = (0.42, 0.92)) and a higher probability of PCP visits at 13–30 days post-ED visit (HR = 1.5, 95% CI = (1.01, 2.22)). Veterans enrolled in ACC were connected to VA PCP visits (50%), VA benefits (19%), home health care (10%), mental health and substance use treatment (7%), transportation (7%), financial assistance (5%), and homeless resources (2%). Conclusion We developed and implemented a program addressing dual-users’ SDOH needs post non-VA ED discharge. Social workers connected dual-users to needed follow-up care and resources which reduced fragmentation and adverse outcomes.

An Evaluation of the Work Social Worker in the Imprisonment With Active Preparation for Post-Penitentiary Care in Slovakia

The aim of social work in social services in the treatment of a prisoner is the mitigation of social problems or the elimination of their possible causes, and the preparation of a prisoner for release from prison. Social work, social services and social counselling are the specialised forms of care for an individual, the enhancement of his individual potentials, the optimisation of behaviour in the specific moments of his life. A relationship between a prisoner and a social worker is an important milestone which affects the quality of the counselling activity. However, the relationship develops step by step, and the social worker gradually gains trust and authority. However, in the development of such a relationship, the social worker in the helping profession must have certain principles to be followed. Social work in serving custody and serving an imprisonment sentence is a professional activity focused on clarifying the social problems of the prisoners which influenced their criminal activity, or whose existence is a risk factor for the resocialisation prognosis, so-called information assistance, support and counselling focused on limiting the negative effects of the prison environment and eliminating or minimising the causes of social problems. Social work in helping professions with prisoners belongs to a science area of social work. According to the place of work, we can divide social work with the punished persons into two subgroups: social work in the prison – i.e. penitentiary social work; and social work following the imprisonment sentence – post-penitentiary social work.

The Role of Social Work in Residential Aged Care Facilities: Evaluation of a Pilot Program in Australia

In some international settings, social workers are employed within aged care settings. However, in Australia, social workers rarely work in residential aged care facilities. In an innovative program, an Australian health network employed a social worker in an aged residential care facility from 2010 to 2011. In this research we examine and evaluate this program. Qualitative semi-structured interviews with nine key stakeholders and data extraction from medical records were conducted. Data from medical records and interview transcripts were coded and themes extracted using thematic analysis. Thematic analysis identified five key themes reflecting the roles performed by the social worker. These were: (1) The importance of having an independent third party, (2) The provision of emotional support to residents, carers and families during the transition period, (3) The importance of role clarity, (4) The provision of family-centered care, and (5) Social work responses to potential difficulties which were preventative rather than reactive. The move into residential aged care can be an overwhelming, and in some cases, traumatic transition for residents and families. Results identified that timely and expert social work intervention can improve the transition process through the provision of counselling to effectively manage grief, loss, and psychosocial issues.

PREREQUISITES FOR THE PROFESSIONAL PROMOTION OF SOCIAL WORKERS IN THE LIGHT OF THE APPLICABLE LAW

The regulations on the entitlement to practice the profession of a social worker are set out in Art. 116 of the Act of March 12, 2004 on social assistance. When assessing qualifications for employment as a social worker, the key is to meet the requirement of appropriate education. Employment in local government social welfare units is regulated by the provisions of the Regulation of the Council of Ministers of May 15, 2018 on the remuneration of local government employees. A social worker has the opportunity to raise professional qualifications by participating in specialization in the profession of a social worker. In the process of social assistance reform, which seems to be going on, the important issue of professional development of social workers in the context of career advancement was overlooked. The Act on Social Assistance does not define any path to promotion. The regulation on remuneration of local government employees also does not regulate the possibility of professional promotion. The Act on Local Government Employees does not contain such regulations either.

Deprivation and delinquency in the adolescent forensic patient

Drawing upon Donald Winnicott’s classic paper, “Delinquency as a Sign of Hope”, the author has underscored the importance of recognising the role of emotional loss in the aetiology and treatment of adolescent forensic patients, and she has elucidated how this particular psychoanalytical lens can assist psychotherapists to work more effectively with deprivational trauma. The author has also described her experience as both a field social worker and as a forensic psychotherapist, and has shared moving clinical material with great clarity and generosity, demonstrating the value of incorporating Winnicott’s insights into the forensic consulting room. In particular, the author has examined how the patient can use the psychotherapist as an understanding object who can help to counteract earlier deprivations.

Christiansen, Kikkan Ustvedt

As a feminist, social worker, administrator, educator, researcher, writer, and editor Kikkan Ustvedt Christiansen (1932–2020) was one of the pioneers in developing social work as a professional practice into an academic discipline and research field in Norway. Even when she ended her career as a respected researcher in child welfare, she never surrendered her identity as a practitioner and engagement for social justice.