Reintegration Partnership Project: Summary of Key Findings and Recommendations

There are approximately 2.6 million men and women who have served in the U.S. military during the post-9/11 period and their transitions home after deployment often create a rollercoaster of mixed experiences. About 40 percent of the fighting and support services deployed to Iraq and Afghanistan are members of the National Guard and Reserve Forces who often return to civilian communities that are ill-prepared to accommodate their reintegration needs. This brief describes the Reintegration Partnership Project, which explored the transition process for California National Guard members and their families after Reintegration Skills Training (RST), an evidence-based problem-solving practice aimed at easing the challenges associated with transition from combat to civilian life. It also reports findings of a follow-up assessment of the reintegration experience for California National Guard members

Azúcar y nervios: Explanatory models and treatment experiences of Hispanics with diabetes and depression

This study examined the explanatory models of depression, perceived relationships between diabetes and depression, and depression treatment experiences of low-income, Spanish-speaking, Hispanics with diabetes and depression. A purposive sample (n = 19) was selected from participants enrolled in a randomized controlled trial conducted in Los Angeles, California (United States) testing the effectiveness of a health services quality improvement intervention. Four focus groups followed by 10 in-depth semi-structured qualitative interviews were conducted. Data were analyzed using the methodology of coding, consensus, co-occurrence, and comparison, an analytical strategy rooted in grounded theory. Depression was perceived as a serious condition linked to the accumulation of social stressors. Somatic and anxiety-like symptoms and the cultural idiom of nervios were central themes in low-income Hispanics' explanatory models of depression. The perceived reciprocal relationships between diabetes and depression highlighted the multiple pathways by which these two illnesses impact each other and support the integration of diabetes and depression treatments. Concerns about depression treatments included fears about the addictive and harmful properties of antidepressants, worries about taking too many pills, and the stigma attached to taking psychotropic medications. This study provides important insights about the cultural and social dynamics that shape low-income Hispanics' illness and treatment experiences and support the use of patient-centered approaches to reduce the morbidity and mortality associated with diabetes and depression

Effects and moderators of psychosocial interventions on quality of life, and emotional and social function in patients with cancer : an individual patient data meta-analysis of 21 RCTs

Objective: This individual patient data (IPD) meta‐analysis aimed to evaluate the effects of psychosocial interventions (PSI) on quality of life (QoL), emotional function (EF), and social function (SF) in patients with cancer, and to study moderator effects of demographic, clinical, personal, and intervention‐related characteristics. Methods: Relevant studies were identified via literature searches in 4 databases. We pooled IPD from 22 (n = 4217) of 61 eligible randomized controlled trials. Linear mixed‐effect model analyses were used to study intervention effects on the post‐intervention values of QoL, EF, and SF (z‐scores), adjusting for baseline values, age, and cancer type. We studied moderator effects by testing interactions with the intervention for demographic, clinical, personal, and intervention‐related characteristics, and conducted subsequent stratified analyses for significant moderator variables.Results: PSI significantly improved QoL (β = 0.14,95%CI = 0.06;0.21), EF (β = 0.13,95%CI = 0.05;0.20), and SF (β = 0.10,95%CI = 0.03;0.18). Significant differences in effects of different types of PSI were found, with largest effects of psychotherapy. The effects of coping skills training were moderated by age, treatment type, and targeted interventions. Effects of psychotherapy on EF may be moderated by cancer type, but these analyses were based on 2 randomized controlled trials with small sample sizes of some cancer types. Conclusions: PSI significantly improved QoL, EF, and SF, with small overall effects. However, the effects differed by several demographic, clinical, personal, and intervention‐related characteristics. Our study highlights the beneficial effects of coping skills training in patients treated with chemotherapy, the importance of targeted interventions, and the need of developing interventions tailored to the specific needs of elderly patients

Social networks, social support and coping with serious illness: The family connection

Selected social support and family research is reviewed to highlight potential problems in social support exchange as patients and families collectively cope with illness and disability. Results indicate that family support is a primary source of patient support and that the impact of illness on families is substantial, underscoring their need for support. Results also indicate that there are numerous opportunities for problematic supportive exchange within families. The case is made that future studies of social support are needed to answer a series of questions about social support process within families coping with serious illness.social network social support family coping serious illness

Social Work in Health Care in 2025: The Landscape and Paths of Transformation

Social work in health care will, over the next 25 years, be transformed in concert with a complex and rapidly changing healthcare landscape and critical advances in behavioral and social science. Professional practice, research and education will be shaped by evolving patterns of health and illness, changing population demographics, developments in medicine, behavioral and social science, technology innovation and applications, and healthcare delivery cost and market forces. The profession’s practice, research and educational communities must take actions now to guide the necessary transformation of social work in health care and, in the process, significantly influence the delivery of behavioral and psychosocial health care

Depression and family interaction among low-income, predominantly hispanic cancer patients: a longitudinal analysis

PurposeAmong cancer patients, family interaction has been associated with depression. According to the stress generation theory, depression among cancer patients triggers stressful interpersonal events that contribute to poor family interactions and additional depression. This conflict may occur with a spouse/partner or other family member, including extended family. This study evaluated the longitudinal association between depression and marital and family conflict among low-income, predominantly Hispanic cancer patients.MethodsData were collected during a randomized controlled clinical trial of depression treatment among 472 low-income cancer patients with baseline depression scores of 10 or more on the Patient Health Questionnaire-9 and whose depression symptoms and negative family interactions were assessed at baseline and at 6, 12, 18, and 24 months. Considering that not all participants were in an intimate relationship, only 237 participants were included in the analysis of marital conflict. Mixed linear modeling with and without decomposition of between- and within-person variability was conducted to examine the longitudinal association between family interaction and depression.ResultsOverall, family conflict was significantly associated with changes in depression over time, and marital conflict was significantly associated with mean depression levels over 2 years. In addition, within-subject change in both marital and family conflict was significantly associated with within-patient deviation from average depression levels.ConclusionsFindings provide evidence of an association between depression and negative family interaction among depressed cancer patients. Cancer patients with clinically significant depressive symptoms may benefit from clinical assessment and psychotherapy relevant to family interaction

Building the Profession’s Research Infrastructure

Beginning in 1988, the social work profession undertook a twenty-five year endeavor to enhance its research capacity and to assure greater representation of social work research needs, priorities and findings at the federal level, where major policy initiatives take place. Described here are some of the key processes, highlighting the efforts to achieve professional solidarity, and the interventions, by social workers, federal "insiders" and outside advocacy agents that carried the work forward. Details and accomplishments of this long-term, carefully sustained, and still incomplete professional self-strengthening change strategy provide insights for future collective professional endeavors. Twenty-five years ago the social work profession began a sustained effort to strengthen its research infrastructure in support of demonstrating practice effectiveness, advancing knowledge for critical social problems, and informing national policy. The steps and processes undertaken and the outcomes achieved by this effort have been described elsewhere (Austin, 1998; Corvo, Zlotnik, & Chen, 2008; TFSWR, 1991; Zlotnik, Biegel, & Solt, 2002; Zlotnik & Solt, 2006, 2008). What we want to capture through this, our eye-witness account, are some of the nuanced and specific actions, obstacles, and decisions involved in this effort. Recreating this case study of a profession's self-strengthening change strategy – targeted both to the external environment and its own internal one – can provide insights for future profession-wide, collective efforts