The purpose of this study was to identify factors associated with mental health service utilization among adults with head injury with loss of consciousness (LOC) using Andersen’s model of health. This secondary data analysis used the 2011–2014 National Health and Nutrition Examination Survey with data collected from 7,399 adults. Binary logistic regression was conducted to determine odds associated with predisposing, enabling, and needs factors on head injury with LOC and mental health service utilization. A total of 948 (12.8 percent) adults 40 years and older self-reported head injury with LOC. Head injury with LOC was higher among men and people with lower income, illicit drug use history, and moderate to severe depression. Mental health service utilization for people with head injury with LOC was lower among older-age adults and those with no health insurance. However, utilization was higher among adults with military service, history of drug use, and moderate to severe depression. Social workers in health care settings play critical roles serving adults with traumatic brain injury (TBI) through mental health and substance use disorder treatment and bridging gaps in service access. Social workers should recognize the complex needs of clients with TBI and factors affecting mental health service use.
Single-parent families have emerged as a common family structure, with one in four U.S. children living in single-parent households. Research on single parents has traditionally adopted a deficit-based perspective, and the challenges and barriers faced by single-parent families are well documented. In particular, students from single-parent families often struggle in school settings, with increased rates of behavior problems, lower academic achievement, and less parental engagement in the child’s education. Despite these challenges, an emerging body of literature supports focusing on resilience and strengths, rather than deficits and problems, when working with children and families. Adopting a strengths-based perspective also facilitates collaborative alliances among single parents and various service systems and helping professionals, including social workers and school personnel. This article provides an overview of single-parent families, outlines strengths-based and collaborative interventions for working with children and families, and then presents pragmatic guidelines and a case illustration to demonstrate the practical application of such interventions.
Trauma affecting youth and families takes a variety of forms, from random one‐time events such as accidents and natural disasters to chronic and highly personal trauma from child abuse or intimate partner violence. Though trauma has received increasing attention in theory and intervention research over the last several decades, the prevailing theories and treatments have limitations due to a linear perspective focused on the trauma problems of the individual. This is particularly concerning given the high dropout rates for trauma‐focused treatments and the complexities of intergenerational trauma that cannot be adequately conceptualised at the level of the individual. To inform and improve family‐based treatment of youth and family trauma, this paper proposes a theoretical framework informed by social constructivism and systems theory. Social constructivism upholds that reality is constructed through communication as an adaptive process for survival, with multiple potential realities possible. Systems theory promotes a non‐linear view of causality within a system, such that the structure and properties of a system determine outcomes more than the inputs that go into the system. Together, the principles of these meta‐theories contradict the orthodox focus on traumatic events causing trauma symptoms, and instead imply that family‐based treatment should focus on helping families shift assumptions and dynamics that sustain the problem in the present. The joint application of a social constructivism–systems theory framework for trauma introduces several new principles to inform family‐based treatment: (a) post‐trauma realities; (b) mutual survival; (c) power–justice balance; and (d) adaptive reorganisation. The implications of these principles for youth and family trauma treatment will be discussed. Future intervention development and research should consider these principles in the ongoing effort to improve family therapy for youth and family trauma.
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