Drug Abuse and Drug Treatment Programs

Council on Social Work Education Educational Policy and Accreditation Standards by Chapter The Council on Social Work Education’s Educational Policy and Accreditation Standards requires all social work students to develop nine competencies and recommends teaching and assessing 31 related component behaviors, listed as Educational Policy (EP) Competencies 1–9 below. The multicolor icons (see figure at right) and end of chapter “Competency Notes” connect these important standards to class work in the chapters identified below with bold blue type.

The 9 Competencies and 31 Component Behaviors (EPAS, 2015)

Chapter(s) Where Referenced

Competency 1—Demonstrate Ethical and Professional Behavior: 3

a. Make ethical decisions by applying the standards of the NASW Code of Ethics, relevant laws and regulations, models for ethical decision-making, ethical conduct of research, and additional codes of ethics as appropriate to context

b. Use reflection and self-regulation to manage personal values and maintain professionalism in practice situations

c. Demonstrate professional demeanor in behavior; appearance; and oral, written, and electronic communication

d. Use technology ethically and appropriately to facilitate practice outcomes 3

e. Use supervision and consultation to guide professional judgment and behavior 3

Competency 2—Engage Diversity and Difference in Practice: 3, 7, 12, 13, 14, 16

a. Apply and communicate understanding of the importance of diversity and difference in shaping life experiences in practice at the micro, mezzo, and macro levels

3, 7, 12, 13, 14, 16

b. Present themselves as learners and engage clients and constituencies as experts of their own experiences

c. Apply self-awareness and self-regulation to manage the influence of personal biases and values in working with diverse clients and constituencies

3, 7, 12, 13, 14, 16

Competency 3—Advance Human Rights and Social, Economic, and Environmental Justice:

3, 7, 12, 13, 14, 16

a. Apply their understanding of social, economic, and environmental justice to advocate for human rights at the individual and system levels

3, 7, 12, 13, 14, 16

b. Engage in practices that advance social, economic, and environmental justice 3, 7, 12, 13, 14, 16

Competency 4—Engage in Practice-informed Research and Research-informed Practice:

3, 7, 12, 13, 14, 16

a. Use practice experience and theory to inform scientific inquiry and research 3

b. Apply critical thinking to engage in analysis of quantitative and qualitative research methods and research findings

3, 7, 12, 13, 14, 16

c. Use and translate research evidence to inform and improve practice, policy, and service delivery

3, 7

Competency 5—Engage in Policy Practice: 1, 3, 6, 7, 12, 13, 14, 16

a. Identify social policy at the local, state, and federal level that impacts well-being, service delivery, and access to social services

1, 3, 6, 7, 12, 13, 14, 16

b. Assess how social welfare and economic policies impact the delivery of and access to social services

c. Apply critical thinking to analyze, formulate, and advocate for policies that advance human rights and social, economic, and environmental justice

3, 7, 12, 13, 14, 16

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The 9 Competencies and 31 Component Behaviors (EPAS, 2015)

Chapter(s) Where Referenced

Competency 6—Engage with Individuals, Families, Groups, Organizations, and Communities:

2, 3, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17

a. Apply knowledge of human behavior and the social environment, person-in- environment, and other multidisciplinary theoretical frameworks to engage with clients and constituencies

2, 3, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17

b. Use empathy, reflection, and interpersonal skills to effectively engage diverse clients and constituencies

Competency 7—Assess Individuals, Families, Groups, Organizations, and Communities:

a. Collect and organize data, and apply critical thinking to interpret information from clients and constituencies

b. Apply knowledge of human behavior and the social environment, person-in- environment, and other multidisciplinary theoretical frameworks in the analysis of assessment data from clients and constituencies

c. Develop mutually agreed-on intervention goals and objectives based on the critical assessment of strengths, needs, and challenges within clients and constituencies

d. Select appropriate intervention strategies based on the assessment, research knowledge, and values and preferences of clients and constituencies

Competency 8—Intervene with Individuals, Families, Groups, Organizations, and Communities:

3, 4, 5, 7, 8, 10, 13

a. Critically choose and implement interventions to achieve practice goals and enhance capacities of clients and constituencies

3, 4, 5, 7, 8, 10, 13

b. Apply knowledge of human behavior and the social environment, person-in- environment, and other multidisciplinary theoretical frameworks in interventions with clients and constituencies

3, 4, 5, 7, 8, 10, 13

c. Use inter-professional collaboration as appropriate to achieve beneficial practice outcomes

d. Negotiate, mediate, and advocate with and on behalf of diverse clients and constituencies

e. Facilitate effective transitions and endings that advance mutually agreed-on goals 3

Competency 9—Evaluate Practice with Individuals, Families, Groups, Organizations, and Communities:

a. Select and use appropriate methods for evaluation of outcomes 3

b. Apply knowledge of human behavior and the social environment, person-in- environment, and other multidisciplinary theoretical frameworks in the evaluation of outcomes

c. Critically analyze, monitor, and evaluate intervention and program processes and outcomes

d. Apply evaluation findings to improve practice effectiveness at the micro, mezzo, and macro levels

TWELFTH EDITION

Introduction to SOCIALWORKand SOCIALWELFARE Empowering People

CHARLES ZASTROW George Williams College of Aurora University

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About the Author

Charles Zastrow, MSW and PhD is Assistant Director and Professor in the Social Work Program at George Williams College of Aurora University at Williams Bay, Wisconsin. He has worked as a practitioner in a variety of public and private social welfare agencies and has chaired 23 social work accreditation site visit teams for the Council on Social Work Education (CSWE). He has served two terms as a Commissioner on the Commission on Accreditation of CSWE. He has been a Board Member of the Association of Baccalaureate Social Work Pro- gram Directors, Inc. (BPD). Dr. Zastrow is a licensed Clinical Social Worker in the State of Wisconsin. In addition to Introduction to Social Work and Social Welfare, Dr. Zastrow has written three other social work textbooks: The Practice of Social Work (10th ed.), Social Work with Groups (8th ed.), Understanding Human Behavior and the Social Environment (9th ed.) (with Dr. Karen Kirst-Ashman).

Contributing Authors DEBRA BORQUIST-CONLON, MSSW, APSW

Child Protection Team Social Worker University of Wisconsin Health/American Family Children’s Hospital

KATHERINE DRECHSLER, MSW Adjunct Faculty Member University of Wisconsin–Whitewater Doctoral Student in Social Work Aurora University

RACHEL DUNN, MSW, CAPSW Field Coordinator George Williams College of Aurora University

DON NOLAN, MSSW, BCD Social Worker Jefferson County Public School System, Wisconsin

MICHAEL WALLACE, MSSW, LCSW Clinical Social Worker and Lecturer Social Work Department University of Wisconsin–Whitewater

MARY R. WEEDEN, MSW, LCSW Doctoral Candidate, Loyola University Clinical Therapist for Eating Disorders Assistant Professor, Concordia University, Wisconsin

iii

To Kathy, my wife,

who has invigorated my life!

Brief Contents

PART I Introduction: Social Welfare and Social Work

1 Social Welfare: Its Business, History, and Future 1

2 Social Work as a Profession and a Career 37

3 Generalist Social Work Practice 65

PART II Social Problems and Social Services

4 Poverty and Public Welfare 107

5 Emotional/Behavioral Problems and Counseling 130

6 Family Problems and Services to Families 168

7 Sexual Orientation, Gender Identity, and Services to Lesbian, Gay, Bisexual, Transgender, and Questioning (LGBTQ) Individuals 215

8 Drug Abuse and Drug Treatment Programs 250

9 Crime, Juvenile Delinquency, and Correctional Services 289

10 Problems in Education and School Social Work 330

11 Work-Related Problems and Social Work in the Workplace 362

12 Racism, Ethnocentrism, and Strategies for Advancing Social and Economic Justice 385

13 Sexism and Efforts for Achieving Equality 422

14 Aging and Gerontological Services 451

15 Health Problems and Medical Social Services 482

16 Physical and Mental Disabilities and Rehabilitation 512

17 Overpopulation, Misuse of the Environment, and Family Planning 534

Contents

Empowering People xv Values and Ethics xvi Preface xvii

PART I INTRODUCTION: SOCIAL WELFARE AND SOCIAL WORK

CHAPTER 1

Social Welfare: Its Business, History, and Future 1 Goal of Social Welfare 2

Social Welfare as an Institution and as a Discipline 2

Social Welfare’s Relationship to Sociology and to Other Academic Disciplines 3

Social Welfare’s Relationship to Social Work 4

Social Welfare’s Relationship to Other Institutions 5

Social Welfare’s Relationship to Human Services 5

Residual View versus Institutional View of Social Welfare 6

Liberalism versus Conservatism 6

Developmental View of Social Welfare 8

History of Social Welfare 10 Early European History 10 The Elizabethan Poor Law 10

The Industrial Revolution 10 Turn of the 20th Century 11 The Great Depression and the Social Security Act 12 The Great Society and War on Poverty 15 Compassionate Conservatism 17 Barack Obama—A Time for Change 17 Where Do We Stand Today? 17

The Future 19

Dramatic Changes Foreseen in the American Family 19 Biomedical Technology 20 New Family Forms 27 Concluding Comments 33

Summary 34

Competency Notes 34

CHAPTER 2

Social Work as a Profession and a Career 37 A Brief History of Social Work 38

A Multiskilled Profession 40 A Problem-Solving Approach 42 Generalist Social Work Practice 42

Micro-, Mezzo-, and Macropractice 42 Social Casework 42 Case Management 43 Group Work 43 Group Therapy 43 Family Therapy 43 Community Organization 44 Administration 44 Other Areas of Professional Activity 45

M ar y Ka te

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M yr le en

Pe ar so n/ Al am

vii

A Medical versus a Systems Model of Human Behavior 46

An Ecological Model of Human Behavior 47

Goals of Social Work Practice 48 Goal 1: Enhance the Problem-Solving, Coping, and

Developmental Capacities of People 48 Goal 2: Link People with Systems That Provide Them with

Resources, Services, and Opportunities 48 Goal 3: Promote the Effectiveness and Humane Operation

of Systems That Provide People with Resources and Services 48

Goal 4: Develop and Improve Social Policy 48 Goal 5: Promote Human and Community Well-Being 49

The Strengths Perspective and Empowerment 50

Social Work Stereotypes 51

Future Employment Opportunities in Social Work Are Excellent 52

Private Practice of Social Work 57

International Social Work 57

Self-Awareness and Identity Development 60 Identity Formation 60 Questions for Arriving at a Sense of Identity 61

Summary 62

Competency Notes 63

CHAPTER 3

Generalist Social Work Practice 65 Generalist Social Work Practice Defined 66

A Variety of Roles 66 Enabler 67 Broker 67 Advocate 67 Activist 67 Mediator 67 Negotiator 67 Educator 68 Initiator 68 Empowerer 68 Coordinator 68 Researcher 68 Group Facilitator 68 Public Speaker 68

Social Work with Individuals 68

Social Work with Families 69 Family Problems 69

Social Work with Groups 70 Therapy Groups 72

Social Work with Organizations 74

Social Work with the Community 81 A Brief History of Community Practice 82 Models of Community Practice 82

Knowledge, Skills, and Values for Social Work Practice 86

Social Work Values 86 Respect for the Dignity and Uniqueness of the

Individual 91 Clients’ Right to Self-Determination 91 Confidentiality 92 Advocacy and Social Action for the Oppressed 95 Accountability 95 The Institutional Orientation 96 Respect for the Spiritual and Religious Beliefs of Others 96 Promoting Social and Economic Justice, and Safeguarding

Human Rights 97

Social Work Education 102 Two-Year Associate Programs 102 Undergraduate and Graduate Education 102

Summary 104

Competency Notes 105

PART II SOCIAL PROBLEMS AND SOCIAL SERVICES

CHAPTER 4

Poverty and Public Welfare 107 The Problem of Poverty 108

A Brief History of Our Response to the Poor 108

The Rich and the Poor 111

St ev e Ha

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M on ke y Bu si ne ss

Im ag es /

Sh ut te rs to ck .c om

viii Contents

Defining Poverty Is a Policy Problem 114

Who Are the Poor? 115

Causes of Poverty 115

The Culture of Poverty 116

Functions of Poverty 117

Social Insurance Programs 118 Old Age, Survivors, Disability, and Health Insurance

(OASDHI) 118 Medicare 119 Unemployment Insurance 119 Workers’ Compensation Insurance 119

Public Assistance Programs 119 Supplemental Security Income 121 General Assistance 121 Medicaid 121 Supplemental Nutrition Program (SNAP) 122 Housing Assistance 122 Temporary Assistance to Needy Families 123 Family Allowance Program 125

Social Work and Public Welfare 126 Working with Discouraged People 126

Summary 127

Competency Notes 128

CHAPTER 5

Emotional/Behavioral Problems and Counseling 130 A Perspective on Emotional and Behavioral

Problems 131

Nature and Extent of Emotional and Behavioral Problems 131

What Is Mental Illness? 132 Medical Model 132 Interactional Model 135

Labeling as the Cause of Chronic “Mental Illness” 141

The Homeless 142

Civil Rights 143

Plea of Innocent by Reason of Insanity 144

Use of Psychotropic Drugs 145

Managed Mental Health Care 145 Managed Care and Evidence-Based Practice 146

Treatment 148 Brief History 148 Current Trends 149

Treatment Facilities: Community Mental Health Centers 150

Social Work and Mental Health 151

Counseling 152 How to Counsel 153 Comprehensive and Specialized Counseling

Approaches 157

Changing Unwanted Emotions 159 Meaningful Activity 159 Changing Self-Talk 159 Changing the Distressing Event 160 Destructive Ways of Dealing with Unwanted

Emotions 161

Counseling versus Therapy/Psychotherapy 161

Why Is Counseling/Psychotherapy Therapeutic? 164

Summary 165

Competency Notes 166

CHAPTER 6

Family Problems and Services to Families 168 Diverse Family Forms 169

The American Family: Past and Present 169 The Family in Preindustrial Society 169 The Family in Industrial Society 171

Divorce 172 Reasons for Marital Happiness 173 Divorce Laws 175

Empty-Shell Marriages 177 Marriage Counseling 178 Additional Marriage-Related Services 178

E Te is te r/ Bl ic kw

in ke l/A

ge Fo to st oc k

M ic ha el

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Contents ix

Family Violence 179 Spouse Abuse 180 Child Abuse and Neglect 182 Protective Services 186 Multidisciplinary Teams and Child Advocacy

Centers 189

Sexual Abuse of Children 193 Child Molestation 193 Incest 195

Births Outside of Marriage 197 Single-Parent Services 200 Foster Care and Adoption 202

Rape 203 Date Rape 207 Effects on Victims 209

Summary 211

Competency Notes 212

CHAPTER 7

Sexual Orientation, Gender Identity, and Services to Lesbian, Gay, Bisexual, Transgender, and Questioning (LGBTQ) Individuals 215 Dimensions of Sexuality 216

Biological Dimension 216 Gender Dimension 216 Sexual Orientation Dimension 216 Not a Problem but the Result of a Social Problem 216

A History of Oppression 219 Early Western Concepts of Homosexuality 219 Freudian Theories Regarding the Nature of

Homosexuality 220 The Emergence of a Homosexual Identity and

Community 221 World War II 221 The Gay Liberation Movement 223 Intersectionality of Oppression 226

The Coming Out Process 226 Being Out 227

Unveiling of Gay Identity 227 Postmodern Approaches to Coming Out 228

Practice Considerations for LGBTQ Persons 229 Lesbians 230 Gay Men 233 Bisexuals 236 Transgender Persons 238 Questioning Persons 242

How You, as a Social Work Student, Can Help 243 Start with Yourself 243 Make Social Work Organizations Welcoming 243 Work for Social Justice 244

Summary 244

Competency Notes 245

CHAPTER 8

Drug Abuse and Drug Treatment Programs 250 Drugs and Drug Abuse 251

A Brief History of Our Drug-Taking Society 252

Sociological Theories of Drug Abuse 253 Anomie Theory 253 Labeling Theory 253 Differential Association 254

Drug Subcultures 254

Facts about, and Effects of, Commonly Used Drugs 255 Depressants 255 Stimulants 264 Hallucinogens 267 Tobacco 268 Marijuana 269 Anabolic Steroids 270

Rehabilitation Programs 271 Alcohol Treatment Programs 271 Other Drug Treatment Programs 279 Understanding and Treating Codependency 281

Suggestions for Curbing Drug Abuse in the Future 281 Educational Programs 282

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