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This paper discusses a doctoral level epistemology course in social work, the course design and the arts-based methods used to help students conceptualize and transform their ideas around epistemol...

The walk-in counselling (WIC) model of service delivery has been found to reduce psychological distress more quickly than a traditional model of service delivery involving a wait list. A question r...

An increasing number of family service agencies and community-based mental health service providers are implementing a single-session walk-in counselling (SSWIC) as an alternative to traditional counselling. However, few economic evaluations have been undertaken.To conduct a cost-effectiveness analysis of two models of service delivery, SSWIC compared to being waitlisted for traditional counselling.A quasi-experimental design was employed. Data were collected from two community-based Family Service Agencies, one using SSWIC and one using traditional counselling. Participants were assessed at baseline and four weeks after the baseline. Cost-effectiveness was estimated from the societal and payer's perspective.The societal and payer's costs for SSWIC were higher than for those waiting for traditional counselling, and health outcomes were better. SSWIC is not cost-effective compared to being on the waitlist for traditional counselling (or, for a few patients, having received counselling, but after a wait of several weeks).SSWIC has the potential to reduce the pressure on the mental health care system by reducing emergency visits and wait lists for ongoing mental health services and eliminating costly-no shows at counselling appointments. Long-term studies involving multiple walk-in counselling services and comparison services are needed to support the findings of this study.

Dominant discourses around grieving processes describe a progression that is time-limited. Others challenge this conception suggesting that grieving processes evolve and are ongoing. Some people subscribe to cutting ties with the deceased and moving on, while others encourage continuing attachments with the deceased for solace. This paper explores the case of a 14-year-old boy hospitalized for suicidal ideation. In the past four years both his father and grandfather have died and his brother has moved away to college. The denial of death culture in the hospital is explored. Traditional psychoanalytic/developmental models are discussed and how they can distort understanding of the adolescent grieving process. Political implications of psychotherapy including alternative approaches to practice are discussed.

Single-session therapy (SST) delivered in walk-in counseling clinics is dramatically increasing in Ontario; however, studies of the clinical effectiveness of SST are few, and those that exist are limited by weak research designs. The pilot study reported here had two objectives: 1) to learn more about the clinical effectiveness of SST as delivered in a walk-in counseling clinic and 2) to better understand how the quality of research on this model of service delivery can be improved. We measured psychological distress, stage of change as posited by the Transtheoretical Model of Change (TTM), recent use of health and social services, and recent ability to work and undertake normal activities in a sample of clients attending the KW Counselling Services walk-in counseling clinic in Kitchener-Waterloo, Ontario. Follow-up data, although limited by a low response rate, suggest that clients show a decrease in distress, improvement in general functioning, and decreased use of health services one month and four mon...

While two people, the social worker and client, might physically sit in therapy there can be invisible presences that influence the therapeutic process. Psychoanalytic relational theory and the concept of the “analytic third” will be used in case discussion to examine the presence of the organization, the social worker's and client's relationship to the organization, and conflicts that exist. Understanding agency context, the role social workers play and pressures they feel can support therapists to be mindful practitioners. Implications for social work practice and education will be discussed.

Relationship building is critical in case management with the seriously mentally ill. A theoretical framework, such as relational psychoanalytic theory, with a strong integrative emphasis provides a structure for the complex interplay of internal and external factors/forces in case management. The purpose of this paper is to provide a literature review in the area of case management: relational psychoanalytic theory, relationship building and psychodynamic theory. The review concludes outlining the appropriateness of this theoretical framework for case management.

This article is a report of research that explored how the death of a parent influences a woman's identity development. Qualitative methodology and data analysis procedures based on grounded theory were used for the research. Eighteen women who experienced parental death between age 11 and 17, were recruited by convenience sampling. Shifts in family relationships and roles, in part, influenced who these young women became. Many young women were expected to take on a caregiving role to support the surviving parent and replace the deceased. The transition in the relationship between the adolescent girl and surviving parent was an important theme for identity development.

Given two million deaths annually in the U. S., social work education and training have been cited as woefully inadequate in end-of-life care. In response, two of the authors developed two post-Masters programs in end-of-life care for social work. This paper describes their curricula and the methods used to evaluate both programs, including measurements of the participants' self-efficacy before and after the programs. The analysis of evaluative data from the classroom and first-year field experiences of each program shows that participants increased their levels of skill, knowledge, values, and self-efficacy.

This article is based on a larger research study that focused on how an adolescent girl's identity development is influenced by the death of a parent. A sample of 18 women was recruited for the study. This article highlights the transformation of these women's spiritual and religious beliefs as part of their identity development following the death of their parents. The different pathways the women took with respect to their views on religion and spirituality are exemplified in what follows, highlighting themes of struggle and connection.

This is a report of a qualitative analysis of a sample of bereaved families in which one parent died and in which children scored in the clinical range on the Child Behavior Check List. The purpose of this analysis was to learn more about the lives of these children. They were considered to be at risk of developing emotional and behavioral problems associated with the death. We discovered that many of these “high risk” children had a continuing bond with the deceased that was primarily negative and troubling for them in contrast to a comparison group of children not at risk from the same study. Five types of legacies, not mutually exclusive, were identified: health related, role related, personal qualities, legacy of blame, and an emotional legacy. Coping behavior on the part of the surviving parent seemed to make a difference in whether or not a legacy was experienced as negative.

A significant increase in the number of walk-in counselling clinics offering single-session therapy (SST) prompted this review of the empirical support for the effectiveness of SST.The article is intended to (1) increase practitioners' knowledge of the empirical support for the effectiveness of single-session counselling with client populations typically served in community-based mental health and counselling agencies and (2) identify priorities for future research on SST.A thorough review of relevant databases was undertaken to locate published studies reporting client outcomes following SST. The focus of the review is research involving clients and presenting problems typically seen in community-based mental health and family counselling agencies.The findings suggest that the majority of clients attending either previously scheduled or walk-in SST find it sufficient and helpful. The studies imply that this model of service delivery leads to perceived improvement in presenting problems in general, and on specific measures of variables such as depression, anxiety, distress level and confidence in parenting skills.Many of the studies have methodological limitations, and future research requires increased use of standardized measures, control groups and larger and more diverse samples.

Introducing single-session walk-in counselling services in a counselling agency virtually eliminated a lengthy wait list and reduced costly no-shows for scheduled counselling. A pilot study found that client distress decreased significantly following the single session, and a high proportion of clients were "ready for change." The service diverts clients from using hospitals and family doctors/walk-in clinics and toward using community social services. It also enables an earlier return to work and usual activities. The social benefits (reduced hospital use and faster return to work) exceed the cost of the service. This information is helping to make the case for sustaining and expanding these services.