Is Social Work Still Racist? A Content Analysis of Recent Literature

Trauma-Informed Cultural Humility Mental Health Practice: Centering History among African American Women

Social work has made significant strides in providing mental health services. However, advancement in mental health practices grounded in social work values, such as trauma-informed care and cultural humility mental health practice (CHMHP), is still lacking. One possible reason is that many strategies overlook clients' historical contexts, particularly the collective history held by the community to which the client belongs. By centering "history" in social work practices, clinical social workers can be more equipped to provide high-quality, client-centered services. This article advocates for adopting trauma-informed CHMHP as a critical strategy to elevate history in clinical social work practice and proposes that trauma-informed CHMHP can improve mental health service quality among clients of color who are profoundly disrupted by historical trauma. Specifically, this article proposes that using trauma-informed CHMHP to address historical trauma can enhance mental health treatment outcomes and experiences for African American women. Clinical social workers trained to address these interconnected issues can help reduce disparities in quality treatment access.

From Gaslighting to Enlightening: Reproductive Justice as an Interdisciplinary Solution to Close the Health Gap

This conceptual article aims to inform social work educators on facilitating critical discourse among social work students by applying reproductive justice, leveraging interdisciplinary practice, and addressing the Social Work Grand Challenges. Reproductive justice tenets provide an interdisciplinary framework that assists in the development of the learning environment, participant's critical thinking, self-awareness, and self-regulation; preparing them for professional dialog and ethical decision making. This article will outline the tenets of reproductive justice, providing resources and tools for creating an environment that will assist in the facilitation of critical and professional conversations; while providing strategies that incorporate interdisciplinary partners into the classroom thus providing a reproductive justice sensitive analysis and solutions for approaching social issues that affect the people social workers serve.

From Colorblindness to Critical Investigations: Examining Structural Racism in Social Work Research

Current and persistent racialized inequalities in the United States raise important research questions investigating the social structures and systems that underlie racist outcomes. Consequently, social workers are called to centralize race and racism in their research agendas and utilize critical race theories and methodologies to examine institutional racism. This study investigates the extent to which critical race frameworks are utilized in mainstream social work research. The researchers conducted a content analysis of three top-ranked mainstream social work research journals (N = 407) to determine the extent to which critical race theories and methodologies are utilized for the investigation of institutional racism. Findings demonstrate a dearth of critical investigation into issues of race and racism in mainstream social work research as well as the underutilization of critical race frameworks. In conclusion, researchers argue for a critical shift in mainstream social work research through utilizing critical race theoretical frameworks and methodologies.

African-Centered Social Work in the 21st Century: A Content Analysis

Endorsement of African-centered theory and practice are widespread within Black communities across the United States. The usage of African-centered frameworks is also common among many Black social workers. However, past research suggests that African-centered theory and subsequent models of practice are marginalized within social work literature and curricula. Since advocacy began for the inclusion of African-centered approaches to practice during the mid to late 1990s, there have been no strategic analyses tracing how African-centered scholarship has advanced within social work. This study sought to examine to what extent the African-centered framework is included within scholarship among prominent social work journals. A content analysis was conducted of articles in six major social work journals published between 2000 and 2019. A total of 42 articles met the criteria for inclusion. While there has been a level of change in the number of published articles of African-centered social work, findings suggest that relative to other practice modalities/models, African-centered scholarship is noticeably lacking in social work literature. The article concludes with implications to advance culturally responsive research and practice with communities of African descent.

Just Research: Advancing Antiracist and Antioppressive Social Work Research

The Society for Social Work and Research (SSWR) created its Research Capacity and Development Committee in 2017 to build research capacity across the careers of social work scholars. The committee has initiated multiple conferences and webinar sessions that have increasingly focused on antiracist and antioppressive (ARAO) research, including "Mentorship for Antiracist and Inclusive Research" and "Strategies for Supporting Antiracist Pedagogy & Scholarship: Reimagining Institutional Systems & Structures." This commentary integrates themes from these sessions and other discussions among committee members about strategies to advance ARAO research. Although SSWR board members reviewed and approved this submission, it is not an official statement of SSWR or its board of directors.

Racial Injustice in Schools: Underscoring Social Work's Obligation to Promote Antiracist Practice

Children of color (COC) continue to have a range of disparate educational experiences that implicate structural and institutional racism as powerful, detrimental forces in P-12 schools. As members of a profession dedicated to empowerment and the dismantling of oppression, social workers are called to respond. Social workers work in and with schools in diverse roles (for example, as practitioners, community partners, organizational leaders, and contracted providers) and are ethically obligated to challenge injustice. This article-anchored in a framework focused on how race operates in schools and in the field of social work-considers the state of affairs for COC in schools, social work's professional and ethical obligations, and extant opportunities for social workers to learn to address structural racism. The authors identify a gap between COC experiences and social work candidates' preparation to respond, and therefore advocate for social work's more explicit commitment to antiracist practice, research, and pedagogy. The authors share examples from within and beyond the field of social work that can guide next steps, anticipate challenges that would arise, and assert the importance of pursuing antiracism as a route toward meeting our profession's ethical obligations. The article concludes with a discussion of implications for social work education, research, and practice.

High-level psychotropic polypharmacy: a retrospective comparison of children in foster care to their peers on Medicaid

BACKGROUND

The use of antipsychotic medication and psychotropic polypharmacy has increased in the United States over the last two decades especially for children from low-income families and those in foster care. Although attention has been paid to providing greater insight, prescribing patterns remain concerning since there is a lack of evidence related to safety and efficacy. High-level psychotropic polypharmacy has not been described. We aim to compare the use of HLPP for children receiving Medicaid services and those in foster care and identify factors associated with the duration of use of high-level psychotropic polypharmacy. Additionally, we will examine the frequency of laboratory metabolic screening and emergency department, inpatient, and outpatient visits.

METHODS

A cross-sectional, secondary analysis of statewide data describes trends in high-level psychotropic polypharmacy from 2012 to 2017 and the prevalence and predictors of high-level psychotropic polypharmacy duration and resource use in 2017 for all children on Medicaid and those in foster care. High-level psychotropic polypharmacy included concurrent use, at least four classes of medications including an antipsychotic, and at least 30 days duration.

RESULTS

High-level psychotropic polypharmacy increased from 2012 to 2014 for both groups but stabilized in 2015-2016. Children in foster care showed a slight increase compared to their peers in 2017. There was no association between duration and demographic characteristics or foster care status. Diagnoses predicted duration. Neither group received metabolic monitoring at an acceptable rate.

CONCLUSIONS

Concerning patterns of high-level psychotropic polypharmacy and metabolic monitoring were identified. Cautious use of high-level psychotropic polypharmacy and greater oversight to ensure that these children are receiving comprehensive services like behavioral health, primary care, and primary prevention.

Impaired Financial Decision-Making as an Early Indicator of Cognitive Decline: A Commentary

Cognitive impairment and dementia are public health concerns with significant financial implications for both individual households and public insurance systems. Though research has refined diagnostic tools for cognitive impairment and dementia diseases, little attention has focused on how cognitive decline may impact financial security. Research indicates that financial decision-making may be one of the first cognitive abilities impacted by cognitive decline, putting individuals at risk of financial fraud and exploitation. However, financial decision-making is not directly assessed in cognitive screenings. Identification of prodromal decline in financial decision-making may help individuals to preserve their financial security and reduce the likelihood of relying on public benefits. This commentary outlines the need for social workers and researchers to better understand the relationship between cognitive health, financial decision-making, and financial security in later life to formulate culturally responsive strategies that can uphold and benefit financial statuses, especially for minoritized communities.

Race and Ethnicity in the Social Work Grand Challenges

Race, ethnicity, and racism (RER) are interconnected with the critical problems tackled in the Grand Challenges for Social Work (GCSW). Yet, the extent to which the GCSW discuss the central role of RER is less clear. This article investigates how the GCSW integrate RER in their discourse. Using content analysis, authors examined all 21 concept papers that comprise the 12 initial GCSW to determine their attention to RER. Authors assessed whether each paper made any reference to race or ethnicity, whether race or ethnicity was considered as a primary theme, and whether racism was mentioned. Nine GCSW had at least one paper that mentioned race or ethnicity; seven had at least one paper that treated race and ethnicity as a major construct. Five GCSW contained at least one paper that discussed racism's impacts on their topical interests. None of the papers analyzed in the study defined or specified their conceptualization of racism. The GCSW are strategically positioned to widen and deepen social work's focus on RER, and the recent adoption of the 13th GCSW to "Eliminate racism" is an important first step. Authors encourage the social work field to embrace a more explicit, renewed, and continued commitment to eradicating systemic racism.

Preparing Social Workers to Confront Social Injustice and Oppression: Evaluating the Role of Social Work Education

Since the presidential election of 2016, bias-related incidents, hate-filled rhetoric, and extremist violence have been increasing in the United States. Because social workers are often working with individuals and communities affected by these incidents, practitioners may have increasing responsibility to confront social injustice and oppression. However, limited evidence on the preparedness of social workers to assume this responsibility, particularly among those who are still students, exists. To address this gap, this study used focus group and survey data from the Diversity and Oppression Scale to explore the preparedness of MSW students (N = 22) to confront oppression. Six themes were identified as integral to student experiences in their programs: (1) social worker responsibility to confront oppression, (2) use of dominant group discourse on oppression, (3) variation in faculty preparation and comfort, (4) a focus on knowledge of oppression versus skills and process, (5) role of personal responsibility and experience in student preparation, and (6) strategies to increase student preparedness to confront oppression. Factors identified to enhance students' level of preparedness include faculty opportunities for development, changes to the explicit and implicit curriculum, and creating a formalized way to integrate topics on oppression and diversity into all facets of the curriculum.

Faith as a Mechanism for Health Promotion among Rural African American Prostate Cancer Survivors: A Qualitative Examination

Conceptualized using critical race theory as a theoretical underpinning, this study analyzed the lived experiences of older, rural, African American male prostate cancer (hereafter referenced as PrCA) survivors' faith and health promotion practices within Northeast Louisiana. Qualitative data from journaling, observations, and semi-structured interviews were obtained from ten older, African American male PrCA survivors residing in four rural parishes of Louisiana. The data analysis employed a two-stage approach known as Polkinghorne's analysis of narratives and narrative analysis using an art-based methodological approach. Framed as composite character counterstories, survivors' narratives revealed how survivors made sense of and gave meaning to their PrCA diagnosis, treatment, recovery, and survivorship. Specifically, their counterstories indicate that centering and honoring the unique and often taken-for-granted perspectives of older, rural, African American male PrCA survivors offered a deeper understanding of the multiple factors influencing their quality of life, as well as the sociostructural mechanisms impacting their survivorship care. Faith was examined as both a secular and sacred source of support that these men viewed as central to the acceptance of their diagnosis, treatment, recovery, and survivorship.

Racial Disparities in Healthcare: How COVID-19 Ravaged One of the Wealthiest African American Counties in the United States

The COVID-19 pandemic swept the globe in January of 2020 causing mass panic and extreme hysteria. While pandemics are not new, COVID-19 is emerging as a public health crisis in nearly every household in America. In this paper, I discuss how COVID-19 has ravaged one of the wealthiest African American counties in the United States. Using Public Health Critical Race Praxis (PHCR) I seek to examine how disparities exist in health care and public funding is not equally distributed regardless of wealth and status for minoritized communities. Using PCHR's framework I highlight many of the disparities that exist in health care for people of color during this global health crisis and provide implications for improvement in federal, state, and local funding in communities of color. This article advances scholarship on the intersection between public health and social work particularly alluding to the need for increased advocacy for marginalized communities.

Former NICU Families Describe Gaps in Family-Centered Care

Care and outcomes of infants admitted to neonatal intensive care vary and differences in family-centered care may contribute. The objective of this study was to understand families' experiences of neonatal care within a framework of family-centered care. We conducted focus groups and interviews with 18 family members whose infants were cared for in California neonatal intensive care units (NICUs) using a grounded theory approach and centering the accounts of families of color and/or of low socioeconomic status. Families identified the following challenges that indicated a gap in mutual trust and power sharing: conflict with or lack of knowledge about social work; staff judgment of, or unwillingness to address barriers to family presence at bedside; need for nurse continuity and meaningful relationship with nurses and inconsistent access to translation services. These unmet needs for partnership in care or support were particularly experienced by parents of color or of low socioeconomic status.