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Competency 7—Assess Individuals, Families, Groups, Organizations, and Communities. Social workers

collect and organize data, and apply critical thinking to interpret information from clients and constituencies; 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; develop mutually agreed-on intervention goals and objectives based on the critical assessment of strengths, needs, and challenges within clients and constituencies; and 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. Social workers

critically choose and implement interventions to achieve practice goals and enhance capacities of clients and constituencies; apply knowledge of human behavior and the social environment, person-in-environment, and other multidisciplinary theoretical frameworks in interventions with clients and constituencies; use interprofessional collaboration as appropriate to achieve beneficial practice outcomes; negotiate, mediate, and advocate with and on behalf of diverse clients and constituencies; and facilitate effective transitions and endings that advance mutually agreed-on goals.

Competency 9—Evaluate Practice with Individuals, Families, Groups, Organizations, and Communities. Social workers

select and use appropriate methods for evaluation of outcomes; apply knowledge of human behavior and the social environment, person-in-environment, and other multidisciplinary theoretical frameworks in the evaluation of outcomes; critically analyze, monitor, and evaluate intervention and program processes and outcomes; and

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

Dimensions of Human Behavior: Person and Environment and Social Work Core Competencies

Chapter Ethical and Professional Behavior

Engage Diversity and Difference

Human Rights and Justice

Research and Practice

Policy Practice

Social Work Engagement

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Dimensions of Human Behavior Sixth Edition

To all the advocates working for economic, social, and environmental justice in the United States and around the world. You are a constant inspiration for me, and your stories have warmed my heart and given me hope as I worked on this book in times when hope often seemed fragile.

Dimensions of Human Behavior Person and Environment

Sixth Edition

Elizabeth D. Hutchison Emeritus Virginia Commonwealth University

and contributing authors

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Library of Congress Cataloging-in-Publication Data

Names: Hutchison, Elizabeth D., author.

Title: Dimensions of human behavior : person and environment / Elizabeth D. Hutchison, Virginia Commonwealth University, USA.

Description: Sixth Edition. | Thousand Oaks : SAGE Publications, [2018] |Revised edition of the author’s Dimensions of human behavior, [2015] |

Includes bibliographical references and index.

Identifiers: LCCN 2018015527 | ISBN 9781544339290 (pbk. : alk. paper)

Subjects: LCSH: Social psychology. | Human behavior. | Social structure. | Social service.

Classification: LCC HM1033 .D56 2018 | DDC 302—dc23 LC record available at https://lccn.loc.gov/2018015527

This book is printed on acid-free paper.

Acquisitions Editor: Joshua Perigo

Content Development Editor: Sarah Dillard

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Proofreader: Rae-Ann Goodwin

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https://lccn.loc.gov/2018015527

Brief Contents 1. Case Studies 2. Preface 3. Acknowledgments 4. PART I A MULTIDIMENSIONAL APPROACH FOR

MULTIFACETED SOCIAL WORK 1. • Chapter 1 Human Behavior: A Multidimensional Approach 2. • Chapter 2 Theoretical Perspectives on Human Behavior

5. PART II THE MULTIPLE DIMENSIONS OF PERSON 1. • Chapter 3 The Biological Person 2. • Chapter 4 The Psychological Person: Cognition, Emotion, and

Self 3. • Chapter 5 The Psychosocial Person: Relationships, Stress, and

Coping 4. • Chapter 6 The Spiritual Person

6. PART III THE MULTIPLE DIMENSIONS OF ENVIRONMENT 1. • Chapter 7 The Physical Environment 2. • Chapter 8 Cultures 3. • Chapter 9 Social Structure and Social Institutions: Global and

National 4. • Chapter 10 Families 5. • Chapter 11 Small Groups 6. • Chapter 12 Formal Organizations 7. • Chapter 13 Communities 8. • Chapter 14 Social Movements

7. Glossary 8. References 9. Index

10. About the Author 11. About the Contributors

Detailed Contents Case Studies Preface Acknowledgments PART I A MULTIDIMENSIONAL APPROACH FOR MULTIFACETED SOCIAL WORK

Chapter 1 Human Behavior: A Multidimensional Approach Chapter Outline Learning Objectives

• Case Study 1.1: Joshua, Making a New Life Human Behavior: Individual and Collective A Multidimensional Approach

Personal Dimensions Environmental Dimensions Time Dimensions

Diversity, Inequality, and the Pursuit of Social Justice: A Global Perspective

Diversity Inequality Advancing Human Rights and Social, Economic, and Environmental Justice

Knowing and Doing Knowledge About the Case Knowledge About the Self Values and Ethics

Scientific Knowledge: Theory and Research Theory Empirical Research Critical Use of Theory and Research

Organization of the Book Implications for Social Work Practice Key Terms Active Learning Web Resources

Chapter 2 Theoretical Perspectives on Human Behavior Chapter Outline Learning Objectives

• Case Study 2.1: End of Life Care for Maria Chavez Multiple Perspectives for a Multidimensional Approach Systems Perspective Conflict Perspective Exchange and Choice Perspective Social Constructionist Perspective Psychodynamic Perspective Developmental Perspective Behavioral Perspective Humanistic Perspective The Merits of Multiple Perspectives Implications for Social Work Practice Key Terms Active Learning Web Resources

PART II THE MULTIPLE DIMENSIONS OF PERSON Chapter 3 The Biological Person

Chapter Outline Learning Objectives

• Case Study 3.1: Cheryl’s Legs and Head • Case Study 3.2: A Diabetes Diagnosis for Jenna • Case Study 3.3: Melissa’s HIV Diagnosis • Case Study 3.4: HIV, Thomas’s Hero • Case Study 3.5: Louise and Stewart, Huntington’s, Obesity, and Cardiovascular Disease • Case Study 3.6: Juan and Belinda’s Sexual Life in Retirement

An Integrative Approach for Understanding the Intersection of Interior Biological Health and Illness and Exterior Environmental Factors Systems Taxonomy: Six Interior Environment Systems

Nervous System Endocrine System Immune System Cardiovascular System Musculoskeletal System Reproductive System

Heredity, Genetics, and the Reproductive System Ecobiodevelopmental Framework to Understand the Relationship Between Interior Health and Exterior

Environments Implications for Social Work Practice Key Terms Active Learning Web Resources

Chapter 4 The Psychological Person: Cognition, Emotion, and Self

Chapter Outline Learning Objectives

• Case Study 4.1: The Premed Student Cognition and Emotion Theories of Cognition

Cognitive Theory Information Processing Theory Social Learning Theory Theory of Multiple Intelligences Theories of Moral Reasoning Theories of Cognition in Social Work Practice

Theories of Emotion Physiological Theories of Emotion Psychological Theories of Emotion

Psychoanalytic Theory Ego Psychology Attribution Theory: A Cognitive Perspective Theory of Emotional Intelligence

Social Theories of Emotion Theories of Emotion in Social Work Practice

Cognitive/Emotional “Disorders” The Self

The Self as a Soul The Self as Unfolding Potentials The Self as Organizing Activity The Self as Cognitive Structure The Self as Shared Symbolic Experience The Self as a Flow of Experience

Implications for Social Work Practice Key Terms Active Learning Web Resources

Chapter 5 The Psychosocial Person: Relationships, Stress, and

Coping Chapter Outline Learning Objectives

• Case Study 5.1: Dan’s Coping Strategies The Self in Relationships

Relational Theory Attachment Theory Impact of Early Nurturing on Development Feminist Theories of Relationships Social Identity Theory

The Concept of Stress Categories of Stress Stress and Crisis Traumatic Stress Vulnerability to Stress

Coping and Adaptation Biological Coping Psychological Coping Coping Styles Coping and Traumatic Stress Social Support

Virtual Support How Social Support Aids Coping How Social Workers Evaluate Social Support

Normal and Abnormal Coping The Medical (Psychiatric) Perspective Psychological Perspectives The Sociological Approach: Deviance The Social Work Perspective: Social Functioning

Implications for Social Work Practice Key Terms Active Learning Web Resources

Chapter 6 The Spiritual Person Chapter Outline Learning Objectives

• Case Study 6.1: Caroline’s Challenging Questions • Case Study 6.2: Naomi’s Health Crisis • Case Study 6.3: Matthew’s Faith Journey • Case Study 6.4: Trudy’s Search for the Sacred

• Case Study 6.5: Leon’s Two Worlds • Case Study 6.6: Jean-Joseph’s Serving the Spirits • Case Study 6.7: Amira’s Quest for Self • Case Study 6.8: Beth’s Framework for Living

The Spiritual Dimension The Meaning of Spirituality Spirituality in the United States and Globally

Theories of Spiritual Development Fowler’s Stages of Faith Development Transpersonal Theory Wilber’s Integral Theory of Consciousness Summary and Critique of Fowler’s and Wilber’s Theories

The Role of Spirituality in Social Work Spirituality and Human Diversity

Race and Ethnicity Sex and Gender Sexual Orientation Other Aspects of Diversity

Spirituality and the Human Experience Problems in Living Individual and Collective Well-Being

Spiritual Assessment Implications for Social Work Practice Key Terms Active Learning Web Resources

PART III THE MULTIPLE DIMENSIONS OF ENVIRONMENT Chapter 7 The Physical Environment

Chapter Outline Learning Objectives

• Case Study 7.1: Ben Watson’s Changing Experience With the Physical Environment

Theories of Human Behavior and the Physical Environment Stimulation Theories Control Theories

Privacy Personal Space Territoriality Crowding

Behavior Settings Theories Ecocritical Theories

The Natural Environment Benefits and Costs of Human Interaction With the Natural Environment Environmental and Ecological Justice

The Built Environment Technology Healing Environments Urban Design and Health

Place Attachment Homelessness Accessible Environments for Persons With Disabilities Implications for Social Work Practice Key Terms Active Learning Web Resources

Chapter 8 Cultures Chapter Outline Learning Objectives

• Case Study 8.1: Rubina Living Across Cultures What Is Culture? Theories of Culture

Materialistic Perspective Mentalist Perspective Other Theoretical Perspectives

Major Concepts in the Study of Culture Values Ideology Symbols Language Norms Subcultures and Countercultures Ideal Culture Versus Real Culture

Ethnocentrism and Cultural Relativism Culture and Power

Race Ethnicity Gender Sexuality

Social Class Disability

Genes and Culture Digital Culture How Culture Changes Implications for Social Work Practice Key Terms Active Learning Web Resources

Chapter 9 Social Structure and Social Institutions: Global and National

Chapter Outline Learning Objectives

• Case Study 9.1: Leticia Renteria’s Struggle to Make It in the United States

Patterns of Social Life Contemporary Trends in Global and U.S. Social Institutions

Trends in the Government and Political Institution Trends in the Economic Institution Trends in the Educational Institution Trends in the Health Care Institution Trends in the Social Welfare Institution Trends in the Religious Institution Trends in the Mass Media Institution Trends in the Family and Kinship Institution

Theories of Social Inequality Classical Sociological Theories of Social Inequality The Contemporary Debate Structural Determinism Versus Human Agency

Implications for Social Work Practice Key Terms Active Learning Web Resources

Chapter 10 Families Chapter Outline Learning Objectives

• Case Study 10.1: The Sharpe Family’s Deployment Adjustments

Family Defined The Family in Historical Perspective

Theoretical Perspectives for Understanding Families Family Systems Perspective Exchange and Choice Perspective on Families Symbolic Interaction Perspective on Families Feminist Perspective on Families Life Course Developmental Perspective on Families Family Stress, Coping, and Resilience Perspective

Diversity in Family Life Diversity in Family Structures

Nuclear Families Extended Families Cohabiting Opposite-Sex Couples Couples With No Children Lone-Parent Families Stepfamilies Same-Sex Partner Families Military Families

Economic and Cultural Diversity Economic Diversity Cultural Diversity Immigrant Families

Challenges to Family Life Family Violence Divorce and Relationship Dissolution Substance Abuse

Implications for Social Work Practice Key Terms Active Learning Web Resources

Chapter 11 Small Groups Chapter Outline Learning Objectives

• Case Study 11.1: The Sexuality and Gender Group at a Women’s Residential Substance Abuse Treatment Facility

Small Groups in Social Work Therapy Groups Mutual Aid Groups Psychoeducational Groups Self-Help Groups

Task Groups Virtual Groups

Dimensions of Group Structure Group Composition

Heterogeneity Versus Homogeneity Homogeneity/Heterogeneity in Group Composition: Social Justice Issues

Basic Group Processes Theories of Group Processes

Psychodynamic Theory Symbolic Interaction Theory Status Characteristics and Expectation States Theory Exchange Theory Self-Categorization Theory

Group Development Stage Theories and Models Process Models

Group Dynamics Formal and Informal Leadership Formal and Informal Roles Communication Networks Group Cohesiveness

Interdisciplinary Teams and Leadership Interdisciplinary Teams and Social Work The Social Worker’s Role on Interdisciplinary Teams Social Workers and Leadership

Implications for Social Work Practice Key Terms Active Learning Web Resources

Chapter 12 Formal Organizations Chapter Outline Learning Objectives

• Case Study 12.1: Changing Leadership, Changing Times at Beacon Center

A Definition of Formal Organizations Perspectives on Formal Organizations

Rational Perspective The Ideal-Type Bureaucracy

Scientific Management Human Relations Theory Management by Objectives (MBO) Decision-Making Theory

Systems Perspective Political Economy Model Institutional Theory of Organizations Learning Organization Theory

Interactional/Interpretive Perspective Organizational Culture Model Managing Diversity Model Appreciative Inquiry Model of Organizational Change

Critical Perspective Theory of Gendered Organizations Organizations as Multiple Oppressions Nonhierarchical Organizations

Burnout: A Negative Organizational Outcome Social Work and Formal Organizations

Technology and Social Service Organizations Social Work Leadership in Formal Organizations Culturally Sensitive Care Systems Implications for Social Work Practice Key Terms Active Learning Web Resources

Chapter 13 Communities Chapter Outline Learning Objectives

• Case Study 13.1: A Rural West Virginia Community Struggles to Recover • Case Study 13.2: An Evolving Online Support Community

A Definition of Community Territorial Community and Relational Community Social Workers and Communities: Our History Theoretical Approaches to Community

Contrasting Types Approach Spatial Arrangements Approach Social Systems Approach

Social Capital Approach Conflict Approach

Social Workers and Communities: Contemporary Issues Community as Context for Practice Versus Target of Practice Agency Orientation Versus Social Action Conflict Model of Practice Versus Collaborative Model Expert Versus Partner in the Social Change Process

Implications for Social Work Practice Key Terms Active Learning Web Resources

Chapter 14 Social Movements Chapter Outline Learning Objectives

• Case Study 14.1: Fighting for Our Water, Land, and Air

A Definition of Social Movements Social Movements and the History of Social Work Perspectives on Social Movements

Political Process Perspective Openness of the Political System Stability of Political Alignments Availability of Elite Allies International Relations

Mobilizing Structures Perspective Informal and Formal Structures Information and Communication Technology (ICT) The Life Course of Social Movements

Cultural Framing Perspective Frames for Understanding That a Problem Exists Frames for Recognizing a Window of Opportunity Frames for Establishing Goals Frames for Identifying Pathways for Action

Emerging Perspectives Social Movement Outcomes Social Movement Trends

Social Movements and Contemporary Social Work Implications for Social Work Practice Key Terms Active Learning Web Resources

Glossary References Index About the Author About the Contributors

Case Studies

Chapter Case Case Information Page

1. Human Behavior: A Multidimensional Approach

1.1 Joshua, Making a New Life

20-something male refugee from the Democratic Republic of Congo

2. Theoretical Perspectives on Human Behavior

2.1 End of Life Care for Maria Chavez

92-year-old female in hospice care, living with 65-year-old daughter in midsize southwestern city, some family conflict

3. The Biological Person

3.1 Cheryl’s Legs and Head

20-something female, rural Idaho, military, leg amputation, brain injury

3.2 A Diabetes Diagnosis for Jenna

12-year-old Franco American girl, rural Maine, type 1 diabetes

3.3 Melissa’s HIV Diagnosis

Young-adult female, urban professional, HIV diagnosis, reproductive issues

3.4 HIV, Thomas’s Hero

6-year-old boy, diagnosed with leukemia at age 3, experimental treatment with HIV virus

3.5 Louise and Stewart, Huntington’s, Obesity, and Cardiovascular Disease

81-year-old Jewish woman with Huntington’s disease, Haitian caregiver, sudden death of husband, caregiving decisions

3.6 Juan and Belinda’s Sexual Life in Retirement

67-year-old Mexican American couple, both widowed in former relationships, getting reacquainted and considering a sexual relationship

4. The Psychological Person

4.1 The Premed Student

24-year-old Chinese American male undergraduate student working toward admission to medical school; comes to university counseling center reporting anxiety, sadness, and anger

108

5. The Psychosocial Person

5.1 Dan’s Coping Strategies

24-year-old Chinese American male undergraduate student working toward admission to medical school; comes to university counseling center reporting anxiety, sadness, and anger

131

Late-adolescent female,

6. The Spiritual Person

6.1 Caroline’s Challenging Questions

Baptist, from North Carolina, first year in university, first time encountering people from faiths other than Christianity

160

6.2 Naomi’s Health Crisis

42-year-old female, member of Reform Jewish congregation, breast cancer

160

6.3 Matthew’s Faith Journey

70-year-old male, widower, Catholic, active in outreach and interfaith dialogue

161

6.4 Trudy’s Search for the Sacred

35-year-old female, geographical relocation from small town in Arkansas to urban California, Buddhist

161

6.5 Leon’s Two Worlds

23-year-old male, gay, African Methodist Episcopal Church

162

6.6 Jean- Joseph’s Serving the Spirits

50-year-old male, originally from Haiti, Catholic and believer in Vodoun

162

6.7 Amira’s Quest for Self

22-year-old Pakistani American female, intergenerational struggles over culture and religion

163

20-something female

6.8 Beth’s Framework for Living

20-something female union organizer, raised with a strong code of ethics not based in religion

164

7. The Physical Environment

7.1 Ben Watson’s Changing Experience With the Physical Environment

20-something male, spinal cord injury 197

8. Cultures 8.1 Rubina Living Across Cultures

22-year-old Pakistani American female, mental health issues, intergenerational struggles over gender roles and religion

229

9. Social Structure and Social Institutions

9.1 Leticia Renteria’s Struggle to Make It in the United States

30-year-old married mother of three young children, living in Coachella Valley of California, undocumented immigrant from Mexicali, Mexico, impoverished seasonal laborer

262

10. Families

10.1 The Sharpe Family’s Deployment Adjustments

Four-generation African American family, small southwestern town, father deployed to both Iraq and Afghanistan in past decade, issues of deployment adjustment

300

11. Small Groups

11.1 The Sexuality and Gender Group at a Women’s Residential Substance Abuse Treatment Facility

Support group for lesbian, bisexual, questioning, and transgender women in a residential substance abuse treatment facility

344

12. Formal Organizations

12.1 Changing Leadership, Changing Times at Beacon Center

Different styles of leadership over time in a homeless advocacy and service organization in a midsize midwestern city

372

13. Communities

13.1 A Rural West Virginia Community Struggles to Recover

A community in rural West Virginia struggles to recover from economic, natural disaster, and opioid addiction crises

402

13.2 An Evolving Online Support Community

Online support community Parents of Suicide (POS) evolves

403

14. Social Movements

14.1 Fighting for Our Water, Land, and Air

Evolving story of the environmental justice movement

428

Preface

In the preface to the first edition of this book, I noted that I have always been intrigued with human behavior. I didn’t know any social workers when I was growing up—or even that there was a social work profession —but I felt an immediate connection to social work and social workers during my junior year in college when I enrolled in an elective titled Introduction to Social Work and Social Welfare. What attracted me most was the approach social workers take to understanding human behavior. I was a sociology major, minoring in psychology, and it seemed that each of these disciplines—as well as disciplines such as economics, political science, and ethics—added pieces to the puzzle of human behavior; that is, they each provided new ways to think about the complexities of human behavior. Unfortunately, it wasn’t until several years later when I was a hospital social worker that I began to wish I had been a bit more attentive to my coursework in biology, because that discipline increasingly holds other pieces of the puzzle of human behavior. But when I sat in that Introduction to Social Work and Social Welfare course, it seemed that the pieces of the puzzle were coming together. I was inspired by the optimism about creating a more humane world, and I was impressed with an approach to human behavior that clearly cut across disciplinary lines.

Just out of college, amid the tumultuous societal changes of the late 1960s, I became an MSW student. I began to recognize the challenge of developing the holistic understanding of human behavior that has been the enduring signature of social work. I also was introduced to the tensions in social work education, contrasting breadth of knowledge versus depth of knowledge. I found that I was unprepared for the intensity of the struggle to apply what I was learning about general patterns of human behavior to the complex, unique situations that I encountered in the field. I was surprised to find that being a social worker meant learning to understand my own behavior, as well as the behavior of others.

Since completing my MSW, I have provided services in a variety of social work settings, including a hospital, nursing homes, state mental health and mental retardation institutions, a community mental health center, a school-based program, public child welfare programs, and a city jail. Sometimes the target of change was an individual, and other times the

focus was on bringing about changes in dyadic or family relationships, communities, organizations, or social institutions. I have also performed a variety of social work roles, including case manager, therapist, teacher, advocate, group facilitator, consultant, collaborator, program planner, administrator, and researcher. I love the diversity of social work settings and the multiple roles of practice. My varied experiences strengthened my commitment to the pursuit of social justice, enhanced my fascination with human behavior, and reinforced my belief in the need to understand human behavior holistically.

For almost 30 years, I taught courses such as Human Behavior in the Social Environment to undergraduate students, MSW students, and doctoral students. The students and I struggled with the same challenges I encountered as a social work student in the late 1960s: the daunting task of developing a holistic understanding of human behavior, the issue of breadth versus depth of knowledge, and discovering how to use general knowledge about human behavior in unique practice situations. Increasingly, over time, my students and I also recognized a need to learn more about human and social diversity, and to build a knowledge base that provided tools for promoting social justice. My experiences as student, practitioner, and teacher of human behavior led me to write this book.

Multidimensional Understanding of Human Behavior Social work has historically used the idea of person-in-environment, or person and environment, to develop a multidimensional understanding of human behavior. The idea that human behavior is multidimensional has become popular with most social and behavioral science disciplines. Recently, we have recognized the need to add the aspect of time to the person–environment construct, to capture the dynamic, changing nature of person-in-environment.

The purpose of this book is to help you to breathe life into the abstract idea of person-in-environment. As I did in the first five editions, I identify relevant dimensions of both person and environment, and my colleagues and I present up-to-date reports on theory and research about each of these dimensions. All the while, we encourage you to link the micro world of personal experience with the macro world of social trends—to recognize

the unity of person and environment. We help you make this connection by showing how several of the same theories have been used to understand dimensions of both person and environment. A companion volume to this book, The Changing Life Course, builds on the multiple dimensions of person and environment analyzed in this book and demonstrates how they work together with the dimension of time to produce patterns in unique life course journeys.

Breadth Versus Depth The most difficult challenge I have faced as a student and teacher of human behavior is to develop a broad, multidimensional approach to human behavior without an unacceptable sacrifice of depth. It is indeed a formidable task to build a knowledge base both wide and deep. After years of struggle, I have reluctantly concluded that although both breadth and depth are necessary, it is better for social work to err on the side of breadth. Let me tell you why.

Social workers are doers; we use what we know to tell us what to do. If we have a narrow band of knowledge, no matter how impressive it is in its depth, we will “understand” the practice situations we encounter from this perspective. This can lead us to use the same solutions for all situations, rather than to tailor solutions to the unique situations we encounter. The risk and resilience literature suggests that human behavior is influenced by the many risk factors and protective factors that exist in the multiple dimensions of contemporary social arrangements. What we need is a multidimensional knowledge base that allows us to scan widely for, and think critically about, risk factors and protective factors and to craft multipronged intervention programs to reduce risks and strengthen protective factors.

To reflect recent developments in the social and behavioral sciences, this book introduces dimensions of human behavior not covered in similar texts. Chapters on the biological and spiritual dimensions of person, the physical environment, social institutions, and social movements provide important insights into human behavior not usually covered in social work texts. In addition, we provide up-to-date information on the typically identified dimensions of human behavior.

General Knowledge and Unique Situations The purpose of the social and behavioral sciences is to help us understand general patterns in person–environment transactions. The purpose of social work assessment is to understand unique configurations of person and environment dimensions. Those who practice social work must interweave what they know about unique situations with general knowledge. To assist you in this process, as we did in the first five editions, we begin each chapter with one or more case studies, which we then interweave with contemporary theory and research. Most of the stories are composite cases and do not correspond to actual people and social groups known to the authors. In this sixth edition, we continue to expand on our efforts in the last five editions to call more attention to the successes and failures of theory and research to accommodate human diversity related to gender and gender identity, class, race and ethnicity, culture, sexual orientation, and disability. More important, we have extended our attention to diversity by being very intentional in our effort to provide a global context for understanding person–environment transactions. The attention to the global world continues to be expanded in this edition. The most significant changes in this sixth edition are the greatly increased content on the impact of new technologies on all dimensions of the person and environment, increased content on neurobiology, and increased content on environmental justice. New technologies are driving change at all levels, neurobiological research is filling in missing details in our understanding of human behavior, and social justice cannot be advanced without environmental justice.

About This Book The task of developing a solid knowledge base for doing social work can seem overwhelming. For me, it is an exciting journey, because I am learning about my own behavior as well as the behavior of others. I love it that knowledge development and cultural change are happening at such a fast clip that I learn something new every day about the influences on human behavior. What I learn enriches my personal life as well as my professional life. My colleagues and I wanted to write a book that gives you a state-of-the-art knowledge base, but we also wanted to make learning an exciting adventure for you. We have tried to write as we teach, with enthusiasm for the content and a desire to connect with your process

of learning. We continue to use some special features that we hope will aid your learning process. As in the first five editions, key terms are presented in bold type in the chapters and defined in the Glossary. Critical thinking questions are presented throughout all chapters. Active learning exercises are presented at the end of each chapter. Learning objectives are new to this edition.

The bulk of this sixth edition will be familiar to instructors who used earlier editions of Dimensions of Human Behavior: Person and Environment. Many of the changes that are included came at the suggestion of instructors and students who have been using the fifth edition. To respond to the rapidity of changes in complex societies, all chapters have been comprehensively updated. As the contributing authors and I worked to revise the book, we were once again surprised to learn how much the knowledge base had changed since we worked on the previous edition. We did not experience such major change between the first four editions, and this led us to agree with the futurists who say that we are at a point where the rate of cultural change will continue to accelerate rapidly. You will want to use the many wonders of the World Wide Web to update information you suspect is outdated.

New in This Edition The more substantial revisions for this edition include the following:

Learning objectives have been added to each chapter. Even more content has been added on human diversity in all its forms. Content on the impact of the new information, communication, and medical technologies on person and environment continues to be updated and expanded. Consistency with Council on Social Work Education (CSWE) curriculum guidelines is explicated where appropriate. To assist visual learners grasp the abstract concepts of human behavior theories, new visual metaphors are used in Chapter 2 to represent the major theoretical perspectives used in the book. The chapter on the biological person takes a much more integrative approach to examine biological systems. Content on neuroscience continues to be expanded and updated. Content on trauma is expanded in several chapters.

New content on the impact of the physical environment on human behavior has been added throughout. New content on environmental and ecological justice has been added to the chapters on the physical environment and social movements, and woven into other chapters as well. The chapter on cultures has been completely rewritten with greater emphasis on how the dynamics of power are embedded in culture. A new approach to organizing family theories is presented. New organizational theories are presented. Some new exhibits have been added and others updated. Twelve new case studies have been added to reflect contemporary issues. Web resources have been updated.

Digital Resources

edge.sagepub.com/hutchisonpe6e

SAGE edge offers a robust online environment featuring an impressive array of free tools and resources for review, study, and further exploration, keeping both instructors and students on the cutting edge of teaching and learning.

SAGE edge for Students provides a personalized approach to help you accomplish your coursework goals in an easy-to-use learning environment.

Mobile-friendly eFlashcards and quizzes strengthen your understanding of key terms and concepts Learning objectives reinforce the most important material Video and multimedia links that appeal to students with different learning styles. EXCLUSIVE! Access to full-text SAGE journal articles that have been carefully chosen to support and expand on the concepts presented in each chapter

SAGE edge for Instructors supports your teaching by making it easy to integrate quality content and create a rich learning environment for students. SAGE edge includes the following:

Test banks with a diverse range of pre-written and editable options,

http://edge.sagepub.com/hutchisonpe6e

helping you assess students’ progress and understanding Sample course syllabi for semester and quarter courses assist in structuring your course Editable, chapter-specific PowerPoint® slides offering you flexibility in creating multimedia presentations Case study-specific discussion questions help launch classroom interaction by prompting students to engage with the material and by reinforcing important content. EXCLUSIVE! Access to carefully selected SAGE journal articles that support and expand concepts presented in each chapter Lecture notes summarizing key concepts by chapter to aid in preparing lectures

One Last Word I imagine that you, like me, are intrigued with human behavior. That is probably a part of what attracted you to social work. I hope that reading this book reinforces your fascination with human behavior. I also hope that when you finish this book, and in the years to come, you will have new ideas about the possibilities for social work action.

Learning about human behavior is a lifelong process. You can help me in my learning process by letting me know what you liked or didn’t like about the book.

—Elizabeth D. Hutchison

Reno, Nevada

[email protected]

Acknowledgments

A project like this book is never completed without the support and assistance of many people. A sixth edition stands on the back of the first five editions, and over the years since I started work on the first edition of this book in the mid-1990s, a large number of people have helped me keep this project going. I am grateful to all of them, some of them known to me and others working behind the scenes in a way not visible to me.

Steve Rutter, former publisher and president of Pine Forge Press, shepherded every step of the first edition and provided ideas for many of the best features of the second edition, which are carried forward in the third, fourth, fifth, and now this sixth edition. Along with Paul O’Connell, Becky Smith, and Maria Zuniga, he helped to refine the outline for the second edition, and that outline continues to be used in this book. I am especially grateful to Becky Smith, who worked with me as a developmental editor for the first two editions. She taught me so much about writing and readers, and I often find myself thinking How would Becky present this? Kassie Graves provided disciplined and creative editorial assistance from 2006 to 2016, for the third, fourth, and fifth editions of this book.

The contributing authors and I are grateful for the assistance Dr. Maria E. Zuniga offered during the drafting of the second edition. She provided many valuable suggestions for how to improve the coverage of cultural diversity in each chapter. Her suggestions improved the second edition immensely and have stayed with us as lasting lessons about human behavior in a multicultural society.

I am grateful once again to work with a fine group of contributing authors. They were gracious about timelines and incorporating feedback from reviewers. Most important, they were committed to providing a state-of- the-art knowledge base for understanding the multiple dimensions of human behavior for use in social work practice. I am also grateful for collaborators who have provided rich case studies for Chapters 1, 2, 8, 9, and 13.

We were lucky to be working again with the folks at SAGE. Joshua Perigo

came aboard as I worked to turn months of research and writing into what you see in this book. He came with prior experience in working with professors who use the book and with an organized view of what is helpful to instructors and students. He has consistently been responsive to my questions and concerns. How lucky I am to be working with Mark Bast as copy editor again. He is a delight to work with, catches my errors, and makes the words flow better. I would work with him forever. I am grateful to have Tracy Buyan join the project as production editor; she is the person who turns words and ideas into a gorgeous book. Thanks also to Alexandra Randall who has provided editorial assistance with a number of tasks. Many more people have worked behind the scenes to help us complete this project. I wish I could thank them by name. I love the folks at SAGE!

I am grateful to my former faculty colleagues at Virginia Commonwealth University (VCU), who set a high standard for scientific inquiry and teaching excellence. They also provided love and encouragement through both good and hard times. My conversations about the human behavior curriculum with colleagues Rosemary Farmer, Stephen Gilson, Marcia Harrigan, Holly Matto, Mary Secret, and Joe Walsh over many years have stimulated much thinking and resulted in many ideas found in this book.

My students over 30 years also deserve a special note of gratitude. They taught me all the time, and many things that I have learned in interaction with them show up in the pages of this book. They also provided a great deal of joy to my life journey, and I continue to enjoy keeping up with many of them on social media. Those moments when I learn of former students doing informed, creative, and humane social work are special moments, indeed, and I am happy to say there are many such moments. One former student is a chapter coauthor, and two former students have contributed case studies for this edition. I have also enjoyed receiving e- mails from students from other universities who are using the books, and I have found their insights to be very helpful.

As always, my deepest gratitude goes to my husband, Hutch. Since the first edition of this book was published, we have weathered several challenging years and experienced many celebratory moments. He is constantly patient and supportive and often technically useful. But, more important, he makes sure that I don’t forget that life can be great fun. He has now accompanied me through many changes for over three fourths of my life journey.

Finally, I am enormously grateful to a host of reviewers who thoughtfully evaluated the fifth edition and provided very useful feedback about how to improve it. Their ideas were very helpful in framing our work on this sixth edition.

Alicia Borre Hampton University Cynthia Bott Siena College Gwendolyn D. Perry-Burney California University of Pennsylvania Leona Mickles-Burns Marygrove College Carmelita Dotson Middle Tennessee State University Heather Goltz University of Houston Johanna Slivinske Youngstown State University Debra Mowery University of South Florida Emeka Nwadiora Temple University Karl Johnson Northern Michigan University Lisa Richardson St. Catherine University Michele R. Braley St. Catherine University/University of St. Thomas Nicole Lee Virginia Commonwealth University Cheri Carter Temple University

Part I A Multidimensional Approach for Multifaceted Social Work

Devyani Hakakian is beginning her workday at an international advocacy organization devoted to women’s rights. Sylvia Gomez and other members of her team at the rehabilitation hospital are meeting with the family of an 18-year-old male who is recovering from head injuries sustained in a motorcycle accident. Mark Bernstein is on the way to the county jail to assess the suicide risk of an inmate. Caroline O’Malley is knocking at the door of a family reported to her agency for child abuse. Helen Moore is preparing a report on environmental justice for a legislative committee. Juanita Alvarez is talking with a homeless man about taking his psychotropic medications. Stan Weslowski is meeting with a couple who would like to adopt a child. Andrea Thomas is analyzing the results of a needs assessment recently conducted at the service center for older adults where she works. Anthony Pacino is wrapping up a meeting of a cancer support group. Sam Belick is writing a social history for tomorrow’s team meeting at the high school where he works. Sharlena Cook is preparing to meet with a group of Head Start parents to discuss parenting issues. Sarah Sahair has just begun a meeting of a recreational group of 9- and 10-year-old girls. Jane Kerr is facilitating the monthly meeting of an interagency coalition of service providers for substance-abusing women and their children. Ann Noles is planning a fund-raising project for the local Boys’ and Girls’ Club. Meg Hart is wrapping up her fourth counseling session with a lesbian couple. Chien Liu is meeting with a community group concerned about youth gang behavior in their neighborhood.

Mary Wells is talking with one of her clients at the rape crisis center. Nagwa Nadi is evaluating treatment for post-traumatic stress disorder at a Veteran’s Administration hospital.

What do these people have in common? You have probably guessed that they all are social workers. They work in a variety of settings, and they are involved in a variety of activities, but they all are doing social work. They all are involved in activities to engage with, assess, and intervene in human behavior. Social work is a multifaceted profession, and because it is multifaceted, social workers need a multidimensional understanding of human behavior. This book provides such an understanding. The two chapters in Part I introduce you to a multidimensional way of thinking about human behavior and set the stage for subsequent discussion. In Chapter 1, you are introduced to the multiple dimensions of person, environment, and time that serve as the framework for the book, and you are introduced to social work’s emphasis on diversity, inequality, and social justice. You also are given some tools to think critically about the multiple theories and varieties of research that make up our general knowledge about these dimensions of human behavior. In Chapter 2, you encounter eight theoretical perspectives that contribute to multidimensional understanding. You learn about their central ideas and their scientific merits. Most important, you consider the usefulness of these eight theoretical perspectives for social work.

1 Human Behavior A Multidimensional Approach

Elizabeth D. Hutchison

Chapter Outline Learning Objectives Case Study 1.1: Joshua, Making a New Life Human Behavior: Individual and Collective A Multidimensional Approach

Personal Dimensions Environmental Dimensions Time Dimensions

Diversity, Inequality, and the Pursuit of Justice: A Global Perspective Diversity Inequality Advancing Human Rights and Social, Economic, and Environmental Justice

Knowing and Doing Knowledge About the Case Knowledge About the Self Values and Ethics

Scientific Knowledge: Theory and Research Theory Empirical Research Critical Use of Theory and Research

Organization of the Book Implications for Social Work Practice Key Terms Active Learning Web Resources

Learning Objectives

1.1 Recognize one’s own emotional and cognitive reactions to a case study. 1.2 Outline the elements of a multidimensional person-in-environment approach to human behavior. 1.3 Advocate for an emphasis on diversity; inequality; social, economic, and environmental justice; and a global perspective in social work’s approach to human behavior. 1.4 Summarize four ingredients of knowing how to do social work. 1.5 Analyze the roles of theory and research in guiding social work practice. 1.6 Apply knowledge of the multidimensional person-in-environment framework; diversity; inequality; and the pursuit of human rights and social, economic, and environmental justice to recommend guidelines for social work engagement, assessment, intervention, and evaluation.

Case Study 1.1 Joshua, Making a New Life Joshua spent the first 10 years of his life in the city of Uvira in the South Kivu Province of the Democratic Republic of Congo (DRC), formerly Zaire. He is the fourth oldest child in a family that included 11 children. He is of the Banyamulenge ethnic group, and his family spoke Swahili, Kinyamulenge, and French while living in Uvira. He was raised Christian in the United Methodist Church. Joshua’s family lived comfortably in Uvira. His mother owned a boutique that sold clothes, shoes, lotions, accessories, and petroleum. His father bought cows, had them butchered, and then sold the meat.

Of his life in Uvira, Joshua recalls that a typical day included getting up for breakfast and spending the day at school. After school, he did chores and sometimes helped his mom in her boutique. Then he played soccer until dinner. It was a good life.

All of that changed sometime in 2003. The long-standing Congo civil war was getting closer to his family’s home in Uvira. Joshua recalls hearing gunshots about 15 miles away. His family left their home in Uvira in the middle of the night by foot and walked across the Burundi border to the nearby Gatumba Refugee Camp run by the United Nations High Commissioner for Refugees (UNHCR). They were joined on the walk and in the camp by a lot of other people from Uvira. Life was hard in the crowded camp where people slept in tents, with mosquitos buzzing around. Sometimes there was not enough water or food for the whole camp. The

hygiene in the camp was not good, and a lot of people were sick. Joshua lost a lot of friends and family in the camp. He recalls that the children were not able to attend school in the camp.

A terrible thing happened on August 13, 2004. There was a heinous massacre at the Gatumba Refugee Camp, killing 166 refugees and seriously wounding over 100 more. News reports indicate that refugees who were members of the Banyamulenge ethnic group were the specific target of the massacre. Joshua’s mom died of gunshot wounds, and his 8-year-old sister’s body was never found. The whole camp was burned down, and Joshua’s family was separated. Joshua, who was 11 years old at the time, ran with his 7-month- old sister. They were first in the hospital and then taken in by a stranger with whom they stayed for several weeks before finding their father and other siblings. Their father had been shot during the massacre and was taken to the hospital. Two of Joshua’s siblings were also found in the hospital. Other siblings had found safety a few miles away at a makeshift camp. After finding his father and siblings, Joshua and his 7-month-old sister stayed with an extended family relative in Bujumbura, Burundi, for about 4 months. His father went to a hospital in Kenya, and some siblings were in an orphanage. At some point, Joshua and some older siblings went back to Uvira in the DRC. They stayed in the house where they had lived before they fled and were able to go to school again, but not right away.

In 2006, Joshua’s father was discharged from the hospital; came back to Uvira; and took all the family back to Bujumbura, Burundi, where he filed for refugee status. Joshua and his siblings went to a few interviews for the refugee status application, but mostly the process was handled by his father, and Joshua doesn’t know much about it.

In May 2007, Joshua’s family, consisting of a single father and 10 children, arrived in Boise, Idaho. Joshua was almost 14 years old, and he felt excited and eager to begin school. He was also struck by how cold the weather was. Joshua’s father received Supplemental Security Income (SSI) because of disability related to wounds from the massacre. His father also had to continue with treatment for his wounds, was hospitalized from time to time, and continues to receive periodic treatment. His father is now ordained as a pastor in a local African church and currently serves on a committee for the local African community. He received his citizenship in 2013.

The language issue was really hard at first for Joshua, but it was even harder for his older siblings and father. Joshua graduated from high school in 2011, from community college in 2013, and from university in May 2017. He received citizenship in September 2017 and was married in October 2017. He coaches local Nations United and Boys & Girls Club soccer teams and

works as the employment specialist and donations manager at the Agency for New Americans, the refugee resettlement agency that sponsored his family during their resettlement. All of Joshua’s surviving siblings still live in Boise. Unfortunately, his oldest sister died in November 2016. She had been shot in the head during the massacre, and her injuries left her paralyzed on the left side of her body. She had gotten married after the family arrived in Boise and left six children behind when she died. Joshua says the family misses her very much.

Story provided by Agency for New Americans, Boise, Idaho

Human Behavior: Individual and Collective As eventful as it has been, Joshua’s story is still unfolding. As a social worker, you will become a part of many unfolding life stories, and you will want to have useful ways to think about those stories and effective ways to be helpful to people like Joshua, his family, and other refugees from the DRC, as well as the many other people you will encounter in your social work journey. This book and its companion volume, Dimensions of Human Behavior: The Changing Life Course, provide ways for you to think about the nature and complexities of human behavior—the people and situations at the center of social work practice. To begin to do that, we must first clarify the purpose of social work and the approach it takes to individual and collective human behavior. This is laid out in the 2015 Educational Policy and Accreditation Standards of the Council on Social Work Education (CSWE):

The purpose of the social work profession is to promote human and community well-being. Guided by a person-in-environment framework, a global perspective, respect for human diversity, and knowledge based on scientific inquiry, the purpose of social work is actualized through its quest for social and economic justice, the prevention of conditions that limit human rights, the elimination of poverty, and the enhancement of the quality of life for all persons. (p. 5)

The CSWE was formed in 1952 to bring the accreditation of social work education under a single body, bringing together separate accrediting bodies for medical social work, psychiatric social work, and generalist

practice to accredit both undergraduate and graduate social work education programs. Three years later, in 1955, the National Association of Social Workers (NASW) was formed by consolidating seven existing organizations, the American Association of Social Work plus specialized associations of psychiatric social workers, medical social workers, school social workers, group workers, community organizing social workers, and social work researchers. Both the newly formed CSWE and NASW were dedicated to identifying what was common to all social work practice. The CSWE immediately set to work to develop curriculum policy and accreditation standards for a social work education that could prepare students for all practice settings and social work roles.

In these early efforts to identify the common base of social work, presenters of one workshop at the 1952 meeting of the American Association of Schools of Social Work, a forerunner of CSWE, argued that “knowledge and understanding of human behavior is considered an indispensable base for social work education and for all social work activity” (Social Welfare History Archives, 1952, p. 1). I agree wholeheartedly with that statement. Whether we are concerned about

how an individual client can get better control of emotions and implicit cognitive biases; how a family can improve its communication patterns; how a group can become more cohesive; how to maximize the benefits of increasing diversity in an organization; how a community can become empowered to solve problems; or the most effective ways to organize for human rights and social, economic, and environmental justice;

we are concerned about human behavior.

In the first working definition of social work practice after the formation of CSWE and NASW, in 1958 Harriet Bartlett linked the person-in- environment perspective on human behavior to the definition of social work (Kondrat, 2008). That connection has endured for 6 decades. In discussion of social work competencies, the CSWE 2015 curriculum policy statement notes that social workers “apply knowledge of human behavior and the social environment, person-in-environment, and other multidisciplinary theoretical frameworks” to engage with, assess, intervene with, and evaluate practice with “individuals, families, groups,

organizations, and communities” (CSWE, 2015, pp. 8–9).

As you think about Joshua’s story, you may be thinking, as I was, not only about Joshua but also about the different environments in which he has lived and the ways in which both Joshua and his environments have changed over time.

In this book, we use the language of “person and environment” rather than “person-in-environment” because the emphasis is not always on the individual person. Although the person-in-environment (person and environment) construct noted in the CSWE educational policy is an old idea in social work, it still is a very useful way to think about human behavior—a way that can accommodate such contemporary themes in human life as the emotional life of the brain, human–robot relationships, social media, human rights, economic globalization, and environmental justice. This book elaborates and updates the person and environment construct that has guided social work intervention since the earliest days of the profession. The element of time is added to the person and environment construct to call attention to the dynamic nature of both people and environments. This is important in rapidly changing societies around the world. Early social workers could not have imagined television and air travel, much less cell phones, Facebook, Instagram, Twitter, Tumblr, or online courses. And, no doubt, the world 50 years from now would seem as “foreign” to us as the United States seemed to Joshua and his family when they first arrived here.

As they live their lives in the natural environment, humans join with other humans to develop physical landscapes and structures, technologies, and social systems that form the context of their lives. These landscapes, structures, technologies, and systems are developed by collective action, by humans interacting with each other. Once developed, they then come to shape the way humans interact with each other and their natural environments. Structures, technologies, and systems can support or deter individual and collective well-being. Usually, they benefit some individuals and groups while causing harm to others. Social workers are concerned about both individual and collective behavior and well-being. When I talk about human behavior, I am referring to both the individual and collective behavior of humans. Sometimes we focus on individual behavior, and other times we are more concerned about the social systems created by human interaction.

This book identifies multiple dimensions of both person and environment and draws on ongoing scientific inquiry, both conceptual and empirical, to examine the dynamic understanding of each dimension. Special attention is paid to globalization; diversity; human rights; and social, economic, and environmental justice in examination of each dimension. In this chapter, a multidimensional approach to person and environment is presented, followed by discussion of diversity, inequality, and the pursuit of social justice from a global perspective. After a brief discussion of the process by which professionals such as social workers move from knowing to doing, the chapter ends with a discussion of how scientific knowledge from theory and research informs social work’s multidimensional understanding of human behavior.

A Multidimensional Approach Social work’s person and environment construct has historically recognized both person and environment as complex and multidimensional, that is, as having several identifiable dimensions. A dimension refers to a feature that can be focused on separately but that cannot be understood without also considering other features. This last piece is really important: Although we can focus on one dimension of a human story to help us think about that dimension more clearly, no one dimension can be understood without considering other dimensions as well. We are walking a treacherous path here by separating out the dimensions to explore each in some depth. The fear is that by doing so, we will reinforce the human tendency to think of these dimensions as things that are separate and unrelated rather than recognizing how they are all utterly intertwined. As neuroscientist Robert Sapolsky (2017, p. 5) warns “It’s human behavior. And, it is indeed a mess, a subject involving brain chemistry, hormones, sensory cues, prenatal environment, early experience, genes, both biological and cultural evolution, and ecological pressures, among other things.” In a similar vein, writing about child development, Arnold Sameroff (2010, P. 7) writes that “it is both child and parent, but it is also neurons and neighborhoods, synapses and schools, proteins and peers, and genes and governments.” Think about Joshua. What comes quickly to your mind as you think about the factors that influence his current behavior?

If we were writing a book focusing on only one type of behavior, such as

aggression as Sapolsky (2017) writes about, we could demonstrate how all the elements of person and environment are intertwined to create that one type of behavior. Because, instead, we are writing a book that covers the wide range of human behaviors, both individual and collective behaviors, we organize the book around various dimensions of person and environment and do our best to illustrate how those dimensions are related to each other. For example, the chapter on cultures includes discussion of the neuroscience of prejudice as well as discussion of gene–culture co- evolution. We encourage you to pay particular attention to these discussions of the way in which different dimensions of person and environment are intertwined.

With an explosion of research across a number of disciplines in the past few decades, the trend has been to expand the range of dimensions of both person and environment folded into the person and environment construct. Time too can be thought of as multidimensional. Let’s look at some of the dimensions of person, environment, and time in Joshua’s story.

If we focus on the person in Joshua’s story, we think about the conditions in the refugee camp that threatened his biological systems. We think about how he survived while many others died in the camp, where hygiene was poor and water and food were scarce. We also think about the biological damage done to members of his family at the time of the massacre and are reminded how humans often carry biological reminders of physically and emotionally traumatic situations. Joshua appears to have emotional resilience and good problem-solving skills, having had the discernment to run from the massacre with his baby sister, the fortitude to survive the perilous days while the family waited to be resettled in the United States, and the flexibility to adapt to a new life once he arrived in the United States. He was able to learn a new language and culture and plan for the future. Their Christian faith has been a source of comfort for him and his family as they adapted to a new environment.

If we focus on the environment, we see many influences on Joshua’s story. Consider first the physical environment. Joshua lived a comfortable life in the city of Uvira, where he spent his days in school and was able to be outside playing soccer after chores were done. From there, he took a short walk across the Burundi border to a crowded and primitive refugee camp where he has memories of being attacked by mosquitoes. After the massacre, he, his father, and his siblings lived where they could—in

camps, hospitals, and other people’s homes. They were finally resettled in a city about the size of his original city of Uvira but where the climate was much colder. They were surrounded by mountains as they had been in Uvira. Joshua is once again able to be outside playing soccer.

Culture is a dimension of environment that exerts a powerful influence in Joshua’s story. Ethnic culture clash was a large part of the Congo civil war, and Joshua and his family were of the Banyamulenge ethnic group that had been targets for ongoing discrimination and exclusion since the colonial period. Such cultural conflict is not new; historical analysis suggests that intercultural violence has actually declined in recent times (Pinker, 2011), but it continues to be a source of great international upheaval and the driving force behind refugee resettlement. As is true in many parts of the world, ethnic conflict is intertwined in the Congo with control over a natural resource, in this case coltan, a metallic ore used in electronics such as computers and cell phones (McMichael, 2017).

Joshua’s story has been powerfully influenced by the geopolitical unrest that marked his young life in Africa. His relationships with social institutions have changed over time, and he has had to learn new rules based on his changing place in the social structure. Even though his country was engaged in civil war during much of his young life, it did not reach his city until he was 10 years old. Before that, his family lived in relative comfort and peace. His family was relieved to get to the United Nations refugee camp, but life there was hard, and ultimately the war followed them there, even though the camp was supposed to be protected by the Burundi government. Once they arrived in the United States, Joshua and his siblings were able to go to school again, to make their way economically, and to work toward citizenship in their adopted country.

Another dimension of the environment, family, is paramount to Joshua. He has suffered family loss and endured time when members of his family were separated before resettling in the United States. He has been lucky, however, to have his father and surviving siblings living nearby. Many refugee families end up spread across several continents, and that may be true for Joshua’s extended family. Joshua now has a wife to count as family.

Small groups, organizations, and communities have been important forces in Joshua’s life, but he has had little direct contact with social movements. His soccer teams are important small groups in the life he has created in

Boise. He participates in small groups at church and in the African community in Boise. He is a member of the small staff group at the refugee resettlement agency.

Several organizations have been helpful to Joshua and his family since they fled Uvira. The refugee camp was an organization that brought initial safety but ultimately trauma and loss. Joshua’s association with other organizations has been much more positive; he did well in several school organizations and has returned to work for the refugee resettlement agency that sponsored his family and assisted them to make a successful resettlement. The African Christian church where his father is a minister is a source of close relationships, spiritual connectedness, and continuity with life in Uvira.

Joshua and his family have needed to adapt their behavior to live in three different types of communities. In Uvira, they were surrounded by extended family, long-term friends and neighbors, and a church community. In the crowded refugee camp, disease and despair were common, and Joshua was not able to go to school. That community was split, with some being targeted for massacre while others were not. Now he lives in a city in southwestern Idaho in proximity to other refugees from the DRC and worships with many of them.

We don’t know if Joshua is aware that the Gatumba Refugees Survivors Foundation (2018) has spearheaded a social movement to undertake inquiry about the Gatumba massacre, to return the Banyamulenge refugees to the DRC, and to develop memorial services for those who were killed and maimed in the massacre in cities across North America where the Banyamulenge refugees have resettled. We don’t know how Joshua would feel about the goal to repatriate the Banyamulenge refugees, given that he has been living in Boise since he was 13 years old and seems to have put down deep roots there. The Boise community of Banyamulenge refugees might appreciate a memorial service in Boise, however, as they heal from the trauma of that massacre.

Time is also an important part of Joshua’s story. His story, like all human stories, is influenced by the human capacity to live not only in the present time but also in past and future times. Escape, crowded camps, massacre, family loss and separation, and resettlement are past events in his family’s life and can be vividly recalled. There were times in the family’s life when they needed to focus on future possibilities with such questions as “Will

our father get better?” and “Will we be granted refugee status, and if so when and where will we go?” This future thinking has had an enormous impact on the current circumstances of the family’s lives. In the interview for this case study, Joshua engaged in thinking about his past life in Uvira and the refugee camp, as well as the massacre event, but for the most part, he lives largely in the present while imagining possibilities for the future with his wife, siblings, and father.

Joshua’s story is also influenced by the historical times in which he has lived and is living. He has lived in a time of violent ethnic discord in his home country, and the civil strife continues in the DRC (Human Rights Watch, 2017). He is lucky to have lived in an era of international support for refugees, but in his personal life as well as his work at the refugee resettlement organization, he has seen hostility to refugees grow in the last political cycle. The times in which we live shape our behaviors in many ways.

Another way to think about the role of time in human behavior is to consider the way in which age, or life stage, influences behavior. Joshua notes that although learning English was difficult for him, it was much easier for him at age 13 than it was for his father and his older siblings. He finds this stage of his life, with school behind him and a new marriage, to be an exciting time with a future stretching out before him.

As suggested, social work has historically recognized human behavior as an interaction of person with environment, although the relative emphasis on different dimensions of person and environment has changed over time (see Kondrat, 2008). Today, a vast multidisciplinary literature is available to help us in our social work efforts. The good news is that the multifaceted nature of this literature provides a broad knowledge base for the varied settings and roles involved in social work practice. The bad news is that this literature is highly fragmented, scattered across a large number of fields. What we need is a structure for organizing our thinking about this multifaceted, multidisciplinary, fragmented literature.

The multidimensional approach provided in this book should help. This approach is built on the person–environment–time model described earlier. Although in this book we analyze specific dimensions of person and environment separately, including information on how our understanding of these dimensions has changed over time, keep in mind the earlier caution that dimension refers to a feature that can be focused on separately

but cannot be understood without considering other features. The dimensions identified in this book were traditionally studied as detached or semidetached realities, with one dimension characterized as causing or leading to another. In recent years, however, behavioral science scholars have collaborated across disciplines, leading to exciting new ways of thinking about human behavior, which the contributing authors and I share with you. I emphasize again that I do not see the dimensions analyzed in this book as detached realities, and I am not presenting a causal model. I want instead to show how these dimensions work together, how they are interwoven with each other, and how many possibilities are opened for social work practice when we think about human behavior in a multidimensional way. I am suggesting that humans engage in multidetermined behavior, that is, behavior that develops as a result of many causes. As Sapolsky (2017, p. 8) says, “It is impossible to conclude that behavior is caused by a gene, a hormone, a childhood trauma”— because all these factors and many others interact in one individual to produce unique results—“you have to think complexly about complex things” like human behavior. Exhibit 1.1 is a graphic overview of the dimensions of person, environment, and time discussed in this book. Exhibit 1.2 defines and gives examples of each dimension.

Critical Thinking Questions 1.1

What courses have you taken that added to your understanding of human behavior? How does content from any of these courses help you to understand Joshua’s story and how a social worker might have been helpful to Joshua and his family at any time during their resettlement? Do you agree that the person and environment construct is still useful for social work? Explain your answer.

Exhibit 1.1 ● Person, Environment, and Time Dimensions

Personal Dimensions Any story could be told from the perspective of any person in the story. The story at the beginning of this chapter is told from Joshua’s perspective, but it could have been told from the perspectives of a variety of other persons such as a member of a different ethnic group in the DRC, Joshua’s father or one of his siblings, a staff member at the Gatumba refugee camp, the family in Burundi who took Joshua and his baby sister in, or the case manager at the refugee resettlement agency. You will want to recognize the multiple perspectives held by different persons involved in the stories of which you become a part in your social work activities.

You also will want tools for thinking about the various dimensions of the persons involved in these stories. In recent years, social work scholars, like contemporary scholars in other disciplines, have taken a biopsychosocial approach that recognizes human behavior as the result of interactions of integrated biological, psychological, and social systems (see Melchert, 2013; Sameroff, 2010; Sapolsky, 2017). In this approach, psychology— personality, emotion, cognition, and sense of self—is seen as inseparable from biology. Emotions and cognitions affect the health of the body and are affected by it (Smith, Fortin, Dwamena, & Frankel, 2013). Neurobiologists are identifying the brain circuitry involved in thoughts and emotions (Davidson & Begley, 2012; Sapolsky, 2017). They are finding evidence that the human brain is wired for social life (Lieberman, 2013). They are also finding that the social environment has an impact on brain structure and processes and environments actually turn genes on and off. Environments influence biology, but the same environment acts on diverse

genetic material (Hutchison, 2014). This can help us understand how some people survived and some did not before the massacre in the Gatumba refugee camp. Two people with the same genetic makeup and biological characteristics can have very different behavioral outcomes, and two people with very different genetic makeup and biological characteristics can have the same or similar behavioral outcomes. In addition, two people with the same or similar experiences with the environment can have very different behavioral outcomes, and two people with very different experiences with the environment can have the same or similar behavioral outcomes (Sameroff, 2010).

Exhibit 1.2 ● Definitions and Examples of Dimensions of Person, Environment, and Time Exhibit 1.2 ● Definitions and Examples of Dimensions of Person,

Environment, and Time

Dimension Definition Examples

Person

Biological The body’s biochemical, cell, organ, and physiological systems

Nervous system, endocrine system, immune system, cardiovascular system, musculoskeletal system, reproductive system

Psychological The mind and the mentalprocesses

Cognitions (conscious thinking processes), emotion (feelings), self (identity)

Themes of morality; ethics; justice;

Spiritual The aspect of the person that searches for meaning and purpose in life

interconnectedness; creativity; mystical states; prayer, meditation, and contemplation; relationships with a higher power

Environment

Physical The natural and human-built material aspects of the environment

Water, sun, trees, buildings, landscapes

Culture

A system of knowledge, beliefs, values, language, symbols, patterns of behavior, material objects, and institutions that are created, learned, shared, and contested by a group of people

Values, ideology, symbols, language, norms, subcultures, countercultures

Social structure and social institutions

Social structure: a set of interrelated social institutions developed by human beings to provide stability to society and order to individual lives Social institutions: stable, organized, patterned sets of roles, statuses, groups, and organizations that provide a basis for behavior in particular areas of social life

Social structure: social class Social institutions: government, economy, education, health care, social welfare, religion, mass media, and family

Dyads Two persons bound togetherin some way

Parent and child, romantic couple, social worker and client

A social group of two or more

Families persons, characterized by ongoing interdependence with long-term commitments that stem from blood, law, or affection

Nuclear family, extended family, chosen family

Small groups

Two or more people who interact with each other because of shared interests, goals, experiences, and needs

Friendship group, self-help group, therapy group, committee, task group, interdisciplinary team

Formal organizations

Collectivities of people, with a high degree of formality of structure, working together to meet a goal or goals

Civic and social service organizations, business organizations, professional associations

Communities

People bound either by geography or by network links (webs of communication), sharing common ties, and interacting with one another

Territorial communities such as neighborhoods; relational communities such as the social work community, the disability community, a faith community, a soccer league

Social movements

Consciously organized and sustained attempts by ordinary people working outside of established

Civil rights movement, poor people’s movements, disability

institutions to change some aspect of society

movement, gay rights movement, environmental justice movement

Time

Linear time Time in terms of a straightline Past, present, future

Historical era A discrete block of time inhuman history

Progressive Era, the Great Depression, 1960s

Chronological age

Age of a person measured in years, months, and days from the date the person was born; may also be described in terms of a stage of the human life course

Six months old (infancy), 15 years old (adolescence), 80 years old (late adulthood)

In recent years, social work scholars and those in the social and behavioral sciences and medicine have argued for greater attention to the spiritual dimension of persons as well (Pandya, 2016). Beginning in the late 20th century, a group of U.S. medical faculty and practitioners initiated a movement to reclaim medicine’s earlier spiritual roots, and content on spirituality and health is now incorporated into the curricula of over 75% of U.S. medical schools (Puchalski, Blatt, Kogan, & Butler, 2014). Developments in neuroscience have generated new explorations of the unity of the biological, psychological, and spiritual dimensions of the person. For example, recent research has focused on the ways that emotions and thoughts, as well as spiritual states, influence the immune system and some aspects of mental health (Davidson & Begley, 2012). One national longitudinal study examined the role of spirituality in physical and mental health after the collective trauma of the 9/11 attacks and found that high levels of spirituality were associated with fewer infectious ailments, more positive emotions, and more immediate processing of the traumatic event in the 3 years following the attacks (McIntosh, Poulin, Silver, & Holman, 2011). Spirituality and religious

affiliation appear to be a source of resilience for Joshua, his family, and the Boise African community. In this book, we give substantial coverage to all three of these personal dimensions: biological, psychological, and spiritual.

Environmental Dimensions Social workers have always thought about the environment as multidimensional. As early as 1901, Mary Richmond (1917) presented a model of social work case coordination that took into account not only personal dimensions but also family, neighborhood, civic organizations, private charitable organizations, and public relief organizations. Several models for classifying dimensions of the environment have been proposed since Mary Richmond’s time. Social workers (see, e.g., Ashford, LeCroy, & Williams, 2018) have been influenced by Uri Bronfenbrenner’s (2005) ecological perspective, which identifies the five interdependent, nested categories or levels of systems presented in Exhibit 1.3. You might notice some similarities between Bronfenbrenner’s model and the one presented in Exhibit 1.1. By adding chronosystems in his later work, Bronfenbrenner was acknowledging the importance of time in person–environment transactions, but this book presents a more fluid, less hierarchical model of person and environment than presented by Bronfenbrenner. Some social work models have included the physical environment (natural and built environments) as a separate dimension (see Norton, 2009). There is growing evidence of the impact of the physical environment on human well-being and growing concern about environmental justice issues in the physical environment.

To have an up-to-date understanding of the multidimensional environment, I recommend that social workers have knowledge about the eight dimensions of environment described in Exhibit 1.2 and presented as chapters in this book: the physical environment, cultures, social structure and social institutions, families, small groups, formal organizations, communities, and social movements. We also need knowledge about dyadic relationships—those between two people, the most basic social relationship. Dyadic relationships receive attention throughout the book and are emphasized in Chapter 5, which focuses on the psychosocial person. Simultaneous consideration of multiple environmental dimensions provides new possibilities for action, perhaps even new or revised approaches to social work practice.

Exhibit 1.3 ● Five Categories or Levels of Systems as Presented by Uri Bronfenbrenner

Source: Adapted from Bronfenbrenner and Morris, 2006.

These dimensions are neither mutually exclusive nor hierarchically ordered. For example, family is sometimes referred to as a social institution, families can also be considered small groups or dyads, and family theorists write about family culture. Remember, dimensions are useful ways of thinking about person–environment configurations, but we should not think of them as detached realities.

Time Dimensions

When I was a doctoral student in a social work practice course, Professor Max Siporin began his discussion of social work assessment with this comment: “The date is the most important information on a written social work assessment.” This was Siporin’s way of acknowledging the importance of time in human behavior, of recognizing the ever-changing nature of both person and environment. The importance of time in human behavior is reflected in the 2006 finding that time is the most commonly used noun in print in the English language; person is the second most common (BBC News, 2006).

There are many ways to think about time. Physics is generally seen as the lead discipline for studying time, and quantum physics has challenged much about the way we think about time. Various aspects of time are examined by other disciplines as well, and there are a number of different ways to think about time. In this book and the companion volume Dimensions of Human Behavior: The Changing Life Course, we examine three dimensions of time that have been studied by behavioral scientists as important to the understanding of human behavior: linear time, historical era, and chronological age.

Linear time—time ordered like a straight line from the past through the present and into the future—is the most common way that humans think about time. Although it is known that people in some cultures and groups think of time as stationary rather than moving (Boroditsky, Fuhrman, & McCormick, 2011), contemporary behavioral science researchers are interested in what they call “mental time travel,” the human ability to remember events from the past and to imagine and plan for the future (Eacott & Easton, 2012). The research on mental time travel has focused on the conscious processes of reminiscence and anticipation, but there is also considerable evidence that past events are stored as unconscious material in the brain and the body and show up in our thoughts and emotions (see Davidson & Begley, 2012; Sapolsky, 2017). Traces of past events also exist in the natural and built environments, for example, in centuries-old buildings or in piles of debris following a hurricane or tornado.

Sapolsky (2017) uses the perspective of linear time to demonstrate how different dimensions of person and environment influence a specific behavior. When a behavior occurs, we can think about the multiple influences on that behavior in the context of time:

1. A second before the behavior: What went on in the person’s brain a second before the behavior?

2. Seconds to minutes before the behavior: What sensory input reached the brain?

3. Hours to days before the behavior: What hormones acted hours to days earlier to change how responsive the person was to particular sensory stimuli?

4. Days to months before the behavior: What features of the environment in the days and months before the behavior changed the structure and function of the person’s brain and thus changed how it responded to hormones and environmental stimuli?

5. Early development: What genetic codes were created at the time of conception, and what elements of the fetal and early childhood environment shaped the structure and function of the brain and body and affected gene expression?

6. Centuries to millennia before the behavior: How has culture shaped the behavior of people living in that individual’s group? What ecological factors, including the physical environment, helped shape that culture?

Linear time is measured by clocks and calendars. When I think of time, I tend to think of clocks, calendars, and appointments. And I often seem to be racing against time, allowing the clock to tell me when an event should begin and end. This is the way most people in affluent countries with market economies think of time. This approach to time has been called clock time (Zimbardo & Boyd, 2008). However, this approach to time is a relatively new invention, and many people in the contemporary world have a very different approach to time. In nonindustrialized countries, and in subcultures within industrialized countries, people operate on event time, allowing scheduling to be determined by events. For example, in agricultural societies, the most successful farmers are those who can be responsive to natural events—sunrise and sunset, rain, drought, temperature—rather than to scheduled events (Zimbardo & Boyd, 2008). That is the way my grandfather lived in rural Tennessee.

Photo 1.1 Three dimensions of human behavior are captured in this photo—person, environment, and time.

Clock time cultures often use the concept of time orientation to describe the extent to which individuals and collectivities are invested in the three temporal zones—past, present, and future. Research indicates that cultures differ in their time orientation. In most cultures, however, some situations call for us to be totally immersed in the present, others call for historical understanding of the past and its impact on the present, and still others call for attention to future consequences and possibilities. Psychologists Philip Zimbardo and John Boyd (2008) have been studying time orientation for more than 30 years and have identified the six most common time perspectives held in the Western world:

the past-positive: invested in the past, focused on its positive aspects past-negative: invested in the past, focused on its negative aspects present-hedonistic: invested in the present and getting as much pleasure as possible from it present-fatalistic: invested in the present, sees life as controlled by fate future: invested in the future, organizes life around goals transcendental-future: invested in the future, focuses on new time after death

Zimbardo and Boyd’s research using the Zimbardo Time Perspective Inventory (ZTPI) in a number of Western societies indicates that human well-being is maximized when people in these societies live with a balance of past-positive, present-hedonistic, and future perspectives. People with biases toward past-negative and present-fatalistic perspectives are at greater risk of developing physical and mental health problems. Zimbardo and Boyd’s (2008) book The Time Paradox suggests ways to become more past-positive, present, and future oriented to develop a more balanced time orientation. You might want to visit www.thetimeparadox.com and complete the ZTPI to investigate your own time orientation.

Photo 1.2 Time is one of the three elements outlined in this text for studying human behavior. It recognizes that people and environments are ever changing, dynamic, and flowing.

http://www.thetimeparadox.com

Zimbardo and Boyd have carried out their research in Western societies

and acknowledge that the ZTPI may not accurately reflect time orientation in other societies. They make particular note that their description of present-hedonistic and present-fatalistic does not adequately capture the way Eastern religions think about the present. Recently, Western behavioral scientists have begun to incorporate Eastern mindfulness practices of being more fully present in the current moment (present orientation) to help people buffer the persistent stresses of clock time and goal monitoring (future orientation) (Davidson & Begley, 2012). Research also indicates age-related differences in time orientation, with older adults tending to be more past oriented than younger age groups (Yeung, Fung, & Kam, 2012). Women have been found to be more future oriented and men more present oriented (Zimbardo & Boyd, 2008). Researchers have found that trauma survivors who experienced the most severe loss are more likely than other trauma survivors to be highly oriented to the past (see Zimbardo, Sword, & Sword, 2012). Zimbardo and colleagues (Zimbardo & Boyd, 2008; Zimbardo et al., 2012) suggest that trauma survivors may need assistance to think in different ways about past trauma and to enhance their capacity for past-positive, present, and future thinking. With this goal in mind, they have developed what they call time perspective therapy for working with people with post-traumatic stress disorder (PTSD) (Sword, Sword, Brunskill, & Zimbardo, 2014). This approach might be useful to some members of the refugee community of which Joshua is a part. It is something to keep in mind when we interact with refugees, military men and women who have served in war zones, and other groups who have an increased likelihood of having a history of trauma. It is also important for social workers to be aware of the meaning of time for the individuals and communities they serve.

Two other dimensions of time have been identified as important to the understanding of human behavior. Both dimensions are aspects of linear time but have been separated out for special study by behavioral scientists. The first, historical era, refers to the specific block or period of time in which individual and collective lives are enacted. The historical era in which we live shapes our environments. The economies, physical environments, institutions, technologies, and geopolitical circumstances of a specific era provide both options for and constraints on human behavior. We can see what impact the historical era in which Joshua spent his childhood has had on his life trajectory. In an earlier time, he might have continued to live peacefully in Uvira. How would his life have been different or the same? The second time dimension, chronological age,

seems to be an important variable in every society. How people change at different ages and life stages as they pass from birth to death has been one of the most enduring ways of studying both individual and collective behavior. Historical era is examined throughout this book and its companion book The Changing Life Course, and chronological age is the organizing framework for The Changing Life Course.

Critical Thinking Questions 1.2

How would our understanding of Joshua’s story change if we had no knowledge of his prior life experiences in the DRC and the Gatumba refugee camp—if we only assessed his situation based on his current functioning? What personal and environmental dimensions would we note in his current functioning?

Diversity, Inequality, and the Pursuit of Justice: A Global Perspective The Council on Social Work Education requires that social work educational programs provide a global perspective to their students. I think this is a great idea, but what exactly does it mean, and why is it valued? We are increasingly aware that we are part of an interconnected world, and Joshua’s story is one reminder of this. But just how connected are we? In her book Beyond Borders: Thinking About Global Issues, Paula Rothenberg (2006) wrote, “A not so funny, but perhaps sadly true, joke going around claims that people in the United States learn geography by going to war” (p. xv). Certainly, we learned something about the maps of Afghanistan and Iraq in the past 2 decades, but what do we know about the map of the DRC? A global perspective involves much more than geography, however. Here are some aspects of what it means to take a global perspective:

To be aware that my view of the world is not universally shared, and others may have a view of the world that is profoundly different from mine To have a growing awareness of the diversity of ideas and cultural practices found in human societies around the world To be curious about conditions in other parts of the world and how they relate to conditions in our own society

To understand where I fit in the global social structure and social institutions To have a growing awareness of how people in other societies view my society To have a growing understanding of how the world works, with special attention to systems and mechanisms of inequality and oppression around the world

We have always been connected to other peoples of the world, but those connections are being intensified by globalization, a process by which the world’s people are becoming more interconnected economically, politically, environmentally, and culturally. It is a process of increased connectedness and interdependence that began at least 5 centuries ago but has intensified in recent times and is affecting people around the world (C. Mann, 2011). This increasing connectedness is, of course, aided by rapid advancements in communication technology. There is much debate about whether globalization is a good thing or a bad thing, a conversation that is picked up in Chapter 9 as we consider the globalization of social institutions. What is important to note here is that globalization is increasing our experiences with social diversity and raising new questions about inequality, human rights, and social justice.

Diversity In its statement of social work competencies, the CSWE (2015) identifies Competency 2: Engage Diversity and Difference in Practice. The description of this competency states that “social workers understand how diversity and difference characterize and shape the human experience and are critical to the formation of identity. The dimensions of diversity are understood as the intersectionality of multiple factors including but not limited to age, class, color, culture, disability and ability, ethnicity, gender, gender identity and expression, immigrant status, marital status, political ideology, race, religion/spirituality, sex, sexual orientation, and tribal sovereign status” (p. 7). To understand who Joshua is we would want to think of him in relation to many of these factors.

Diversity has always been a part of the social reality in the United States. Even before the Europeans came, the Indigenous people were divided into about 200 distinct societies with about 200 different languages (Parrillo, 2009). Since the inception of the United States of America, many waves of

immigration have established the multiethnic, multicultural character of the country. We value our nation’s immigrant heritage and take pride in the ideals of equality of opportunity for all who come. However, there have always been tensions about how we as a nation handle diversity. Are we a melting pot where all are melted into one indistinguishable model of citizenship, or are we a pluralist society in which groups have separate identities, cultures, and ways of organizing but work together in mutual respect? Pioneer social worker Jane Addams (1910) was a prominent voice for pluralism during the early 20th century, and that stance is consistent with social work’s concern for human rights.

Even though diversity has always been present in the United States, it is accurate to say that some of the diversity in our national social life is new. Clearly, there is increasing racial, ethnic, and religious diversity in the United States, and the mix in the population stream has become much more complex in recent years (Parrillo, 2009). The United States was 87% White in 1925, 80% White in 1950, and 72% White in 2000; by 2050, it is projected that we will be about 47% White (Taylor & Cohn, 2012). It is important to note, as you will read in Chapter 8, Cultures, that the meaning of White has been and continues to be a moving target in the United States. But why is this demographic change happening at this time? A major driving force is the demographic reality that native-born people are no longer reproducing at replacement level in the wealthy postindustrial nations, which, if it continues, will lead to a declining population skewed toward advanced age. One solution used by some countries, including the United States, is to change immigration policy to allow new streams of immigration. The current rate of foreign-born persons in the United States is lower than it has been throughout most of the past 150 years, but foreign-born persons are less likely to be White than when immigration policy, prior to 1965, strictly limited entry for persons of color. With the recent influx of immigrants from around the globe, the United States has become one of many ethnically and racially diverse nations in the world today. In many wealthy postindustrial countries, including the United States, there is much anti-immigrant sentiment, even though the economies of these countries are dependent on such migration. Waves of immigration have historically been accompanied by anti-immigrant sentiment. There appear to be many reasons for anti-immigrant sentiment, including fear that new immigrants will dilute the “purity” of the native culture, racial and religious bias, and fear of economic competition. Like other diverse societies, we must find ways to embrace the diversity and seize the

opportunity to demonstrate the human capacity for intergroup harmony.

On the other hand, some of the diversity in our social life is not new but simply newly recognized. In the contemporary era, we have been developing a heightened consciousness of human differences—gender and gender identity differences, racial and ethnic differences, cultural differences, religious differences, differences in sexual orientation, differences in abilities and disabilities, differences in family forms, and so on. This book intends to capture the diversity of human experience in a manner that is respectful of all groups, conveys the positive value of human diversity, and recognizes differences within groups as well as among groups.

As we seek to honor differences, we make a distinction between heterogeneity and diversity. We use heterogeneity to refer to individual- level variations—differences among individuals. For example, as a social worker who came in contact with Joshua’s family at the time they were resettled in Boise, you would want to recognize the ways in which they are different from you and from other clients you serve, including other clients of Banyamulenge heritage. An understanding of heterogeneity allows us to recognize the uniqueness of each person and situation. Diversity, on the other hand, is used to refer to patterns of group differences. Diversity recognizes social groups, groups of people who share a range of physical, cultural, or social characteristics within a category of social identity. As a social worker, besides recognizing individual differences, you will also want to be aware of the diversity in your community, such as the distribution of various ethnic groups, including those of Banyamulenge heritage. Knowledge of diversity helps us to provide culturally sensitive services.

I want to interject a word here about terminology and human diversity. As the contributing authors and I attempted to uncover what is known about human diversity, we struggled with terminology to define identity groups. We searched for consistent language to describe different groups, and we were dedicated to using language that identity groups would use to describe themselves. However, we ran into challenges endemic to our time related to the language of diversity. It is not the case, as you have probably observed, that all members of a given identity group at any given time embrace the same terminology for their group. As we reviewed literature from different historical moments, we recognized the shifting nature of

terminology. In addition, even within a given historical era, we found that different researchers used different terms and had different decision rules about who composes the membership of identity groups. Add to this the changing way that the U.S. Census Bureau establishes official categories of people, and in the end, we did not settle on fixed terminology to consistently describe identity groups. Rather, we use the language of individual researchers when reporting their work, because we want to avoid distorting their work. We hope you will not find this too distracting. We also hope that you will recognize that the ever-changing language of diversity has both constructive potential to find creative ways to affirm diversity and destructive potential to dichotomize diversity into the norm and the other.

Inequality Attending to diversity involves recognition of the power relations and the patterns of opportunities and constraints for social groups. If we are interested in the Banyamulenge community in our city, for example, we will want to note, among other things, the neighborhoods where they live, the access to community resources and quality of the housing stock in those neighborhoods, the comparative educational attainment in the community, the occupational profile of the community, the comparative income levels, and so on. When we attend to diversity, we not only note the differences between groups but also how socially constructed hierarchies of power are superimposed on these differences.

Recent U.S. scholarship in the social sciences has emphasized the ways in which three types of categorizations—gender, race, and class—are used to develop hierarchical social structures that influence social identities and life chances (Rothenberg, 2016; Sernau, 2017). This literature suggests that these social categorizations create privilege, or unearned advantage, for some groups and disadvantage for other groups. In a much-cited article, Peggy McIntosh (2016) has pointed out the mundane daily advantages of White privilege that are not available to members of groups of color, such as assurances “that my children will be given curricular materials that testify to the existence of their race,” and “Whether I use checks, credit cards, or cash, I can count on my skin color not to work against the appearance of financial reliability.” We could also generate lists of advantages of male privilege, age privilege, economic privilege, heterosexual privilege, ability privilege, Christian privilege, and so on.

McIntosh argues that members of privileged groups benefit from their privilege but have not been taught to think of themselves as privileged. They take for granted that their advantages are normal and universal and are often resistant to attempts to point out the privilege of their social locations. For survival, members of nonprivileged groups must learn a lot about the lives of groups with privilege, but groups with privileged status are not similarly compelled to learn about the lives of members of nonprivileged groups.

Michael Schwalbe (2006) argues that those of us who live in the United States also carry “American privilege,” which comes from our dominant position in the world. (I would prefer to call this “U.S. privilege,” because people living in Canada, Ecuador, and Brazil also live in America.) According to Schwalbe, among other things, American privilege means that we don’t have to bother to learn about other countries or about the impact of our foreign policy on people living in those countries. For example, we don’t have to learn about how our society’s romance with computers and cell phones helps to drive conflict over the natural resource of coltan in the Congo. Perhaps that is what Rothenberg (2006) was thinking of when she noted ignorance of world geography among people who live in the United States. American privilege also means that we have access to cheap goods that are produced by poorly paid workers in impoverished countries. As Chapter 9 shows, the income and wealth gap between nations is mind-boggling. Sernau (2017) reports that the combined income of the 25 richest Americans is almost equal to the combined income of the world’s poorest 2 billion people. In 2016, the average per capita income in the DRC was $6,700 in U.S. dollars, compared with $57,400 in the United States (Central Intelligence Agency, 2017a). Economic conditions in the DRC have been hurt by continuous war for many years. It is becoming increasingly difficult to deny the costs of exercising American privilege by remaining ignorant about the rest of the world and the impact our actions have on other nations.

As we strive to provide a global context, we encounter current controversies about appropriate language to describe different sectors of the world. Following World War II, a distinction was made between First World, Second World, and Third World nations, with First World referring to the Western capitalist nations, Second World referring to the countries belonging to the socialist bloc led by the Soviet Union, and Third World referring to a set of countries that were primarily former colonies of

the First World. More recently, many scholars have used the language of First World, Second World, and Third World to define global sectors in a slightly different way. First World has been used to describe the nations that were the first to industrialize, urbanize, and modernize. Second World has been used to describe nations that have industrialized but have not yet become central to the world economy. Third World has been used to refer to nonindustrialized nations that are considered expendable in the global economy. This approach has lost favor in recent years because it is thought to suggest some ranking of the value of the world’s societies. Immanuel Wallerstein (1974, 1979) uses different language but makes a similar distinction; he refers to wealthy core countries, newly industrialized semiperiphery countries, and the poorest periphery countries. Wallerstein is looking not to rank the value of societies but to emphasize the ways that some societies (core) exploit other societies (periphery). Other writers divide the world into developed and developing countries (McMichael, 2017), referring to the level of industrialization, urbanization, and modernization. Although scholars who use those terms are not necessarily using them to rank the value of different societies, the terms are sometimes used that way. Still other scholars divide the world into the Global North and the Global South, calling attention to a history in which the Global North colonized and exploited the people and resources of the Global South. This system of categorization focuses specifically on how some societies exploit other societies. And, finally, some writers talk about the West versus the East, where the distinctions are largely cultural. We recognize that such categories carry great symbolic meaning and can either mask or expose systems of power and exploitation. As with diversity, we attempted to find a respectful language that could be used consistently throughout the book. Again, we found that different researchers have used different language and different characteristics to describe categories of nations, and when reporting on their findings, we have used their own language to avoid misrepresenting their findings.

It is important to note that privilege and disadvantage are multidimensional, not one-dimensional. One can be privileged in one dimension and disadvantaged in another; for example, I have White privilege but not gender privilege. As social workers, we need to be attuned to our own social locations—where we fit in a system of social identities, such as race, ethnicity, gender and gender identity, social class, sexual orientation, religion, ability/disability, age, and citizenship. We must recognize how our own particular social locations shape how we see

the world, what we notice, and how we interpret what we “see.”

It is important for social workers to acknowledge social inequalities because our interactions are constantly affected by inequalities of various types. In addition, there is clear evidence that social inequalities are on the rise in the United States. Although income inequality has been growing in all of the wealthy nations of the world over the past 2 decades, the United States gained the distinction as the most unequal wealthy nation in this period, and the gap has continued to widen since the deep economic crisis that began in 2008 (Sernau, 2017).

Advancing Human Rights and Social, Economic, and Environmental Justice There is another important reason why social workers must acknowledge social inequalities. The National Association of Social Workers (NASW) Code of Ethics identifies social justice as one of six core values of social work and mandates that “Social workers challenge social injustice” (NASW, 2017). The third social work competency identified by the CSWE (2015) is to “Advance Human Rights and Social, Economic, and Environmental Justice” (p. 7). The statement of this competency specifies that every person has “fundamental rights such as freedom, safety, privacy, an adequate standard of living, health care, and education” (p. 7). To challenge injustice, we must first recognize it and understand the ways it is embedded in a number of societal institutions. That is the subject of Chapter 9 in this book.

Suzanne Pharr (1988) provides some useful conceptual tools that can help us recognize injustice when we see it. She identifies a set of mechanisms of oppression, whereby the everyday arrangements of social life systematically block opportunities for some groups and inhibit their power to exercise self-determination. Exhibit 1.4 provides an overview of these mechanisms of oppression. As you review the list, you may recognize some that are familiar to you, such as stereotyping and perhaps blaming the victim. There may be others that you have not previously given much thought to. I have often found that the concept of internalized oppression is new to students, but it quickly becomes a concept that helps them think differently about the client groups they encounter. You may also recognize, as I do each time I look at the list, that although some of these

mechanisms of oppression are sometimes used quite intentionally, others are not so intentional but occur as we do business as usual. For example, when you walk into your classroom or other public room, do you give much thought to the person who cleans that room, what wage this person is paid, whether this is the only job this person holds, and what opportunities and barriers this person has experienced in life? Most likely the classroom is cleaned in the evening after it has been vacated by teachers and students, and the person who cleans it, like many people who provide services that make our lives more pleasant, is invisible to you. Giving serious thought to common mechanisms of oppression can help us to recognize social injustice and think about ways to challenge it.

Exhibit 1.4 ● Common Mechanisms of Oppression Exhibit 1.4 ● Common Mechanisms of Oppression

Economic power and control

Limiting of resources, mobility, education, and employment options to all but a few

Myth of scarcity

Myth used to pit people against one another, suggests that resources are limited and blames people (e.g., poor people, immigrants) for using too many of them

Defined norm

A standard of what is good and right, against which all are judged

The other Those who fall outside “the norm” but are defined in relation to it, seen as abnormal, inferior, marginalized

Invisibility Keeping “the other’s” existence, everyday life, andachievements unknown

Distortion Selective presentation or rewriting of history so thatonly negative aspects of the other are included

Stereotyping Generalizing the actions of a few to an entire group,denying individual characteristics and behaviors

Violence and the threat of violence

Laying claim to resources, then using might to ensure superior position

Lack of prior claim

Excluding anyone who was not originally included and labeling as disruptive those who fight for inclusion

Blaming the victim

Condemning the others for their situation, diverting attention from the roles that dominants play in the situation

Internalized oppression

Internalizing negative judgments of being the other, leading to self-hatred, depression, despair, and self- abuse

Horizontal hostility

Extending internalized oppression to one’s entire group as well as to other subordinate groups, expressing hostility to other oppressed persons and groups rather than to members of dominant groups

Isolation Physically isolating people as individuals or as a“minority” group

Assimilation Pressuring members of minority groups to drop their culture and differences and become a mirror of the dominant culture

Tokenism Rewarding some of the most assimilated others withposition and resources

Emphasis on individual solutions

Emphasizing individual responsibility for problems and individual solutions rather than collective responsibility and collective solutions

Source: Adapted from Pharr, 1988.

In recent years, social workers have expanded the conversation about social justice to include global social justice. As they have done so, they

have more and more drawn on the concept of human rights to organize thinking about social justice (see Mapp, 2014; Wronka, 2017). In the aftermath of World War II, the newly formed United Nations (1948) created a Universal Declaration of Human Rights (UDHR) that spelled out the rights to which all humans were entitled, regardless of their place in the world, and this document has become a point of reference for subsequent definitions of human rights. Cox and Pawar (2013) identify eight philosophical values suggested by the UDHR: life (human and nonhuman); freedom and liberty; equality and nondiscrimination; justice; solidarity; social responsibility; evolution, peace, and nonviolence; and relationships between humankind and nature.

A number of theories of social justice have been proposed. Probably the most frequently cited theory of social justice in the social work literature is John Rawls’s (1971, 2001) theory of justice as fairness. In the past decade or so, some social work scholars (Banerjee & Canda, 2012; Carlson, Nguyen, & Reinady, 2016; Morris, 2002) have recommended the capabilities approach to social justice, originally proposed by Amartya Sen (1992, 2009) and revised by Martha Nussbaum (2011). The capabilities approach draws on both Western and non-Western thinking. In this approach, capabilities are, in simplest terms, opportunities and freedoms to be or do what we view as worthwhile; justice is served when people have such opportunities and freedoms. Nussbaum carries the capabilities approach a step further and identifies 10 core capabilities that all people in all societies must have to lead a dignified life. She asserts that promotion of social justice involves supporting the capabilities of people who are denied opportunities and freedoms related to any of the core capabilities. See Exhibit 1.5 for an overview of the core capabilities identified by Nussbaum.

Critical Thinking Questions 1.3

What impact is globalization having on your own life? Do you see it as having a positive or negative impact on your life? What about for Joshua? Do you think globalization is having a positive or negative impact on his life? Do you agree with Martha Nussbaum that it is important for all people to have opportunities and freedoms in relation to the 10 core capabilities she identifies? How do you see Joshua in relation to these core capabilities?

Exhibit 1.5 ● Nussbaum’s 10 Core Capabilities Exhibit 1.5 ● Nussbaum’s 10 Core Capabilities

Capability Definition

Life To live to the end of a normal life course

Bodily health To have good physical health and adequatenourishment and shelter

Bodily integrity To exercise freedom of movement, freedomfrom assault, and reproductive choice

Senses, imagination, and thought

To have pleasant sensory experiences, pain avoidance, adequate education, imagination, free self-expression, and religious freedom

Emotion To experience a full range of emotion and tolove and be loved

Practical reason To think critically and make wise decisions

Affiliation To live with others with empathy andcompassion, without discrimination

Concern for other species

To show concern for animals, plants, and other aspects of nature

Play To laugh and play and enjoy recreationalactivities

Control over one’s political and material environment

To participate freely in the political process and have equal access to employment and property

Source: Adapted from Nussbaum, 2011.

Knowing and Doing Social workers, like other professional practitioners, must find a way to move from knowing to doing, from “knowing about” and “knowing that” into “knowing how to” (for fuller discussion of this issue, see Hutchison, Charlesworth, Matto, Harrigan, & Viggiani, 2007). We know for the purpose of doing. Like architects, engineers, physicians, and teachers, social workers are faced with complex problems and case situations that are unique and uncertain. You no doubt will find that social work education, social work practice, and even this book will stretch your capacity to tolerate ambiguity and uncertainty. That is important because, as Carol Meyer (1993) has suggested, “There are no easy or simple [social work] cases, only simplistic perceptions” (p. 63). There are four important ingredients of “knowing how” to do social work: knowledge about the case, knowledge about the self, values and ethics, and scientific knowledge. These four ingredients are intertwined in the process of doing social work. The focus of this book is on scientific knowledge, but all four ingredients are essential in social work practice. Before moving to a discussion of scientific knowledge, I want to say a word about the other three ingredients.

Knowledge About the Case I am using case to mean the situation at hand, a situation that has become problematic for some person or collectivity, resulting in a social work intervention. Our first task as social workers is to develop as good an understanding of the situation as possible: Who is involved in the situation, and how are they involved? What is the nature of the relationships of the people involved? What are the physical, societal, cultural, and community contexts of the situation? What are the contextual constraints as well as the contextual resources for bringing change to the situation? What elements of the case are maintaining the problematic situation? How have people tried to cope with the situation? What preferences do the involved people have about the types of intervention to use? What is the culture, and what are the social resources of the social agency to whose attention the situation is brought? You might begin to think about how you would answer some of these questions in relation to Joshua’s family when they arrived in Boise and were assisted by the refugee resettlement agency.

It is important to note that knowledge about the case is influenced by the quality of the relationship between the social worker and client(s). There is good evidence that people are likely to reveal more aspects of their situation if they are approached with commitment, an open mind, warmth, empathic attunement, authentic responsiveness, and mutuality (Hepworth, Rooney, Rooney, & Strom-Gottfried, 2017). For example, as Joshua became comfortable in the interview, feeling validated by the interviewer, he began to engage in deeper reflection about what happened in the DRC and Burundi. He had never put the story together in this way before. This can be an important part of his grieving and adjustment process. The integrity of knowledge about the case is related to the quality of the relationship, and the capacity for relationship is related to knowledge about the self.

But knowledge about the case requires more than simply gathering information. We must select and order the information at hand and decide if further information is needed. This involves making a series of decisions about what is relevant and what is not. It also involves searching for recurring themes as well as contradictions in the information. For example, family loss is a consistent theme throughout Joshua’s story, as is his strength and commitment to move forward to adjust to new situations. Listening to his story, you notice that the Gatumba massacre is mentioned very early in the story telling, and this alerts us to the possibility that other Banyamulenge refugees may need to reflect on the Gatumba massacre.

To assist you in moving between knowledge about the case and scientific knowledge, each chapter in this book begins, as this one does, with one or more case studies. Each of these unique stories suggests what scientific knowledge is needed. For example, to work effectively with Banyamulenge refugees like Joshua, you will want to understand some things about the DRC, the Banyamulenge ethnic group, grief reactions, the acculturation process, challenges facing immigrant families, and cross- cultural communication. Throughout the chapters, the stories are woven together with relevant scientific knowledge. Keep in mind that scientific knowledge is necessary, but you will not be an effective practitioner unless you take the time to learn about the unique situation of each person or collectivity you serve. It is the unique situation that guides what scientific knowledge is needed.

Knowledge About the Self

In his book The Spiritual Life of Children, Robert Coles (1990) wrote about the struggles of a 10-year-old Hopi girl to have her Anglo teacher understand Hopi spirituality. Coles suggested to the girl that perhaps she could try to explain her tribal nation’s spiritual beliefs to the teacher. The girl answered, “But they don’t listen to hear us; they listen to hear themselves” (p. 25, emphasis in the original). This young girl has captured, in a profound way, a major challenge to our everyday personal and professional communications: the tendency to approach the world with preconceived notions that we seek to validate by attending to some information while ignoring other information (Kahneman, 2011). The capacity to understand oneself is needed in order to tame this very human tendency.

Three types of self-knowledge are essential for social workers: understanding of one’s own thinking processes, understanding of one’s own emotions, and understanding of one’s own social location. We must be able to think about our thinking, a process called metacognition. We all have biases that lead to thinking errors, and it is very difficult to get control of our biases. In addition, both anger and stress can lead us to think less critically and make erroneous judgments (Sapolsky, 2017). As Daniel Kahneman (2011) suggests in his book Thinking Fast and Slow, constant questioning of our own thinking can become tedious and immobilize us. The best we can do, therefore, is to understand the types of situations in which we are likely to make mistakes and slow down and use multiple sources of information to help correct for our biases. We also must be able to recognize what emotions get aroused in us when we hear stories like Joshua’s and when we contemplate the challenges of a given situation, and we must find a way to use those emotions in ways that are helpful and avoid using them in ways that are harmful. Although writing about physicians, Gunnar Biorck (1977) said it well when he commented that practitioners make “a tremendous number of judgments each day, based on inadequate, often ambiguous data, and under pressure of time, and carrying out this task with the outward appearance of calmness, dedication and interpersonal warmth” (p. 146).

In terms of social location, as suggested earlier, social workers must identify and reflect on where they fit in a system of social identities, such as race, ethnicity, gender and gender identity, social class, sexual orientation, religion, ability/disability, age, and so on. A strong personal identity in relation to important societal categories, and an understanding

of the impact of those identities on other people, is essential for successful social work intervention across cultural lines. This type of self-knowledge requires reflecting on where one fits in systems of privilege.

Values and Ethics The CSWE (2015) indicates the importance of values and ethics for social work practice by making it number one in its identification of social work competencies: Competency 1: Demonstrate Ethical and Professional Behavior (p. 7). Knowledge about the self is critical to ethical and professional social work practice. To engage in such practice, we must “use reflection and self-regulation” (p. 7) to manage our personal values and our very human cognitive biases and emotional reactions. That is why the first learning objective for each chapter in this book and the companion volume Dimensions of Human Behavior: The Changing Life Course is to recognize one’s own cognitive and emotional reactions to the case studies that introduce the chapter.

The process of developing knowledge about the case is a dialogue between the social worker and client system, and social workers have a well- defined value base to guide the dialogue. Six core values of the profession have been set out in a preamble to the Code of Ethics established by the National Association of Social Workers (NASW) in 1996 and revised in 2017. These values are service, social justice, dignity and worth of the person, importance of human relationships, integrity, and competence. The value of social justice was discussed earlier in the chapter. As demonstrated in Exhibit 1.6, the Code of Ethics articulates an ethical principle for each of the core values. Value 6, competence, requires that we recognize the science available to inform our work. It requires understanding the limitations of the available science for considering the situation at hand but also that we use the strongest available evidence to make practice decisions. This is where scientific knowledge comes into the picture.

Critical Thinking Questions 1.4

If you were the social worker at Joshua’s refugee resettlement program when he first arrived in the United States, what knowledge about the case would you like to have? What information would you find most

important? What emotional reactions did you have to reading Joshua’s story? What did you find yourself thinking about his story? Where do you see Joshua fitting in systems of privilege? Where do you see yourself fitting? How might any of this impact your ability to be helpful to Joshua and his family?

Exhibit 1.6 ● Core Values and Ethical Principles in the NASW Code of Ethics

1. Value: Service

Ethical principle: Social workers’ primary goal is to help people in need and to address social problems.

2. Value: Social justice

Ethical principle: Social workers challenge social injustice.

3. Value: Dignity and worth of the person

Ethical principle: Social workers respect the inherent dignity and worth of the person.

4. Value: Importance of human relationships

Ethical principle: Social workers recognize the central importance of human relationships.

5. Value: Integrity

Ethical principle: Social workers behave in a trustworthy manner.

6. Value: Competence

Ethical principle: Social workers practice within their areas of competence and develop and enhance their professional expertise.

Source: National Association of Social Workers, 2017.

Scientific Knowledge: Theory and Research 82

The CSWE (2015) notes that social work practice is guided by “knowledge based on scientific inquiry” (p. 5). Ethical social workers are always searching for or recalling what is known about the situations they encounter, turning to the social and behavioral sciences for this information. Scientific knowledge serves as a screen against which the knowledge about the case is considered. It suggests hypotheses, or tentative statements, to be explored and tested, not facts to be applied, in transactions with a person or social group. Because of the breadth and complexity of social work practice, usable knowledge must be culled from diverse sources and a number of scientific disciplines. Science, also known as scientific inquiry, is a set of logical, systematic, documented methods for answering questions about the world. Scientific knowledge is the knowledge produced by scientific inquiry. Two interrelated approaches to knowledge building, theory and empirical research, fit the scientific criteria of being logical, systematic, and documented for the public. Together, they create the base of knowledge that social workers need to understand commonalities among their clients and practice situations. In your coursework on social work research, you will be learning much more about these concepts, so I only provide a brief description here to help you understand how this book draws on theory and research.

Theory As we discuss in Chapter 2, the CSWE (2015) notes that “social workers understand theories of human behavior and the social environment, and critically evaluate and apply this knowledge” (p. 6). Social workers use theory to help organize and make sense of the situations they encounter. A theory is an interrelated set of concepts and propositions, organized into a deductive system, that explains relationships among aspects of our world. As Elaine Leeder (2004) so aptly put it, “To have a theory is to have a way of explaining the world—an understanding that the world is not just a random series of events and experiences” (p. 9). Thus, theory gives us a framework for engaging with, assessing, and planning interventions with client systems. It seems to be human nature to develop theories to make sense of the world. As social workers we put our personal theories of the world to the test by studying theories proposed by serious scholars of human behavior. I want to emphasize that theories allow us to organize our thinking, but theories are not “fact” or “truth.”

Other terms that you will often encounter in discussions of theories are

model, paradigm, and perspective. Model usually is used to refer to a visual representation of the relationships between concepts, paradigm most often means a way of seeing the world, and perspective is an emphasis or a view. Paradigms and perspectives are broader and more general than theory. But different scholars use these terms in different ways, and sometimes interchangeably.

If you are to make good use of theory, you should know something about how it is constructed. Concepts are the building blocks of theory. They are symbols, or mental images, that summarize observations, feelings, or ideas. Concepts allow us to communicate about the phenomena of interest. Some relevant concepts in Joshua’s story are culture, cultural conflict, refugee, resettlement, acculturation, trauma, loss, and grief.

Theoretical concepts are put together to form propositions, or assertions. For example, loss and grief theory proposes that the loss of a person, object, or ideal leads to a grief reaction. This proposition, which asserts a particular relationship between the concepts of loss and grief, may help a refugee resettlement social worker understand some of the sadness, and sometimes despair, that he or she sees in work with refugee families. They have lived with an accumulation of losses—loss of land, loss of livelihood, loss of roles, loss of status, loss of family members, loss of familiar language and rituals, and many more.

Theories are a form of deductive reasoning, meaning they lay out general, abstract propositions that we can use to generate specific hypotheses to test in unique situations. In this example, loss and grief theory can lead us to hypothesize that refugees are grieving the many losses they have suffered, but we should understand that this may not be the case with all refugees. Theory is about likelihood, not certainty.

Social and behavioral science theories are based on assumptions, or beliefs held to be true without testing or proof, about the nature of human social life. Theoretical assumptions have raised a number of controversies, three of which are worth introducing at this point.

1. Do the dimensions of human behavior have an objective reality that exists outside a person’s consciousness, or is all reality based on personal perception (subjective reality)?

2. Is human behavior determined by forces beyond the control of the person (determinism), or are people free and proactive agents in the

creation of their behavior (voluntarism)? 3. Are the patterned interactions among people characterized by

harmony, unity, and social cohesion or by conflict, domination, coercion, and exploitation?

The nature of these controversies will become more apparent to you in Chapter 2. The contributing authors and I take a middle ground on all of them: We assume that reality has both objective and subjective aspects, that human behavior is partially constrained and partially free, and that social life is marked by both cohesion and conflict.

Empirical Research Traditionally, science is equated with empirical research, which is widely held as the most rigorous and systematic way to understand human behavior. Research is typically viewed, in simple terms, as a problem- solving process, or a method of seeking answers to questions. If something is empirical, we experience it through our senses, as opposed to something we experience purely in our minds. The process of empirical research includes a careful, purposeful, and systematic observation of events with the intent to note and record them in terms of their attributes, to look for patterns in those events, and to make our methods and observations public. Each empirical research project is likely to raise new questions, often producing more questions than answers. The new questions become grist for future research. Like theory, empirical research is a key tool for social workers. The CSWE (2015) specifies that social workers “use and translate research evidence to inform and improve practice, policy, and service delivery” (p. 8). It is important to understand, however, that empirical research, like theory, informs us about probabilities, not certainties (Firestein, 2012). For example, research can tell us what percentage of parents who were abused as children will become abusive toward their own children, but it cannot tell us whether a specific parent who was abused as a child will become abusive toward his or her children. Social workers, of course, must make decisions about specific parents, recognizing the probabilities found in research as well as considering the knowledge about the case.

Just as there are controversies about theoretical assumptions, there are also controversies about what constitutes appropriate research methods for understanding human behavior. Modern science is based on several

assumptions, which are generally recognized as a positivist perspective: The world has an order that can be discovered, findings of one study should be applicable to other groups, complex phenomena can be studied by reducing them to some component part, findings are tentative and subject to question, and scientific methods are value-free. Quantitative methods of research are preferred from the positivist perspective. These methods use quantifiable measures of concepts, standardize the collection of data, attend only to preselected variables, and use statistical measures to look for patterns and associations (Engel & Schutt, 2017).

Over the years, the positivist perspective and its claim that positivism = science have been challenged. Critics argue that quantitative methods cannot possibly capture the subjective experience of individuals or the complex nature of social life. Although most of these critics do not reject positivism as a way of doing science, they recommend other ways of understanding the world and suggest that these alternative methods should also be considered part of science. Various names have been given to these alternative methods. I refer to them as the interpretist perspective, because they share the assumption that reality is based on people’s definitions of it, and research should focus on learning the meanings that people give to their situations. This is also referred to as a constructivist perspective.

Interpretists see a need to replace quantitative methods with qualitative methods of research, which are more flexible and experiential and are designed to capture how participants view social life rather than to ask participants to respond to categories preset by the researcher (Engel & Schutt, 2017). Participant observation, intensive interviewing, and focus groups are examples of qualitative methods of research. Interpretists assume that people’s behavior cannot be observed objectively, that reality is created as the researcher and research participants interact. Researchers using qualitative methods are more likely to present their findings in words than in numbers and to attempt to capture the settings of behavior. They are likely to report the transactions of the researcher and participant as well as the values of the researcher, because they assume that value-free research is impossible.

In this controversy, it is our position that no single research method can adequately capture the whole, the complexity, of human behavior. Both quantitative and qualitative research methods have a place in a

multidimensional approach, and used together they may help us to see more dimensions of situations. This is the view of the CSWE (2015), which states that “social workers understand quantitative and qualitative research methods and their respective roles in advancing a science of social work and in evaluating their practice” (p. 8). This view has much in common with postpositivism, which developed in response to criticism of positivism. Postpositivism is a philosophical position that recognizes the complexity of reality and the limitations of human observers. It proposes that scientists can never develop more than a partial understanding of human behavior (Engel & Schutt, 2017). Neuroscientist Stuart Firestein (2012) reminds us that we must learn to live with “unknowable unknowns” (p. 30) and become capable of working with uncertainties. Nevertheless, science remains the most rigorous and systematic way to understand human behavior.

Critical Use of Theory and Research You may already know that social and behavioral science theory and research have been growing at a fast pace in modern times, and you will often feel, as McAvoy (1999) aptly put it, that you are “drowning in a swamp of information” (p. 19), both case information and scientific information. Ironically, as you are drowning in a swamp of information, you will also be discovering that the available scientific information is incomplete. You will also encounter contradictory theoretical propositions and research results that must be held simultaneously and, where possible, coordinated to develop an integrated picture of the situation at hand. That is, as you might guess, not a simple project. It involves weighing available evidence and analyzing its relevance to the situation at hand. That requires critical thinking. Critical thinking is a thoughtful and reflective judgment about alternative views and contradictory information. It involves thinking about your own thinking and the influences on that thinking, as well as a willingness to change your mind. It also involves careful analysis of assumptions and evidence. Critical thinkers also ask, “What is left out of this conceptualization or research?” “What new questions are raised by this research finding?” Throughout the book, we call out critical thinking questions to support your efforts to think critically.

As you read this book and other sources of scientific knowledge, begin to think critically about the theory and research they present. Give careful thought to the credibility of the claims made. Let’s look first at theory. It is

important to remember that although theorists may try to put checks on their biases, they write from their own cultural frame of reference, from a particular location in the social structure of their society, and from life experiences. As we work in a highly diversified world, we need to be attentive to the possibilities of biases related to race, gender and gender identity, culture, religion, sexual orientation, abilities/disabilities, social class, and so on—as well as professional or occupational orientation. One particular concern is that such biases can lead us to think of disadvantaged members of society or of members of minority groups as pathological or deficient.

Photo 1.3 Theories and research about human behavior are boundless and constantly growing. Active readers must question what they read.

Social and behavioral science scholars disagree about the criteria for evaluating theory and research. However, I recommend the criteria presented in Exhibit 1.7 because they are consistent with the multidimensional approach of this book and with the value base of the social work profession. (The five criteria for evaluating theory presented in Exhibit 1.7 are also used in Chapter 2 to evaluate eight theoretical perspectives relevant to social work.) There is agreement in the social and behavioral sciences that theory should be evaluated for coherence and conceptual clarity as well as for testability and evidence of empirical

support. The criterion of comprehensiveness is specifically related to the multidimensional approach of this book. We do not expect all theories to be multidimensional, but critical analysis of a theory should help us identify deterministic and unidimensional thinking where they exist. The criterion of consistency with emphasis on diversity and power arrangements examines the utility of the theory for a profession that places high value on social justice, and the criterion of usefulness for practice is essential for a profession.

Just as theory may be biased toward the experiences of members of dominant groups, so too may research be biased. The results may be misleading, and the interpretation of results may lead to false conclusions about members of minority groups. Bias can occur at all stages of the research process.

Funding sources and other vested interests have a strong influence on which problems are selected for research attention. For example, there is much controversy about how gun violence research was frozen in the United States in 1996 when Congress, under pressure from the National Rifle Association, passed legislation that banned funding by the U.S. Centers for Disease Control and Prevention for research that could be used to advocate or promote gun control (American Psychological Association, 2013). Bias can occur in the definition of variables for study. For example, using “offenses cleared by arrests” as the definition of crime, rather than using a definition such as “self-reported crime involvement,” may lead to an overestimation of crime among minority groups of color, because those are the people who are most often arrested for their crimes (Monette, Sullivan, DeJong, & Hilton, 2014). Bias can occur in choosing the sample to be studied. Because there are fewer of them, members of minority groups may not be included in sufficient numbers to demonstrate the variability within a particular minority group. Or a biased sample of minorities may be used (e.g., it is not uncommon to make Black/White comparisons on a sample that includes middle-class Whites and low-income Blacks). Analysis of articles in the major behavioral science journals indicates that most of the samples are drawn almost exclusively from Western, educated, industrialized, and democratic (WEIRD) societies (Henrich, Heine, & Norenzayan, 2010). This same analysis concludes that these research participants are different from most other people of the world in

important ways. We need to keep this in mind as we review available empirical research. Bias can occur in data collection. The validity and reliability of most standardized measuring instruments have been evaluated by using them with White, non-Hispanic male respondents, and their cultural relevance with people of color, women, impoverished persons, or members of other groups is questionable. Language and literacy difficulties may arise with both written survey instruments and interviews. Some groups may be reluctant to participate in research because they don’t trust the motives of the researchers. Bias can occur in interpretation of the data, because empirical research typically fails to produce uncontestable results (Firestein, 2012).

As with theory evaluation, there is no universally agreed-upon set of criteria for evaluating research. I recommend the nine criteria presented in Exhibit 1.7 for considering the credibility of a research report. These criteria can be applied to either quantitative or qualitative research. Many research reports would be strengthened if their authors were to attend to these criteria.

Critical Thinking Questions 1.5

If I drew a line on the floor with objective reality at one end and subjective reality at the other end, where would you place yourself on the line to demonstrate your own understanding of human behavior?

Objective Reality ________________ Subjective Reality

And if I drew another line with determinism at one end and voluntarism at the other end, where would you place yourself on this line?

Determinism ____________________ Voluntarism

And if I drew a third line with harmony, unity, and social cohesion on one end and conflict, domination, coercion, and exploitation at the other end, where would you place yourself on this line to demonstrate your theory about what happens in human social interaction?

Harmony Conflict, Domination Unity _________________ Coercion, Exploitation Cohesion

Organization of the Book In this book, Part I includes two stage-setting chapters that introduce the framework for the book and provide a foundation for thinking critically about the discussions of theory and research presented in Parts II and III. Part II comprises four chapters that analyze the multiple dimensions of persons—one chapter each on the biological person, the psychological person (or the self), the psychosocial person (or the self in relationship), and the spiritual person. The eight chapters of Part III discuss the environmental dimensions: the physical environment, cultures, social structure and social institutions, families, small groups, formal organizations, communities, and social movements.

As noted earlier, presenting person and environmental dimensions separately, as we do in Parts II and III, is a risky approach. I do not wish to reinforce any tendency to think about human behavior in a way that camouflages the inseparability of person and environment. In our work as social workers, we engage in both analysis and synthesis. Sometimes we need to think analytically, breaking down a complex situation by thinking more critically about specific aspects and dimensions of the situation, whether that is a biological system or a pattern of family relationships. But we also need to be able to put the puzzle pieces back together to see the whole story. That is synthesis. We are always working back and forth between analysis and synthesis. Each chapter in the book attempts to capture some of the complexity of multiple interacting dimensions of behavior.

Exhibit 1.7 ● Criteria for Evaluating Theory and Research Exhibit 1.7 ● Criteria for Evaluating Theory and Research

Criteria for Evaluating Theory

Coherence and conceptual clarity. Are the concepts clearly defined and consistently used? Is the theory free of logical inconsistencies? Is it stated in the simplest possible way, without oversimplifying?

Testability and evidence of empirical support. Can the concepts and propositions be expressed in language that makes them observable and accessible to corroboration or refutation by persons other than

the theoretician? Is there evidence of empirical support for the theory?

Comprehensiveness. Does the theory include multiple dimensions of persons, environments, and time? What is included and what is excluded? What dimension(s) is (are) emphasized? Does the theory account for things that other theories have overlooked or been unable to account for?

Consistency with social work’s emphasis on diversity and power arrangements. Can the theory help us understand diversity? How inclusive is it? Does it avoid pathologizing members of minority groups? Does it assist in understanding power arrangements and systems of oppression?

Usefulness for social work practice. Does the theory assist in the understanding of person–environment transactions over time? Can principles of action be derived from the theory? At what levels of practice can the theory be used? Can the theory be used in practice in a way that is consistent with the NASW Code of Ethics?

Criteria for Evaluating Research

Corroboration. Are the research findings corroborated by other researchers? Are a variety of research methods used in corroborating research? Do the findings fit logically with accepted theory and other research findings?

Multidimensionality. Does the research include multiple dimensions of persons, environments, and time? If not, do the researchers acknowledge the omissions, connect the research to larger programs of research that include omitted dimensions, or recommend further research to include omitted dimensions?

Definition of terms. Are major variables defined and measured in such a way as to avoid bias against members of minority groups?

Limitation of sample. Does the researcher make sufficient effort to include diversity in the sample? Are minority groups represented in

sufficient numbers to show the variability within them? When demographic groups are compared, are they equivalent on important variables? Does the researcher specify the limitations of the sample for generalizing to specific groups?

Influence of setting. Does the researcher specify attributes of the setting of the research, acknowledge the possible contribution of the setting to research outcomes, and present the findings of similar research across a range of settings?

Influence of the researcher. Does the researcher specify his or her attributes and role in the observed situations? Does the researcher specify his or her possible contributions to research outcomes?

Social distance. Does the researcher attempt to minimize errors that could occur because of literacy, language, and cultural differences between the researcher and respondents?

Specification of inferences. Does the researcher specify how inferences are made, based on the data? What biases, if any, do you identify in the inferences?

Suitability of measures. Does the researcher use measures that seem suited to, and sensitive to, the situation being researched?

Implications for Social Work Practice The multidimensional approach outlined in this chapter suggests several principles for social work engagement, assessment, intervention, and evaluation—for both prevention and remediation services.

For successful social work engagement, allow people to tell their own stories and pay attention to how they describe the pattern and flow of their person–environment configurations. In the assessment process, collect information about all the critical dimensions of the changing configuration of person and environment. In the assessment process, attempt to see the situation from a variety of perspectives. Use multiple data sources, including the person(s), significant others, and direct observations.

Use the multidimensional database of information about critical dimensions of the situation to develop a dynamic picture of the person–environment configuration. Link intervention strategies to the dimensions of the assessment. In general, expect more effective outcomes from interventions that are multidimensional, because the situation itself is multidimensional. Pay particular attention to the impact of diversity and inequality on the unique stories and situations that you encounter. Allow the unique stories of people and situations to direct the choice of theory and research to be used. Use scientific knowledge to suggest tentative hypotheses to be explored in the unique situation. Give attention to multiple dimensions of person–environment configurations in practice evaluation.

Key Terms assumptions 24 concepts 24 critical thinking 25 deductive reasoning 24 determinism 24 dimension 6 diversity 17 empirical research 24 globalization 16 heterogeneity 17 hypotheses 23 interpretist perspective 25 linear time 13 multidetermined behavior 9 multidimensional 6 objective reality 24 positivist perspective 24 postpositivism 25 privilege 17 propositions 24 qualitative methods of research 25 quantitative methods of research 24

science 23 subjective reality 24 theory 23 time orientation 13 voluntarism 24

Active Learning 1. We have used multiple dimensions of person, environment, and time to

think about Joshua’s story. If you were the social worker at the refugee resettlement agency that sponsored his family’s resettlement, you would bring your own unfolding person–environment–time story to that encounter. With the graphic in Exhibit 1.1 as your guide, write your own multidimensional story. What personal dimensions are important? What environmental dimensions? What time dimensions? What might happen when these two stories encounter each other?

2. Select a social issue that interests you, such as child abuse or youth gangs. List five things you “know” about this issue. Think about how you know what you know. How would you go about confirming or disproving your current state of knowledge on this topic?

Web Resources

No doubt, you use the Internet in many ways and know your way around it. I hope that when you find something in this book that confuses you or intrigues you, you will use the incredibly rich resources of the Internet to do further exploration. To help you get started with this process, each chapter of this textbook contains a list of Internet resources and websites that may be useful to readers in their search for further information. Each site listing includes the address and a brief description of the contents of the site. Readers should be aware that the information contained on websites may not be truthful or reliable and should be confirmed before the site is used as a reference. Readers should also be aware that Internet addresses, or URLs, are constantly changing; therefore, the addresses listed may no longer be active or accurate. Many of the Internet sites listed in each chapter contain links to other sites containing more information on the topic. Readers may use these links for further investigation.

Information on topics not included in the Web Resources sections of

each chapter can be found by using one of the many Internet search engines provided free of charge on the Internet. These search engines enable you to search using keywords or phrases, or you can use the search engines’ topical listings. You should use several search engines when researching a topic, for each will retrieve different Internet sites. We list the search engines first.

Aol Search: http://search.aol.com

Ask: www.ask.com

Bing: www.bing.com

Google: www.google.com

Yahoo! http://search.yahoo.com

There are several Internet sites maintained by and for social workers, some at university schools of social work and some by professional associations:

Council on Social Work Education (CSWE): www.cswe.org

CSWE is the accrediting body for academic social work programs; site contains information about accreditation, projects, and publications.

Information for Practice: http://ifp.nyu.edu

Site developed and maintained by Professor Gary Holden of New York University’s School of Social Work contains links to many federal and state Internet sites as well as journals, assessment and measurement tools, and sites maintained by professional associations.

International Federation of Social Workers: www.ifsw.org

Site contains information about international conferences, policy papers on selected issues, and links to human rights groups and other social work organizations.

National Association of Social Workers (NASW): www.socialworkers.org

Site contains professional development material, press room, advocacy information, and resources.

http://search.aol.com

http://www.ask.com

http://www.bing.com

http://www.google.com

http://search.yahoo.com

http://www.cswe.org

http://ifp.nyu.edu

http://www.ifsw.org

http://www.socialworkers.org

Society for Social Work and Research (SSWR): www.sswr.org

SSWR is a nonprofit organization devoted to involving social workers in research and research applications. Site contains research news, job postings, and links to social work–related websites.

http://www.sswr.org

2 Theoretical Perspectives on Human Behavior

Elizabeth D. Hutchison Leanne Wood Charlesworth Cory Cummings

Chapter Outline Learning Objectives Case Study 2.1: End of Life Care for Maria Chavez Multiple Perspectives for a Multidimensional Approach Systems Perspective Conflict Perspective Exchange and Choice Perspective Social Constructionist Perspective Psychodynamic Perspective Developmental Perspective Behavioral Perspective Humanistic Perspective The Merits of Multiple Perspectives Implications for Social Work Practice Key Terms Active Learning Web Resources

Learning Objectives 2.1 Recognize one’s own cognitive and emotional reactions to a case study. 2.2 Recognize the major themes of eight different perspectives on human behavior: systems, conflict, exchange and choice, social constructionist, psychodynamic, developmental, behavioral, and humanistic. 2.3 Analyze the merits of a multitheoretical approach to human

behavior. 2.4 Apply knowledge of eight theoretical perspectives on human behavior to recommend guidelines for social work engagement, assessment, intervention, and evaluation.

Case Study 2.1 End of Life Care for Maria Chavez The hospice social worker met Maria Chavez during the initial psychosocial assessment at her daughter’s home in a medium-sized city in the American Southwest. He had learned from the hospice administrators that Maria was diagnosed with end-stage Parkinson’s disease and Parkinson’s dementia. He had also learned that during a recent visit to her primary care provider, the provider had talked with Maria and her daughter about Maria’s prognosis. Her condition was deteriorating quickly, and her provider recommended hospice care.

The social worker meets Maria’s 65-year-old daughter, Sarah, upon entering the home. Sarah takes the social worker to a bedroom where 92-year-old Maria is lying in bed. After a few minutes of small talk, Sarah leaves the room so that the social worker and Maria can speak privately. The social worker learns during the interview that Maria moved in with Sarah after she’d lost the ability to live independently. Maria wasn’t able to tell the social worker when she moved in with her daughter, but she thought it was a few weeks ago. Although Maria’s short-term memory was poor, her long- term memory was vivid. She shared numerous stories about her past. Maria Chavez was born Maria Sarah Gallegos to Sarah and Raymond Gallegos in 1925 in New York City. The youngest of nine children, she grew up during the Great Depression, and her family experienced severe financial hardship when her father died in 1934. Her mother was unable to work, and she and her siblings were expected to support the family. Maria tells the social worker that during the Depression (and a bit thereafter) when she was a young teen, her mother sexually exploited her and her sisters to make money for the family. She never believed God loved her, and she was terrified she’d go to hell. The social worker made a note to ask the hospice chaplain to make a call on Maria as soon as possible.

After a few stories about her early life, Maria was tired and needed to rest. The social worker left Maria’s room and continued the assessment with her daughter, Sarah, who was in the kitchen making lunch. Sarah filled the social worker in on details about her mother’s family, religion, and work. First and

foremost, Maria is a proud mother of five children: four daughters and one son. Juan, her only son, died in a car accident when he was 16 years old. Sarah and one other daughter live in the area, and the other two live back East: one in New York City and one in Washington, DC, where Maria once lived. Maria and her husband, Juan, moved to the Southwest in the late 1980s because Maria had many relatives in the area. After Juan died from cancer sometime in the 1990s, Sarah moved to the area to be closer to her mother. One of her sisters followed a few years later.

In addition to being a proud mother, Maria is also a devout Catholic. The social worker noticed that her faith held significance for her when he met with her in her room. He recalled seeing a large crucifix hanging on the wall, a statue of Our Lady of Guadalupe in one corner of the room, and a Catholic Mass playing on her television set.

Sarah reported that her mother had enjoyed an impressive career. In 1944, Maria moved to Washington, DC, and joined the Women’s Army Corps. Sarah shared memories of conversations she’d had with her mom about her work. She recalled stories her mother told about the mood of the country during World War II and mentioned that her parents met during a dance for army service members. She reported that Maria continued to work throughout her marriage, working for NASA in the 1960s and 1970s.

The social worker learned that Maria moved in with Sarah 3 years ago after multiple falls, two inpatient hospitalizations, and a recommendation from a hospital social worker that Maria could no longer safely live alone at home. Before Maria started to show increasing signs and symptoms of dementia, which are currently moderate but not severe, she named Sarah her durable power of attorney for all legal, financial, and health care decisions. Even though Maria has moderate dementia, Sarah feels obligated to get her mom’s approval on financial decisions. Maria has always been frugal and focused on money, perhaps because of growing up with such economic hardship. In addition, there is a will, and the sisters are concerned that Sarah not spend too much of Maria’s money. Maria still has a house that she does not want to sell, and she has a savings account. And yet Sarah reports that she is struggling to make ends meet. She is divorced and doesn’t receive any financial support from her ex-husband. She says that her siblings don’t provide any assistance, financially or instrumentally. She also reports that they come for visits, complain about the bad job Sarah is doing, give advice about how she could do better, and then they leave.

As she talks about her current financial difficulties, Sarah starts to cry. She states that she was managing financially for the first few months after her mother moved in with her because her son, David, had moved in to be

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Maria’s full-time caregiver. With that assistance she was able to continue working full-time as a certified nursing assistant (CNA). Being a CNA has been a lifesaver because she knows how to help her mother with all her daily living activities. However, she quit her job 6 months after her mother moved in when she learned that David was stealing Maria’s anti-anxiety and pain medications. When she confronted David, she learned that he’d been using opiates and benzodiazepines for years. Sarah convinced David to go into an inpatient substance abuse treatment program where he seemed to do well. After leaving the treatment program, he moved back in with Sarah to provide care for Maria so Sarah could return to work. However, 2 months after he was discharged, David overdosed on heroin and died. Now, on top of all this, Sarah is beginning to have her own health problems, including hypertension, and type 2 diabetes. She expresses fear about her own future health and financial well-being.

—Bryan Norman

Multiple Perspectives for a Multidimensional Approach As you think about the details of the unfolding story of Maria Chavez and her daughter, Sarah, you may discover that you have some theory or theories of your own about what is happening with them and what can and should be done to be helpful to them. If we asked you what caught your attention as you read the story, we would begin to learn something about your theory or theories of human behavior, as you have developed it or them so far. There is much information in the case material as presented, but the case may have raised questions for you as well, and left you wanting more information. What you see as gaps in the information might also tell us something about your theory or theories. Theories help us organize vast and multifaceted information. The purposes of this chapter are twofold: first, to help you identify and refine your own theory or theories of human behavior and, second, to help you think critically about commonly used formal theories of human behavior that have been developed by behavioral science scholars and used to guide social work practice.

As noted in Chapter 1, social work has a long tradition of being guided by a person and environment construct for understanding human behavior. Different theories have been considered essential to understanding person

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and environment in different time periods, but theory has always been an important resource for social work practice in all settings. In its 2015 Educational Policy Statement, the Council on Social Work Education reiterated the important role that theory plays in social work practice, noting the way that theory supports the development of four social work competencies. It states that “social workers understand theories of human behavior and the social environment, and critically evaluate and apply this knowledge” to facilitate

engagement with (Competency 6), assessment of (Competency 7), intervention with (Competency 8), and evaluation of practice (Competency 9)

“with individuals, families, groups, organizations, and communities” (Council on Social Work Education, 2015, pp. 8–9).

Although different theories have been considered essential knowledge for social workers in different periods of time, there is general agreement that contemporary social workers must use a range of theories that draw on a number of disciplines to help us understand the practice situations we encounter and to see the possibilities for change. As we have come more and more to recognize that human behavior is multidimensional, we have also recognized the need for multiple disciplines and a multitheoretical framework to understand it (Bell, 2012; Melchert, 2013; Sapolsky, 2017). There are many theories from which to draw, general theories of human behavior as well as theories designed to understand the specific dimensions of person and environment covered in this book. There are also a number of ways of organizing existing theories into categories or perspectives. We have organized them into eight broad perspectives: the systems perspective, conflict perspective, exchange and choice perspective, social constructionist perspective, psychodynamic perspective, developmental perspective, behavioral perspective, and humanistic perspective. An overview of the big ideas, major concepts, and related theories of each perspective is presented in Exhibit 2.1. This exhibit can be a helpful review as you continue to learn more about human behavior.

Exhibit 2.1 ● Big Ideas, Major Concepts, and Related Theories of Eight Theoretical Perspectives

Exhibit 2.1 ● Big Ideas, Major Concepts, and Related Theories of Eight

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Exhibit 2.1 ● Big Ideas, Major Concepts, and Related Theories of Eight

Theoretical Perspectives

Theoretical Perspective Big Ideas Major Concepts Related Theories

Systems

• Systems are made of interrelated members that constitute a linked whole.

• Each part of the system impacts all other parts and the system as a whole.

• All systems are subsystems of other larger systems.

• Systems maintain boundaries that give them their identities.

• The dynamic interactions within, between, and among systems

• Boundary

• Interactions

• Interrelated parts

• Feedback mechanisms

• Closed system

• Open system

• Homeostasis

• Interdependence

• Mutual influence

• Holistic

• Complexity

• Risk factors

• Protective factors

• Autopoietic

• General systems theory

• Ecological theory

• Bioecological perspective

• Risk and resilience theory

• Globalization theory

• Autopoietic systems theory

• Fuzzy set theory

• Deep ecology theory

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produce both stability and change, sometimes even rapid dramatic change.

Conflict

• All social systems have inequalities in the distribution of valued resources.

• Power is unequally divided, and powerful social groups impose their will on nondominant groups.

• Conflict and the potential for conflict underlie unequal social relationships.

• Members of nondominant groups often become alienated from society.

• Conflict

• Dominance

• Oppression

• Inequality

• Exploitation

• Power

• Capitalism

• Neoliberalism

• Dominant groups

• Nondominant groups

• Alienation

• Microaggressions

• Critical theory

• Prosumer capitalism theory

• Postcolonial theory

• Neoliberalism theory

• Critical race theory

• Feminist theories

• Intersectionality theories

• Pluralistic theory of social conflict

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• Social change may occur when nondominant groups recognize patterns of inequality and injustice and take action to increase their own power.

• Privilege

• Empowerment

• Empowerment theories

Exchange and choice

• Individual and collective actors engage in social exchange of material and nonmaterial resources and make choices in pursuit of those resources.

• Choices in social exchange are based on self- interest as well as community interest.

• Choices in social exchange are based on both

• Resources

• Choices

• Social exchange

• Benefits/costs

• Reciprocity

• Norms • Networks

• Values

• Expectations

• Social exchange theory

• Rational choice theory

• Social network theory

• Social capital theory

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reason and emotion and on values, norms, and expectations.

• Social exchange operates on a norm of reciprocity, but exchange relationships are often unbalanced.

• Power comes from unequal resources in exchange.

• Exchange network

• Expectations

• Social capital

• Interaction ritual chain

• Market model

• Polis model

chain theory

• Actor-network theory

• Polis model of policy analysis

• People construct meaning, a sense of self, and a social world through their interactions with each other.

• Social reality is created when people, in social interaction, develop shared

• Meaning

• Sense of self

• Social interaction

• Shared meanings

• Symbols

• Social constructions

• Multiple realities

• Symbolic interaction theory

• Postmodern

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Social constructionist

meaning, a common understanding of their world.

• There is no singular objective reality but rather the multiple realities that are created in different contexts.

• Social interaction is grounded in language customs, as well as cultural and historical contexts.

• People can modify meanings in the process of interaction.

• Subjective reality

• Essentialist/essentialism

• Impression management

• Human consciousness

• Looking-glass self

• Generalized other

• Reification

• Claims making

• Labeling

• Standpoint

• Bifurcation of consciousness

• Entrainment

• Re-storying

theories

• Phenomenological sociology

• Standpoint theory

• Queer theory

• Affect theory

• Solution-focused practice theory

• Narrative practice theory

• Emotions have a central place in human behavior.

• Unconscious,

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Psychodynamic

as well as conscious, mental activity serves as the motivating force in human behavior.

• Early childhood experiences are central in the patterning of an individual’s emotions and, therefore, central to problems throughout life.

• Individuals may become overwhelmed by internal or external demands.

• Individuals frequently use ego defense mechanisms to avoid becoming overwhelmed by internal or external

• Needs

• Drives

• Emotions

• Eros/Thanatos

• Mastery

• Conscious

• Preconscious

• Unconscious

• Connectedness

• Id

• Ego

• Superego

• Ego strengths

• Adaptation

• Defense mechanisms

• Ego psychology

• Object relations theory

• Self psychology

• Relational- cultural theory

• Drive or instinct theory

• Topographical theory of the mind

• Structural model of the mind

• Psychosexual stage theory

• Attachment theory

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by internal or external demands.

Developmental

• Human development occurs in clearly defined, age- graded stages.

• Each stage of life is qualitatively different from all other stages.

• Each stage builds on earlier stages.

• Human development is a complex interaction of biological, psychological, and social factors.

• Moving from one stage to the next involves new tasks and changes in statuses and roles.

• Developmental stages

• Developmental tasks

• Epigenetic principle

• Psychosocial crisis

• Cohort effect

• Historical trends

• Developmental transitions

• Interdependent lives

• Diversity in life course trajectories

• Developmental risk/developmental protection

• Cumulative advantage

• Cumulative disadvantage

• Turning point

• Life span/life cycle theory

• Epigenetic model of human development

• Psychosexual stage theory (Freud)

• Psychosocial stage theory (Erikson)

• Cognitive development theory (Piaget)

• Moral development theories (Kohlberg & Gilligan)

• Life course perspective

• Social identity theory

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Behavioral

•Human behavior is learned when individuals interact with the environment.

• Human behavior is learned through different mechanisms of learning, including association of environmental stimuli, reinforcement, imitation, and personal expectations and meaning.

• All human problems can be formulated as undesirable behavior.

• All behavior can be defined and changed.

• Unconditioned stimulus/conditioned stimulus

• Unconditioned response/conditioned response

• Instrumental conditioning

• Reinforcement

• Reward/punishment

• Behavioral consequence/behavioral antecedent

• Observation

• Expectation

• Model

• Self-efficacy

• Efficacy expectation

• Agency (personal, proxy, collective)

• Learned helplessness

• Systematic desensitization

• Classical conditioning

• Operant conditioning

• Cognitive social learning theory

• Cognitive behavioral theory/therapy

• Dialectical behavioral theory/therapy

• Cognitive processing theory/therapy

• Each person is unique and has value.

• Freedom of action

• Search for meaning

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Humanistic

has value.

• Each person is responsible for the choices he or she makes within the limits of freedom.

• People always have the capacity to change themselves, even to make radical change.

• Human behavior can be understood only from the vantage point of the internal frame of reference of the person.

• Human behavior is driven by a desire for growth, personal meaning, and competence and by a need to experience a bond with others.

• Mystical moments

• Hierarchy of needs

• Physiological needs

• Safety needs

• Belonging needs

• Esteem needs

• Self-actualization

• Self-understanding

• Self-directed behavior

• Dignity and worth of individuals

• Empathy

• Warmth

• Genuineness

• Suffering

• Personal growth

• Human strengths

• Human virtues

• Human competence

• Learned optimism

• Core capabilities

• Phenomenal self

• Humanistic psychology

• Existential psychology

• Positive psychology

• Capabilities approach

• Maslow’s theory of hierarchy of needs

• Transpersonal theory

• Rogers’s client- centered approach to therapy

• Posthumanist approach

• Humanistic theory of organizations

• Appreciative inquiry theory

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We have selected these eight perspectives for a number of reasons. Each has a wide range of applications across dimensions of human behavior and is used in empirical research. Each has been reconceptualized and extended over time to keep current with rapid knowledge development. Each paid little attention to diversity, and most paid little attention to inequality in early versions, but each has evolved over time to address both diversity and inequality. Each is European American in heritage, but in recent years, each has been influenced by thinking in other regions of the world, although there is still a need for much more international input. Some of the perspectives had multidisciplinary roots in their early versions, and each has benefited by collaboration across disciplines in more recent refinement and elaboration. Some blurring of the lines between perspectives has begun to occur. Theorists are being influenced by each other, as well as by societal changes, and have begun to borrow ideas from each other and to build new theory by combining aspects of existing theory. As you can see, theory, like other aspects of human behavior, is ever-changing.

Each of the perspectives presented in this chapter comprises a number of diverse theories. We present the “big ideas” of each perspective and not a detailed discussion of the various theories within the perspective. Although we trace the development of each perspective over time, we pay particular attention to some of the recent extensions of the perspectives that seem most useful in contemporary times. We draw special attention to instances where new research is supporting premises of the early root theories as well as recent theoretical revisions. If you are interested in a more in-depth look at these theoretical perspectives, there are many resources to help you do this. We introduce the perspectives in this chapter, and you will see variations of them throughout subsequent chapters where theory and research about specific dimensions of person and environment are explored.

In this chapter, in addition to presenting an overview of the big ideas, we analyze the scientific merit of the perspectives and their usefulness for social work practice. The five criteria for critical understanding of theory identified in Chapter 1 provide the framework for our discussion of the perspectives: coherence and conceptual clarity, testability and empirical support, comprehensiveness, consistency with social work’s emphasis on diversity and power arrangements, and usefulness for social work practice. This analysis is in keeping with the recommendations in the 2015 CSWE

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diversity and power arrangements, and usefulness for social work practice. This analysis is in keeping with the recommendations in the 2015 CSWE Educational Policy and Accreditation Standards for Competencies 6, 7, 8, and 9, noted earlier, that call for social workers to “critically evaluate and apply” theories of human behavior (pp. 8–9). With the analysis of testability and empirical support, it assists with the development of Competency 4: Engage in Practice-Informed Research and Research- Informed Practice (p. 8). With the analysis of diversity and power arrangements, it assists with the development of Competency 2: Engage Diversity and Difference in Practice and Competency 3: Advance Human Rights and Social, Economic, and Environmental Justice (pp. 7–8). The discussion of usefulness for social work practice includes discussion of policy implications, helping to develop Competency 5: Engage in Policy Practice (p. 8). It also analyzes whether the theoretical perspective can be used in practice in a way that is consistent with the NASW Code of Ethics, thereby assisting in the development of Competency 1: Demonstrate Ethical and Professional Behavior (p. 7).

Systems Perspective When you read the case study at the beginning of this chapter, you may have thought of it as a story about a family system—a story about Maria, Sarah, David, and Sarah’s unnamed siblings—rather than “Maria Chavez’s story,” even though the hospice case file reads “Maria Chavez.” You may have noted how Maria’s, Sarah’s, and David’s lives have been interrelated in recent years and the impact each has had on the overall well-being of the family. You may be thinking about the changing health statuses of Maria, Sarah, and David over time, and about how Sarah and David kept adjusting their caregiving roles as other circumstances in the family changed. You also may note that this family, like other families, has a boundary indicating who is in and who is out, and you may be wondering if the boundary around this family allows sufficient input from friends, extended family, neighbors, religious organizations, and so on. You may have questions about whether sibling relationships can be enhanced to provide more financial and emotional support for Sarah as she cares for Maria. Given the importance of religion in Maria’s life, besides a referral to the hospice chaplain, it is essential to explore the relationship that Sarah and Maria have with the neighborhood Catholic parish and what resources the parish can offer to the family. Medicare coverage for hospice care is an

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important resource for the family and will bring important support services for both Maria and Sarah. These are some of the ideas that the systems perspective suggests for understanding what is happening in the Maria Chavez family.

The systems perspective sees human behavior as the outcome of interactions within and among systems of interrelated parts. Its roots are very multidisciplinary, and there are many theoretical variations. During the 1940s and 1950s, a variety of disciplines—including mathematics, physics, engineering, biology, psychology, cultural anthropology, economics, and sociology—began looking at phenomena as the outcome of interactions within and among systems. Mathematicians and engineers used the new ideas about system feedback mechanisms—processes that use the conditions of one component to regulate the functions of another or by which outputs of the system are fed back as inputs in a circular manner —to develop military and communication technologies. The development of the computer and sophisticated computer models for analyzing information has influenced continuous revision of the systems perspective. Exhibit 2.2 provides a visual representation of the systems perspective, and Exhibit 2.1 lists the big ideas, major concepts, and related theories of the perspective.

Social workers were attracted to the systems perspective in the 1960s, and general systems theory was the dominant theoretical perspective in the social work literature during the 1960s and 1970s. This approach was based primarily on the work of biologist Ludwig von Bertalanffy, who defined systems as “sets of elements standing in interrelation” (von Bertalanffy, 1969, p. 38). He proposed that any element is best understood by considering its interactions with its constituent parts as well as its interactions with larger systems of which it is a part. For example, Maria Chavez’s family is best understood by considering the interactions among the family members as well as the interactions the family has with other social systems, such as their neighborhood, the health care system, and workplace systems. Von Bertalanffy identified two types of systems: closed systems and open systems. A closed system is isolated from other systems in its environment. An open system is in constant interaction with other systems. He emphasized that feedback mechanisms produce both stability (homeostasis) and change within and across systems. Socially and geographically isolated families and communities could be considered examples of closed systems. Internet-based social networks are examples

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of open systems. It is not yet clear to Maria Chavez’s social worker how opeln or closed the Maria Chavez family system is.

Exhibit 2.2 ● Systems Perspective

In the 1980s, ecological theory, also known as ecosystems theory, became popular across several disciplines, including social work. This theory comes from the field of ecology, which focuses on the relationships and interactions between living organisms and their environments. Interdependence and mutual influence are emphasized. The environment exerts influence on an individual, family, or social group, but individuals, families, and groups can also have an impact on external systems. Social workers who promoted the ecological perspective called for a holistic view of practice situations that considers the multiple environmental influences involved (Germain & Gitterman, 1996). The ecological perspective extended general systems theory by considering the important role of physical environments in human behavior. While still emphasizing human behavior in the social environment, the social work profession has recently begun to acknowledge the important role of the physical environment as evidenced by the inclusion of environmental justice, in addition to social and economic justice, in the statement of social work competencies in the 2015 CSWE Educational Policy and Accreditation Standards.

Influenced by scientific inquiry in a number of disciplines, several new systems theories have emerged in the last 2 decades or so. Taken as a whole, these new theories are attempting to explain the complexity of contemporary life. Five systems approaches are currently “hot” and relevant to contemporary social work. The first of these approaches

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bioecological perspective, which he revised to pay more attention to biomedical factors (Bronfenbrenner, 2005). As it evolves, the bioecological approach includes the many and varied attempts to incorporate ongoing neuroscience research into theorizing about the ways that biological factors are intertwined with psychological and sociocultural factors in the creation of human behavior. This approach considers gene– environment interactions; the impact of the environment on brain development; and the intertwined nature of biology, cognition, and emotion. One theoretical approach often used in social work is risk and resilience theory, which is an extension of the ecological perspective. It draws on concepts from epidemiology and public health to explain the complexity of influences on human behavior. This theory proposes risk factors and protective factors in both the person and the environment. Risk factors increase the likelihood of a harmful outcome of person and environment interactions, and protective factors support a positive outcome (see Jenson & Fraser, 2016). Proponents of the risk and resilience approach acknowledge the complexity of influences on human behavior.

A second recent systems approach is globalization theory. As discussed in Chapter 1, globalization is the process by which the world’s people are becoming more interconnected economically, politically, environmentally, and culturally. Globalization theory (see Robinson, 2007) emerged in reaction against earlier social theories about the globalization process that were thought to present a Western bias, focusing on developments in the West, and implying if not explicitly arguing that the rest of the world had little choice but to become increasingly like the West. There are many versions of globalization theory, but all of them shift the focus from the West to consider transnational cultural, economic, and political processes that flow in many directions, not just from the West to the rest of the world. They call attention to processes of cultural imperialism, whereby a culture of a large and powerful country, organization, or other social entity has a great influence on another less powerful country, or other social entity. Here are two examples. Anthony Giddens (2000) writes of the “runaway world” of globalization, suggesting that globalization creates risk and undermines local cultures but can also help to revive local cultures as they put their own local twist on aspects of global culture. Ulrich Beck (2007) criticizes theorists who present a purely economic analysis of globalization, arguing that globalization is much more multidimensional and multidirectional than that. He writes about transnational actors who crisscross and undermine the boundaries of nation-states. He is interested

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crisscross and undermine the boundaries of nation-states. He is interested in the identities and differential power of these actors. With this attention to power and exploitation, globalization theories begin to merge with the conflict perspective.

Photo 2.1 The pieces of this globe come together to form a unified whole—each part interacts and influences the other parts—but the pieces are interdependent, as suggested by the systems perspective.

Globalization theories focus on how the open boundaries of global systems produce complexity. European social workers (see Ahmed-Mohamed, 2011; Kihlström, 2012) are drawing on a third type of systems theory that conceptualizes the openness of systems in a very different way. German sociologist Niklas Luhmann (2011) has proposed a systems theory that suggests that in highly complex societies, systems must find a way to reduce complexity to make life more manageable. They do this by developing cultures and structures that clearly differentiate the system from other systems. Systems are open to interaction with other systems, but they are operatively closed, meaning that system behavior is influenced only by the system’s operations—its language, culture, and processes—not by the language, culture, and processes of other systems. The environment can affect the system only by causing it irritations or disruptions, but the system will have its own conditions for responding to these irritations. Luhmann argues that systems are autopoietic, meaning they are self-created and reproduced. For example, think about social workers who work in child protective services. They assess child safety

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systems, they must recognize that those systems use their own very different language, culture, and processes to think about child safety.

Other newer systems theories take other positions on the issue of boundaries. Here is a fourth type of systems theory. Fuzzy set theory, developed in mathematics, proposes that membership of a set is not binary —with binary meaning you are either a member or you are not. Fuzzy set theory acknowledges that you may be a member to a certain degree. In fuzzy sets, objects are assigned a number from 0 to 1 to indicate the degree to which the object belongs in the set—either not at all (0) or completely (1). From this perspective, what value would you give to Maria Chavez’s daughters who are not involved in her caregiving? Would you give them a value of 0 or 1, or would you say their family membership lies somewhere between “member” and “not member”? Reisch and Jani (2012) suggest that social workers should consider such theories that recognize the blurring of system boundaries in complex societies. As DePoy and Gilson (2012) suggest, fuzzy set theory could be a useful way to think about issues related to group membership, including race, ethnicity, and gender. This nonbinary way of thinking about social identities receives further attention in Chapter 8, Cultures.

Other systems theories emphasize the openness of systems. Deep ecology, a fifth newer systems approach, has emerged with an emphasis on the notion of the total interconnectedness of all elements of the natural and physical world (Besthorn, 2012). Sociologist John Clammer (2009) suggests that deep ecology, with its addition of connections to the natural and physical worlds, can help to bridge Western and Eastern social science. As discussed in Chapter 7, The Physical Environment, deep ecology is an important perspective for thinking about environmental justice.

This is how the criteria for evaluating theory apply to the systems perspective:

Coherence and conceptual clarity. Early systems theories were often criticized as vague and somewhat ambiguous. Although consistency in use of terms has improved in recent theorizing, concepts in some versions of systems theories remain highly abstract and often confusing in their generality. Recent bioecological theories, particularly risk and resilience theory, are derived from multidisciplinary research, and a great deal of coherence and

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particularly risk and resilience theory, are derived from multidisciplinary research, and a great deal of coherence and conceptual clarity is developing in the literature on this systems approach. Testability and empirical support. Even with poorly defined and highly abstract concepts in early systems theorizing, a long tradition of research supporting a systems perspective can be found in anthropology and sociology (see White, Klein, & Martin, 2015, for a discussion of the use of the systems perspective to study family systems). The systems perspective has been greatly strengthened in recent years with developments in neuroscience, epidemiology, and a rapidly expanding empirical literature on ecological risk and resilience. Mathematicians have developed fuzzy logic systems for analyzing membership in fuzzy sets that are beginning to be used in the social as well as natural sciences but are not yet used by social work researchers. Comprehensiveness. Clearly, the systems perspective is devoted to the ideal of comprehensiveness, or holism. It incorporates the various dimensions of human systems as well as various dimensions of environmental systems, nonhuman as well as human. It does better than any other perspective discussed here in accommodating rapid developments in neuroscience. Systems theorists recognize—even if they do not always make clear—the social, cultural, economic, and political environments of human behavior. They acknowledge the role of external influences and demands in creating and maintaining patterns of interaction within the system. Bioecological theories and research are shedding light on the complex interactions of various biological systems with each other and with the physical and social environments. Recent formulations have explicitly added a time dimension to accommodate both past and future influences on human behavior (see Bronfenbrenner, 2005). Globalization theory calls attention to the impact of rapid communications on world systems. Deep ecology calls attention to the complex interplay of humans and the physical environment. Diversity and power. Although diversity is not addressed in most systems theorizing, recent versions of the systems perspective, with their attention to complexity and continuous dynamic change, open many possibilities for diversity. Furthermore, although most systems theorists do not address the role of power in systems transactions, some can accommodate the idea of power differentials better than

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consensus and shared values. The emphasis on system stability can rightly be criticized as socially conservative and oppressive to those who lack power within the system. Contemporary systems theory has begun to recognize power and oppression, and some versions of globalization theory call attention to how powerful nations exploit the cultures, economies, and political arrangements of less powerful nations (McMichael, 2017). Usefulness for social work practice. The systems perspective is perhaps more useful for assessment and practice evaluation than for directing social work engagement and interventions, but several social work practice textbooks were based on the systems perspective in the 1970s and 1980s. Systems thinking is consistent with the NASW ethical principle “Social workers recognize the central importance of human relationships.” The greatest value of the systems perspective is that it can be used at any level of practice, including individual, family, group, organization, or community. It also has merit because it surpasses other perspectives in suggesting that we should widen the scope of assessment and intervention and expect better outcomes from multidimensional interventions. The risk and resilience approach is informative for social work assessment with individuals and communities as well as for program and policy development, suggesting ways to reduce risk and increase protection. Globalization theory is consistent with social work’s ethical stance on social justice and is an essential perspective for social workers involved in international social work, in work with immigrants and refugees, and in international disaster relief work. It is a useful perspective for engaging with and assessing individuals, families, and communities who feel left out or left behind by globalization, including those who currently approach life with a fierce nationalism. Autopoietic systems theory is helpful when social workers are engaged in advocacy; it reminds us that to be effective advocates we must make the effort to understand the language, culture, and processes of the social systems we target with our advocacy efforts. Fuzzy set theory reminds social workers to avoid approaching new practice situations with a fixed binary lens regarding such social categories as gender and gender identity, race, social class, ethnicity, sexual orientation, disability, and so on. Deep ecology is useful for thinking about how to promote environmental justice.

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thinking about how to promote environmental justice.

Conflict Perspective As he thinks about Maria Chavez and her family, the hospice social worker is struck by the precarious financial and health situation that Sarah finds herself in as she cares for her mother. She has worked most of her life in a job that is valuable to society but one that has not been well paid. She is beginning to face health problems, and it is not clear what her health care options are. The social worker is reminded of ongoing political debates in the United States about health care funding for people with limited economic resources. Although the systems perspective helps us think about how interdependent the family members are, you may be thinking that Sarah and her siblings have some competing interests in relation to resources of time and money. The hospice social worker knows that communications about time and money can become tense in such families. He wonders why it is that Sarah is the one carrying the financial, physical, and emotional costs of Maria’s care, as seems to be the case. These are some of the observations about the Maria Chavez family suggested by the conflict perspective.

The conflict perspective has become popular over and over again throughout history, with roots that can be traced back to German philosopher Georg Hegel (1770–1831) and Italian philosopher Niccolo Machiavelli (1469–1527), and perhaps even further back, drawing attention to conflict, dominance, and oppression in social life. The conflict perspective emphasizes conflicts that arise because of inequalities in the distribution of resources. It typically looks for sources of conflict in the economic and political arenas, and more recently in the cultural arena. Exhibit 2.3 provides a visual representation of the conflict perspective, and Exhibit 2.1 lists the big ideas, major concepts, and related theories of the perspective.

The roots of contemporary conflict theory are usually traced to the works of Karl Marx and his collaborator Friedrich Engels, as well as the works of Max Weber. Marx (1887/1967) and Engels (1884/1970) focused on economic structures, suggesting that the capitalist economic system is divided into capitalists and workers. Capitalists decide what is to be done and how to do it, and they own the products produced by the workers as well as the means of production. Capitalists pay workers as little as they

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can get away with, and they, not the workers, reap the benefits of exploiting natural resources. According to Marx, this system produces false consciousness: Neither capitalists nor workers are aware that the system is based on exploitation; workers think they are getting a fair day’s pay, and capitalists think workers are fairly rewarded. Marx proposed, however, that workers are capable of recognizing the exploitation and achieving class consciousness, but capitalists are incapable of recognizing the exploitation in the system.

Weber (1904–1905/1958) rejected this singular emphasis on economics in favor of a multidimensional perspective on social class that included prestige and power derived from sources other than economics. Contemporary conflict theory tends to favor Weber’s multidimensional perspective, calling attention to a confluence of social, economic, and political structures in the creation of inequality. Jürgen Habermas (1984, 1981/1987) and other critical theorists argue that as capitalism underwent change, people were more likely to be controlled by culture than by their work position. Our lives became dominated by the culture industry, which is controlled by mass media. Critical theorists suggest that the culture industry plays a major role in turning workers into consumers, calling attention to the role of the advertising industry in exploiting consumers. They suggest that in the contemporary world, workers work very hard, sometimes at second and third jobs, in order to consume. They describe the exploitation of consumers as a pleasant kind of control: People spend more and more time working to be able to shop, and shopping becomes the major form of recreation. Working and shopping leave little time for reflective or revolutionary thinking. George Ritzer (2013) suggests that the same might be said about the time we spend on social media.

Exhibit 2.3 ● Conflict Perspective

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Marx emphasized the exploitation involved in the production of goods, and the critical theorists emphasize the exploitation involved in consumer capitalism. George Ritzer (2015) suggests that we have entered a new form of capitalism that he calls prosumer capitalism, in which the lines between production and consumption are blurred. In prosumer capitalism, we are engaged in economic activities in which we are simultaneously producers and consumers. We buy (consume) a new Mac or iPhone and are responsible for setup and installation, in what is often frustrating work, especially as we try to protect against such privacy threats as a camera getting hacked or a search history being exposed. We consume fast food and clean our own tables. We pump our own gas and use self-checkout at the grocery store. Facebook and other social media is another example. Paid employees at Facebook provide an architecture for our participation. But we are unpaid prosumers who provide the content that entice other people to join the site. We build and share profiles that generate data that can be sold for profit. Ritzer suggests that prosumer capitalism creates a new type of exploitation. It turns us into free workers while eliminating or downgrading the skill set and compensation of some paid work positions. It uses the labor of prosumers to create great wealth for a relatively small group of economic elites in a process that is usually not transparent to the prosumer. It is made possible by new technologies such as self-scanner machines, 3-D printers, ATMs, and medical technologies that allow us to measure basic biological functions at home.

Photo 2.2 This homeless woman on a street in prosperous Beverly Hills, California, is one of many examples of unequal power in the

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global economy, a focus of the conflict perspective.

Immanuel Wallerstein (2004) is a neo-Marxist who has focused on international inequality. He proposed that the capitalist world system is divided into three geographic areas with greatly different levels of power: A core of nations dominates the capitalist worldwide economy and exploits the natural resources and labor in other nations. The periphery includes nations that provide cheap raw materials and labor that are exploited to the advantage of the core. The semiperiphery includes nations that are newly industrializing; they benefit from the periphery but are exploited by the core.

Postcolonial theory focuses on the ongoing impact of 18th- and 19th- century colonialism on the social, cultural, political, and economic development of both the colonizing nations and the colonies. It considers how colonizers racialized people they were colonizing (as non-White) and examines the ways that a colonial mentality continues to influence how we think and talk about race and ethnicity. It argues that contemporary Western societies have created an image of themselves grounded in their encounter with colonized people, an image that nourishes and sustains Western privilege and power. The end of the colonial era did not destroy the power structures established by colonialism. Many postcolonial

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theorists argue that we now live in a neocolonial world in which a philosophy of neoliberalism puts great faith in the rationality of a free market and opposes any form of collectivism, state planning, or safety net for those who are economically disadvantaged, using the argument that any governmental involvement would hurt economic growth. Neoliberalism became prominent at the end of the colonial era, ensuring that those who held power during the colonial era were well situated to continue to hold power (see Go, 2013).

Power relationships are a major focus of the conflict perspective. Some theorists in the conflict tradition limit their focus to the large-scale structure of power relationships, but many theorists, especially critical theorists, also look at the reactions and adaptations of individual members of nondominant groups. These theorists note that oppression of nondominant groups leads to their alienation, or a sense of indifference or hostility. Critical race theory (CRT) was developed by legal scholars in the United States who wanted to draw attention to racial oppression in the law and society (see Delgado, 2017). They began by questioning why racism persists in spite of civil rights laws that challenge it. They rejected the liberal position that racism is only a relic of the past carried forward by poorly educated or troubled individuals. Rather, it is an ordinary and normal part of contemporary society (Harris, 2015). CRT calls attention to how microaggressions, brief, everyday exchanges that send denigrating messages and insults to people of color or members of any other minority identity group, create alienation for members of the group (Cappicci, Chadha, Bi Lin, & Snyder, 2012). Recent critical race theorists have incorporated the work of cognitive psychologists who examine implicit bias, a concept examined in Chapter 8, Cultures.

Feminist theories focus on male domination of the major social institutions and present a vision of a just world based on gender equity. As feminist theories have evolved over time, they have raised several basic questions about the organization of social life. Patricia Lengermann and Gillian Niebrugge (2018) trace the development of feminist theory, suggesting that it has moved through the following sequence of questions being raised:

1. And what about the women? Where are the women in any situation being reported? What are their contributions to the situation? If they are not present in the situation, why not?

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2. Why is all this the way it is? What social forces are involved in the way women are situated in the world?

3. And what about the differences among women? Feminist and critical race theorists have developed intersectionality theory, which recognizes vectors of oppression and privilege, including not only gender but also class, race, global location, sexual orientation, and age (see Collins, 2012).

4. How can we change and improve the social world so as to make it a more just place for all people, not just women?

5. How and why does gender inequality persist in the modern world? This is a similar question to the one raised about race in CRT.

Before the development of contemporary intersectionality theory, Lewis Coser (1956) proposed a pluralistic theory of social conflict, which recognizes that more than one social conflict is going on at all times and that individuals hold cross-cutting and overlapping memberships in status groups. Social conflict exists between economic groups, racial groups, ethnic groups, religious groups, age groups, gender groups, and so forth.

Early social workers in the settlement house tradition recognized social conflict and structured inequality, and focused on eliminating oppression of immigrants, women, and children. Concepts of power and social conflict were revived in the social work literature in the 1960s. In the past 2 decades, with renewed commitment to social justice in its professional code of ethics and in its curriculum guidelines, social work has drawn more heavily on the conflict perspective to understand dynamics of privilege, or unearned advantage, as well as discrimination and oppression. Social workers have used the conflict perspective as a base to develop practice-oriented empowerment theories, which focus on processes that individuals and collectivities can use to recognize patterns of inequality and injustice and take action to increase their own power (e.g., Gutierrez, 1990, 1994; Lee & Hudson, 2017; Rose, 1992, 1994; Solomon, 1976, 1987). Here is how the conflict perspective rates on the five criteria for evaluating social work theory:

Coherence and conceptual clarity. Most concepts of the conflict perspective are straightforward—conflict, power, domination, inequality—at least at the abstract level. Like all theoretical concepts, however, they become less straightforward when we begin to define them for the purpose of measurement. Across the various versions of

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the conflict perspective, concepts are not consistently used. One major source of variation is whether power and privilege are to be thought of as objective material circumstances, subjectively experienced situations, or both. In general, theories in the conflict tradition are expressed in language that is relatively accessible and clear. This is especially true of many of the practice-oriented empowerment theories developed by social workers. On the other hand, most recent conflict theorizing in the critical theory tradition is stated at a high level of abstraction. Testability and empirical support. Conflict theory has developed, in the main, through attempts to codify persistent themes in history. The preferred research method is empirical research that looks at large- scale patterns of history (see McMichael, 2017; Skocpol & Williamson, 2012; Wallerstein, 2004). As with other methods of research, critics have attacked some interpretations of historical data from the conflict perspective, but the historical analyses of Theda Skocpol and Immanuel Wallerstein are some of the most influential works in contemporary sociology. In addition to historical analysis, conflict theorists have used experimental methods to study reactions to coercive power (see Zimbardo, 2007) and naturalistic inquiry to study social ranking in interaction rituals (Collins, 2004). Contemporary conflict theorists are also drawing on network analysis, which plots the relationships among people within groups, and are finding support for their propositions about power and domination. Family researchers have used conflict theory, specifically the concept of power, to study family violence (White et al., 2015). Both feminist and critical race theorists have proposed storytelling as a form of empirical investigation. Maria Chavez would have an important story to tell about the early experiences of women in the U.S. military. Comprehensiveness. Traditionally, the conflict perspective focused on large-scale social institutions and social structures, such as economic and political institutions, even global ones. In the contemporary era, conflict theorists integrate conflict processes at the societal level with those at the community, small-group, and family levels. They suggest that we should recognize conflict as a central process in social life at all levels. Family theorists propose a conflict theory of families (White et al., 2015). Some conflict theories propose that oppression of nondominant groups leads to a sense of alienation, and recent empowerment theories give considerable attention to individual perceptions of power. The conflict perspective does not explicitly

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address biology, but it has been used to examine racial and social class health disparities. Most conflict theories do consider dimensions of time. They are particularly noteworthy for recommending that the behavior of members of minority groups should be put in historical context, and indeed, as discussed, empirical historical research is the method many conflict theorists prefer. Diversity and power. The conflict perspective is about inequality, power arrangements, and systems of oppression. It, more than any other perspective presented in this chapter, helps us look at group- based patterns of inequality. In that way, it also assists us in understanding diversity. Intersectionality theory, which recognizes that individuals have overlapping memberships in a variety of status groups, is particularly useful for considering human diversity. A major strength of the conflict perspective is that it discourages pathologizing members of minority groups by encouraging recognition of the historical, cultural, economic, and political context of their behavior. Empowerment theories guide practice interventions that build on the strengths of members of minority groups. Usefulness for social work. Concepts from the conflict perspective have great value for understanding power dimensions in societal, organizational, community, group, family, and dyadic relationships, as well as the power differential between social worker and client. Clearly, the conflict perspective is crucial to social work because it shines a spotlight on how domination and oppression might be affecting human behavior; it illuminates processes by which people become estranged and discouraged; and it encourages social workers to consider the meaning of their power relationships with clients, particularly nonvoluntary clients. The conflict perspective is essential to the social justice mission of social work. Social workers have been in the forefront of developing practice-oriented empowerment theories, and the conflict perspective has become as useful for recommending particular practice strategies as for assisting in the assessment process. Empowerment theories provide guidelines for working at all system levels (e.g., individual, family, small group, community, and organization), but they put particular emphasis on group work because of the opportunities presented in small groups for solidarity and mutual support. Social movement theories (see Chapter 14), which are based in the conflict perspective, have implications for the mobilization of oppressed groups, but the conflict perspective in general provides little in the way of specific policy direction.

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Critical Thinking Questions 2.1

What resources might be drawn from systems external to the Maria Chavez family to maximize Maria’s end of life care? Sometimes, hospice social workers find that unresolved family conflicts are complicating end of life care for a parent or other family member. How important do you think it is for Maria Chavez’s social worker to try to improve sibling relationships between Sarah and her sisters?

Exchange and Choice Perspective Another way to think about the Maria Chavez family is to consider the choices that were made by Maria, Sarah, her sisters, and David when Maria could no longer safely live alone. Those choices included with whom Maria would live; who would provide her care; who would provide which financial and emotional resources; and who would be responsible for legal, financial, and health care decisions related to Maria. One might wonder about the history of family relationships in this family: Who feels they owe what to whom? What does Sarah consider the rewards and costs of caring for her mother? And how did her sisters calculate the rewards and costs of providing such care themselves? What expectations does Maria have for each of her daughters, and what expectations do the sisters have for each other? What expectations do the sisters have for how Sarah manages Maria’s finances? How do they understand the fairness of the current caregiving arrangements and of the will that spells out the terms for sharing Maria’s estate? This way of thinking about the Maria Chavez family is suggested by the exchange and choice perspective.

The various streams of the exchange and choice perspective, which has roots in behavioral psychology, economics, anthropology, philosophy, and sociology, share the common focus on the processes whereby individual and collective actors seek and exchange resources and the choices made in pursuit of those resources. Resources may be material or nonmaterial; for example, time, money, material goods, sex, affection, loyalty, social contacts. These ideas are visually represented in Exhibit 2.4, and Exhibit 2.1 lists the big ideas, major concepts, and related theories of the perspective.

Social exchange theory, originally proposed by George Homans (1958),

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considered social exchange, defined as an interaction in which resources are exchanged, as the core process in social life. Homans started with the premise that social exchange is based on the desire to maximize benefits and minimize costs, a basic belief that social relationships occur in a social marketplace in which people give in order to get. Homans focused on individual motivation in exchanges in dyadic relationships. He saw individuals as always calculating the rewards and costs of relationships and making choices based on those calculations. The theory recognizes that values, norms, and expectations are considered in the evaluation of benefits and costs of relationships.

Peter Blau (1964) developed a social exchange theory that focused on how exchange works in organizations and complex institutions. He proposed that such exchanges are governed by a norm of reciprocity, that receiving resources requires giving resources of relatively equal value. He suggested that such exchanges build trust over time. Blau acknowledged, however, that imbalance of exchange occurs, and, when this happens, actors with the greatest resources hold power. He suggested that the most comfortable exchanges are those in which actors have equality of resources and that trust is fragile in unequal relationships.

The closely related rational choice theory (Coleman, 1990) shares with exchange theories the view that humans are rational (weighing benefits and costs), purposive, and motivated by self-interest. But rational choice theorists are particularly interested in the group dynamics that occur when rational actors make strategic decisions based on values, norms, expectations, and resources. They are interested in the norms and networks formed by social exchanges and how, once created, norms and networks facilitate as well as constrain the behavior and choices of individuals. Coleman used rational choice theory to explore possible public policies that would offer incentives for actors to behave in ways that are more beneficial to others. Rational choice theory is currently popular in sociology, health promotion, and family studies.

Exhibit 2.4 ● The Exchange and Choice Perspective

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Theorists in the rational choice tradition advanced social network theory (Cook, 1987). They introduced the concept of exchange network, which is a set of actors linked together, both directly and indirectly through exchange relationships. Social networks are typically presented visually, with members of the network—individuals, groups, or organizations— represented as points. Lines are drawn between pairs of points to demonstrate a relationship between them. Arrows are often used to show the flow of exchanges in a relationship. These graphic displays illuminate such issues as network size, density of relationships, strength of relationships, reciprocity of relationships, and access to power and influence. Social capital theory is a recent outgrowth of social network theory. Social networks provide social capital, both direct and indirect connections to others that are potential sources of a number of types of resources.

Traditional exchange and choice theories have been criticized on a number of grounds. Some critics have noted that exchange theory has a difficult time accounting for altruistic behavior. Others note that recent neuroscience and cognitive psychology research indicates that humans are not as rational as the theories have suggested. Still other critics note that traditional exchange theory does not address why some rewards are valued more than others. In response to these theoretical concerns, some behavioral scientists have proposed nonrational models of exchange and

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choice.

Sociologist Randall Collins (2004) introduced a form of exchange theory he calls interaction ritual chains. He proposes that social structures are developed by the aggregation of many exchanges over long periods of time. Rituals, or patterned sequences of behavior, develop out of these ongoing exchanges. Interaction rituals become linked or chained together by individuals who are members of multiple networks. Collins suggests that emotion, not reason, is the driving force of social exchange; emotional energy is the motive behind all exchanges. People are more likely to repeat interactions from which they take away emotional energy, and they engage in altruistic behavior because of the emotional energy they receive in the exchange. Collins proposes that physical co-presence is necessary for rituals to develop; co-presence produces common emotional mood, focused attention, and collective emotional energy. He supports this assertion by citing research indicating that the brain waves of participants in ritualized interactions become synchronized. Collins suggests that the self emerges from patterns of interaction; who we hang out with is the key to who we become.

A recent twist of social network theory is a theory called actor-network theory (ANT) (Haraway, 2008; Latour, 2007). The basic premise of this theory is that networks, and societies, are not made up of humans alone. They are made up of both human and nonhuman actors, including such things as animals, aspects of the physical environment, electrons, and computers and other types of technologies. Entities within the network, human as well as nonhuman, can only be understood in relation to other entities. ANT theorists suggest that our study of networks should decenter humans and recognize the important roles that other entities play in network exchanges. They call attention to the important role that material entities—such as keyboards, computer screens, websites, and medical technologies—play in human relationships, suggesting that these entities are more than resources; they are also important actors in network interactions.

Political scientist Deborah Stone (2012) has criticized the dominance of rational choice models of policy analysis that are often used in social work education. She refers to rational choice models as market models and proposes, instead, a polis model, which starts from the point of view of the community rather than the individual. She suggests that a theory of the

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political process must recognize the values of altruism and public interest as well as self-interest. She acknowledges that reasonable people can disagree about what the public interest is and proposes that the political process involves a negotiation of ideas about that. In the political process, participants are influenced in their choices by people in their networks and by their loyalties, operating by “laws of passion,” rather than “laws of reason.” They form alliances to gain power. Stone argues that whereas the market model proposes that participants in the political process have access to accurate and complete information for making political choices, in reality, information about policy issues is “ambiguous, incomplete, often strategically shaded, and sometimes deliberately withheld” (Stone, 2012, p. 30). She argues that we cannot be effective in influencing policy if we do not understand the nonrational aspects of the policy development process.

Here is an analysis of how well the exchange and choice perspective meets the criteria for judging social work theory.

Coherence and conceptual clarity. There is much consistency within each stream of the exchange and choice perspective. There is also much consistency across streams about the important role of exchange and choice in human behavior, but the theories differ in their focus on micro versus macro relationships. There is a great deal of inconsistency across theories, however, about issues of rationality and self-interestedness. Although concepts are sometimes presented at a high level of abstraction, most theories in the perspective define and measure terms in a clear and consistent manner. Testability and empirical support. The exchange and choice perspective has stimulated empirical research at several levels of analysis, with mixed results. Cognitive psychologists Daniel Kahneman and Amos Tversky (1982, 1984) dealt a blow to the rational choice perspective in the 1980s. They reported research findings that individual choices and decisions are often inconsistent with assumed rationality and that, indeed, situations are often too complicated for individuals to ascertain the most rational choice. On the other hand, more than modest support for the perspective has been found in research on dyads and families (see Sutphin, 2010). Researchers across a wide range of disciplines are using statistical methods to calculate the balance of costs and benefits of particular courses of action, such as conserving natural habitats (Naidoo &

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Adamowicz, 2006) or prescribing antidepressant medications instead of cognitive behavioral therapy (Hollinghurst, Kessler, Peters, & Gunnell, 2005). Collins’s (2004) theory about the important role of emotions in social exchange is supported by neuroscience research that indicates that brain waves of people in ritualized interactions become synchronized. Comprehensiveness. Although all streams of the exchange and choice perspective are interested in human interactions, the different streams focus on different dimensions in which interactions occur. The perspective has been used to study dyads, families, small groups, networks, communities, organizations, and institutions (see White et al., 2015). In general, the exchange and choice perspective is weak in exploration of personal dimensions, but Homans (1958) was interested in human motivation, and Randall Collins (2004) has been explicit in identifying the biological mechanisms involved in the emotional energy he sees as the engine of social exchange. ANT adds an important dimension by considering the role that nonhuman elements, especially technologies, play in human relationships. This approach suggests that the person and environment construct should include nonhuman elements as well as human elements (human behavior in the environment rather than human behavior in the social environment). The exchange and choice perspective attends to time in terms of the history of past exchanges. Diversity and power. Although they were designed to look at patterns, not diversity, early exchange and choice theories provided some tools for understanding diversity in behaviors that come out of particular social exchanges. All theories in this perspective recognize power as deriving from unequal resources in the exchange process but do not consider differential power that has been assigned to different identity groups. Although the exchange and choice perspective does not explicitly pathologize members of minority groups, those versions that fail to put social exchanges in historical, political, and economic contexts may unintentionally contribute to the pathologizing of these groups. Usefulness for social work practice. Some versions of the exchange and choice perspective serve as little more than a defense of the rationality of the marketplace of social exchange, suggesting a noninterventionist approach. In other words, if all social exchanges are based on rational choices, then who are we to interfere with this process? This stance, of course, is inconsistent with the purposes of

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social work. However, the perspective can be very useful for promoting the social work value of the importance of human relationships. It can be particularly useful to enhance social workers’ understanding of the decision-making process involved in deciding whether to disclose sexual abuse and in deciding whether to leave or stay in relationships involving intimate partner violence. In the assessment process, social workers can engage both individual and collective clients in identifying their networks of exchange, including their exchanges with nonhuman elements. Such assessments can lead to interventions focused on strengthening positive network relationships and eliminating or diminishing negative relationships (with both human and nonhuman elements). Furthermore, such assessment and intervention activities can serve as a concrete map for practice evaluation. Social network theory, with its recent emphasis on social capital, suggests tools for enhancing the resources of individuals and groups, including networks of social service providers. It can also be used for evaluating the effectiveness of social work practice for such enhancements. Randall Collins’s (2004) theory of exchange rituals suggests ways to create and reinforce altruism and group solidarity. Deborah Stone’s (2012) polis model provides tools for thinking about the complexities of the policymaking process and can help social workers be more realistic about how they might influence that process.

Social Constructionist Perspective As the hospice social worker drives back to the office, the Maria Chavez family is on his mind. He thinks about the stories he heard from both Maria and Sarah and about the meaning these stories have for them. From Maria, he heard stories of early financial hardship and early sexual exploitation. He wonders what meaning Maria makes of these stories as she approaches the end of her life. He also heard a story about fear of rejection by God and thinks it is important for Maria to have some help in reworking this story as she approaches death. From Sarah, he heard stories about Maria being a proud mother and devout Catholic. He heard Sarah’s pride in her mother’s work history. He also heard Sarah’s love of her son, David, and her grief over his death. He heard fear about her financial and health future, and he thought he heard resentment about the lack of support from her sisters. He hopes he can be a good listener for both Maria and

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Sarah as they make meaning of the life that Maria has lived and the care that Sarah has provided. This way of thinking about the Maria Chavez family is consistent with the social constructionist perspective.

To understand human behavior, the social constructionist perspective focuses on how people construct meaning, a sense of self, and a social world through their interactions with each other. They learn, through their interactions, to classify the world and their place in it. People interact with each other and the physical world based on shared meanings, or shared understandings about the world. In this view, people develop their understandings of the world and themselves from social interaction, and these understandings shape their subsequent social interactions. A visual representation of this way of thinking about human behavior is presented in Exhibit 2.5, and Exhibit 2.1 lists the big ideas, major concepts, and related theories of the perspective.

The early roots of the social constructionist perspective come from symbolic interaction theory developed by sociologists in the United States in the mid-20th century. This theory proposes that as humans interact, they develop symbols to which they attach meaning. Words are symbols, but so are piercings, tattoos, national flags, crucifixes, fashion styles, and the types of homes we build. The symbolic interactionist would be interested in what meaning Maria Chavez’s daughter, Sarah, attaches to the words addiction and caregiving. For the symbolic interactionist, society is constructed by human beings engaging in symbolic interaction. You may recall that social exchange theorists are also concerned with social interaction, but their focus is on social interaction as an exchange of resources rather than on how social interaction produces meaning, a sense of self, and social life (society), which is the focus of the interactionist (Blumer, 1998).

To the social constructionist, there is no singular objective reality, no true reality that exists “out there” in the world. There are, instead, multiple realities based on the shared subjective realities created as people interact in different contexts. Social constructionists actually disagree about whether there is, in fact, some objective reality out there. Radical social constructionists believe there is not. They believe there is no reality beyond our personal experiences. Most postmodern theorists fall in this category, arguing that there are no universals, including no universal truth, reality, or morality (Dybicz, 2011; Lyotard, 1984). They emphasize that

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social categories, such as race and gender, are social constructions, and they oppose essentialist beliefs in the inevitability of traits of such categories. More moderate social constructionists believe there are “real objects” in the world, but those objects are never known objectively; rather, they are only known through the subjective interpretations of individuals and collectivities (Williams, 2006).

Exhibit 2.5 ● Social Constructionist Perspective

Social constructionists also disagree about how constraining the environment is. Some see individual actors in social interactions as essentially free, active, and creative (Gergen, 1985). Others suggest that individual actors are always performing for their social audiences, based on their understanding of community standards for human behavior (Berger & Luckmann, 1966; Goffman, 1959). Although this idea has been around for a while, it is taking on new meaning in the current world of proliferating communication technology, which provides us with many modalities for performing for our audiences, for engaging in what Goffman (1959) refers to as impression management. The dominant position is probably the one represented by Schutz’s (1932/1967) phenomenological sociology. While arguing that people shape social reality, Schutz also suggests that individuals and groups are constrained by the preexisting social and cultural arrangements constructed by their predecessors.

The social constructionist perspective sees human understanding, or human consciousness, as both the product and the driving force of social interaction. Social constructionists see the self as developing from the interpretation of social interaction. Cooley introduces the concept of the

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looking-glass self, which can be explained as “I am what I think you think I am.” The looking-glass self has three components: (1) I imagine how I appear to others, (2) I imagine their judgment of me, and (3) I develop some feeling about myself that is a result of imagining their judgments of me. George Herbert Mead (1959) suggests that one has a self only when one is in community and that the self develops based on our interpretation of the generalized other, which is the attitude of the entire community.

Some social constructionists put greater emphasis on the nature of social interactions than on human consciousness, calling attention to gestures and language that are used as symbols in social interaction (Charon, 1998). These symbols take on particular meaning in particular situations. Social constructionists call attention to the human tendency toward reification, treating something abstract as a physical thing. For example, a flag comes to represent the abstract concept of patriotism. These social constructionists also see social problems as social constructions, created through claims making, labeling, and other social processes. Social workers have used the social constructionist approach to understand how society has constructed the meaning of phenomena such as parental incapability (Ben-David, 2011) and homelessness (Cronley, 2010) over time, as well as the processes by which these socially constructed definitions become internalized.

Three adaptations of postmodern theory are receiving a lot of attention in social work and the behavioral sciences: standpoint theory, queer theory, and affect theory. Standpoint theory argues that what people know and believe is shaped by where they stand in society, their geographies, cultures, socioeconomic statuses, races, genders, and so on. While recognizing that no two people have exactly the same standpoint, we must also recognize our own standpoints and be reflective about them. At the core of standpoint theory is the belief that not all standpoints are equally valued and that marginalized people must live with a bifurcation of consciousness (from one’s own perspective as well as the perspective of dominant standpoints) while dominant groups enjoy the privilege of remaining oblivious to nondominant standpoints. You may have noticed that standpoint theory is a blend of the social constructionist and conflict perspectives. It was first developed as feminist standpoint theory, but Dorothy Smith (2005) has begun to focus not only on gender but also on the exclusion and oppression of other standpoints, such as those based on class, race, sexual orientation, and ablebodiness.

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Queer theory attacks the essentialism (the belief that every entity has a set of attributes that are necessary to its identity and function) of identity categories, particularly those related to sexuality. The theory argues that sexuality is not fixed and stable and does not determine who we are. It is a social construction that, as such, is always open to transformation. Queer theory argues that not only has sexuality been institutionalized as a binary structure, but one element of the binary has been constructed as inferior to the other. A controversial version of queer theory has criticized the gay and lesbian rights movement for fighting for rights based on minority identity, arguing that this only perpetuates a false binary approach to sexuality and contributes to the essentializing of sexual identity. Others have argued that it is important to recognize the way that gay and lesbian identities, as well as other minority identities, can be a powerful tool for collective action (Burgess, 2011). Both neuroscience research and cognitive psychology research (see Kahneman, 2011; Sapolsky, 2017) indicate that categorizing and identity building are an inherent part of human cognition, but the importance of queer theory is that it reminds us of the critical role that culture and other environmental systems play in shaping these cognitions. Queer theory is a reminder, also, of the important role that sexuality plays in human behavior.

Affect theory is a significant departure from other postmodern theory because it calls attention to the independent role that biology and matter play in the construction of reality (see Blackman & Venn, 2010). It calls for breaking down the artificial barriers between the natural and social sciences, noting that both biology and social processes play important roles in creating human reality. In affect theory, affect refers to a nonconscious, automatic form of emotion. Emotion is what happens to affect once it undergoes the social processes that make it conscious. Affect theorists are interested in the way that human bodies affect each other as they interact, calling attention to a process of entrainment identified by neurologists—a process in which the nervous and hormonal systems of interacting people are brought into alignment (Brennan, 2004). You may recall that this idea is also prominent in Collins’s theory of interaction ritual chains. Like the actor-network theory discussed earlier, affect theory takes seriously the important role of nature and other nonhuman elements in human behavior.

This is how the social constructionist perspective measures against the criteria for judging theories.

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Coherence and conceptual clarity. Social constructionism, both the original phenomenological and symbolic interactional concepts as well as the contemporary postmodern conceptualizations, is often criticized as vague and unclear. Over the past few decades, a great diversity of theorizing has been done within this broad theoretical perspective, and there is much fragmentation of ideas. That situation is consistent, however, with postmodernist understanding of multiple realities. Sociologists in the conflict and rational choice traditions have begun to incorporate social constructionist ideas, particularly those related to meaning making, which has further blurred the boundaries of this perspective but also attests to the usefulness of that concept. In addition, social constructionist theorists have begun to incorporate principles from the conflict perspective. There is inconsistency among the various streams of the perspective about how constraining history is on human interaction and how free humans are to reconstruct their social interactions. Testability and empirical support. Because of the vagueness of its concepts, the social constructionist perspective has been criticized for being difficult to operationalize for empirical research. Like DePoy and Gilson (2012), we think the constructionist perspective has made a great contribution to scientific inquiry by calling attention to the limitations of positivist research methods to explain all of human behavior, and for pointing out the possibilities for bias in those research methods. Social constructionists propose alternative research methodology that focuses more on narrative and storytelling. Social constructionism has stimulated a trend in the behavioral sciences to use a mix of quantitative and qualitative research methodologies to accommodate both objective and subjective reality. This is providing a richer picture of human behavior. Affect theory, the newest theory discussed here, has incorporated findings from the natural sciences, and many ideas of the theory are well supported by empirical research. For example, the distinction between affect and emotion is supported by neuroscience research that finds that much of human behavior is an unconscious or automatic response mediated by the amygdala, whereas emotional responses shaped by cognitive activities in the frontal cortex are a slower process (Sapolsky, 2017). Comprehensiveness. Until the development of affect theory, social constructionism had paid little attention to the role of biology in human behavior. In some versions of social constructionism, cognitive processes are central, and the social construction of

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emotions is considered in others. With the emphasis on meaning making, social constructionism is open to the role of religion and spirituality in human behavior. With its emphasis on social interaction, the social constructionist perspective is strong in attention to the social environment. It has been criticized for failing to pay sufficient attention to the macro world of social institutions and social structure, but standpoint theory and queer theory correct for this omission. Time, and the role of history, is respected in the social constructionist perspective, with many authors drawing attention to the historical era in which behavior is constructed. Diversity and power. With its emphasis on multiple social realities, the social constructionist perspective is strong in its ability to accommodate diversity. It has been criticized for failure to provide the theoretical tools necessary for the analysis of power relationships. Some critics have suggested that many postmodern versions of social constructionism, by ignoring power while focusing on multiple voices and multiple meanings in the construction of reality, reduce oppression to mere difference (Williams, 2006). These critics suggest that this reduction of oppression to difference masks the fact that some actors have greater power than others to privilege their own constructions of reality and to disadvantage the constructions of other actors. As you have seen, however, this criticism does not apply to standpoint theory and queer theory. Social work scholars have been attracted to those versions of the social constructionist perspective that have incorporated pieces of the conflict tradition (see Freeman & Couchonnal, 2006), particularly the early work of Michel Foucault (1969) on the relationship between power and knowledge. They propose that in contemporary society, minority or “local” knowledge is denied credibility in majority-dominated social arenas and suggest that social work practitioners can bring credibility to minority viewpoints by allowing oppressed individuals and groups to tell their own stories. Most theorizing about empowerment integrates conflict and social constructionist thinking. Usefulness for social work practice. Social constructionism gives new meaning to the old social work adage, “Begin where the client is.” In the social constructionist perspective, the social work relationship begins with developing an understanding of how the client views the situation and what the client would like to have happen. It is certainly useful for engagement and assessment, but it is also useful for social work intervention. The current strong interest in solution-focused and

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narrative and storytelling therapies is based on the social constructionist perspective. Solution-focused approaches attempt to help clients construct solutions rather than solve problems (Greene & Lee, 2011). They are based on the assumption that clients want to change and are capable of envisioning the change they would like to see. Narrative therapy starts with the assumption that we all tell ourselves stories about our lives, developing dominant story lines and forgetting material that does not fit into them. A goal of therapy is to help clients see more realities in their story lines, with other possible interpretations of events (Walsh, 2014). The social worker should engage the client in thinking about the social, cultural, and historical environments in which his or her version of reality was constructed, which, for members of oppressed groups, may lead to empowerment through restorying, or revision of the story line (Greene & Cohen, 2005). Joseph Walsh (2014) suggests that narrative therapy can be particularly helpful to hospice patients who are reflecting on their life stories. That is, indeed, the approach of the hospice social worker who is working with Maria Chavez and her family. At the level of groups and organizations, the social constructionist perspective recommends getting discordant groups to engage in sincere discussion of their disparate constructions of reality and to negotiate lines of action acceptable to all (Riera, 2005). That kind of process is much needed in the world today.

Critical Thinking Questions 2.2

Both the exchange and choice and the social constructionist perspectives focus on social interactions. What do you see as the main difference in these two perspectives? What resources, both material and nonmaterial, do you seeing being exchanged in the Maria Chavez family? What resources must be secured by interactions with people and systems outside the family? What shared meanings do you think Maria and Sarah hold? If you were their social worker, how would the meanings you hold about the social world be similar to and different from theirs? In what contexts have you developed your sense of self and your understandings of the social world?

Psychodynamic Perspective

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Maria Chavez seems to have had much success in her adult life, but the few memories she shares with the social worker focus on early hardship and exploitation, and those early experiences could have played a role in her current need for antianxiety medication. Her daughter, Sarah, has been a devoted care provider to Maria, but her fears about her future are apparent in her first meeting with the hospice social worker—and easy to understand. Think about the losses and stresses Sarah has faced in the past few years: new caregiving responsibilities, worry over her son’s addictions, grief over her son’s death, financial worries, health worries, and the impending death of her mother. This accumulation of loss and stress would challenge the adaptive capacities of most any human. In the midst of all that loss, we also note the attachment Sarah has for her mother and the strong commitment she has made to her care. We do not see the same level of commitment from Sarah’s sisters and do not know the history of that. As we explore the Maria Chavez family’s situation from the psychodynamic perspective, these and other ideas emerge.

The psychodynamic perspective is concerned with how internal processes such as needs, drives, and emotions motivate human behavior. The perspective has evolved over the years, moving from the classical psychodynamic emphasis on innate drives and unconscious processes toward greater emphasis on the adaptive capacities of individuals and their interactions with the environment. The origins of all psychodynamic theories are in the work of Sigmund Freud. More recent formulations of the perspective include ego psychology, object relations, self psychology, and relational-cultural theories. We elaborate on these more recent developments later. Exhibit 2.6 presents a visual representation of the psychodynamic perspective, and Exhibit 2.1 lists the big ideas, major concepts, and related theories of the perspective.

Exhibit 2.6 ● Psychodynamic Perspective

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To trace the evolution of the psychodynamic perspective, it is essential to begin with its Freudian roots. Sigmund Freud looked at the human personality from a number of interrelated points of view; the most notable are his drive or instinct theory, topographical theory, structural theory, and psychosexual stage theory, summarized shortly. Freud revised each of these approaches to human personality over time, and different followers of Freud have attended to different aspects of his theoretical works, further revising each of them over time.

Drive or instinct theory. This theory proposes that human behavior is motivated by two basic instincts: thanatos, or the drive for aggression or destruction, and eros, or the drive for life (through sexual gratification). Revisions of drive theory have suggested that human behavior is also motivated by drives for mastery (see Goldstein, 1996) and for connectedness (Berzoff, Flanagan, & Hertz, 2016). Topographical theory of the mind. Topographical theory proposes three states of mind: conscious mental activities of which we are fully aware; preconscious thoughts and feelings that can be easily brought to mind; and unconscious thoughts, feelings, and desires of which we are not aware but which have a powerful influence on our behavior. Although all psychodynamic theorists believe in the unconscious, the different versions of the theory put different emphases on the importance of the unconscious in human behavior. Structural model of the mind. This model proposes that personality is structured around three parts: the id, which is unconscious and strives for satisfaction of basic instincts; the superego, which is made up of conscience and ideals and is the censor of the id; and the ego, which is the rational part of personality that mediates between the id and the

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superego. Freud and his early followers were most interested in the id and the pathologies that emanate from it, but later followers have focused primarily on ego strengths and the drive for adaptation. Both ego psychology and self psychology are part of this later tradition. Psychosexual stage theory. This theory proposes a five-stage model of child development, based on sexual instincts: the oral phase (birth to about 18 months), when the search for pleasure is centered in the mouth; the anal phase (from about 18 months to 3 years), when the search for pleasure is centered in the anus; the phallic phase (ages 3 to 6), when the search for pleasure is centered in the genitals; the latency phase (ages 6 to 8), when erotic urges are repressed; and the genital phase (adolescence onward), when the search for pleasure is centered in the genitals and sexual intimacy. Freud asserted that there was no further personality development in adulthood. Recent revisions of psychodynamic theory, starting with the work of Erik Erikson (1963), have challenged that idea. Although they still give primacy to the childhood years, they suggest that personality continues to develop over the life course. Recent theories also put less emphasis on sexual instincts in stage development.

Let’s turn now to some revisions of Freudian theory. Ego psychology gives primary attention to the rational part of the mind and the human capacity for adaptation. It recognizes conscious as well as unconscious attempts to cope and the importance of both past and present experiences. Defense mechanisms, unconscious processes that keep intolerable threats from conscious awareness, play an important role in ego psychology (see Goldstein, 2001). Object relations theory studies how people develop attitudes toward others in the context of early nurturing relationships and how those attitudes affect the view of the self as well as social relationships (Flanagan, 2016a). In this tradition, John Bowlby’s attachment theory has become the basis for a psychobiological theory of attachment (Shilkret & Shilkret, 2016). Self psychology focuses on the individual need to organize the personality into a cohesive sense of self and to build relationships that support it (Flanagan, 2016b). Relational- cultural theory, also known as relational feminist theory, proposes that the basic human drive is for relationships with others. The self is understood to develop and mature through emotional connectedness in mutually empathic relationships, rather than through a process of separation and independence as proposed by traditional object relations theory. Human connectedness is emphasized, human diversity acknowledged, and human

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difference normalized rather than pathologized (Berzoff, 2016).

In recent years, social workers who practice from a psychodynamic perspective have drawn on both biological research and propositions from conflict theorists to extend the psychodynamic perspective. Joan Berzoff (2011) writes about why psychodynamically oriented social work practice with “vulnerable, oppressed, and at-risk clients” must be informed by biological research, particularly neuroscience research, concepts of power and privilege, and critical race theory with its emphasis on intersectionality (p. 132). She also analyzes the contribution that traditional psychodynamic theories can make to understanding discrimination, scapegoating, and oppression.

Like other behavioral science theorizing, psychodynamic theory was developed before neuroscientists and cognitive psychology scientists had the tools to study the biological mechanisms involved with cognition and emotion. Recent research in these fields is giving credence to some of the inclinations of both Freudian and neo-Freudian theory while filling in the gaps related to biological mechanisms. There is much more to be learned, but here is some of what is known already. (Cognition and emotion are the focus of Chapter 4, The Psychological Person.)

First, both neuroscience and cognitive psychology research suggest that Freud was correct to propose that much of human behavior is based on unconscious emotional and cognitive processes. The limbic system is central to the emotions that fuel behavior. The limbic system indirectly regulates autonomic bodily functioning and hormone release, and autonomic and hormonal conditions feed back to the brain to influence behavior, mostly unconsciously. Much research of the limbic system has focused on the amygdala, two almond-shaped clusters of neurons that serve to rapidly appraise stimuli and mobilize responses to stress. It is the brain region involved in feeling afraid and anxious and the region most involved in generating aggression. As any warning system should, the amygdala works so fast that it responds in advance of a conscious awareness of danger. Research by cognitive psychologists indicates that much of human behavior is based on activity that is outside of consciousness; although they do not use this language, it appears that they are suggesting both preconscious and unconscious activity (Kahneman, 2011).

Second, the ego psychologists were right that both unconscious and

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conscious processes and both emotion and cognition are key to human behavior. Neuroscientist Robert Sapolsky (2017) argues that the distinction between thought and feeling is a false dichotomy. The cortex is the “gleaming, logical, analytical crown jewel” of the brain (p. 28). Most sensory information flows into there to be decoded, but some sensory information takes a shortcut, bypassing the cortex and going straight to the amygdala. Lots of axonal projections connect the cortex and the amygdala, and the limbic system and cortex stimulate and inhibit each other. They collaborate and coordinate, and they also bicker and undermine each other. This sounds very much like what Freud meant by ego. Emotions filter what gets remembered. When the amygdala wants to mobilize behavior, it seeks approval from the frontal cortex, which is the site of working memory, executive functioning (which includes organizing thoughts and actions, prioritizing tasks, and making decisions), emotion regulation, and impulse control. However, if the amygdala is sufficiently aroused by fear, it produces a faster but less accurate response by bypassing the frontal cortex. It is situations like this in which a cell phone may be seen as a gun. Sapolsky (2017) calls the frontal part of the cortex the superego of the brain.

Third, neuroscientists identify the neurotransmitter dopamine as central to understanding reward, pleasure, and particularly the pursuit of pleasure. It may be implicated in behaviors that some psychodynamic theorists have thought of as id activity.

Fourth, the psychodynamic approach is correct in asserting that early childhood experiences play an important role in behavior across the life course. There is strong evidence from several disciplines that early life experiences shape the structure and functions of the brain in ways that influence behavior throughout the life course.

Fifth, empirical investigation of polyvagal theory is demonstrating how physiological states are associated with stress reactions (see Flores & Porges, 2017; Porges, 2001). Polyvagal theory identifies two distinct branches of the vagus, the tenth cranial, nerve in the autonomic nervous system. The dorsal vagal, the more evolutionary primitive branch, responds by freezing and conserving resources in all bodily systems when threatened. The ventral branch, the more evolutionary advanced branch, works to regulate defensive reactions to stress by stimulating self-soothing and communication with others. Such vagal activity augments the ongoing

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interactions between the prefrontal cortex and the amygdala.

You will read more about the psychodynamic perspective in Chapter 4. Here are the criteria for evaluating theories as applied to the psychodynamic perspective.

Coherence and conceptual clarity. Freud’s original concepts and propositions were not entirely consistent because they evolved over time. Ego psychology and object relations theorists strengthened the logical consistency of the psychodynamic perspective by expanding and clarifying definitions of major concepts. Theories in the psychodynamic perspective are sometimes criticized for the vague and abstract nature of their concepts but perhaps no more than most other theoretical perspectives. Testability and empirical support. Much empirical work has been based on the psychodynamic perspective, and, as discussed earlier, research in other disciplines provides support for some of the propositions of the perspective. Recent long-term longitudinal studies support the importance of childhood experiences but also indicate that personality continues to develop throughout life. There is growing evidence of the supremely important role that attachment plays in shaping development over the life course. Neuroscience research is indicating the important role of emotion in human behavior, explicating the brain mechanisms involved in emotion and suggesting that both genetics and life experiences shape the emotional brain (Davidson & Begley, 2012). Early life experiences are important in this process, but the brain is plastic and can be changed by ongoing life experiences and mental activity. Comprehensiveness. Early psychodynamic theories were primarily concerned with internal psychological processes. Strong attention was paid to emotions, and in recent formulations, cognitions are also acknowledged. Although Freud assumed that biology determines behavior, he developed his theory several decades before neurological science began to uncover the biological base of emotions. Recently, however, psychodynamic theorists have begun to incorporate new developments in neurological sciences about early brain development into their formulations (see, e.g., Berzoff, 2011). With the exception of Carl Jung, early psychodynamic theorists were not interested in the spiritual aspects of human behavior, typically viewing them as irrational defenses against anxiety. Recently, psychodynamically

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oriented social workers have attempted to integrate spirituality into their practice, often drawing on Eastern psychological theories (see Nagai, 2007). As for environments, most psychodynamic theory conceptualizes them as sources of conflicts with which the individual must struggle. Relational-cultural theory, with its emphasis on supporting the growth of relationships and community, takes exception to that view. Overall, however, environments beyond the family or other close interpersonal relationships are ignored. This has led to criticisms of “mother blaming” and “family blaming” in traditional psychodynamic theories. Social, economic, political, and historical environments of human behavior are probably implied in ego psychology, but they are not explicated. As for time, the focus is on how people change across childhood. There has traditionally been little attempt to account for change after childhood or to recognize the contributions of historical time to human behavior, but this is changing. Diversity and power. Traditional psychodynamic theories search for universal laws of behavior and their applicability to unique individuals. Thus, diversity of experience at the group level has been quite neglected in this tradition until recently. Moreover, in the main, “universal” laws have been developed through analysis of European American, heterosexual, middle-class men. Feminists, as well as members of racial and ethnic minority groups, have criticized the psychodynamic bias toward thinking of people as autonomous individuals (Freedberg, 2007; Nagai, 2007). These critics suggest that viewing this standard as “normal” makes the connectedness found among many women and members of racial and ethnic minority groups seem pathological. Recently, proponents of the psychodynamic perspective have tried to correct for these biases and develop a better understanding of human diversity (see Berzoff et al., 2016). Psychodynamic theories are strong in their recognition of power dynamics in parent–child relationships and in exploration of the lifeworlds of children. Until recently, they have been weaker in looking at power issues in other relationships, however, including gender relationships. In the contemporary era, psychoanalytic feminists have reworked Freud’s ideas to focus on patriarchy (Lengermann & Niebrugge-Brantley, 2018). Relational-cultural theory was developed out of concerns about the male bias in existing psychodynamic theories. Usefulness for social work practice. Most versions of the

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psychodynamic perspective have included clinical theory as well as human behavior theory, theory that can be used for engagement, assessment, intervention, and practice evaluation. Differences of opinion about principles of practice reflect the theoretical evolution that has occurred. Practice principles common to all versions of the psychodynamic perspective include the centrality of the professional– client relationship, the curative value of expressing emotional conflicts and understanding past events, and the goals of self- awareness and self-control. Supported by recent neuroscience research, the psychodynamic perspective reminds social workers that many emotions and cognitions happen at the unconscious, automatic level, and are not easily accessed for conscious exploration. This is especially true of traumatic memories. As psychodynamic theorists embrace neuroscience research, the perspective continues to be useful for understanding how trauma is stored and processed. Given our commitment to evidence-based practice, social workers should be aware of empirical evidence of the benefits of a number of adjunct nontalking, somatic interventions for post-traumatic stress disorder (PTSD), including eye movement desensitization and reprocessing (EMDR) (van der Kolk, 2014), neurofeedback (van der Kolk et al., 2016), and yoga (Mitchell et al., 2014; van der Kolk et al., 2014). In exploratory study, music therapy has also been found to produce improvement in PTSD symptoms (Lightstone, Bailey, & Voros, 2015). Polyvagal theory is being used to develop both biological and interpersonal interventions to stimulate and improve functioning in the vagus nerve, interventions that are considered promising for symptom improvement in treatment-resistant major depression. Such interventions include electrical stimulation of the vagus nerve (Tisi, Franzini, Messina, Savino, & Gambini, 2014), yoga (Tyagi & Cohen, 2016), and group therapy (Flores & Porges, 2017). Mindfulness meditation has been found to build better connections between the amygdala and prefrontal cortex (see Davidson & Begley, 2012) and to improve stress reactivity and anxiety symptoms associated with generalized anxiety disorder (Hoge et al., 2013). Not all of these intervention methods are used by social workers, but social workers can work collaboratively with practitioners who are trained in them. It is important to note that in contrast to the classical psychodynamic approach, recent formulations include directive as well as nondirective intervention, short-term as well as long-term intervention, and environmental manipulations—such as locating

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financial and legal counseling for Maria Chavez’s daughter Sarah—as well as intrapsychic manipulations such as emotional catharsis. Ego psychology has also been used to develop principles for prevention activities in addition to principles of remediation. In general, however, the psychodynamic perspective does not suggest practice principles at the level of communities, organizations, and social institutions.

Developmental Perspective Another way to think about the Maria Chavez family is to view their situation in terms of the developmental tasks they face. You might note that Maria is in very late adulthood and engaging in some life review as she faces the end of life. A part of that life review seems centered on early hardship and exploitation. You might also note that her daughter, Sarah, faced a number of stressful situations in late middle age—assuming caregiving responsibilities for her mother, loss of her son, and financial worries related to an unplanned early departure from the labor market. The caregiving responsibilities are not uncommon at Sarah’s life stage, especially for women, but the loss of her son while she was still in late middle age is an uncommon life experience. Like many single women, she enters late adulthood with financial risk. These observations are consistent with the central ideas of the developmental perspective.

The focus of the developmental perspective, perhaps the most widely used of the perspectives presented in this chapter, is on how human behavior unfolds across the life course, how people change and stay the same over time. Human development is seen to occur in clearly defined stages based on a complex interaction of biological, psychological, and social processes. Each new stage involves new tasks and brings changes in social roles and statuses. A visual representation of these ideas is presented in Exhibit 2.7, and Exhibit 2.1 lists the big ideas, major concepts, and related theories of the perspective.

Photo 2.3 Families are composed of people in different life stages, occupying different statuses and playing different roles, as suggested by the developmental perspective.

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Although there are a great number of developmental theories, they can be categorized into two streams of theorizing, one based in psychology and one based in sociology. Life span or life cycle theory, based in psychology, focuses on the inner life during age-related stages. The study of life span development is rooted in Freud’s (1905/1953) theory of psychosexual stages of childhood development, but Erikson (1963) has been the most influential developmental theorist to date because his model of development includes adult, as well as child, stages of development. Erikson (1963) proposed an epigenetic model of human development, in which the psychological unfolding of personality takes place in sequences influenced by biological, psychological, and social forces. Healthy development depends on the mastery of life tasks at the appropriate time in the sequence. Although life span theorists tend to agree with this epigenetic principle, there is also growing agreement that the stages are experienced in a more flexible way than Erikson proposed, with cultural, economic, and personal circumstances leading to some differences in timing and sequencing (Kuther, 2017). For example, Maria Chavez and her siblings assumed financial responsibilities while they were still children and adolescents after their father’s death.

Exhibit 2.7 ● Developmental Perspective

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Erikson divided the life cycle into eight stages, each with a special psychosocial crisis:

Stage 1 (birth to 1 year): basic trust versus mistrust Stage 2 (ages 2 to 3): autonomy versus shame, doubt Stage 3 (ages 3 to 5): initiative versus guilt Stage 4 (ages 6 to 12): industry versus inferiority Stage 5 (ages 12 to 18 or so): identity versus role confusion Stage 6 (early to late 20s): intimacy versus isolation Stage 7 (late 20s to 50s): generativity versus stagnation Stage 8 (late adulthood): integrity versus despair

Chapter 4, The Psychological Person, and Chapter 5, The Psychosocial Person, in this book include several other developmental theories, including Piaget’s theory of cognitive development, Kohlberg’s and Gilligan’s theories of moral development, and social identity theory. In addition, there are a vast number of related theories that use a developmental framework to focus on one particular developmental phase. Examples include theories of perspective taking in middle childhood, theories of sexual identity development in adolescence, and theories of emerging adulthood.

Early life span theorists, including Erikson, saw their models of development as universal, applying equally well to all groups of people. This idea has been the target of much criticism, with suggestions that the traditional models are based on the experiences of European American, heterosexual, middle-class men and do not apply well to members of other

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groups. This criticism has led to a number of life cycle models for specific groups, such as women (Borysenko, 1996), gay and lesbian persons (e.g., Troiden, 1989), and African Americans (Cross, Parham, & Black, 1991). Life span theories have also been criticized for failing to deal with historical time and the cohort effects on human behavior that arise when groups of persons born in the same historical time share cultural influences and historical events at the same period in their lives.

These criticisms have helped to stimulate development of the multidisciplinary life course perspective. This relatively new perspective conceptualizes the life course as a social, rather than psychological, phenomenon that is nonetheless unique for each individual, with some common life course markers, or transitions, related to shared social and historical contexts (George, 1993). Glen Elder Jr. (1998) and Tamara Hareven (2000) have been major forces in the development of the life course perspective. In its current state, there are six major themes in this perspective:

Interplay of human lives and historical time Biological, psychological, and social timing of human lives Linked or interdependent lives Human capacity for choice making Diversity in life course trajectories Developmental risk and protection

As you may recall, the life course perspective is the conceptual framework for the companion volume to this book: Dimensions of Human Behavior: The Changing Life Course.

The life course perspective would emphasize how the life course trajectories of Maria Chavez and her siblings were altered by the early death of their father and how what happens in one generation reverberates up and down the extended family line. Think about how David and Sarah reorganized their work and personal lives to care for Maria Chavez. Give some thought to how Sarah’s late midlife might have been different if Maria had not required care at that time and if David had not struggled with addiction. This notion that families are linked across generations by both opportunity and misfortune is a central idea of the life course perspective, but you may also recognize it as consistent with the system perspective’s emphasis on interdependence. The evolving life course model respects the idea of role transition that is so central to the

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developmental perspective, but it also recognizes the multiplicity of interacting factors that contribute to diversity in the timing and experience of these transitions.

Here is how the criteria for evaluating theories apply to the developmental perspective.

Coherence and conceptual clarity. Classical developmental theory’s notion of life stages is internally consistent and conceptually clear. Theorists have been able to build on each other’s work in a coherent manner. The life course perspective has begun to develop considerable coherence and clarity about the major concepts. When viewing these two developmental streams together, contradictions appear in terms of universality versus diversity in life span/life course development, although the two models have become much more similar on this issue over time, agreeing that there is considerable diversity in development across the life course. Testability and empirical support. Many of Erikson’s ideas have been employed and verified in empirical research, but until recently, much of developmental research was based on European American, heterosexual, middle-class males. A major concern is that by defining normal as statistical average, life span research fails to capture the lifeworlds of groups who deviate even moderately from the average, or even to capture the broad range of behavior considered normal. Thus, empirical support for the developmental perspective is based to some extent on statistical masking of diversity. The life course perspective has emphasized diversity, however, because it has been developed, in general, from the results of longitudinal research, which follows the same people over an extended period of time. The benefit of longitudinal research is that it clarifies whether differences between age groups are really based on developmental differences or whether they reflect cohort effects from living in particular cultures at particular historical times. There is a growing body of longitudinal research in the life course tradition that suggests that age-graded differences in behavior reflect both developmental factors and historical trends (see Elder & Giele, 2009). The life course perspective is a leading perspective driving longitudinal study of physical and mental health behaviors and outcomes. Comprehensiveness. The developmental perspective, when both theoretical streams are taken together, gets relatively high marks for

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comprehensiveness. Both the life span and the life course streams recognize human behavior as an outcome of complex interactions of biological, psychological, and social factors, although most theorists in both streams pay little attention to the spiritual dimension. The traditional life span approach pays limited attention to the political, economic, and cultural environments of human behavior; the life course perspective pays limited attention to psychological factors. Both approaches attend to the dimension of time, in terms of linear time, but the life course perspective attends to time in a more comprehensive manner, by emphasizing the role of historical time in human behavior. Indeed, the developmental perspective is the only one of the eight perspectives discussed here that makes time a primary focus. Diversity and power. The early life span models were looking for universal stages of human development and did not attend to issues of diversity. More recent life span models have paid more attention to diversity, and diversity of pathways through life is a major theme in the life course perspective. Likewise, the traditional life span approach did not take account of power relationships, with the possible exception of power dynamics in the parent–child relationship. Moreover, traditional life span models are based on the average European American, middle-class, heterosexual male and ignore the worlds of members of nondominant groups. Newer models of life span development have attempted to correct for that failure. Daniel Levinson’s (1996) study of women’s lives is noteworthy in that regard; it includes a sample of women diversified by race and social class and acknowledges the impact of gender power differentials on women’s development. The life course perspective recognizes patterns of advantage and disadvantage in life course trajectories, and life course researchers have done considerable work on the accumulation of advantage and disadvantage over the life course (see Seabrook & Avison, 2012). Usefulness for social work practice. Developmental theory is often used for assessment purposes in social work practice, to evaluate biological, psychological, and social development of individuals. The theoretical perspective can also aid indirectly in the identification of potential personal and social developmental resources. The life course perspective is more promising than traditional life span theories for understanding diverse persons in diverse environments. It suggests that individuals must always be assessed within familial, cultural,

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social, economic, and historical contexts. Overall, the developmental perspective can be viewed as optimistic. Most people face difficult transitions, life crises, and developmental or other challenges at some point, and many people have been reassured to hear that their struggle is “typical.” The developmental perspective is particularly useful for suggesting how to engage people of specific life stages, particularly children and adolescents and for indicating stage-appropriate interventions. Because the developmental perspective sees individuals as having the possibility to rework their inner experiences, as well as their family relationships, clients may be assisted in finding new strategies for getting their lives back on course. The life course perspective’s use of the concept of “turning points” provides clues for how social workers can help individuals, families, groups, organizations, and communities to use life situations as turning points to get their lives and social groupings back on track. The life course perspective, with its emphasis on developmental risk and protection, is being used to develop public health interventions that develop and enhance protective factors related to both physical and mental health. Such interventions are preventive in nature and may occur at the individual, family, or community level. Life course research also has abundant implications for social policy and for practice evaluation.

Critical Thinking Questions 2.3

Both the psychodynamic and developmental perspectives provide stage theories of human behavior, but they put different emphases on the importance of childhood experiences. How important do you think Maria Chavez’s childhood experiences are to her current situation? The psychodynamic perspective sees emotion as holding a central place in human behavior. What emotions do you experience as you read the story of the Maria Chavez family? How do you think these emotions are related to your own childhood experiences? How do you think those emotions might be helpful for work with the Maria Chavez family? How might they not be helpful?

Behavioral Perspective The hospice social worker thinks about how Maria Chavez’s daughter, Sarah, is serving as a caregiver for her mother but also has worked as a

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certified nursing assistant, a paid caregiving role. He is curious, as he often is when interacting with paid caregivers, about whether she had particular role models for the caregiving role in her family or other relationships. He is struck by Sarah’s statement that she feels obligated to get her mother’s approval for financial decisions even though her mother has dementia and has assigned power of attorney over financial matters to Sarah. He hears that Maria has always kept a tight control over money and thinks that she has modeled this behavior for Sarah. He is wondering, however, about the behaviors Maria has engaged in to shape and reinforce Sarah’s carefulness about her mother’s money. He also hears that Sarah’s sisters want her to be frugal with her mother’s money and he wonders how they go about reinforcing this idea with Sarah. This is an issue that could be explored during his next visit. He also wants to explore whether the fears about the future that Sarah expressed toward the end of their conversation is based on being overwhelmed with the current situation or is a long-term pattern of doubting her own personal competence. Viewing the Maria Chavez family from a behavioral perspective can lead to such questions.

Theories in the behavioral perspective suggest that human behavior is learned as individuals interact with their environments. There are disagreements among the different streams of behavioral theory, however, about the processes by which behavior is learned. Over time, three major versions of behavioral theory have been presented, proposing different mechanisms by which learning occurs. The general themes of the behavioral perspective are represented visually in Exhibit 2.8, and Exhibit 2.1 lists the big ideas, major concepts, and related theories of the perspective.

Classical conditioning theory, also known as respondent conditioning, sees behavior as learned through association, when a naturally occurring stimulus (unconditioned stimulus) is paired with a neutral stimulus (conditioned stimulus). This approach is usually traced to a classic experiment by Russian physiologist Ivan Pavlov, who showed, first, that dogs naturally salivate (unconditioned response) to meat powder on the tongue (unconditioned stimulus). Then, a ringing bell (conditioned stimulus) was paired with the meat powder a number of times. Eventually, the dog salivated (conditioned response) to the ringing of the bell (conditioned stimulus). In other words, an initially neutral stimulus comes to produce a particular behavioral response after it is repeatedly paired with another stimulus of significance. Biomedical research indicates that

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many bodily functions are affected by classical conditioning, and neuroscience research has found that fear responses in the amygdala are trained through classical conditioning (Farmer, 2009; Sapolsky, 2017). Classical conditioning plays a role in understanding many problems that social work clients experience. For example, someone like Maria Chavez’s grandson, David, who had a drug addiction problem may have experienced urges to use when in a location where he often engaged in drug using behavior before getting sober. Anxiety disorders are also often conditioned; for example, a humiliating experience with public speaking may lead to a deep-seated and long-lasting fear of it, which can result in anxiety attacks in situations where the person has to speak publicly. After a traumatic experience, the body and the brain are conditioned to reexperience the traumatic situation when exposed to sights, sounds, smells, and other sensory stimuli associated with the original traumatic experience (van der Kolk, 2014). This approach looks for antecedents of behavior—stimuli that precede behavior—as the mechanism for learning.

Exhibit 2.8 ● Behavioral Perspective

Photo 2.4 Classical conditioning is traced to an experiment Russian physiologist Ivan Pavlov performed with dogs.

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Operant conditioning theory, sometimes known as instrumental conditioning, sees behavior as the result of reinforcement. It is built on the work of two American psychologists, John B. Watson and B. F. Skinner. In operant conditioning, behavior is learned as it is strengthened or weakened by the reinforcement (rewards and punishments) it receives or, in other words, by the consequences of the behavior. Behaviors are strengthened when they are followed by positive consequences and weakened when they are followed by negative consequences. A classic experiment demonstrated that if a pigeon is given a food pellet each time it touches a lever, over time the pigeon learns to touch the lever to receive a food pellet. This approach looks for consequences—what comes after the behavior—as the mechanism for learning behavior. We all use operant conditioning as we go about our daily lives. We use positive reinforcers, such as smiles or praise, to reward behaviors we find pleasing, in hopes of strengthening those behaviors. Negative reinforcers are also used regularly in social life to stop or avoid unpleasant behavior. For example, an adolescent girl cleans her room to avoid parental complaints. Avoiding the complaints reinforces the room-cleaning behavior.

Cognitive social learning theory, also known as cognitive behavioral theory or social cognitive theory, with Albert Bandura as its chief contemporary proponent, suggests that behavior is also learned by

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imitation, observation, beliefs, and expectations. In this view, the “learner” is not passively manipulated by elements of the environment but can use cognitive processes to learn behaviors. Cognitive-behavioral therapy (CBT), developed in the 1960s, focuses on helping people to better understand the thoughts and emotions that lead to problematic behavior and to develop new ways of thinking and behaving. Observing and imitating models is a pervasive method for learning human behavior. Bandura (1977a, 1986) proposes that human behavior is also driven by beliefs and expectations. He suggests that self-efficacy (a sense of personal competence) and efficacy expectation (an expectation that one can personally accomplish a goal) play an important role in motivation and human behavior. Bandura (2001, 2002) has extended his theory of self- efficacy to propose three models of agency (the capacity to intentionally make things happen): personal agency of the individual actor; proxy agency, in which people reach goals by influencing others to act on their behalf; and collective agency, in which people act cooperatively to reach a goal.

Although the different streams of behavioral theorizing disagree about the mechanisms by which behavioral learning occurs, there is agreement that all human problems can be defined in terms of undesirable behaviors. Furthermore, all behaviors can be defined, measured, and changed.

This is how the behavioral perspective rates on the criteria for evaluating theories.

Coherence and conceptual clarity. Although there are disagreements about the mechanisms of learning among the various streams of the behavioral perspective, within each stream ideas are logically developed in a consistent manner. The behavioral perspective gets high marks for conceptual clarity; concepts are very clearly defined in each of the streams. Testability and empirical support. Behavioral concepts are easily measured for empirical investigation because theorizing has been based, in very large part, on laboratory research. This characteristic is also a drawback of the behavioral perspective, however, because laboratory experiments by design eliminate much of the complexity of person–environment interactions. In general, however, all streams of the behavioral perspective have attained a relatively high degree of empirical support. Biomedical researchers have found that many

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bodily functions are affected by classical conditioning, including immune functioning and brain functioning. Neuroscientists have found that CBT has a powerful effect on the brain activity involved in depression (Davidson & Begley, 2012). On the other hand, recent research in Sweden (Werbart, Levin, Andersson, & Sandell, 2013) found that CBT produced no better results than psychodynamic or integrative therapy in outpatient psychiatric care. Davidson and Begley (2012) suggest that the skill level of the CBT therapist for targeting specific neural circuits is an important variable, but understanding of this is in the early stages. Comprehensiveness. Overall, the behavioral perspective sacrifices multidimensional understanding to gain logical consistency and testability. Little attention was paid to biology in early theorizing, but in his later work, Bandura (2001, 2002) recognized the role of biology in human behavior. Even so, biological research provides some of the best evidence for behavioral theory, with the research noted earlier about the benefits of CBT and research about how bodily functions are classically conditioned. Cognition and emotion are not included in theories of classical and operant conditioning, but they do receive attention in social cognitive theory. Spiritual factors are considered unmeasurable and irrelevant in classical and operant conditioning theories. For this reason, social behaviorism is sometimes seen as dehumanizing. Although environment plays a large role in the behavioral perspective, the view of the environment is quite limited in classical and operant conditioning. Typically, the behavioral perspective searches for the one environmental factor, or contingency, that has reinforced or has the possibility of reinforcing one specific behavior. The identified contingency is usually in the micro system (such as the family) or sometimes in the meso system (e.g., a school classroom), but these systems are not typically put in social, economic, political, or historical contexts. One exception is Bandura’s cognitive social learning theory, which acknowledges broad systemic influences on the development of gender roles. Time is important in this perspective only in terms of the juxtaposition of stimuli and reinforcement. The behaviorist is careful to analyze antecedents and consequences of behavior. Diversity and power. The behavioral perspective receives low marks in terms of both diversity and power issues. Very little attention has been paid to recognizing diversity in human behaviors, and it is assumed that the same mechanisms of learning work equally well for

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all groups. Neuroscientist Sapolsky (2017) suggests that behaviorists were often right about human behavior but were wrong in one big way: They failed to acknowledge that we are not all born the same, and the same training will not produce the same results in all humans. Likewise, the behavioral perspective attends little to issues of power and oppression. Operant behavioral theory recommends rewards over punishment, but it does not account for the coercion and oppression inherent in power relationships at every system level. It is quite possible, therefore, for the professional behavior modifier to be in service to oppressive forces. On the other hand, behavioral methods can be used to serve social work values. Bandura (1986) writes specifically about power as related to gender roles. He and other theorists note that persons in nondominant positions are particularly vulnerable to learned helplessness in which a person’s prior experience with environmental forces has led to low self-efficacy and expectations of efficacy. Maier and Seligman (2016) recently analyzed the neural circuitry of learned helplessness. Usefulness for social work practice. A major strength of the behavioral perspective is the ease with which principles of behavior modification can be extrapolated, and it is probably a rare social worker who has not used behavioral principles for social work assessment and intervention at some point. Behavioral theories are not particularly useful for social work engagement, however. Social workers and psychologists have used behavioral methods primarily to modify undesirable behavior of individuals. For example, systematic desensitization techniques are used to diminish or eradicate anxiety symptoms. Parent training programs often teach parents how to make more effective use of reinforcements to strengthen positive behaviors and weaken negative behaviors in their children. Social workers often model how to enact new behaviors for their clients. Dialectical behavior therapy teaches adaptive coping related to emotion regulation, distress tolerance, cognitive distortions, and interpersonal communication (Walsh, 2014). Cognitive behavioral therapy has been found to be particularly useful for reducing symptoms of major depression (Davidson & Begley, 2012). Cognitive processing therapy, which teaches clients to challenge their trauma-related beliefs and assumptions, has been found to have long-term benefit for reducing symptoms of post-traumatic stress disorder (Iverson, King, Cunningham, & Resick, 2015). However, although the potential exists, behavioral methods have not been used effectively to produce

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social reform. Richard Stuart (1989) reminds us that behavior modification was once a “social movement” that appealed to young social reformers who were interested in changing social conditions that produce atypical or problematic behaviors in contrast with contemporary use of the theory to modify undesirable behaviors. Skinner’s Walden Two (1948) was the impetus for attempts by these young reformers to build nonpunitive communities, which represented significant modification of social conditions (see Kinkade, 1973; Wheeler, 1973). Indeed, Bandura’s (2002) conceptualization of proxy agency and collective agency has implications for social reform.

Humanistic Perspective Consistent with the social work code of ethics, the hospice social worker who is making contact with the Maria Chavez family believes in the dignity and worth of all humans. His experiences as a hospice social worker have reinforced his belief that each person is unique, and even though he has worked with many hospice patients, he expects Maria Chavez’s story to be in some ways unlike any other story he has heard. He is eager to hear more about how Maria understands her situation and whether there are any things that are particularly important to her in the limited time she has left. He takes note of the resilience that Maria demonstrated as she transcended early hardships to build a robust career while raising a family in a time when that was not a typical path for women. He wants to acknowledge that with Maria. He also notes Sarah’s pride in her mother’s accomplishments, her courage in the face of an accumulation of stress, her strength in convincing her son to seek addiction treatment, and her commitment to her mother’s care, and he wants to give that affirming feedback to Sarah. He also wants to hear more about what is important to Sarah during Maria’s final days. His thoughts and planned course of action reflect the humanistic perspective.

The humanistic perspective is often called the “third force” of psychology, because it was developed in reaction to the determinism found in early versions of both the psychodynamic (behavior as intrapsychically determined) and behavioral (behavior as externally determined) perspectives. We are using the term humanistic perspective to include humanistic psychology and existential psychology, both of which

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emphasize the individual’s freedom of action and search for meaning. We also extend the term to include the growing movement of positive psychology and the capabilities approach. The main ideas of the humanistic perspective are presented visually in Exhibit 2.9, and Exhibit 2.1 lists the big ideas, major concepts, and related theories of the perspective.

Perhaps the most influential contributions to humanistic psychology were made by Carl Rogers (1951) and Abraham Maslow (1962). Abraham Maslow (1962) was drawn to understand “peak experiences,” or intense mystical moments of feeling connected to other people, nature, or a divine being. Maslow found peak experiences to occur often among self- actualizing people, or people who were expressing their innate potentials. Maslow developed a theory of a hierarchy of needs, which suggests that higher needs cannot emerge in full motivational force until lower needs have been at least partially satisfied. Physiological needs are at the bottom of the hierarchy, and the need for self-actualization is at the top:

1. Physiological needs: hunger, thirst, sex 2. Safety needs: avoidance of pain and anxiety; desire for security 3. Belongingness and love needs: affection, intimacy 4. Esteem needs: self-respect, adequacy, mastery 5. Self-actualization: to be fully what one can be; altruism, beauty,

creativity, justice

Exhibit 2.9 ● Humanistic Perspective

Maslow is considered one of the founders of transpersonal psychology,

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which he labeled as the “fourth force” of psychology. We include transpersonal psychology under the umbrella of the humanistic perspective, but it is not discussed here because it receives considerable attention in Chapter 6, The Spiritual Person.

Carl Rogers (1951) was interested in the capacity of humans to change in therapeutic relationships. He began his professional career at the Rochester Child Guidance Center, where he worked with social workers who had been trained at the Philadelphia School of Social Work. He has acknowledged the influence of Otto Rank, Jessie Taft, and the social workers at the Rochester agency on his thinking about the importance of responding to client feelings (Hart, 1970). He came to believe that humans have vast internal resources for self-understanding and self-directed behavior. He emphasized, therefore, the dignity and worth of each individual and presented the ideal interpersonal conditions under which people come to use their internal resources to become “more fully functioning.” These have become known as the core conditions of the therapeutic process: empathy, warmth, and genuineness.

Existential psychology, which developed out of the chaos and despair in Europe during and after World War II, presented four primary themes (Krill, 2017):

1. Each person is unique and has value. 2. Suffering is a necessary part of human growth. 3. Personal growth results from staying in the immediate moment. 4. Personal growth takes a sense of commitment.

It is the emphasis on the necessity for suffering that sets existentialism apart from other versions of humanism.

Maslow is said to have coined the term positive psychology when he used it as a chapter title in his 1954 book, Motivation and Personality. As we know it today, positive psychology is a relatively recent branch of psychology that undertakes the scientific study of people’s strengths and virtues and promotes optimal functioning of individuals and communities. Proponents of positive psychology argue that psychology has paid too much attention to human pathology and not enough to human strengths and virtues. Martin Seligman (1998, 2002), one of the authors of the concept of learned helplessness, has been at the forefront of positive psychology, contributing the important concept of learned optimism.

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Positive psychologists argue that prevention of mental illness is best accomplished by promoting human strength and competence. They have identified a set of human strengths that promote well-being and buffer against mental illness, including optimism, courage, hope, perseverance, honesty, a work ethic, and interpersonal skills (Snyder, Lopez, & Pedrotti, 2011). The positive psychology approach is drawing on both Western and Eastern worldviews. A large focus on hope is rooted in Western thinking about individualism, whereas emphasis on balance, compassion, and harmony comes more from Eastern collectivist thinking (Snyder, Lopez, Pedrotti, & McKnight, 2011).

The capabilities approach to social justice, described in Chapter 1, can be classified with the humanistic perspective. The capabilities approach was proposed by welfare economist and political philosopher Amartya Sen (1999). Like other humanistic thinkers, Sen focuses on human agency or people’s ability to pursue and realize goals that they value. He and collaborator Martha Nussbaum (2001) see humans as active, creative, and able to act on behalf of their aspirations. In contrast to earlier humanistic theorists, however, the capabilities approach puts individuals in a wider context and focuses on the idea that social arrangements should aim to support and expand people’s capabilities. As suggested in Chapter 1, Nussbaum lists 10 core capabilities that all people in all societies must have to be able to pursue and realize valued goals. Sen argues, instead, that no such list can be arbitrarily delineated because of the great diversity of people and environments in the world. He recognizes the intersectionalities of diversity that exist in social life, that one person can belong to many different groups. He thinks that individuals should be left to decide which capabilities they choose to enhance or neglect.

In sociology, a posthumanist approach has recently developed (see Franklin, 2007). Posthumanists criticize the humanist perspective for separating humanity from the nonhuman world. They are particularly critical of what they see as an elevation of the importance of humans over nature and other nonhuman elements. This is a similar argument to the one made by actor-network theory and is compatible with the ecological justice movement, discussed in Chapter 7, which argues that all human activities must align with the rights of nature and natural systems.

This is how the humanistic perspective rates on the criteria for evaluating theories.

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Coherence and conceptual clarity. Theories in the humanistic perspective are often criticized for being vague and highly abstract, with concepts such as “being” and “phenomenal self.” As you will see in Chapter 6, The Spiritual Person, the language of transpersonal theories is particularly abstract, with discussion of self-transcendence and higher states of consciousness. Indeed, theorists in the humanistic perspective, in general, have not been afraid to sacrifice coherence to gain what they see as a more complete understanding of human behavior. The positive psychology movement is working to bring greater consistency and coherence to humanistic concepts, and Nussbaum’s core capabilities are quite explicit. Testability and empirical support. As might be expected, empirically minded scholars have not been attracted to the humanistic perspective, and consequently until recently there was little empirical literature to support the perspective. A notable exception is the clinical side of Rogers’s theory. Rogers began a rigorous program of empirical investigation of the therapeutic process, and such research has provided strong empirical support for his conceptualization of the necessary conditions for the therapeutic relationship: warmth, empathy, and genuineness (Sollod, Wilson, & Monte, 2009). Recent research across several disciplines has demonstrated that a high level of practitioner empathy is associated with positive client outcomes (Gerdes & Segal, 2011). The positive psychology movement is focusing, with much success, on producing empirical support for the role of human strengths and virtues in human well-being (see Chaves, Lopez-Gomez, Hervas, & Vazques, 2017). Some researchers have suggested that neuroscience research is calling the notion of free will (human agency) into question, arguing that it provides clear evidence that human behavior is determined by the gene–environment interactions that shape the brain (Kurzweil, 2012). Other neuroscientists provide evidence that humans have the power to “live our lives and train our brains” in ways that shift emotions, thoughts, and behaviors (Davidson & Begley, 2012, p. 225). That is a high endorsement for some of the tenets of the humanistic perspective. Comprehensiveness. The internal life of the individual is the focus of the humanistic perspective, and it is strong in consideration of both psychological and spiritual dimensions of the person. With its emphasis on a search for meaning, the humanistic perspective is the only perspective presented in this chapter to explicitly recognize the role of spirituality in human behavior. (Other theories of spirituality

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are discussed in Chapter 6.) In addition, Maslow recognizes the importance of satisfaction of basic biological needs. Most theorists in the humanistic tradition give limited attention to the environments of human behavior. A dehumanizing world is implicit in the works of Maslow and Rogers, but neither theorist focuses explicitly on the environments of human behavior, nor do they acknowledge that some environments are more dehumanizing than others. The positive psychology movement has begun to examine positive environments that can promote human strengths and virtues, including school, work, and community environments (Snyder et al., 2011). The capabilities perspective calls for social institutions to support and expand people’s capabilities. Diversity and power. The humanistic perspective, with its almost singular consideration of an internal frame of reference, devotes more attention to individual differences than to differences between groups. The one exception is Sen’s capabilities perspective, which emphasizes the great diversity of human capabilities and values. In general, far too little attention is given in the humanistic tradition to the processes by which institutional oppression influences the phenomenal self—the individual’s subjectively felt and interpreted experience of “who I am.” Like the social constructionist perspective, however, the humanistic perspective is sometimes quite strong in giving voice to experiences of members of nondominant groups. With the emphasis on the phenomenal self, members of nondominant groups are more likely to have preferential input into the telling of their own stories. The social worker’s intention to hear and honor the stories of each member of the Maria Chavez family may be a novel experience for each family member, and the social worker may, indeed, hear very different stories from what he expects to hear. Rogers developed his respect for the personal self, and consequently his client-centered approach to therapy, when he realized that his perceptions of the worlds of his low-income clients in the Child Guidance Clinic were very different from their own perceptions. Usefulness for social work. If the social constructionist perspective gives new meaning to the old social work adage “Begin where the client is,” it is social work’s historical involvement in the development of the humanistic perspective that gave original meaning to the adage. It is strong in recommendations for engaging with individuals, families, groups, organizations, and communities. It is limited in terms of providing specific interventions, but it is

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consistent with social work’s value of the dignity and worth of the individual. The humanistic perspective suggests that social workers begin by developing an understanding of how the client views the situation, and with its emphasis on the individual drive for growth and competence, it recommends a “strengths” rather than “pathology” approach to practice. George Vaillant (2002), a research psychiatrist, suggests that this attention to strengths is what distinguishes social workers from other helping professionals. From this perspective, then, we might note that Maria Chavez’s past courage in the face of early hardships and Sarah’s strong commitment to caring for her mother are strengths that the social worker can emphasize in his interactions with them. At the organizational level, the humanistic perspective has been used by organizational theorists, such as Douglas McGregor (1960), to prescribe administrative actions that focus on employee well-being as the best route to organizational efficiency and effectiveness. Appreciative inquiry is another organizational model that focuses on identifying the positives and dreams of what might be in organizations (Lewis, Passmore, & Cantore, 2016). Positive psychology is popular in clinical work and is beginning to propose guidelines for developing positive environments in schools, workplaces, and communities.

Critical Thinking Questions 2.4

Both cognitive social learning theory and theories in the humanistic perspective emphasize the important role of human agency, the capacity to intentionally make things happen, in human behavior. Other theories in the behavioral perspective and most of the other perspectives discussed here put less emphasis on human agency. Now that you have examined eight theoretical perspectives, how much agency do you think humans have over their behavior, in general? Explain. How much agency do you think members of the Maria Chavez family have? Explain.

The Merits of Multiple Perspectives You can see that each of these perspectives puts a different lens on the unfolding story of Maria Chavez and her family. Although they all are seeking to understand human behavior, different aspects of behavior are

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emphasized. No one theory will ever tell the whole story of human behavior, but each of these perspectives tells an important partial story, a partial story that will be particularly helpful in some situations. You can also see that each of the eight perspectives has been used to guide social work practice over time. Some of the perspectives are particularly useful for suggesting how to engage with client systems; some are especially useful for assessment, some are particularly strong for suggesting social work interventions, and some can be used to guide practice evaluation. It was suggested in Chapter 1 that each situation can be examined from several perspectives and that using a variety of perspectives brings more dimensions of the situation into view. Cognitive psychologists have provided convincing evidence that all of us, whether new or experienced social workers, have biases that predispose us to do too little thinking, rather than too much, about the practice situations we confront. We are particularly prone to ignore information that is contrary to our hypotheses about situations. Consequently, we tend to end our search for understanding prematurely. One step we can take to prevent this premature closure is to think about practice situations from multiple theoretical perspectives.

We have provided an overview of eight theoretical perspectives in this chapter and discussed some of the theories related to them. In Chapters 3 through 14, you will encounter other theories related to these perspectives, theories used to understand specific dimensions of person and environment. To help you see the connections between the perspectives discussed here and theories discussed in subsequent chapters, Exhibit 2.10 cues you to where you will find these related theories in the chapters that follow.

As a competent professional, you must view the quest for adequate breadth and depth in your knowledge base as an ongoing, lifelong challenge and responsibility. We hope that over time you will begin to use these multiple perspectives in an integrated fashion so that you can see the many dimensions—the contradictions as well as the consistencies—in stories like the Maria Chavez family. We encourage you to be flexible and reflective in your thinking and your “doing” throughout your career. We remind you, again, to use general knowledge such as that provided by theoretical perspectives only to generate hypotheses to be tested in specific situations, not as facts inherent in every situation.

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Critical Thinking Questions 2.5

At the beginning of the chapter, we wondered what got your attention when you read the story of Maria Chavez. As you read about the eight theoretical perspectives, did you see any ideas that addressed the things that caught your attention about the story? If so, what were they? Were there things that caught your attention that did not seem to be addressed by any of the perspectives? If so, what were they? Which perspectives seemed more closely aligned with what caught your attention upon first reading the story? Which perspectives provided you with useful new ways to think about the story?

Implications for Social Work Practice The eight perspectives on human behavior discussed in this chapter suggest a variety of principles for social work assessment and intervention.

In assessment, consider any recent system changes that may be affecting the client system. Assist families and groups to renegotiate unsatisfactory system boundaries. Develop networks of support for persons experiencing challenging life transitions.

Exhibit 2.10 ● Where Related Theories of Eight Theoretical Perspectives Are Found in Chapters 3–14

Perspective Found in Later Chapters

Chapter 3: Proximal to distal environment approach; systems perspective on the human body; ecobiodevelopmental framework

Chapter 4: Information processing theory; multiple intelligences theory

Chapter 5: Risk and resilience framework; social network theory

Chapter 7: Behavior settings theory; deep ecology

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Systems Chapter 8: Materialist perspective; practice orientation; gene-culture-co-evolutionary theory

Chapter 9: Functional theories of inequality

Chapter 10: Systems perspective on families; family stress, coping, and resilience perspective; family economic stress model

Chapter 12: Systems perspective on organizations: political economy model, institutional theory, learning organization theory

Chapter 13: Social systems approach to communities

Conflict

Chapter 7: Ecocritical theories, ecofeminist theories

Chapter 8: Neo-Marxist critical theory

Chapter 9: Marxist theory of inequality; Weber’s life chance theory of inequality; dependency theory; Wallerstein’s world systems perspective

Chapter 10: Feminist perspective and families

Chapter 12: Critical perspective on organizations: theory of gendered organizations, organizations as multiple oppressions, and nonhierarchical organizations

Chapter 13: Conflict approach to communities

Chapter 14: Political opportunities perspective on social movements

Chapter 5: Social network theory

Chapter 10: Exchange and choice perspective on families

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Exchange and choice

Chapter 11: Status characteristics and expectation states theory; exchange theory and groups

Chapter 12: Rational perspective on formal organizations: ideal-type bureaucracy theory, scientific management, human relations theory, management by objective, decision-making theory

Chapter 13: Social capital approach to communities

Chapter 14: Mobilizing structures perspective on social movements

Social constructionist

Chapter 3: Constructivist perspective on disability

Chapter 4: James Averill’s social constructionist theory of emotions, the self as shared symbolic experience

Chapter 8: Mentalist perspective, poststructuralism, and postmodernism approaches to culture

Chapter 10: Symbolic interaction perspective on families

Chapter 11: Symbolic interaction and groups

Chapter 12: Interactional/interpretive perspective on formal organizations: organizational culture model, managing diversity model, and appreciative inquiry model

Chapter 14: Cultural perspective on social movements

Chapter 4: Greenberg’s theory of primary and secondary emotions; fight or flight stress theory; differential emotions theory; psychoanalytic

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Psychodynamic

theory; ego psychology; attribution theory; theory of emotional intelligence; the self as organizing activity

Chapter 5: Relational theory; attachment theory; psychoanalytic feminist theory; gender feminist theory; multicultural theory

Chapter 7: Control theories of the relationship between the physical environment and human behavior

Chapter 10: Bowen’s theory of differentiation of self; family stress, coping, and resilience perspective

Chapter 11: Psychodynamic theory and groups

Developmental

Chapter 3: Ecobiodevelopmental framework

Chapter 4: Piaget’s cognitive theory; Kohlberg’s and Gilligan’s theories of moral intelligence

Chapter 5: Social identity theory; Erikson’s psychosocial theory

Chapter 10: Life course developmental perspective on families; family economic stress model

Chapter 11: Self-categorization theory; stage models of group development

Behavioral

Chapter 4: Social learning theory; cognitive behavioral theory/therapy; the self as cognitive structure

Chapter 7: Stimulation theories, attention restoration theory, and psychophysiological stress recovery theory of the relationship between physical environments and human behavior

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Humanistic

Chapter 4: The self as unfolding potential; the self as flow of experience

Chapter 6: Fowler’s stages of faith development; transpersonal theory; Wilber’s integral theory of consciousness

Chapter 10: Family resilience perspective

Chapter 12: Appreciative inquiry model of organizational change

In assessment, consider power arrangements and forces of oppression, and the alienation that emanates from them. Assist in the development of advocacy efforts to challenge patterns of dominance, when possible. Be aware of the power dynamics in your relationships with clients; when working with nonvoluntary clients, speak directly about the limits and uses of your power. In assessment, consider the patterns of exchange in the social support networks of individual clients, families, and organizations, using network maps where useful. Assist individuals, families, and organizations to renegotiate unsatisfactory patterns of exchange, when possible. Recognize the role of both reason and emotion in the policymaking process. Begin your work by understanding how clients view their situations. Engage clients in thinking about the environments in which these constructions of self and situations have developed. When working in situations characterized by differences in belief systems, assist members to engage in sincere discussions and to negotiate lines of action. Assist clients in expressing emotional conflicts and in understanding how these are related to past events, when appropriate. Help them develop self-awareness and self-control, where needed. Assist clients in locating and using needed environmental resources. In assessment, consider the familial, cultural, and historical contexts in the timing and experience of developmental transitions. Recognize human development as unique and lifelong. In assessment, consider the variety of processes by which

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behavior is learned. Be sensitive to the possibility of learned helplessness when clients lack motivation for change. Consider issues of social justice and fairness before engaging in behavior modification. Engage clients by listening to how they see their situations, what kinds of changes they would like to see, and what methods they would like to use to accomplish those changes. Be aware of the potential for significant differences between your assessment of the situation and the client’s own assessment. Focus on strengths rather than pathology; recognize the possibility of learned hopefulness as well as learned helplessness.

Key Terms agency 64 behavioral perspective 63 boundary 38 classical conditioning theory 63 cognitive social learning theory 64 conflict perspective 42 critical race theory 45 critical theorists 43 developmental perspective 59 efficacy expectation 64 empowerment theories 45 exchange and choice perspective 47 feedback mechanisms 38 feminist theories 45 hierarchy of needs 66 humanistic perspective 66 intersectionality theory 45 learned helplessness 65 operant conditioning theory 63 phenomenal self 69 positive psychology 67 psychodynamic perspective 55 reciprocity 47 self-efficacy 64 social capital 48

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social constructionist perspective 51 social exchange theory 47 social network theory 48 systems perspective 38

Active Learning 1. Reread the case study of the end of life care for Maria Chavez.

Next, review the big ideas of the eight theoretical perspectives as presented in Exhibit 2.1. Choose three specific big ideas that you think are most helpful in thinking about the Maria Chavez family. For example, you might choose this big idea from the systems perspective: Each part of the system affects all other parts and the system as a whole. You might also choose this big idea from the humanistic perspective: Human behavior is driven by a desire for growth, personal meaning, and competence and by a need to experience a bond with others. Likewise, you might choose another specific idea from any of the perspectives. The point is to choose the three big ideas that you find most useful. Now, in a small group, compare notes with three or four classmates about which big ideas were chosen. Discuss why these particular choices, and not others, were made by each of your classmates.

2. Choose one of the theoretical perspectives described in this chapter. Spend 5–8 minutes thinking about how you would describe that perspective to a class of 6th graders. Prepare an outline of the presentation you would make to the 6th graders. Post your outline for your classmates to review and provide feedback.

3. Choose a story that interests you in a current edition of a daily newspaper. Read the story carefully and then think about which of the eight theoretical perspectives discussed in this chapter is most reflected in the story.

Web Resources

Conflict Theory(ies) of Deviance: www.umsl.edu/~keelr/200/conflict.html

Site presented by Robert O. Keel at the University of Missouri at St. Louis contains information on the basic

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http://www.umsl.edu/~keelr/200/conflict.html

premises of conflict theory as well as specific information on radical conflict theory and pluralistic conflict theory.

International Humanistic Psychology Association: http://ihpaworld.org

Site maintained by the International Humanistic Psychology Association contains links to events, capacity-building training projects, professional collaboration and development, research, dialogues and networking, and publications and resources.

Personality Theories: http://webspace.ship.edu/cgboer/perscontents.html

Site maintained by C. George Boeree at the Psychology Department of Shippensburg University provides an electronic textbook on theories of personality, including the theories of Sigmund Freud, Erik Erikson, Carl Jung, B. F. Skinner, Albert Bandura, Abraham Maslow, Carl Rogers, Jean Piaget, and Buddhist psychology.

Richards on the Brain: Behavioral Theories: www.richardsonthebrain.com/behavioral-theories

An online library maintained in Parker, Colorado, with the mission to bring together the findings of neuroscience, psychology, and biology. The behavioral theory page includes information on behavioral theory, humanistic psychology, and psychoanalytic theory.

Sociological Theories and Perspectives: www.sociosite.net/topics/theory.php

Site maintained at the University of Amsterdam contains general information on sociological theory and specific information on a number of theories, including interaction theory, conflict theory, network theory, and rational choice theory.

William Alanson White Institute: www.wawhite.org

Site contains contemporary psychoanalysis journal articles, training programs, and a psychoanalysis-in-action blog.

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http://ihpaworld.org

http://webspace.ship.edu/cgboer/perscontents.html

http://www.richardsonthebrain.com/behavioral-theories

http://www.sociosite.net/topics/theory.php

http://www.wawhite.org

Part II The Multiple Dimensions of Person

The multiple dimensions of person, environment, and time have unity; they are inseparable and embedded. That is the way I think about them and the way I am encouraging you to think about them. However, you will be better able to think about the unity of the three aspects of human behavior when you have developed a clearer understanding of the different dimensions encompassed by each one. A review of theory and research about the different dimensions will help you to sharpen your thinking about what is involved in the changing configurations of persons and environments.

The four chapters in Part II provide you with an up-to-date understanding of theory and research about the dimensions of person. The section begins with a chapter on the biological dimension and ends with one on the spiritual dimension. Because so much has been written about the psychological dimension, it is covered in two chapters: the first one about the basic elements of a person’s psychology and the second one about the processes a person uses to maintain psychological balance in a changing environment.

With a state-of-the-art knowledge base about the multiple dimensions of persons, you will be prepared to consider the interactions between persons and environments, which is the subject of Part III. And then you will be able to think more comprehensively and more clearly about the ways configurations of persons and environments change across the life course. The discussion of the life course in the companion volume to this book, The Changing Life Course, attempts to put the dimensions of persons and environments back together and help you think about their embeddedness across time.

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3 The Biological Person

Stephen French Gilson Elizabeth DePoy

Chapter Outline Learning Objectives Case Study 3.1: Cheryl’s Legs and Head Case Study 3.2: A Diabetes Diagnosis for Jenna Case Study 3.3: Melissa’s HIV Diagnosis Case Study 3.4: HIV, Thomas’s Hero Case Study 3.5: Louise and Stewart, Huntington’s, Obesity, and Cardiovascular Disease Case Study 3.6: Juan and Belinda’s Sexual Life in Retirement An Integrative Approach for Understanding the Intersection of Interior Biological Health and Illness and Exterior Environmental Factors Systems Taxonomy: Six Interior Environment Systems

Nervous System Endocrine System Immune System Cardiovascular System Musculoskeletal System Reproductive System

Heredity, Genetics, and the Reproductive System Ecobiodevelopmental Framework to Understand the Relationship Between Interior Health and Exterior Environments Implications for Social Work Practice Key Terms Active Learning Web Resources

Acknowledgments: The authors wish to thank Elizabeth Hutchison for her helpful comments, insights, and suggestions for this chapter.

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Learning Objectives 3.1 Compare one’s own emotional and cognitive reactions to six case studies. 3.2 Use theory to summarize the intersection of the interior body and the exterior environment. 3.3 Recognize the major structures and functions of six biological systems: nervous, endocrine, immune, cardiovascular, musculoskeletal, and reproductive. 3.4 Give examples of how different biological systems interact to produce health and disease. 3.5 Explain the bioecodevelopmental framework for understanding the relationship between interior health and exterior environments. 3.6 Apply knowledge of human biology to recommend guidelines for social work engagement, assessment, intervention, and evaluation.

Case Study 3.1 Cheryl’s Legs and Head Cheryl grew up in rural Idaho in a large extended family and enlisted as a private in the army just after she finished her 3rd year in high school. After basic training, she was first deployed to Iraq and subsequently to Afghanistan for active combat duty. Traveling en route to Ghorak base in southern Afghanistan, Cheryl’s Humvee contacted an explosive device, throwing Cheryl from the vehicle and causing massive injuries to both legs. She sustained a blow to the head as well and lost consciousness for 30 minutes. As a result of serious injuries, Cheryl was taken to the intensive care unit of the closest military hospital by medevac. After she underwent surgery, Cheryl was informed by her physician and social worker that in order to save her life, both of her legs had to be amputated below the knee. To the delight of her medical team, Cheryl’s reaction to this news was not extreme.

Over the 10-month course of her rehabilitation, Cheryl was fitted with different types of prostheses, none of which restored her ability to run and engage in sports. She also experienced “phantom pain” in her right leg, a condition in which pain is experienced in a body part that is no longer present. Following her honorable discharge from the army, Cheryl traveled to a university medical center several states away where she was accepted into an experimental prosthetics program. She was fitted with two below-the- knee robotic prosthetics that are controlled by sensors. Although she did well in her mobility training, Cheryl had a hard time with simple mathematical

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calculations, and her friends and family remarked that Cheryl’s affect seemed vacant compared to how she was prior to her accident. Cheryl was referred to a social worker for counseling for suspected depression. The social worker, who had extensive experience with clients who had head injuries, referred Cheryl for neurological and neuropsychological testing. Cheryl’s MRI scan detected injury to the frontal cortex, the region of the brain that controls affect.

Case Study 3.2 A Diabetes Diagnosis for Jenna Jenna, a 12-year-old Franco American girl who lives in rural Maine, was doing well in school, riding in pony club in the summer, and alpine ski racing in the winter. The youngest of three children, Jenna also worked on her parents’ blueberry farm raking berries to earn spending money. Like many girls her age, Jenna had a sweet tooth, but her parents watched her nutrition, making sure that she was adequately nourished. Drinking sufficient fluids each day was easy for Jenna because it seemed that she was always thirsty for water. But when Jenna started losing weight and engaging in more afternoon napping, Jenna’s parents were concerned that she could be exhibiting an eating disorder. They made an appointment with their family health provider.

On the morning of her appointment, Jenna did not come down from her bedroom. Because it was very unusual for her not to join her family at the breakfast table, her parents became alarmed and immediately went upstairs to find Jenna sitting on her bed, still in her nightgown, which was drenched with perspiration. Jenna was confused and unable to answer simple questions with correct responses. Jenna’s parents immediately took her to the local community hospital.

In the emergency department (ED), after some blood work, a doctor diagnosed Jenna with type 1 diabetes. The ED social worker referred Jenna to the hospital social worker who is helping her with her new insulin pump, a small computerized device that is programmed to deliver insulin to the fatty tissue under the skin. Jenna hates to draw blood daily so the social worker has put her on the waiting list to test out a new cell phone app, Epic Health, which she can use to measure blood glucose levels by placing her finger over the camera device.

Case Study 3.3 Melissa’s HIV Diagnosis

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Melissa’s “perfect life” has just fallen apart. As a young urban professional who grew up in a middle-class suburb in New York, Melissa had always dreamed of a big wedding at her parents’ country club, and her dreams were about to come true. All the plans had been made, invitations sent out, bridesmaids’ dresses bought and measured, and her wedding dress selected. All that remained was finalizing the menu and approving the flower arrangements. Because Melissa and her fiancé, Ashish, planned to have children soon after their marriage, she went to her physician for a physical exam 2 months prior to the wedding. Following common practice, the doctor asked Melissa for permission to conduct an HIV test.

One week following the physical, the doctor’s office called and asked Melissa to return for repeat blood work and a follow-up visit. At the appointment, Melissa learned that she was positive for HIV. Melissa’s physician started her on daily medication to prevent the disease from exacerbating and advised her not to engage in unprotected intercourse.

Melissa had no history of illicit drug use and was relatively conservative in her intimate relationships, having only one partner besides her fiancé. She recalled that this man did not share much about his history.

After couples counseling, Melissa and Ashish decided to proceed with their marriage and their desire to have children. The social worker referred them to an HIV pregnancy clinic to explore their options. At that time, they learned that there are ways to fulfill their desire to have children and minimize the risks of transmitting HIV to Ashish and babies.

Case Study 3.4 HIV, Thomas’s Hero Thomas is a 6-year-old boy who lives with his parents. When he turned 3, he was diagnosed with leukemia. New research and experimental treatments are indicating that one’s own immune system can be used to fight and cure certain cancers, leukemia being one of them. The HIV virus has been manipulated as a hunter, one that can ferret out, activate one’s own immunity, and eliminate cancer cells, particularly in the blood. As Thomas continued to fail, showing no positive responses to conventional treatments, after consultation with his pediatric social worker his parents decided to enroll him in an experimental program in which HIV was a primary treatment agent. Thomas underwent the preparation of T-cell protection and then was treated with the modified HIV virus (chimeric antigen receptor T- cell therapy). Now, at age 6, there is no evidence of cancer in his body.

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Case Study 3.5 Louise and Stewart, Huntington’s, Obesity, and Cardiovascular Disease Louise is an 81-year-old Jewish woman who lives on the west coast of Florida in her own apartment. At the age of 49, Louise was diagnosed with Huntington’s disease, a genetically transmitted neurodegenerative condition affecting all aspects of function, including musculoskeletal integrity, cognition, self-care, speech, and mood. Until the age of 70, Louise was able to walk with the assistance of a rollator (a wheeled walker), to engage in social interactions, and to do light chores in the house. As her disease progressed she became increasingly limited in mobility, fine motor skills, speech, and swallowing. Her husband, Stewart, who was grossly obese and thus unable to provide full care for Louise, found an agency that brought Haitian families into the United States to provide care for elders. Anne, the 39-year-old caregiver, came to work at Louise’s home each day, sometimes bringing her 10-year-old daughter with her. When Louise’s husband died suddenly of a massive heart attack, Anne and her daughter moved into the guest bedrooms of Louise’s home. Anne’s daughter has graduated from undergraduate school and plans to go on for her MSW. Anne remains with Louise at home despite Louise’s son’s attempt to put his mother in a nursing home. Louise’s daughter, now in her early 60s, has Huntington’s but benefits from the new drugs to reduce symptoms and from her exercise regimen that has been empirically shown to reduce the rate of neural degeneration.

Case Study 3.6 Juan and Belinda’s Sexual Life in Retirement Juan and Belinda, now both 67 years old, grew up in the same neighborhood of a southwestern city in the United States and knew one another because they attended the same church, St. Joseph’s Catholic Church. Over the years, they each went their way in life. Each had a family and children, and both have been widowed for several years. Until they met at the senior center two years ago, they had not seen one another since adolescence. Juan lives in an apartment and Belinda resides in a retirement village. Over the past few months, Belinda has become concerned about her heart health because she has experienced palpitations in the late evening. At her health provider’s office, she found that her blood pressure was elevated but not considered hypertensive yet. Juan, a distance runner, trains by running and jogging daily.

Both Juan’s and Belinda’s parents immigrated to the United States from

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Mexico, seeking to improve the opportunities for their families. Because of their common background and religion, Juan and Belinda have found companionship, now turning to love. After spending several months becoming reacquainted, Juan asked Belinda to spend the night at his apartment. Belinda thought her sex life was over but is excited by the potential for intimacy once again. However, she is not sure how to be with Juan, is concerned that he will not find her attractive, questions how to dress for the evening, and is nervous about how to engage in satisfying sex at her age.

An Integrative Approach for Understanding the Intersection of Interior Biological Health and Illness and Exterior Environmental Factors Thinking about Cheryl, Jenna, Melissa, Thomas, Louise and Stewart, and Juan and Belinda highlights the important roles of biology in the social worker’s intellectual toolbox. Yet biology can no longer be considered from a dualist perspective that separates the body from the world in which it functions. Biology is inextricably intertwined with experience, behavior, objects, and environmental influences. As neurobiologist Robert Sapolsky (2017) suggests, “It actually makes no sense to distinguish between aspects of a behavior that are ‘biological’ and those that would be described as, say, ‘psychological’ or ‘cultural.’ Utterly intertwined” (p. 5). Consistent with contemporary theory, social workers can best understand and apply biological knowledge to practice within an expansive proximal (most interior) to distal (furthest) environment continuum, with environment defined as the entire set of conditions under which one operates (DePoy & Gilson, 2012).

Examination of the interior (proximal) environment involves the description and explanation of embodied conditions such as internal organ systems, genetics, interior psychological structures and processes, and so forth, perhaps with some inorganic objects such as pacemakers and other implanted activators embedded within the interior environment. Consider, for example, a knee replacement. Although it is not organic in composition, the new knee is located in the organic property fenced inside the skin, restoring movement and mobility to the receiver. But the new

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body part is not organic, so do we classify it as a body part or consider the new knee as an interloper? And what conditions might influence the extent to which the knee even stays in one’s thoughts and awareness?

Exterior (distal) environments are characterized as nonorganic conditions not contained within the skin’s perimeter (DePoy & Gilson, 2012). But again, the dividing line between interior and exterior is as blurred as what constitutes a body. Consider eyeglasses for example. This “exterior” device enhances sight, and once perched on the nose, is not only functional but is part and parcel of one’s appearance and identity. Sight, appearance, and identity may seem interior, but they are networks of meanings and experiences that render embodiment and its boundaries difficult to draw. Think of the spoken message. Where does it begin and end? Isn’t the spoken word learned from the distal environment? And once learned, speech itself is organic and malleable, acted upon by so many elements. Is speech a brain production, a production of the mouth’s structure and movement, a vibration that reaches beyond the speaker, or a matter of culture? Once articulated, how far does the message move from the speaker, and what types of responses are elicited? Adding screen-mediated speech of the 21st century, Siri for example, to the mix further complicates the exterior–interior binary.

So now that we have introduced the complexity of the biological environment, we recline back on the simplicity sofa for instructive purposes. To help us become familiar with classical biology, an approach in which an array of systems comprises the biological body, we first break down the interior embodied environment into a classification of biological systems and discuss the structures and processes of each. We then reengage in social work thinking as we reunite interior and exterior environments with the assistance of our exemplar case studies. In this process, we always recognize that the boundaries between different categories of environment are often arbitrary, and indeed, all aspects of interior and exterior environments are always interacting with each other (Sapolsky, 2017). Whereas we may have, in the past, considered biology as a separate organic world, it is incumbent upon social work to stay current and creatively apply what is known about the interconnected world of human behavior in our various social work roles. So even when practicing in arenas that do not directly intervene with individuals and families, such as in policy practice, social work is committed to improving life for people. All people have bodies that are an integral part of their

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behavior, and thus knowing about the body and its complexities is essential knowledge for sound social work practice.

Returning to the cases of Cheryl, Jenna, Melissa, Thomas, Louise and Stewart, and Juan and Belinda, their interior environments are the initial reason they are seeking social work assistance. Social workers must be sufficiently informed about interior environment conditions to be able to discuss relevant details of biological functioning with clients when indicated. But we urge you not to think of biology as merely a set of structures and functions. Understanding the interior environment as part of human behavior (what people do and do not do and how they do what they do) (DePoy & Gilson, 2004) is critical for informed social work practice as exemplified by each of the chapter-opening case studies.

Systems frameworks describe and explain human phenomena as sets of interrelated parts. There are many variations and applications of systems approaches ranging from those that look at embodied or interior systems, to those that examine human systems composed of both humans and their surroundings, and even extending to systems that do not contain embodied elements (DePoy & Gilson, 2007). At this point, there is a well-developed theory, supported by rigorously conducted empirical evidence, of the complex relationships in the health of diverse embodied systems (DePoy & Gilson, 2007; Weitz, 2013).

As early as 2001, the National Institutes of Health acknowledged the inseparability of mind and body in their conference titled “Vital Connections: The Science of Mind–Body Interactions” (MacArthur Network on Mind–Body Interactions, 2001). This event spearheaded an important agenda advancing theory and knowledge development linking interior and exterior systems and environments. Renowned scholars reported on several topics focusing on the interaction of exterior and interior environments that continue to receive intense research scrutiny— for example, the neurobiology of human emotions, early care and brain development, the biology of social interactions, socioeconomic status (SES) and health, neuroendocrinology of stress, the role of sleep in health and cognition, and the critical interaction of movement and brain health. Scholarship at this early conference revealed further evidence of the connections between exterior environmental conditions and embodied phenomena, which were previously thought to be only tangentially related to one another. Throughout the 3-day conference, presenters theorized

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about the “integrative mechanisms” that link social and psychological phenomena to the brain and the rest of the body and beyond.

Although these attempts to understand mind–body connections have led to many important theories about health and illness, they may also be misinterpreted. Social workers therefore are advised to heed the warning of a number of medical researchers and social critics against explaining behavior and emotion through a purely medicalized lens (see Conrad, 2007; Lane, 2007; Sapolsky, 2017; Watters, 2010). Such a reductionist perspective may undermine our ability to consider the full range of distal environmental influences on embodied phenomena. Moreover, as defined, medicalization is a process that serves to pathologize typical daily experience and serve it up for medical intervention. Oransky (2012) refers to this phenomenon as “pre-death,” in which typical human passages are seen as conditions to be treated in order to prevent further exacerbation.

Photo 3.1 A medical researcher prepares data to test a hypothesis.

On the flip side of this caution, overattribution of physical experiences to psychological and social conditions fails to consider the interior environmental causes of illness. Look at Cheryl as an example. Her flattened affect is a common symptom of frontal lobe damage, yet it went unrecognized until the social worker referred her for assessment. We

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cannot separate health and illness from exterior social, political, cultural, technological, economic, intellectual, and aesthetic environmental conditions (DePoy & Gilson, 2012; Saleebey, 2012). Thus, comprehensive analysis of embodied conditions is warranted and requires knowledge of biological systems, exterior environment conditions, and their interactions. Although the efficiency of a single explanatory framework is seductive, such thinking may limit our ability to expansively identify the broad nature of problems and needs and constrain a range of appropriate interventions to resolve problems (DePoy & Gilson, 2004, 2011).

The constructivist perspective suggests that human phenomena are pluralistic in meaning. For example, rather than being a singular, scientifically supported entity, through the lens of social construction, a disabling medical condition such as paralysis or low vision is explained by interior bodily circumstances as well as by political, social, cultural, technological, aesthetic, and economic exterior environments (Anastasiou, & Kauffman, 2013; Haig, 2013). Thus, using a social constructionist perspective, the experience of having atypical low vision can be understood in terms of shared cultural understandings of the “expected roles” for persons with atypical vision, or in terms of actions or inactions of political institutions to promote or impede this subpopulation’s access to physical, social, technological, and virtual environments. We may automatically assume that someone with atypical low vision needs professional intervention, but that person may in effect have his or her life well organized and function well in all chosen living and working environments. Consider Kish (2015) who is blind but has devised a human sonar system comprised of tongue clicks to “see.” Thus, rather than being explained by the biological condition itself, limitation associated with an atypical biological condition may be a result of the exterior environment; the characteristics of the task; personal attitude; and available resources such as technology; assistance from family, friends, or employees; accessible transportation; innovative thinking; and welcoming, fully accessible communities (DePoy & Gilson, 2014).

As an example, although social workers do not make medical diagnoses for embodied conditions in the scope of their practice, the social work administrator who is developing or operating a shelter, a food kitchen, or an advocacy center may integrate medical and mental health services with employment, housing, financial, and companionship services (Colby, Dulmus, & Sowers, 2012; Strier, 2013). Cheng (2016) recommended a

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model of caring geographies that promotes healthy and compassionate communities. Consistent with this work, our model of legitimate communities proposes that acceptance and comfort can occur only when the full range of human diversity is appreciated and celebrated (DePoy & Gilson, 2011). As the study of human biology becomes increasingly complex and expansive in its scope, biological diversity includes but extends well beyond race, ethnicity, class, and gender. Embodiment can take many biological forms. Consider, for example, transgender individuals who now can change their organic corpus to fit a gender identity discordant with that assigned at their birth. Or think of the “cyborg,” a client with Parkinson’s disease who has undergone deep brain stimulation and now has an implanted device to control tremors. The constructed meaning of human diversity, updated to include recrafted biologies, is different than it was even a few years ago when the fifth edition of this book was published.

Critical Thinking Questions 3.1

How has technology changed the definition of the body? What are the implications for how social workers should think about the role of the body in human behavior?

Systems Taxonomy: Six Interior Environment Systems Taxonomy is “the science or practice of classification” (Merriam-Webster, 2017a). Classifying phenomena into categories is one way that the human brain tries to make sense of a complex world. The criteria for a classification system differ not only according to topic area but by who does the classifying and the contextual factors that have an influence on knowledge development in any historical era. Over the past decades, taxonomies of human biological systems have been shifting away from an analytical approach based on breaking the body down into separate systems to a network approach in which the interaction of systems, previously classified as distinct, is acknowledged. You may recall the discussion at the end of Chapter 1 in this book that noted that social workers engage in both analysis and synthesis. Sometimes we need to think analytically, breaking down a complex situation by thinking more

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critically about the specific aspects and dimensions of the situation. But we also need to be able to put the puzzle pieces back together to see the whole story. A network framework, based on a synthesis process, helps us to think about complexity, but we do not begin our discussion there because the building blocks first need to be identified before a more textured foundation of understanding can occur. So we now turn to what we refer to as a “paper doll” approach, in which we present and then simply dress the foundations of six biological systems that social workers are most likely to directly encounter in our work: the nervous system, the endocrine system, the immune system, the cardiovascular system, the musculoskeletal system, and the reproductive system. Biological systems not detailed in this chapter (e.g., digestive, respiratory, and urinary system) will make appearances throughout the chapter, sometimes initially undetected but often playing a role in health problems. For example, urinary tract infections can masquerade as delirium, confusion, and even hallucinations in older adults (van Duin, 2012). We urge you to use the discussion of the six systems as a template for your own research and discovery about the body. As you read the descriptions of these six interior environments systems, think about each as more than its structures and functions.

Nervous System In the first case study, Cheryl sustained multiple injuries during military service. Although limb loss was the most obvious and thus the initial focus of intervention, injury to her central nervous system was equally as problematic and pervasive. Traumatic brain injury can range from mild to severe. But even with mild damage, as exemplified by Cheryl, there are typically changes in functioning that may not be immediately obvious. Also recall Louise. At age 81, she is living with the sequelae of Huntington’s disease. Because of central nervous system damage, particularly in the brain, Louise is not able to walk, speak clearly, or swallow easily. Let’s turn now to a discussion of the structures and functions of the nervous system classification and revisit Cheryl and Louise throughout the discussion.

The nervous system provides the structure and processes for multiway communication (communication with multiple pathways) of sensory, perceptual, and autonomically generated information throughout the body. On the basis of function and cell composition, three major divisions are identified as comprising the nervous system:

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1. Central nervous system (CNS): the brain and the spinal cord 2. Peripheral nervous system (PNS): spinal and cranial nerves 3. Autonomic nervous system (ANS): nerves controlling cardiovascular,

gastrointestinal, genitourinary, and respiratory systems

Each of these subsystems has a primary set of functions, but remember that the three act together (and of course with other interior and exterior systems) in providing a control architecture for all human activity. The brain is considered to be the boss. It sends signals received from throughout one’s environments to the spinal cord, which in turn relays the message to specific parts of the body by way of the PNS. Messages from the PNS to the brain travel back via a similar pathway (Carter, 2009; Society for Neuroscience, 2012). Note that Cheryl’s brain injury affects only the part of her nervous system that mediates affect whereas Louise’s damage is much more pervasive. Cheryl’s rehabilitation provider has told Cheryl that she is doing exceptionally well with her robotic legs, but Cheryl shows no emotional response and acts almost as if she has not heard the compliment. She has had damage to the neural structures in the right hemisphere, specifically the cingulate cortex, which is the seat of affect. Damage in that area impairs arousal, awareness, and emotional response. Now consider Louise. Extensive damage to the cells in different parts of her brain has resulted in multiple impairments.

Three major internal regions of the brain are named for their location inside the skull: the forebrain, midbrain, and hindbrain. Viewed from the side (see Exhibit 3.1), the largest structure visible is the cerebral cortex, part of the forebrain and the site of Cheryl’s and some of Louise’s damage. The cerebral cortex is the home of higher mental functions, including thinking, planning, problem solving, affect, and more. This area of the brain is divided into two rounded masses named for their location (left and right hemispheres), connected by nerve fibers. The cerebral cortex is more highly developed in humans than in any other animal. It was thought until recently that each hemisphere was primarily responsible for different functions, one side for language and the other for processing of spatial information such as images and pictures. But this binary, although part of popular culture and used for guidance, is not as clearly delineated as once thought. Contemporary brain research affirms hemispheric differences to some extent but reveals complexity and the amazing capacity of neural material to learn and relearn. Thus, although each hemisphere generally controls the motor and sensory function on the opposite side of the body,

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creative intervention can be used to teach undamaged cells in other locations to learn to feel and move limbs that have been deactivated by brain damage (Belzung & Wigmore, 2013; Kleim, 2011). Note the relationship between the musculoskeletal system and the nervous system.

Exhibit 3.1 ● Selected Areas of the Brain

The cerebral cortex has four lobes, depicted in Exhibit 3.1. As Exhibit 3.2 explains, functions such as vision, hearing, and speech are distributed in specific regions, with some lobes being associated with more than one function. The frontal lobe is the largest, comprising nearly one third of the surface of the cerebral cortex. Lesions of any one of the lobes can have a dramatic impact on the functions of that lobe (Carter, 2009; Society for Neuroscience, 2012). Other forebrain structures process information from the sensory and perceptual organs and send it to the cortex or receive marching orders from cortical centers and relay them down through central nervous system structures to central and peripheral elements throughout the body. Also in the forebrain are centers for memory and emotion, as well as control of essential functions such as hunger, thirst, and sex drive. It is no wonder that so much empirical and clinical attention has been directed to the brain!

The midbrain is a small area, but it contains important centers for sleep and pain as well as relay bridges for sensory information and control of movement.

In Exhibit 3.1, part of the hindbrain, including the cerebellum, can also be seen. The cerebellum controls complex motor programming, including maintenance of muscle tone and posture. This part of the brain is significantly affected in Louise. Other hindbrain structures are essential to the regulation of basic physiological functions, including breathing, heart

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rate, and blood pressure. The brain stem connects the cerebral cortex to the spinal cord.

Exhibit 3.2 ● Regions of the Cerebral Cortex Exhibit 3.2 ● Regions of the Cerebral Cortex

Brain Region Function

Frontal lobe

Motor behavior

Expressive language

Social functioning

Concentration and ability to attend

Reasoning and thinking

Orientation to time, place, and person

Temporal lobe

Language

Memory

Emotions

Parietal lobe

Left parietal lobe

Right parietal lobe

Intellectual processing

Integration of sensory information

Verbal processing

Visual/spatial processing

Occipital lobe Vision

The human brain, which constitutes only about 2% of one’s total body weight, may contain as many as 10 million neurons. The basic working unit of all the nervous subsystems is the neuron, or nerve cell. Although the human body has great diversity of neuronal types, all consist of a cell

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body with a nucleus and a conduction fiber, an axon. Extending from the cell body are dendrites, which function as passages for impulses to the neurons from the axons of other nerve cells. Exhibit 3.3 shows how neurons are linked by axons and dendrites.

Between each axon and dendrite, a gap, or synapse, exists across which chemical and electrical neurotransmitters communicate. As the inset box in Exhibit 3.3 shows, nerve impulses travel from the cell body to the ends of the axons, where they trigger the release of neurotransmitters. The adjacent dendrite of another neuron has receptors distinctly shaped to fit particular types of neurotransmitters such that when the neurotransmitter fits into a slot, the message is passed along.

Exhibit 3.3 ● Features of a Typical Neuron

Although neurotransmitters are the focus of much current research, scientists have not yet articulated all that these busy entities do. Essentially, they may either excite (activate) or inhibit (calm) nervous system responses. But researchers still have much discovery work to accomplish to learn about the full array of neurotransmitters and their actions. Here are a few about which we know.

Acetylcholine (ACh). This neurotransmitter, concentrated in the

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brainstem but also present in other places, is excitatory. Acetylcholine is involved in control of the skeleton and smooth muscles, including the heartbeat, and some glandular functions. It is critical to the transmission of messages between the brain and the spinal cord and affects arousal, attention, memory, and motivation (Bentley & Walsh, 2014). Dopamine (DA). This inhibitory neurotransmitter makes its appearance in many parts of the body, playing a role in regulation of motor behavior, the endocrine system, and the pleasure centers of the brain, and influencing emotional behavior and cognition. Dopamine abnormalities in the limbic system are thought to be involved in schizophrenia. There are five subtypes of dopamine receptors and thus several versions or subtypes of dopamine itself. Remember that the receptors are custom made to accept only certain messages and reject others, allowing complex functions to occur in designated cells and brain regions. Researchers continue to investigate and characterize the range of structures and functions of dopamine (Bentley & Walsh, 2014). Norepinephrine (NE). NE, located in the sympathetic nerves of the peripheral and central nervous systems, is excitatory. It is secreted by the adrenal glands in response to stress and thus as you might guess, influences emotional behavior and alertness as well as having a say in the regulation of anxiety and tensions (Bentley & Walsh, 2014). Serotonin. Present in blood cells, the lining of the digestive tract, and a tract from the midbrain to all brain regions, serotonin is an inhibitory transmitter. It is involved in sensory processes, muscular activity, thinking, regulation of states of consciousness, mood, depression, anxiety, appetite, sleep, and sexual behavior. Several subtypes have been identified in recent years (Bentley & Walsh, 2014). You may have heard of the class of antidepressant drugs called SSRIs (selective serotonin reuptake inhibitors). Although their processes and influence have not been fully understood, these drugs function to increase the cellular level of serotonin. It is interesting to note that SSRIs are also used to treat eating disorders and anxiety, and even improve the consequences of a stroke (Mead et al., 2013). This array of uses provides not only a view of the expansiveness of serotonin but can provoke questions about the potential interrelatedness of the conditions treated by it. Amino acids. Some types of these molecules, found in proteins, are distributed throughout the brain and other body tissues. One amino

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acid, gamma aminobutyric acid (GABA), is thought to play a critical role in inhibiting the firing of impulses of some cells. Thus, GABA is believed to be instrumental in many functions of the CNS, such as motor activity, cardiovascular reactions, pituitary function, and anxiety (Bentley & Walsh, 2014). Current research identifies the “downer” function of GABA, thereby rendering it a supplement that is sold to reduce heightened states of anxiety and fear (Mann et al., 2014). Peptides. Amino acids that are joined together have only recently been studied and admitted to neurotransmitter membership. Opioids, many of which are peptides, play an important role in activities ranging from moderating pain to causing sleepiness. Endorphins, opioid-like substances produced by the body itself, help to minimize pain and enhance adaptive behavior (Society for Neuroscience, 2012). Over the past several years, the opioid addiction epidemic has burgeoned, highlighting advantages and dangers of these pharmaceuticals and the power of some peptides in regulating pleasure and pain.

Biologically, behavior is affected not only by the levels of a neurotransmitter but also by the balance between two or more neurotransmitters. Psychotropic medications, such as the SSRIs introduced earlier, influence behaviors and symptoms associated with diagnoses of mental illness ostensibly by affecting the levels and balance of specific neurotransmitters. Social workers would be well advised to keep current on relevant medical research about the effects of neurotransmitters on human behavior when working with people referred for medication evaluation and when following up with individuals who have been placed on medication treatment regimens (Bentley & Walsh, 2014).

Cheryl’s injury has changed her brain, but brain injuries are not the only way the brain changes. For decades neuroscientists thought that the adult brain was static, fixed, and unchanging. But now we know that is not true. Neuroscientists have learned a lot about neuroplasticity, the ability of the brain to change its structure and patterns of activity in significant ways throughout life. We have learned that the brain can be changed by experience with exterior environments as well as by activity in the interior environment (Davidson & Begley, 2012). Here is an example of change that results from experience with exterior environments: When a visually impaired person learns to read Braille, the “visual cortex” of the brain

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adapts to become a center for processing sensations from the fingers. Here is an example of how the brain is changed by activity in the interior environment: When an athlete engages in mental imagery practice, the motor cortex expands. Neuroscientists are also learning about the ways the brain is shaped by activity in other biological systems. Here is a recent example of research on the complex relationships among exterior environments, the brain, and other biological systems. Chronic stress, often related to experiences with exterior environments, can cause high levels of cortisol secretion; cortisol is a glucocorticoid hormone produced by the adrenal gland (an endocrine gland). High levels of cortisol produce proinflammatory cytokines in the immune system. Recent research indicates that the secretion of proinflammatory cytokines to the brain influences the development and progression of major depressive disorder (Young, Bruno, & Pomara, 2014). This finding is important because we have tended to think, erroneously, of physical and mental illness as unrelated to each other. Here we see interactions of the endocrine system, immune system, and nervous system.

For Cheryl, as for many people living with mild traumatic brain injury, her affect may be influenced by a variety of interior and exterior environment circumstances—including damage to the frontal lobes and the expectations that her family and friends have of her based on how they knew her in her social settings. The complexity of lower-limb amputation renders her mood difficult to decipher; anyone experiencing such a profound loss might be expected to be depressed. The better social workers understand brain functions and brain plasticity and the interaction of affect with other influences on mood, the more they can communicate with medical personnel in a well-informed manner. As she proceeds through physical rehabilitation, Cheryl would also benefit from affective retraining to improve her own awareness of how she is perceived by others and then to provide guidance in affect regulation. A social worker working with Cheryl may fill several roles: case manager, educator, counselor, resource coordinator, and referral source.

Social work with Louise is complex. At this juncture there is little that can be done to improve her condition and prognosis. However, keeping Louise apprised of new treatment developments and assisting her to live in her chosen setting are areas for social work attention.

Endocrine System

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Remember Jenna, the youth diagnosed with type 1 diabetes? Although there is a significant body of research on the disease, no cure has yet been developed. Thus, Jenna now has a condition that has to be medically managed. The careful monitoring of diet, exercise, and blood sugar regulation is not a typical experience for children of her age. Over time, Jenna will have much to learn about how this endocrine disorder is directly entwined with other interior environmental elements such as the musculoskeletal, neurological, and digestive systems, as well as with implanted technology such as an insulin pump, and the immune system.

The endocrine system plays a crucial role in growth, metabolism, learning, and memory. It is comprised of glands that secrete hormones into the blood stream; those hormones bind to receptors in target organs, much as neurotransmitters do in the brain, and affect the metabolism or function of organs (Breedlove & Watson, 2018). Distinguishing differences between hormones and neurotransmitters are often the distance of travel from the point of release to the target, as well as the route of travel. Hormones traverse long distances through the bloodstream; neurotransmitters take shorter jaunts from cell to cell, across the synaptic cleft.

Endocrine glands include the pineal, pituitary, thyroid, parathyroid, pancreas, and adrenal. Endocrine cells are also found in some organs that have primarily a nonendocrine function: the hypothalamus, liver, thymus, heart, kidney, stomach, duodenum, testes, and ovaries. Exhibit 3.4 lists some of the better-known glands and organs, the hormones they produce, and their effects on other body structures.

The most basic form of hormonal communication is from an endocrine cell through the blood system to a target cell. A more complex form involves direct release from one endocrine gland to a target endocrine gland.

Feedback control mechanisms—processes that use conditions of one component to regulate the functions of another component—are the overseers and regulators of hormonal activity. Output consists of hormones released from an endocrine gland; input consists of hormones taken into a target tissue or organ. Because of the precise feedback apparatus, the healthy endocrine system is self-regulating. And as noted earlier, similar to the design of neurotransmitters, hormones too have specific receptors, so that the hormone released from one gland has a specific target tissue or organ (Mader & Windelspecht, 2012).

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A good example of a feedback loop is presented in Exhibit 3.5. The hypothalamus secretes the gonadotropin-releasing hormone (GnRH), which binds to receptors in the anterior pituitary and stimulates the secretion of the luteinizing hormone (LH). LH binds to receptors in the ovaries to stimulate the production of estrogen. Because estrogen has a negative effect on the secretion of LH and GnRH, the loop is completed by both the pituitary and hypothalamus. These elegant loops allow the body to finely control the secretion of hormones.

Exhibit 3.4 ● Selected Endocrine Glands and Their Effects Within the Corpus

Gland Hormone Effect

Pituitary

Adrenocorticotropic (ACTH)

Growth (GH, somatotropic)

Vasopressin

Prolactin

• Stimulates adrenal cortex

• Stimulates cell division, protein synthesis, and bone growth

• Stimulates water reabsorption by kidneys

• Stimulates milk production in mammary glands

Testes Androgens(testosterone)

• Stimulates development of sex organs, skin, muscles, bones, and sperm

• Stimulates development and maintenance of secondary male sex characteristics

Estrogen and

• Stimulates development of sex organs, skin, muscles, bones, and uterine lining

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Ovaries progesterone • Stimulates development and maintenance of secondary female sex characteristics

Adrenal

Epinephrine

Adrenal cortical steroids

• Stimulates fight-or-flight reactions in heart and other muscles

• Raises blood glucose levels

• Stimulates sex characteristics

Pancreas Insulin

Glucagon

• Targets liver, muscles, adipose tissues

• Lowers blood glucose levels

• Promotes formation of glycogen, proteins, and fats

Thymus Thymosins • Triggers development of T lymphocytes, which orchestrate immune system response

Pineal Melatonin • Maintains circadian rhythms(daily cycles of activity)

Thyroid Thyroxin

• Plays role in growth and development

• Stimulates metabolic rate of all organs

Forensic analysis, or the study of why something fails, is a powerful way to understand the feedback control mechanism. Consider what has happened to Jenna. In type 1 diabetes, insulin production is deficient or absent. Without insulin, the body cannot process carbohydrates. When a person without diabetes ingests carbohydrates, blood glucose becomes elevated, triggering the release of insulin, which in turn helps to decrease

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blood sugar by promoting the uptake of glucose by tissues. Additionally, low blood sugar stimulates the release of glucagon, which in turn tells the liver to release glucose, raising blood sugar. This balancing act does not occur when insulin is not properly produced in diabetes, creating a cacophony of sequelae including but not limited to muscle cell and brain deprivation of glucose, heart disease, stroke, and lower-limb amputation. When deprived, muscle cells devour fat and protein reserves in muscle tissue as an energy source, which can potentially negatively affect the musculoskeletal system. Because the brain uses glucose as its fuel source, low blood sugar can seriously affect cognition and overall function given that the brain is the “boss” of the nervous system. In people with advanced and uncontrolled diabetes, the consequences are severe and pervasive. For example, wasting of muscles, weakness, weight loss, and metabolic acidosis, a chemical imbalance in the blood, can occur. Poor circulation on the periphery of the body may lead to gangrene in lower limbs, necessitating amputation. The increase in blood acidity may suppress higher nervous system functions, leading to coma. And malfunction of the respiratory centers in the brain can lead to death (Kapit, Macey, & Meisami, 2000).

Exhibit 3.5 ● An Example of a Feedback Loop

Epidemiologists report a dramatic increase in the incidence of diabetes worldwide in recent years. In 2015, over 20 million Americans were living with diabetes, and among them were 193,000 children under the age of 18 (National Center for Chronic Disease Prevention and Health Promotion. Division of Diabetes Translation, 2017). Another 1.5 million people were diagnosed with diabetes in 2015. It is estimated that $1 out of every $5 spent on health care in the United States is spent on diabetes and its

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consequences; the total cost of diagnosed diabetes in the United States in 2012 was estimated to be $245 billion (American Diabetes Association, 2013). Non-Hispanic Whites are at greater risk of developing type 1 diabetes than other racial and ethnic groups. No known way to prevent type 1 diabetes exists. Maturity-onset diabetes (type 2), non-insulin- dependent diabetes mellitus, is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and particular races or ethnicities. Compared with non-Hispanic White adults, the risk of type 2 diabetes is 18% higher among Asian Americans, 66% higher among Hispanics/Latinos, and 77% higher among non-Hispanic Blacks (National Center for Chronic Disease Prevention and Health Promotion. Division of Diabetes Translation, 2017).

A crucial role for the social worker working with Jenna and her family is to keep her family well informed while helping Jenna and her family manage her diabetes in a manner that fits her lifestyle. Thus, Jenna’s social worker stays current on new research and technology and has Jenna on a wait list for the Epic health system.

Critical Thinking Questions 3.2

How do the insulin pump and Epic health system change our understanding of the nature of the endocrine system and its regulation? Of the body? Of disease management? How can social workers be helpful to people living with both type1 and type 2 diabetes?

Immune System Melissa, from Case Study 3.3, is far from alone in testing positive for HIV. The Centers for Disease Control and Prevention (CDC, 2017a) estimates that 1.1 million people in the United States are living with HIV, and 1 in 7 of them don’t know it. Worldwide, it is estimated that 36.7 million people were living with HIV at the end of 2016 (World Health Organization, 2017a). The human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS), affects people of all ages and racial and ethnic groups. Since the AIDS epidemic started in the early 1980s, over 1 million (1,216,917) people in the United States have been diagnosed with AIDS. In the early days of the AIDS epidemic, it was

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assumed to be terminal. The introduction of highly active antiretroviral therapy (HAART), which became widespread in the United States in 1996, altered the perception of and life with AIDS. It came to be seen as a chronic instead of terminal disease. However, because of lack of access to the drugs, about 1 million people died of HIV-related illnesses worldwide in 2016 (World Health Organization, 2017a).

Most commonly, HIV is transmitted through sexual behaviors and/or needle or syringe use in one of two ways, or perhaps by both: (1) having anal or vaginal sex with someone with HIV without using a condom or taking medicines to prevent it, or (2) sharing needles or syringes, rinse water, or other equipment used to prepare drugs for injection with someone who has HIV. HIV can live in used needles up to 42 days. HIV can also be transmitted from mother to child during pregnancy, birth, or breastfeeding. In extremely rare cases, it has been transmitted by oral sex, receiving a blood transfusion, eating food that has been prechewed by an HIV-infected person, being bitten by a person with HIV, contact with blood and other bodily fluids of an HIV-infected person, or deep open- mouth kissing (Centers for Disease Control and Prevention, 2017a).

Once a person is infected with HIV, the disease-fighting immune system gradually weakens. This compromised system leaves the body vulnerable to other diseases. Over the next few years, Melissa will learn a great deal about how her body does or does not protect itself against disease and infection. But as therapy progresses, Melissa and Ashish can now consider creating their own family, an opportunity that was not on the radar for people with HIV even a few years ago.

If we consider Thomas from Case Study 3.4, however, HIV is a hero rather than a disease burden. For Thomas, HIV rallies his own immunity and provides the delivery system for powerful targeted therapy. The human body is, indeed, a complex phenomenon.

The immune system is made up of organs and cells commonly thought of as working in tandem as the body’s defensive team to eliminate antigens (foreign substances such as bacteria, fungi, protozoa, and viruses) and other toxins that threaten health (Sarafino & Smith, 2010; Świa˛tczak, 2012). When operating in an optimal manner, the immune system distinguishes the body’s own cells and organs from exterior interlopers or interior contaminants (Sarafino & Smith, 2010). The immune system

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mobilizes body resources and attacks when it detects the presence of such interlopers and contaminants. Remember that we cautioned you about the arbitrary distinction between exterior and interior environments? Here is a good example. The foreign substance that can trigger an immune response may be a tissue or organ transplant, or even a device such as an insulin pump.

Sometimes, however, the immune system mistakenly directs its fury at parts of the interior environment it was designed to protect, resulting in an autoimmune disease. Disease examples include rheumatoid arthritis, rheumatic fever, and lupus erythematosus. Diabetes, some cancers, autism, and Huntington’s disease are also on the suspect list of autoimmune conditions (Doyle, 2015; Goehler et al., 2012). With rheumatoid arthritis, the immune system turns on tissues and bones at the joints. In rheumatic fever, the immune system attacks the heart muscle, and the individual with lupus erythematosus has an immune system that wages war against various parts of the interior environment, including the skin and kidneys (Sarafino & Smith, 2010). New therapies for some cancers, such as the one Thomas had, extract T cells (discussed shortly) from the interior body, reprogram them, teaching them to attack targeted cancer cells, and then reintroduce these modified cells into the interior environment where they destroy offending malignancies.

The immune system organs are integrated throughout the body. The following organ list demonstrates their wide reach.

Bone marrow. Protected inside the body’s scaffold, bone marrow is the largest organ in the body. There are two types of bone marrow, red and yellow. Yellow bone marrow is the body’s disaster preparedness nourishment. It stores fat, which the body consumes in cases of extreme starvation. At birth, all bone marrow is red, but as the body ages, more and more red bone marrow moves over for its yellow cousins. In adults, red bone marrow is found in the sternum, ribs, vertebrae, skull, and long bones. The bone marrow produces both red (erythrocytes) and white (leukocytes and lymphocytes) blood cells. Lymph nodes. These small oval or round spongy masses are distributed throughout the body and interact in a network structure of nodes and vessels (Sarafino & Smith, 2010). This complex design provides the thruway for lymph to circulate. Lymph, a clear fluid, has

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the jobs of bathing cells, removing bacteria, and eliminating certain proteins from the body. As the lymph passes through a lymph node, it is purified of infectious organisms, with debris being emptied into the bloodstream to be shuttled away. Spleen. An organ in the upper left quadrant of the abdomen, the spleen functions much like a very large lymph node, but one that acts on blood. The spleen filters out antigens and removes ineffective or worn-out red blood cells from the body (Sarafino & Smith, 2010). Although the spleen is dispensable, its removal renders the person susceptible to certain infections (Mader & Windelspecht, 2012). Thymus. Located along the trachea in the chest behind the sternum, the thymus secretes thymosins, hormones believed to trigger the development of T cells introduced in the case of Thomas. T cells, white blood cells that mature in the thymus, have the task of slowing down, fighting, and attacking antigens (Mader & Windelspecht, 2012).

The immune system’s response to antigens occurs in both specific and nonspecific ways. Nonspecific immunity is more general. “Scavenger” cells, or phagocytes, lurk in the blood and lymph until activated by biochemical signals to congregate at the site of a wound and ingest antigens (Parham, 2009; Sarafino & Smith, 2010; Sompayrac, 2012). This process, known as phagocytosis, is quite effective but has two limitations: (1) Certain bacteria and most viruses can survive after they have been engulfed, and (2) because our bodies are under constant attack and our phagocytes are constantly busy, a major assault on the immune system can easily overwhelm the nonspecific response. Thus, specific immunity is the backup plan (Parham, 2009; Sarafino & Smith, 2010; Sompayrac, 2012).

Specific immunity, or acquired immunity, relies on lymphocytes, which are a type of small white blood cell that play a large role in defending the body against disease. They not only respond to an infection but also develop a memory of that infection such that the body can mobilize a rapid defense against it in subsequent exposure. Certain lymphocytes produce antibodies, protein molecules designed to attach to the surface of specific invaders. The antibodies may recruit other protein substances that puncture the offending micro-organism’s membrane, causing the invaders to explode. Antibodies are assisted in battle by T cells, which destroy foreign cells directly and further choreograph the immune response. Following the primary response, the antibodies remain in the circulatory system at

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significant levels until they are no longer needed. With reexposure to the same antigen, a secondary immune response occurs, characterized by a more rapid rise in antibody levels—over a period of hours rather than days. This rapid response is possible because, during initial exposure to the antigen, memory cells were created. Memory T cells store the information needed to produce specific antibodies. They also have very long lives, making their long-term memory an accurate defensive weapon (Parham, 2009; Sarafino & Smith, 2010; Sompayrac, 2012).

The immune system becomes increasingly vital throughout childhood and declines in effectiveness in older adulthood. Infants are born with relatively little immune defense, but their immune systems gradually become more efficient and complex. Thus, as a child develops, the incidence of serious illness declines. During adolescence and most of adulthood, the immune system, for most people, functions at its peak. As we age, although the numbers of lymphocytes and antibodies circulating in the lymph and blood do not decrease, their potency diminishes.

The functioning of the immune system is intricately tied to the exterior environment; immunity may be compromised by a diet low in vitamins A, E, and C and high in fats and cholesterol. Excess weight may also be damaging to the immune system, robbing it of its power and potency (Parham, 2009; Sarafino & Smith, 2010; Sompayrac, 2012). As we saw with Melissa, serious threats to immunity can occur, such as HIV, other viruses, and even one’s own genetic structure in which immune deficiency is transmitted from parent to child. HIV follows an insidious pathway as infected cells in essence become factories that make copies of themselves, which then proceed to infect, hijack, and destroy other cells. T cells, which instruct other cells when to start fighting off infections, are desirable targets of the HIV virus. By deactivating T cells, HIV weakens the immune system and leaves the body vulnerable to opportunistic infection. Most of us host organisms such as fungi, viruses, and parasites that cohabitate peacefully with us. However, for people with HIV, because of the low T cell count, these same organisms are not necessarily kept at bay and thus may cause serious infection. When such a disease occurs or when the individual’s number of T cells drops below a certain level, the person with HIV is considered to have AIDS.

With contemporary therapy, Melissa may live a typical life span, but for her health and that of those in her intimate environment, she must remain

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on alert. For example, Melissa may be at increased risk for repeated serious vaginal yeast infections increasing the potential of cervical cancer and pelvic inflammatory disease. These conditions, along with the HIV virus, influence her childbearing efficacy. Although the virus is held in abeyance by therapy, both men and women with HIV are vulnerable to opportunistic diseases and infections such as Kaposi’s sarcoma, cytomegalovirus (CMV), AIDS retinopathy, pneumocystis carinii pneumonia (PCP), mycobacterium tuberculosis, and Candida albicans (thrush); atypical functioning such as AIDS dementia, loss of memory, loss of judgment, and depression; and other symptoms such as gastrointestinal dysfunction/distress, joint pain, anemia, and low platelet counts. (Details on these conditions can be found in medical sources.)

The social worker may help to educate Melissa about these increased risks. To protect her health and the health of others, Melissa should be advised to take special precautions. Childbearing will require meticulous surveillance to prevent HIV from doing harm to her husband and unborn child. The social worker therefore has many functions in working with Melissa as she navigates life with this diagnosis. Melissa and her fiancé will need guidance about how to practice safe sex and then how to proceed with conception, pregnancy, and birth.

Because of the tremendous costs for interventions, HAART and pregnancy surveillance, the social worker may link Melissa to sources of financial support. Given advances in medical diagnostics and therapeutics, recent estimates indicate that the lifetime costs of health care associated with HIV may be more than $400,000 per person diagnosed in adulthood (Nakagawa et al., 2015). In addition to providing Melissa with information about her immune system, HIV, AIDS, and other health issues, the social worker can advise Melissa about the protections guaranteed to her under the Americans with Disabilities Act of 1990 and the Amendments Act of 2008. Melissa and Ashish may join an HIV support group for couples who want to have children, and the social worker may offer to provide them with or refer them to counseling. A more distal social work function than direct intervention with Melissa is prevention and public health promotion, perhaps by providing HIV/AIDS education online and on-site to business groups, schools, civic and volunteer associations, and so forth. Considering Thomas and the HIV hero, a major role for social work is to maintain the most current knowledge of HIV, being aware of fear and stigma that may interfere with an understanding of how HIV can be

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harnessed to benefit health.

Cardiovascular System Louise’s husband, Stewart, was one of many people with cardiovascular disease (CVD), pathology of the heart and blood vessels. The most common types of CVD are coronary disease, hypertension, and stroke. CVD is the most common cause of death in this country, responsible for one in four deaths (National Center for Chronic Disease Prevention and Health Promotion. Division for Heart Disease and Stroke Prevention, 2016). Stroke is fatal for approximately 140,000 Americans each year, placing it as a major cause of death. It is also a leading cause of long-term disability, but new “clot-buster” medications and interventions, if delivered immediately, are responsible for decreasing the damage that stroke causes to the brain (Noonan, 2016).

In 2016, results of the Behavioral Risk Factor Surveillance System, a randomized telephone survey, revealed that 6.6% of adults age 18 and older reported being diagnosed with some form of cardiovascular disease (Kaiser Family Foundation, 2017a). Geography, race, ethnicity, weight, age, physical activity, and other health conditions such as diabetes are associated with higher risk for CVD. Men are twice as likely as women to have coronary disease, but the prevalence of hypertension and stroke is about the same for men and women. American Indian or Alaska Natives are more likely than other racial and ethnic groups to have some type of CVD, and Hispanic or Latino adults are less likely than White and African American adults to have CVD. The highest prevalence occurs in adults reporting two or more races (Schiller et al., 2012). As educational and income level increases, the prevalence of CVD decreases (Schiller et al., 2012).

Louise’s husband was morbidly obese, sedentary, and diagnosed with type 2 diabetes and hypertension. He therefore had four of the major risk factors for serious heart disease. In 2017, it was estimated that one in three adults in the United States had high blood pressure (National Center for Chronic Disease Prevention and Health Promotion. Division for Heart Disease and Stroke Prevention, 2016), with a large majority aware of their condition but only a little over one half taking measures to control it (Merai et al., 2016). In 90% to 95% of the cases, the cause of hypertension is unknown, but associated risks can be identified and should be heeded.

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Annual costs of CVD in the United States are estimated at $818 billion for direct medical expenditures and over $275 billion in lost productivity (CDC Foundation, 2015).

To better understand cardiovascular disease, it is first important to gain insight into the functioning of the cardiovascular system. This delicate system has two main structures: the heart and the blood circulatory system (Kapit et al., 2000; Mader & Windelspecht, 2012). The heart’s walls act as a pump comprised of specialized muscle. As the muscle shortens and squeezes the hollow cavities of the heart, blood is forced in the directions permitted by the opening or closing of valves. Blood vessels are conduits throughout the body carrying blood from the heart to the rest of the body’s tissues and then returning the blood to the heart. Exhibit 3.6 shows the direction of the blood’s flow through the heart.

There are three types of blood vessels:

1. Arteries. These have thick walls containing elastic and muscular tissues. The elastic tissues allow arteries to expand and accommodate the increase in blood volume that occurs after each heartbeat. Arterioles are small arteries that branch into smaller vessels called capillaries.

2. Capillaries. The nutritional and cleaning workhorses of the circulation system, capillaries exchange nutrients and waste material with the body’s cells. Oxygen and nutrients transfer out of a capillary into the tissue fluid in surrounding cells, and carbon dioxide and other wastes from the cells are then absorbed.

3. Veins are transitways to move blood from the capillaries to the heart. Some of the major veins in the arms and legs have valves allowing the blood to flow only toward the heart when they are open and block any backward flow when they are closed (Kapit et al., 2000; Mader & Windelspecht, 2012).

Exhibit 3.6 ● The Direction of Blood Flow Through the Heart

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The heart has two sides (right and left), separated by the septum. Each side is divided into an upper and a lower chamber. The two upper, thin-walled chambers are called atria. It is not surprising that atria are smaller than the two lower, thick-walled chambers, called ventricles, because ventricles are the power pumps that initiate blood circulation to the lungs and throughout the body. Valves within the heart direct the flow of blood from chamber to chamber and, when closed, prevent backwash (Kapit et al., 2000; Mader & Windelspecht, 2012).

As Exhibit 3.6 shows, the right side of the heart pumps blood to the lungs, and the left side pumps blood to the tissues of the body. Blood returning from body tissues that is low in oxygen and high in carbon dioxide (deoxygenated blood) enters the right atrium. The right atrium then sends blood through a valve to the right ventricle. In turn, the right ventricle propels blood through another valve and the pulmonary arteries into the lungs. The lungs are the site of exchange, in which the blood rids itself of carbon dioxide waste collected from tissues and accepts oxygen to be delivered throughout the body. Pulmonary veins then carry blood that is high in oxygen (oxygenated) from the lungs to the left atrium. From the left atrium, blood moves through a valve to the left ventricle then to be jettisoned through a valve into the aorta for distribution around the body (Kapit et al., 2000; Mader & Windelspecht, 2012).

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Contraction and relaxation of the heart musculature moves the blood from the ventricles to the lungs and to the body. The right and left sides of the heart contract together—first the two atria, then the two ventricles. Contraction is heard as the heartbeat, which at rest for a healthy person occurs about 70 times per minute. The contraction and relaxation cycle is called the cardiac cycle.

Although the heart will beat independently of any nervous system stimulation, regulation of the heart is primarily the responsibility of the ANS. Once again, consider the network metaphor for interior environment systems. Parasympathetic activities of the nervous system, which tend to be thought of as normal or routine activities, slow the heart rate. Sympathetic activities, associated with stress, increase the heart rate. As blood is pumped from the aorta into the arteries, their elastic walls swell, followed by an immediate recoiling. The alternating expansion and recoiling of the arterial wall is the pulse, which fluctuates with age, activity, and health status. A normal resting pulse for children ages 6 to 15 is 70 to 100 beats per minute and for adults age 18 and older, 60 to 100 beats per minute (Cleveland Clinic, 2014).

Blood pressure is the measure of the pressure of the blood against the wall of a blood vessel. A sphygmomanometer (blood pressure cuff) is the familiar apparatus used in most medical offices that feels as if it is strangling our arms in order to measure blood pressure. The cuff is placed around the upper arm over an artery such that a pressure gauge can be used to measure the systolic blood pressure, the highest arterial pressure, which results from ejection of blood from the aorta. Diastolic blood pressure, the lowest arterial pressure, occurs while the ventricles of the heart are relaxing. Although the sphygmomanometer is still used in most medical settings, wrist cuffs and more recently smartphone apps can also monitor blood pressure. Easy-to-use apps are important preventive tools. Elevated blood pressure is reflected in readings that consistently range from 120 to 129 systolic and less than 80 mm HG diastolic. Hypertension stage 1 is reflected in blood pressure readings consistently ranging from 130 to 139 systolic or 8 to 89 mm HG diastolic.

Blood pressure essentially ascribes a standard number to assess the pumping force and beat rate of the heart as the blood moves through the arteries. The diameter and elasticity of arteries affects blood pressure as smaller spaces and less elastic arteries resulting from clogs require more

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force to transport blood. The heart is responsible for moving blood to the body via arteries and arterioles, and skeletal muscle contraction is the mechanism that actuates the blood as it moves through the venous system. As skeletal muscles contract, they push against the thin or weak (by design) walls of the veins, causing the blood to move past valves. Once past the valve, the blood cannot return, forcing it to move toward the heart.

High blood pressure (hypertension) has been called the silent killer, because many people have it without noticeable symptoms. It is the leading cause of stroke and is a major risk factor for heart attacks and kidney failure.

Stewart was aware that his obesity was a major risk for heart disease. And although he had regular warnings from his cardiologist, Stewart was unable to lose weight. He therefore was fatigued and had difficulty walking. It is possible that regular intervention from social work might have influenced Stewart to start on a mild exercise regimen. However, such intervention should have occurred earlier in Stewart’s life in order for him to attenuate the cardiovascular damage from obesity and lack of movement. Perceptions of exterior conditions such as daily concern about Louise’s neurodegenerative disease may have contributed to the acceleration of Stewart’s cardiovascular disease.

Now consider Juan and Belinda. Juan has been an active athlete throughout his life and thus is less at risk for cardiovascular disease than Belinda. However, Belinda is now aware of her need to monitor her blood pressure and to engage in heart healthy activity. Being better informed about the cardiovascular system and its care can help Belinda maximize the benefits of medical examination and treatment. A social worker may participate in medical care by helping Belinda learn the essential elements of effective health practice, including causes, risks, and prevention of hypertension. Health coaching is an increasing service provided through community and insurance venues. A social worker in this role can support Belinda and advise her to monitor her blood pressure. As Belinda enters an intimate relationship with renewed energy, she has decided to purchase a fitness tracker to monitor her overall health and activity. As advised by her health coach, she will join a virtual community to motivate herself to remain physically fit, thereby lowering her risk for high blood pressure and cardiac disease.

Because high blood pressure has been shown to run in families, the social

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worker can also work with Belinda’s adult children to discuss lifestyle and hereditary factors that might place them at risk for high blood pressure.

The social worker may also work with community organizations, community centers, online groups, and other organizations to advance policy and public health practices to support education and prevention programs as well as a physician and health care provider referral program.

Critical Thinking Questions 3.3

With the compelling evidence about the role of exercise in preventing cardiovascular, as well as other system, illness, what social work programs could be developed to engage sedentary individuals in movement? In what types of settings should such programs be offered?

Musculoskeletal System Both Louise and Cheryl provide examples of musculoskeletal system issues. After a number of years with a variety of physical signs that included what looked like ongoing fidgeting and involuntary twitches, Louise was diagnosed with Huntington’s disease. Although this is a neurodegenerative disease, observable musculoskeletal signs are the most obvious symptoms and are often the motivation for medical assessment. Stiffness and rigidity of muscles can further impair mobility and movement as the disease progresses (Minnig, 2016), and Louise experienced all of these problems over the course of her life to the point of being fully dependent on assistance for all activities of daily living.

Cheryl provides an example of musculoskeletal disorder as well. Cheryl’s condition is localized, whereas Louise illustrates the networked nature of movement posture. When a limb is beyond repair from injury, infection, or other disease process such as diabetes, the body part is amputated. In the blast from the explosive device, the damage to both of Cheryl’s legs was so severe that surgical repair was out of the question, and amputation was necessary. Lower extremity limb loss is classified as below knee (BK) or above knee (AK) (Brackett, Ertle, & Pritchett, 2016). Cheryl’s injuries resulted in bilateral BK amputations. She also experienced phantom right limb pain, a condition in which the brain perceives pain in a missing limb. Again, note the manner in which the central nervous system and the

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musculoskeletal system are inseparable.

Cheryl benefited from the recent development of advanced robotic prostheses for both legs. As she rehabbed, she was able to regain a comfortable and smooth gait that would not have been possible before the availability of this technology. These devices rely on small sensors that are implanted in the musculature of the remaining leg stump and then transmit wireless signals to a miniaturized computer embedded in the artificial limb. The user learns seamless control to move naturally (Szondy, 2015). Cheryl was able to regain not only mobility but her ability to engage in fitness activity. Thus, the technology, though not fully mimicking the activity of the musculoskeletal system, is close enough to restore the capacity to move, navigate, and engage in healthy exercise.

Almost 2 million people have lost one or more limbs in the United States. The primary causes are vascular insufficiency resulting from diabetes and peripheral arterial disease, traumatic injury (particularly in veterans), and cancer in one of the systems contained in a limb (Weiss, Izaguirre- Anariba, Lanza, & Lessnau, 2017). Limb loss is complex, frequently involving significant pain and impairment. Amputation often leaves a person feeling depressed, in mourning due to the loss of a body part, and the object of stigma and pity. Over the past several decades, prosthetic replacements have advanced a great deal. Celebrities such as Oscar Pistorius, a double amputee Olympian, and Aimee Mullins, a model and actress who lost both lower limbs as a child, have raised awareness of the potential for technology to be used innovatively to restore function after limb loss. Pistorius and Mullins both ran competitively using “cheetah legs,” specialized prosthetics designed for speed. As discovery and technology improve prosthetics, amputees have opportunities that were not possible even 10 years ago. Contemporary prosthetics aim to restore movement that is natural and follows the body’s processes.

The contraction and relaxation of muscles attached to the skeleton is the basis for all voluntary movements. Over 600 skeletal muscles in the body account for approximately 40% of body weight (Mader & Windelspecht, 2012). When a muscle contracts, it shortens; it can only pull, not push. Therefore, extension (expanding the angle of a joint) and flexion (decreasing joint angles) operate on muscles working as “antagonistic” pairs. As an example, when the hamstring group in the back of the leg contracts, the quadriceps in the front relax; this action allows the leg to

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bend at the knee. When the quadriceps contract, the hamstring relaxes, allowing the leg to extend.

Here is a good example of how interior systems are networked. The contraction of a muscle occurs as a result of an electrical impulse passed to the muscle by a controlling nerve that releases acetylcholine. When a single stimulus is given to a muscle, it responds with a twitch, a contraction lasting only a fraction of a second. But when there are repeated stimulations close together, the muscle cannot fully relax between impulses. As a result, each contraction benefits from the previous contraction, giving a combined contraction that is greater than an individual twitch. When stimulation is sufficiently rapid, the twitches cease to be jerky and fuse into a smooth contraction/movement called tetanus. However, tetanus that continues eventually produces muscle fatigue due to depletion of energy reserves. So muscles need their rest.

Tone is defined as skeletal muscles in a constant state of contraction. Tone is critical if we are to maintain body posture. If all the muscle fibers in the neck, trunk, and legs were to relax, our bodies would collapse during waking as they do in sleep. Here is another example of how interior systems are networked. Nerve fibers embedded in the muscles emit impulses that communicate to the central nervous system (CNS) the state of particular muscles. This communication allows the CNS to coordinate the contraction of muscles; we are reminded of the supreme importance of the brain once again (Kapit et al., 2000; Mader & Windelspecht, 2012). In its entirety, the musculoskeletal system both provides a support scaffold for the interior body and activates its movement. The skeleton, particularly the large heavy bones of the legs, supports the body against the pull of gravity. However, the skeleton has another critical job as protector of soft tissue and interior organ structures. The skull is the guard for the brain, the rib cage encircles and cradles the heart and lungs, and the vertebrae protect and support the spinal cord. Bones serve as sites for the attachment of muscles. It may not seem so, but bone is a very busy tissue, supplied with nerves and blood vessels. Throughout life, bone cells repair, remold, and rejuvenate in response to stresses, strains, and fractures (Kapit et al., 2000). A typical long bone, such as the arm or leg bone, has a cavity surrounded by a dense area. The dense area contains compact bone; the cavernous area contains blood vessels and nerves surrounded by spongy bone. Far from being weak, spongy bone is designed for strength. And recall that bone marrow is embedded deep within the bones. Thus, bones

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are the production site of red marrow, the specialized tissue that produces red and white blood cells. The cavity of a long bone also contains yellow marrow, which is the fat-storage tissue that is a body’s fail-safe nutrition source (Kapit et al., 2000; Mader & Windelspecht, 2012).

Most bones begin as cartilage. In long bones, growth and calcification (hardening) begin in early childhood and continue through adolescence. Growth hormones and thyroid hormones stimulate bone growth during childhood, another example of how interior systems are networked. Androgens, which are responsible for the adolescent growth spurt, stimulate bone growth during puberty until late adolescence, when these same androgens terminate bone growth.

Bones are joined together at joints. Recall the discussion of flexion and extension, which occurs when muscles act on moveable joints. Thus, long bones and their corresponding joints are what permit flexible body movement (Mader & Windelspecht, 2012) unless other systems such as the nervous system malfunction. Joints are classified according to the amount of movement they permit. Bones of the cranium, which are sutured together, are examples of immovable joints. Joints between the vertebrae are slightly movable. Freely movable joints, which connect two bones separated by a cavity, are called synovial joints. These may be hinge joints (knee and elbow) or ball-and-socket joints (attachment of the femur to the hipbone). Exhibit 3.7 shows the structure of the knee joint. Because these joints move, they are lubricated by synovial fluid (Mader & Windelspecht, 2012).

Bones in a joint are held together by ligaments, and tendons connect muscle to bone. The ends of the bone are capped by cartilage, a softer and more pliable material than bone, which provides added strength and support to the joint. Friction between tendons and ligaments and between tendons and bones is eased by fluid-filled sacs called bursae. Inflammation of the bursae is called bursitis. As we age, synovial joints are the ones most prone to arthritis. As joint lubrication decreases and bones gradually lose their protective covering, pain and mobility impairment may result from bone-on-bone destruction.

Because of the commonly held perspective that individual independence is most desirable, it is not unusual for social workers and other health care professionals to discourage a person with a medical explanation for atypical musculoskeletal function from using exterior environmental

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modifications and resources when these devices are not essential, even though they may be quite useful. Such modifications may include ramps, elevators, and electrically operated doors or assistive devices. Assistive devices are those products designated by the medical community to help an impaired person to communicate, see, hear, or maneuver. Examples include manual wheelchairs, motorized wheelchairs, motorized scooters, and other aids that enhance mobility; hearing aids, telephone communication devices, listening devices, visual and audible signal systems, and other products that enhance the ability to hear; and voice- synthesized computer modules, optical scanners, talking software, and other communication devices. In suggesting technological devices, the social worker should be attentive to stigma that accompanies the term assistive and to the medicalized appearance of many products named assistive technology. Innovative social workers can become a part of the design team in this rapidly emerging field (Mobility Technologies, 2017).

Exhibit 3.7 ● Structure of the Knee Joint

Those who believe that working to “overcome” challenges is a helpful approach in adjusting to or working with atypical function may be well meaning. But implicit within this belief system is the impression that being labeled as “disabled” ascribes deficiency that makes an individual less than whole, less than competent, and less than capable. Think, again, of Kish (2015) who is blind and devised a human sonar system comprised of tongue clicks to see. Although the most commonly held perspective of disability is one of medical deficiency, contemporary disability studies challenge this belief. In other work, we have theorized disability as disjuncture or an ill fit between the body and its context (DePoy & Gilson, 2011). Thus, using this perspective, the diagnosed body is not the sole

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locus for intervention. Social work addresses policy change, exclusion or lack of access, or other conditions that limit a person’s progress toward meeting his or her desired goals.

Consider Cheryl for example. Her prosthetic devices restored her motor functioning and thus eliminated the person–environment ill fit that may have occurred as a result of amputation. Louise used multiple assistive devices, initially starting with a cane for balance, then proceeding to the additional support of a rollator, and then relying on a wheelchair when she was no longer able to control her movements.

Reproductive System Juan and Belinda are at an age when many people no longer think of themselves as sexual beings. However, studies by sex researchers show that female sexuality has no time limit, and male sexual capacity may extend into the 80s (Moody & Sasser, 2015). Although there are physiological and anatomical changes in the vagina and the penis, satisfying sexual activity is not only possible but often desired by many older adults. After menopause, women no longer have to use birth control to avoid pregnancy, but they also lose lubrication and vaginal length. For men, erection may become problematic. After age 40, approximately 40% of men experience some bouts of erectile dysfunction with that number increasing over the age span. However, if a man does not have cardiac or allergic contraindications, pharmaceuticals can be safely used to assist couples to engage in intercourse. Other types of sexual intimacy, including oral sex and masturbation, are prevalent in the lives of older adults (Moody & Sasser, 2015). Juan and Belinda are aspiring to a full and satisfying sex life as they begin to explore their new relationship.

Now consider Melissa. Unlike many women her age, who have unprotected sex in order to conceive, Melissa does not have that option if she wants her fiancé and her fetus to remain healthy and HIV-free. Although Melissa can engage in protected sex for pleasure, she must be ever mindful of her HIV when she and Ashish want to become pregnant. They will want to be under the care of an expert in HIV transmission. To prevent transmitting HIV to Ashish, Melissa and Ashish can engage in simple assisted insemination at home or go to a clinic where more precise methods can be used to improve the likelihood of conception. And to prevent transmitting HIV to a baby, Melissa must be closely monitored

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and receiving HIV medications. After giving birth, Melissa should avoid breastfeeding and provide HIV medications to the baby for 4 to 6 weeks (National Institutes of Health, 2017).

As is evident in these two case examples, and consistent with recent theory and research, sexuality as well as gender is multifaceted. Our case examples are heterosexual, but there are many other influences on reproduction that have to do with gender, gender identity, and gender expression. The discussion that follows focuses on the interior environmental aspects of heterosexual sexuality and reproduction, but before beginning this discussion it is important to say some things about the intersections of sex, gender, and sexual orientation.

First, we want to provide working definitions of these three terms, but before we do so, we point out that the terms themselves are under dispute and receiving considerable reexamination. That said, sex is used to refer to biological characteristics of the reproductive system. In most cultures, two sex categories are recognized at birth: male and female, usually based on type of genitalia. However, in every culture, intersex people may present with both male and female genitalia (Levitt & Ippolito, 2014). In addition, it is possible for a person to be a chromosomal male with female genitals and vice versa. Chromosomal, genetic, anatomical, and hormonal aspects of sex are sometimes not aligned (Rudacille, 2005).

Gender, on the other hand, is a social construct based on socially accepted ideals of what it means to be male and female. In most cultures, two genders are designated: masculine and feminine, which are assumed to flow naturally from the two sex categories of male and female (Caron, 2011). In some cultures, however, more than two genders have been identified and accepted (Davies, 2006; McDermott, 1997). According to some contemporary approaches, rather than being a biological phenomenon, gender is considered to be a function of comfort as a member of a particular gendered group (Kimmel, 2016). Transgender is an umbrella term that refers to individuals who have been assigned a gender (based on biological sex) that defies their understanding of who they are as a gendered person. These individuals may or may not alter their bodies through surgery or hormonal treatment. In recent years, cisgender has been used to describe situations in which people’s gender identity matches their assigned gender based on biological sex. Social workers will need to be aware that the people they engage with may use many different terms to

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describe their gender, or identify no gender at all.

Sexual orientation refers to erotic, romantic, and affectionate attraction to people of the same sex (gay or lesbian), the opposite sex (heterosexual), both sexes (bisexual), or the lack thereof (asexual). Although sexual orientation has often been thought of in binary terms, either heterosexual or homosexual, sexology research indicates that human sexuality does not fit so neatly into a binary system, and researchers are finding diversity, flexibility, and fluidity along a continuum of sexual desire and sexual behavior. As with gender, social workers will need to be aware that the people they engage with may use many different terms to describe their sexual orientation. A person’s sexual orientation is distinct from his or her gender identity or expression. You can read further discussion of the complexities of gender and sex in Chapter 8, Cultures, in this book. Further discussion is beyond the scope of this book, but there is a rich contemporary literature on these topics. So we now return to our discussion of the reproductive system as experienced in heterosexual sexuality.

In humans, the reproductive system comprises internal and external structures. After conception, the sex-determining chromosome produced by the father unites with the mother’s egg, and it is this configuration that determines the child’s sex at birth. In the birthing suite, onlookers distinguish a new person’s sex by the observable presence of specific genitalia.

As Exhibit 3.8 shows, the external male organs are the penis and scrotum. Internal organs consist of the testes, the tubes and ducts that serve to transfer the sperm through the reproductive system, and the organs that help nourish and activate sperm and neutralize some of the acidity that sperm do not like to encounter in the vagina. The penis functions as a conduit for both urine and semen.

Externally, one can view the shaft and the glans (often referred to as the head or tip) of the penis. The shaft contains three cylinders. The two largest are called the corpa cavernosa (singular: corpus cavernosum). During healthy sexual arousal, these structures become engorged with blood and stiffen, creating an erection. The corpus spongiosum, the third cylinder, contains the urethra. It enlarges at the tip of the penis to form a structure called the glans. The ridge that separates the glans from the shaft of the penis is called the corona. The frenulum is the sensitive strip of

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tissue connecting the underside of the glans to the shaft. At the base of the penis is the root, which extends into the pelvis.

Exhibit 3.8 ● The Male Reproductive System

Three glands are part of the feedback loop that for most men maintains a constant level of male hormones in the bloodstream. The primary functions of the testes, or male gonads, are to produce sperm (mature germ cells that fertilize the female egg) and to secrete male hormones called androgens. Testosterone is one of the most important hormones in that it stimulates the development of the sex organs in the male fetus and the later development of secondary sex characteristics such as facial hair, male muscle mass, and a deep voice. Testosterone also lives in women, strengthening bone and lean muscle, and energizing sex drive (BodyLogicMD, n.d.). The two other glands in the reproductive system feedback loop are the hypothalamus and the pituitary gland. Both secrete hormones that serve a regulatory function, primarily maintaining a constant testosterone level in the blood. This is another example of how the body systems are networked.

Before ejaculation, the sperm pass through a number of tubes and glands, beginning with a testis, proceeding through a maze of ducts, and then to an epididymis, which is the convergence of the ducts and serves as the storage facility for sperm in a testicle. Each epididymis empties into the vas deferens, which brings the mature sperm to the seminal vesicles, small glands that lie behind the bladder. In these glands, a nourishing and activating fluid combines with the sperm before the mixture is carried through the urethra to the outside of the penis. The prostate gland, through

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which the urethra passes, produces and introduces the milky fluid that preserves the sperm and neutralizes the alkalinity found in the female reproductive system. Cowper’s glands also make their contribution to the seminal fluid before it leaves the male.

However, even if there is early ejaculation and the Cowper’s glands do not have time to secrete fluid, viable sperm exist in the ejaculate and can fertilize the female egg. Early withdrawal of the penis from a woman’s vagina therefore does not prevent the passage of some viable sperm cells. Pregnancy can thus occur even if the male withdraws before orgasm. It is also important to know that sperm only compose about 1% of the ejaculate (3 to 5 milliliters of fluid total), but this small percentage packs a punch because it contains from 200 million to 400 million sperm. The number of sperm decreases with frequent ejaculation and advancing age.

Exhibit 3.9 shows the external female sex organs. They include the pudendum, also called the vulva, which consists of the mons veneris, the fatty tissue below the abdomen that becomes covered with hair after puberty; the labia majora and minora; the clitoris; and the vaginal opening. Unlike the male, the female has a physical separation between excretion and reproductive organs. Urine passes from the bladder through the urethra to the urethral opening, where it is expelled from the body. The urethra is located immediately in front of the vaginal opening and is unconnected to it.

Exhibit 3.9 ● The Female External Sex Organs

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The labia majora, large folds of skin, contain nerve endings that are responsive to stimulation and protect the inner genitalia. Labia minora join the prepuce hood at the top that covers the clitoris. These structures, when stimulated, engorge with blood and darken, indicating sexual arousal. Resembling the male penis and developing from the same embryonic tissue, the clitoris is about 1 inch long and ¼ inch wide. However, unlike the penis, the clitoris is not directly involved in reproduction but serves primarily to produce sexual pleasure. The vestibule located inside the labia minora contains openings to the urethra and the vagina. It is also a site for arousal because it is rich in nerve endings sensitive to stimulation.

Internal structures of the female reproductive system, shown in Exhibit 3.10, include the vagina, ovaries, fallopian tubes, cervical canal (cervix), and uterus. The vagina connects with the external sexual structures. Composed of three layers and shaped cylindrically, the vagina both receives the penis during intercourse and functions as the birth canal through which the child passes from the uterus to the distal world outside the mother. Because of its multiple functions, the vagina has the flexibility to expand and contract and to change its climate from dry to lubricated. The cervix is the lower end of the uterus and protrudes into the vagina. It maintains the chemical balance of the vagina through its secretions.

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The uterus, also called the womb, serves as the pear-shaped home for the unborn child for the 9-month stay between implantation and birth. The innermost of its three layers, the endometrium, is the tissue that builds to protect and nourish the developing fetus. If pregnancy does not occur, the endometrium is shed monthly through the process of menstruation. If pregnancy does occur, the well-muscled middle layer of the uterus produces the strong contractions necessary at birth to move the fetus out of the uterus, into the vaginal canal, and then into the distal world. The external layer protects the uterus within the body.

The fallopian tubes connect the ovaries to the uterus and serve as a conduit for the ova (egg cells) from the ovaries to the uterus. Located on either side of the uterus, the ovaries have two major functions: the production of ova and the production of the female sex hormones, progesterone and estrogen.

Exhibit 3.10 ● The Female Internal Sex Organs

Until recently it was believed that females were born with the total number of ova they would ever possess. However, several recent studies have strongly suggested that women may make new eggs throughout their reproductive years (Dell’Amore, 2012). This finding could prove to have profound implications not only in terms of overall fertility but also in terms of our response to issues of women’s health, aging, osteoporosis, muscle loss, menopause, and postmenopause (Dell’Amore, 2012), not to mention family planning.

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Estrogen facilitates sexual maturation and regulates the menstrual cycle in premenopausal women. The benefits of estrogen in postmenopausal women, who can only obtain it from taking a supplement, are debatable. Some argue that estrogen maintains cognitive function and cardiac well- being in older women. However, estrogen supplements (also called hormone replacement therapy [HRT]) have been associated with increasing breast and uterine cancer risk, among other problems. Progesterone, although less discussed in the popular media, is critically important in preparing the uterus for pregnancy. It also is a regulator of the menstrual cycle.

Women’s breasts are considered to be secondary sex characteristics because they do not have a direct function in reproduction. However, mammary glands contained in the breast produce milk that is discharged through the nipples and may be the primary nutrition source for the neonate. The nipples are surrounded by the aureoles and become erect when stimulated. The size of the mammary glands is incidental to breast size and milk production. Rather, breast size is a function of the fatty tissue within the breast and can be changed by a skilled surgeon if so desired by the breast owner.

The social worker knowledgeable about interior environment mechanisms can assist Melissa and her fiancé by identifying methods and techniques to engage in safe sex for their own intimacy as well as strategies and practices to safely conceive a child. Social work counseling may also benefit Belinda, who is tenuous about herself as a sexually attractive woman at the age of 67.

Although it is beyond the scope of this chapter to discuss sexual activity among diverse genders and sexual orientations, we urge you to consider this important area and the implications for social work practice. Chapter 10, Families, in this book includes information on options for same-sex couples to engage in the reproductive process.

Heredity, Genetics, and the Reproductive System

Because of its relevance to the reproductive system, this is a good place to provide a brief overview of heredity and genetics. For humans, chromosomes come in pairs, one member from the father and one from the mother, which are transferred at fertilization. Each individual has 22 pairs

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of uniquely shaped autosomal chromosomes complemented by a 23rd pair, the sex chromosomes (XX or XY). In the early stages of their development, sperm cells are called spermatocytes. Each contains 46 chromosomes, including both an X and a Y chromosome that are designed to determine biological sex. The X chromosome (female) is larger than the Y (male) chromosome. As the spermatocytes mature and divide, chromosomes are reduced by half, and only one (either the X or Y) sex- determining chromosome is retained. The mature sperm cell is called the spermatozoon. This cell fertilizes the female egg (ovum), which contains only X chromosomes. Thus, the spermatozoon is the determining factor of the child’s biological sex (females have two X chromosomes, and males have one X and one Y chromosome). Chromosomes are threadlike bodies found in the nucleus of a cell that contain the DNA molecule, with each DNA molecule being composed of many genes, or individual segments or subunits of DNA. Any gene that appears at a specific site on a chromosome is called an allele (one member of a pair). Genes carry the code or set of instructions for a specific trait (characteristic). These traits comprise the physical, biochemical, and physiologic makeup of every cell in the body.

Robinson (2010) notes that “when genes are passed on, some are assertive and dominant while others are shy and recessive” (Kindle location 376). More commonly we refer to genes as either dominant or recessive. A dominant gene is one that expresses its effect in the cell regardless of whether its allele on the matching chromosome is the same or different from the dominant gene (a gene in one strand of DNA that is stronger than the corresponding gene in another strand of DNA). A recessive gene is a gene in one strand of DNA that is weaker than the corresponding gene in another strand of DNA, the effect of which is not evident unless its paired allele on the matching chromosome is also recessive. Recessive genes can be passed on to offspring. Louise’s daughter was the recipient of the unwanted gift of Huntington’s disease. When the matching genes for a trait are different, the alleles are heterozygous. When the genes for a trait are the same (both dominant or both recessive), the alleles are homozygous. Any trait carried on a sex chromosome is considered to be sex linked. Most sex-linked traits are carried on the X chromosome. Sex-linked traits appear almost exclusively in males, and most of these traits are recessive. Robinson (2010) reminds us that “some traits are truly X-linked (such as hemophilia) or Y-linked (such as hairy ears). Other traits are expressed differently in males and females even though the genes that control the

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traits are located on non-sex-linked chromosomes” (Kindle location 2039).

Of particular interest for professions such as social work is Bonduriansky’s (2012) observation that contemporary discussions of heredity have moved away from a “hard heredity” model associated with classical Mendelian genetics. In its place “the model of heredity now emerging is pluralistic, or ‘inclusive’ or ‘extended,’ in that it combines genetic and non-genetic mechanisms of inheritance. The pluralistic model therefore recognizes both hard and soft inheritance, and the potential for a range of intermediate phenomena” (Bonduriansky, 2012, p. 334). Mendelian genetics, or hard heredity, would assert a model of heredity whereby the characteristics of the offspring (child) are determined at the point of conception, “of a set of factors whose nature is unaffected by the environment or phenotype of the parents” (Bonduriansky, 2012, p. 330). Contemporary models of soft genetics recognize all the ways that the exterior environment influences gene expression. Again, the web of complexity and interaction is becoming more visible among interior as well as exterior phenomena.

In 1990, the National Institutes of Health and the Department of Energy joined forces with international partners to sequence the human genome, the complete set of DNA in the human body, in the Human Genome Project (HGP). Since its inception in 1990, this work has progressed exponentially. In April 2003, researchers announced that they had mapped the complete human genome (National Human Genome Research Institute, 2013). The initial primary goals of the HGP were “(i) to identify all genes of the human genome (initially estimated to be 100,000); (ii) to sequence the approximately 3 billion nucleotides (segments) of the human genome; (iii) to develop databases to store this information; (iv) to develop tools for data analysis; (v) to address ethical, legal, and social issues; and (vi) to sequence a number of ‘model organisms’” (Gannett, 2008).

This knowledge has provided researchers and health care professionals with new strategies for diagnosis, treatment, and prevention of a variety of diseases and conditions. The HGP has enabled identification of a large number of disease genes, and almost 54,000 genetic tests for over 10,000 conditions are listed through the CDC Genetic Test Registry. Many tests are marketed prematurely to the public (Centers for Disease Control and Prevention [CDC], 2017b). Continued work on the HGP is intended to allow individualized analysis of each person’s genome, leading to personalized strategies of intervention and prevention, providing

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“preemptive medicine” that takes genetic predisposition to disease into consideration and interrupts the development of it. The National Institutes of Health (2013) has also identified that “the increasing ability to connect DNA variation with non-medical conditions, such as intelligence and personality traits, will challenge society, making the role of ethical, legal and social implications research more important than ever” (p. 2). Moreover, the recent proliferation of home DNA testing such as 23 and Me opens the universe of genetic discovery to the layperson (23andME, 2017). These developments do not come without debates, ethical dilemmas, and policy challenges, all the domain of social work concern. Given the mission of social work to celebrate diversity, it is incumbent on social workers to reexamine beliefs and practices that are and will be reshaped by the advancement of the HGP, genetic medicine, and readily available genetic and DNA history. For example, teasing apart the “right to choose to have a child” versus “abortion as eugenics” should be a major ethical debate engaged by social work, recognizing the tension between such competing values as “preservation of bodily diversity” and “maximizing health benefits.” Questions such as which interior traits should be eliminated, how this action should occur, by whom, overseen by whom, and who makes the rules are critical bioethical concerns. Moreover, economic disparity poses a set of major considerations about who might afford interventions and genetic manipulations that currently are expensive. The negative and positive effects of commercial DNA testing in which discovery of unknown ancestry and health conditions may be illuminating or deeply disturbing is a potent and growing area for social work intervention.

Critical Thinking Questions 3.4

How might knowledge of human genetics affect the nature of reproduction and parenting decisions? What roles do you see for social workers in genetic counseling?

Ecobiodevelopmental Framework to Understand the Relationship Between Interior Health and Exterior Environments In the past decade or so, biomedical researchers have proposed an

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ecobiodevelopmental framework for studying health and disease across the life course, and their research has greatly enriched and expanded the ecological developmental risk and protection approach presented in Chapter 2 in this book (see Shonkoff et al., 2012). They are articulating the ways that genetic predispositions interact with social and physical environments to drive development, referring to the human life course as “nature dancing with nurture over time” (Shonkoff et al., 2012, p. e234). They are drawing on neuroscience, molecular biology, geonomics, developmental psychology, epidemiology, sociology, and economics to consider how early life experiences and environmental circumstances can leave a lasting impact on brain architecture and long-term health.

The major focus of ecobiodevelopmental research is on the ways that early toxic stress disrupts brain development as well as the development in other biological systems. One example of this research is the Adverse Childhood Experiences (ACE) Study initiated by the health maintenance organization Kaiser Permanente and the U.S. Centers for Disease Control and Prevention. The original study found that as the number of adverse childhood experiences increased so did the likelihood of risky health behaviors, chronic physical and mental health conditions, and early death (Felitti et al., 1998). Other researchers have found early life stress, such as economic deprivation, discrimination, and maltreatment, to be associated with reduced head circumference and height deficit, and impairments in learning and behavior, including problems in linguistic, cognitive, and social-emotional skills, decision making, working memory, self-regulation, and mood and impulse control (Abajobir, Kisely, Williams, Strathearn & Najman, 2017; Shonkoff et al., 2012). Adversity may begin in the prenatal period, either in the form of undernutrition or as exposure to maternal stress.

Researchers have been identifying the biological mechanisms by which chronic and/or traumatic stress become a risk for subsequent disease and impairment (see Shonkoff et al., 2012). Here are some examples of what they are finding. The body responds to stress by a process that increases stress hormones that are protective in transitory situations. But chronic or traumatic stress creates an overexposure to stress hormones and produces inflammatory cytokines in the immune system (which pass to the brain), leading to vulnerability to disease, including mood disorders. The chemical processes involved in intensive or chronic stress response can disrupt the architecture of the developing brain. For example, chronic

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stress during early life has been found to produce enlargement and overactivity in the amygdala and orbitofrontal cortex of the brain and loss of neurons and neural connections in the hippocampus and medial prefrontal cortex. Impaired memory and emotion regulation are two of the consequences of these brain changes. Researchers are discovering how environmental conditions and early life experiences influence “when, how, and to what degree” specific genes are actually activated (Shonkoff et al., 2012, p. e234). Neuroscientist Richard Davidson puts it this way: “Genes load the gun but only the environment can pull the trigger” (Davidson & Begley, 2012, p. 63).

Public health experts have long noted the association of poor health outcomes, in all body systems, with low income, low education, unsanitary housing, inadequate health care, unstable employment, and unsafe physical environments (Engels, 1892; Speybroeck et al., 2010). Until recently, however, researchers have made little attempt to move beyond association to understand the causal reasons behind this empirically supported connection of SES and health.

But by the mid-1990s, researchers in several countries began to try to understand how health is causally related to SES. In the United States, that research effort became much more focused in 1997, when the MacArthur Foundation established the Research Network on Socioeconomic Status and Health. This network is interdisciplinary, including scholars from the fields of biostatistics, epidemiology, economics, medicine, neuroscience, psychoneuroimmunology, psychology, and sociology. Beginning in 2000, research on health inequalities related to SES, oppression, and discrimination in the United States increased significantly (Adler & Stewart, 2010a).

As is obvious by now, the relationships between SES and health are complex networks involving interactions of interior and exterior environments. In a classic work of February 2010, the Annals of the New York Academy of Sciences presented a special volume, “The Biology of Disadvantage: Socioeconomic Status and Health.” Nancy Adler and Judith Stewart (2010b), contributors, reviewed research on socioeconomic status and health. They noted that in the United States approximately twice as many Blacks and Hispanics reported being in poor or fair health as Whites and that adults living in poverty were about 5 times as likely as adults with the highest incomes to report poor or fair health. Their review of the

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research indicated several mechanisms by which “socioeconomic status gets under the skin” (p. 11), including these:

Differential access to health care. Adler and Stewart (2010b) noted that health insurance alone does not guarantee access to health care or even decent care. Other important access issues include “travel time, transportation availability and cost, scheduling flexibility, sense of self-efficacy and control” (p. 12). In addition, they noted that health promotion was more important than disease treatment for overall health and longevity. Environmental exposures. People with lower SES have greater exposure to such environmental hazards as air, water, and noise pollution; hazardous waste; and toxins than people with higher SES. These environmental factors are just beginning to be represented in research. Health behaviors. People with lower incomes were more likely than people with higher incomes to be engaged in several types of risky health behaviors, including smoking, physical inactivity, and unhealthy diet. There is evidence that these behaviors are used as coping strategies in the face of stress, but this stereotype is questionable. Exposures to stress. Chronic stress has been linked to such adverse health outcomes as hypertension, susceptibility to infection, buildup of fat in blood vessels and the abdomen, and brain cell atrophy. Stress has also been linked to premature aging at the cellular level, indicated by reduced length of cell structures called telomeres. Neighborhood and community. Individuals living in low-income neighborhoods have been found to report poorer health than individuals living in middle- or high-income neighborhoods, whether or not they themselves are poor. The research so far supports the notion that the health care system alone cannot offset the effects of other distal environment influences on health.

Given social work’s commitment to social, economic, and environmental justice, public health research and practice is an important social work domain. One study revealed that governmental policies aimed at reducing social inequalities resulted in lowered infant mortality rates and increased life expectancy at birth (Navarro et al., 2006).

Health literacy and health information technology (HIT) are additional

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critical factors in health status (positive and negative). The Institute of Medicine defines health literacy as “the degree to which individuals have the capacity to obtain, process, and understand the basic health information and services needed to make appropriate health decisions” (National Network of Libraries of Medicine, 2013, para. 1). Health literacy involves much more than simply translating health information into multiple languages. Reading and listening skills; analytic and decision-making skills; and the freedom to engage in dialogue, questioning, and critical evaluation of health information and health care options are part and parcel of this complex construct.

HIT is changing the nature and practice of health care and provides a potential avenue for reducing health disparities and diminishing the negative associations between poverty and health outcomes. Technology is woven into the health care fabric in pervasive ways, some of which can be accessed by anyone. The continuum from simple static websites that provide health knowledge to the actual receipt of health care through remote technologically mediated interaction has the potential to improve health even for individuals who are not able to travel to a health care facility or office (Wickham & Carbone, 2013). In Chapter 11 of this book, Elizabeth P. Cramer discusses some ways that social workers are using technology-mediated virtual groups to support people with chronic and long-term illness as well as the caregivers of frail elders. Big data analysis and geographic methods of research provide the opportunity for fast discovery, informing immediate and long-term public health needs (Habi, Renner, Bobek, & Laschkoing, 2016). Increasingly, individuals have access to their personal medical information by logging onto a health portal and viewing tests, diagnoses, and interventions as they are documented. Social workers can play an important role, helping people navigate and understand health information technologies (Stanhope & Straussner, 2017).

Critical Thinking Questions 3.5

How can social workers improve their own health literacy? What are some ways they can help clients to improve their health literacy? How can social workers be involved in HIT, and how can HIT help to achieve the goal of decreasing health disparities?

Photos 3.2a & 3.2b Biological health and illness greatly impact

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human behavior. Here, contrast how medical care is delivered in two very different situations, one in a high-tech operating room in the United States and the other in a temporary clinic in Haiti.

Implications for Social Work Practice This discussion of the interior biological person suggests several principles for social work assessment and intervention.

Develop a working knowledge of the body’s interior environmental systems; their interconnectedness; and the complex, elegant, and networked ways they interact with other dimensions of human experience. In assessment, intervention, and evaluation, recognize that interior environmental conditions of health and illness are influenced, and not trivially, by the exterior environmental social, political, cultural, and

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economic context. In assessment and intervention, recognize that the exterior environmental meanings attached to health and illness may influence not only the physical experience but also the values and socioemotional response assigned to health and illness. In assessment and intervention activities, look for the ways that exterior environments and the range of human experiences affect biological functions and vice versa. This is a nonlinear relationship so awareness of complex circuitry is essential. In assessment, intervention, and evaluation, evaluate the reciprocal influence of physiology, cognitive performance, emotional comfort, and overall well-being. In assessment and intervention, consider the ways in which one person’s interior environment health status is part of a network affecting a host of other individuals as well as the intellectual, theoretical, and practice arena of social work. Multiple social work roles are relevant in practice related to the health of the biological system, including the roles of researcher, clinician, educator, case manager, service coordinator, prevention specialist, and policy advocate. New roles are emerging, providing opportunity for social workers to capture our creativity and innovation within the context of the social work mission. Stay current with knowledge and approaches, particularly as technology changes the nature of health, the body, and social work intervention with people’s bodies.

Key Terms acquired immunodeficiency syndrome (AIDS) 88 antibodies 90 antigens 89 assistive devices 95 atria 92 autoimmune disease 89 axon 84 blood pressure 93 cardiovascular system 91 diabetes mellitus 88 endocrine system 86

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high blood pressure (hypertension) 93 human immunodeficiency virus (HIV) 88 immune system 89 lymphocytes 90 musculoskeletal system 94 nervous system 82 neuron 84 neuroplasticity 85 neurotransmitters 84 nonspecific immunity 90 specific immunity 90 synapse 84 testes 98 uterus 99 ventricles 92

Active Learning 1. You have been asked by the local public middle school to teach youth

about the experience of living with one of the following conditions: brain injury, diabetes, HIV, high blood pressure, childhood leukemia, or leg amputation. Locate literature and web resources on your chosen topic, select the material you wish to present, and prepare a presentation in lay terms that will be accessible to the youth audience.

2. Working in small groups, or individually, prepare two arguments, one supporting and one opposing sex education in public schools. Give some consideration to content that should or should not be included in sex education programs in public schools and the ages at which such education should occur. Provide evidence for your arguments.

Web Resources

American Diabetes Association: www.diabetes.org

Site contains basic diabetes information as well as specific information on type 1 diabetes, type 2 diabetes, community resources, and healthy living.

American Heart Association: www.heart.org/HEARTORG

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http://www.diabetes.org

http://www.heart.org/HEARTORG

Site contains information on diseases and conditions, healthy lifestyles, and health news and a heart and stroke encyclopedia.

Centers for Disease Control and Prevention (CDC) Division of HIV/AIDS Prevention: www.cdc.gov/hiv

Site contains basic science information on HIV/AIDS, basic statistics, fact sheets, and links to other resource sites.

Guttmacher Institute: www.guttmacher.org

Site presented by the Guttmacher Institute (formerly the Alan Guttmacher Institute)—a nonprofit organization that focuses on sexual and reproductive health research, policy analysis, and public education—contains information on abortion, law and public policy, pregnancy and birth, pregnancy and disease prevention and contraception, sexual behavior, sexually transmitted infections and HIV, and sexuality and youth.

MacArthur SES & Health Network: www.macses.ucsf.edu

Site has overviews of questions of interest to four working groups: a social environment group, a psychosocial group, an allostatic load (physiological wear and tear on the body resulting from chronic stress) group, and a developmental group.

National Center for Health Statistics: www.cdc.gov/nchs

Site contains FastStats on a wide range of health topics as well as news releases and a publication listing.

Neuroscience for Kids: http://faculty.washington.edu/chudler/neurok.html

Site maintained by faculty at the University of Washington presents basic neuroscience information on the brain, spinal cord, peripheral nervous system, neurons, and sensory system, including the effects of drugs on the nervous system and neurological and mental disorders.

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http://www.cdc.gov/hiv

http://www.guttmacher.org

http://www.macses.ucsf.edu

http://www.cdc.gov/nchs

http://faculty.washington.edu/chudler/neurok.html

4 The Psychological Person Cognition, Emotion, and Self

Joseph Walsh

Chapter Outline Learning Objectives Case Study 4.1: The Premed Student Cognition and Emotion Theories of Cognition

Cognitive Theory Information Processing Theory Social Learning Theory Theory of Multiple Intelligences Theories of Moral Reasoning Theories of Cognition in Social Work Practice

Theories of Emotion Physiological Theories of Emotion Psychological Theories of Emotion

Psychoanalytic Theory Ego Psychology Attribution Theory: A Cognitive Perspective Theory of Emotional Intelligence

Social Theories of Emotion Theories of Emotion in Social Work Practice

Cognitive/Emotional “Disorders” The Self

The Self as a Soul The Self as Unfolding Potentials The Self as Organizing Activity The Self as Cognitive Structure The Self as Shared Symbolic Experience The Self as a Flow of Experience

Implications for Social Work Practice Key Terms

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Active Learning Web Resources

Learning Objectives 4.1 Recognize one’s own emotional and cognitive reactions to a case study. 4.2 Define cognition and emotion. 4.3 Compare five major theories of cognition (cognitive, information processing, social learning, multiple intelligences, moral reasoning) and cognitive behavioral intervention theory. 4.4 Compare four major categories of theories of emotion (physiological theories, psychological theories, social theories, and social work practice theories). 4.5 Recognize how cognitive and emotional characteristics can be involved in cognitive and emotional “disorders.” 4.6 Compare six perspectives on the self (as soul, as unfolding potentials, as organizing activity, as cognitive structure, as shared symbolic experience, and as flow of experience). 4.7 Apply knowledge of cognition, emotion, and self to recommend guidelines for social work engagement, assessment, intervention, and evaluation.

Case Study 4.1 The Premed Student Dan Lee is a 24-year-old single Chinese American male undergraduate student working toward admission into medical school. He came to the counseling center to get help with his feelings of anxiety, tension, sadness, and anger related to that task and for some ongoing interpersonal conflicts. Dan was having difficulty concentrating on his studies and was in danger of failing a course he needed to pass in order to stay on track for medical school. He was specifically preoccupied with perceived personal slights from several friends, his sister, and his mother. Dan told the social worker that he needed help learning how to get these significant others to behave more responsibly toward him so that he could focus more intensively on his own work. Dan reported that he also had been diagnosed several years ago with an auditory processing disorder, which meant he was slow to process other people’s verbal communications at times and prepare his responses to them.

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Dan is the older of two children (his sister is 22) born to a couple who had grown up in Taiwan and moved to the United States before the children were born. His father, a surgeon, and his mother, a homemaker, divorced when Dan was 7. He and his sister had lived with their mother since then and only had occasional contact with their father. Dan had internalized the values of his family and culture; he understood that he needed to assume primary responsibility for the well-being of his mother and sister while also achieving high social status for himself. He also exhibited the cultural value of obedience to authority and saw himself as the family’s primary authority figure, being the only male member. While a student at the diverse university, Dan maintained cultural ties through his membership in a church that served the Chinese American community.

Dan tried hard to be a good son and brother but held a firm position that others should always accede to his directives. He believed he was always “right” in decisions he made about his mother and sister (regarding where they lived, how his mother spent her time, and what kinds of friends and career choices his sister should make). Regarding his friends, who were mostly limited to casual contacts at school and at his volunteer job at a community health center, Dan felt that whenever there was a conflict or misunderstanding it was always “their fault.” He felt disrespected at these times and became so preoccupied with these “unjust sleights” that he couldn’t concentrate on much else for days afterward. Dan gave one example of a friend who had arrived more than 20 minutes late on two occasions for scheduled social outings. The second time he demanded that the friend apologize for being irresponsible and insensitive, and when the friend did not do so to Dan’s satisfaction, the relationship ended. These kinds of relationship disruptions were common in his life. Dan’s family and friends often did not accept his admonitions, and he wanted to learn from the social worker how to better help these other people see that he was always “rational” and “correct” in his thinking. Dan had warmer feelings toward his peers at church, all of whom were Asian Americans. He spent most of his Sunday afternoons there, participating in social events and singing in the choir. Dan was also in regular contact with an ex-girlfriend, mostly by e-mail but occasionally by phone. He had broken up with her 6 months ago, and although she hoped they would resume a romantic relationship, Dan did not think this would happen.

Spencer, the social worker, is a U.S.-born Caucasian male, several years older than Dan, who had some understanding of the Chinese value system in which the client was raised. He liked Dan, appreciating his intelligence, his motivation to get help, and his ability to articulate his concerns, but he also observed that Dan demonstrated a striking rigidity in his attitudes toward others. Still, he initially validated Dan’s perspective on the presenting issues.

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Spencer easily engaged Dan in substantive conversations each time they met, reflecting back to Dan the difficulty of his competing demands and desire to help his family members lead safe and productive lives. Before long, however, Dan began challenging Spencer’s nondirective feedback. “I want to know what you think I should do here.” “How can I approach my sister so she won’t be so defensive about my input?” “I tell my mother she shouldn’t speak to my dad so often, but she keeps doing so anyway. How can I get her to stop?”

Dan was having difficulty balancing his desires for personal development with his need to care for two adult family members in a manner he felt appropriate. He seemed to have internalized conditions of worth related to his family responsibility and, having begun doing so at such a young age, had become quite rigid in his approach to helping the family. Dan’s defensive posture involved distorting the motives of others as oppositional rather than expressions of their own personal inclinations. Further, he never seemed to be able to relax and have fun, except when at church. In recognizing Dan’s rigidity as a defense, Spencer helped him reflect on the possibility that the behaviors of others toward him might not be intentionally oppositional but reflective of differences of opinion. Perhaps Dan could feel good about his well-meaning efforts while recognizing that one’s influence over others cannot be absolute.

Spencer was patient in his responses to Dan: “It’s a difficult situation you are in, and you’re trying your hardest to do the best for your family, and it’s frustrating that you can’t find ways to help them understand your concern.” “It hurts you to see other people move in directions you believe are not good for them.” “You feel strongly that certain people should do what you suggest even though they disagree.” Despite these empathic responses that Spencer believed reflected positive regard, Dan became increasingly frustrated with the social worker. “I thought you were a professional. I thought you were trained to help people. Why can’t you come up with some new ideas for me to try?”

Dan’s emotions were not always evident beneath his rigid exterior. The primary feelings he expressed to the social worker were anxiety, anger, sadness, and frustration. Over time Dan maintained his rigid perspective. He tried to consider his situation from the points of view of others, but he always came back to the position that he was “rational” and others were “irrational.” He occasionally accused the social worker of being incompetent for not answering his questions concretely enough. Spencer himself became frustrated with his inability to help Dan broaden his perspective on interpersonal differences and Dan’s inability to distinguish disagreement from disrespect. During the course of their year of working together, Spencer

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employed the following interventions, which alternately focused on Dan’s thinking and emotions: cognitive therapy (restructuring), behavior change, and psychodynamic therapy (so that Dan might become more aware of the range of his feelings and how the sources of his anger might be based in his family history and upbringing). Although Dan noted little progress for several months, Spencer was encouraged by the fact that he continued coming in faithfully, week after week.

Cognition and Emotion Dan’s problems at college reflect his personal psychology, which can be defined as his mind and his mental processes. His story illustrates the impact on social functioning of a person’s particular patterns of cognition and emotion. Cognition can be defined as our conscious or preconscious thinking processes—the mental activities of which we are aware or can become aware with reflection. Cognition includes taking in relevant information from the environment, synthesizing that information, and formulating a plan of action based on that synthesis (Ronen & Freeman, 2007). Beliefs, key elements of our cognition, are ideas we hold to be true. Our assessment of any idea as true or false is based on the synthesis of information. Erroneous beliefs, which may result from misinterpretations of perceptions or from conclusions based on insufficient evidence, frequently contribute to distress and interpersonal problems.

Emotion is a difficult concept to define but can be understood as a feeling state characterized by our appraisal of a stimulus, changes in bodily sensations, and displays of expressive gestures (Mulligan & Scherer, 2012). The term emotion is often used interchangeably in the study of psychology with the term affect, but the latter refers only to the physiological manifestations of feelings. Affect may be the result of drives (innate compulsions to gratify basic needs), which generate both conscious and unconscious feelings (those of which we are not aware but that influence our behavior). In contrast, emotion is always consciously experienced. Likewise, emotion is not the same as mood, a feeling disposition that is more stable than emotion, usually less intense, and less tied to a specific situation.

The evolution of psychological thought since the late 1800s has consisted largely of a debate about cognition and emotion—their origins, the nature of their influence on behavior, and their influence on each other. The only

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point of agreement seems to be that cognition and emotion are complex and interactive.

Theories of Cognition Theories of cognition, which emerged in the 1950s, assume that conscious thinking is the basis for almost all behavior and emotions. Emotions are defined within these theories as the physiological responses that follow our cognitive evaluations of input. In other words, thoughts produce emotions.

Cognitive Theory Jean Piaget’s cognitive development theory is the most influential theory of cognition in social work and psychology (Lightfoot, Lalonde, & Chandler, 2004). In his system, our capacity for reasoning develops in stages, from infancy through adolescence and early adulthood. Piaget saw the four stages presented in Exhibit 4.1 as sequential and interdependent, evolving from activity without thought, to thought with less emphasis on activity—from doing, to doing knowingly, and finally to conceptualizing. He saw normal physical and neurological development as necessary for cognitive development.

A central concept in Piaget’s theory is that of the schema, defined as internalized representations of the world or ingrained and systematic patterns of thought, action, and problem solving. Our schema develop through social learning (watching and absorbing the experiences of others) or direct learning (our own experiences). Both processes may involve assimilation (responding to experiences based on existing schema) or accommodation (changing schema when new situations cannot be incorporated within an existing one). As children, we are motivated to develop schema as a means of maintaining psychological equilibrium, or balance. Any experience that we cannot assimilate creates anxiety, but if our schema are adjusted to accommodate the new experience, the desired state of equilibrium will be restored. From this perspective, you might interpret Dan’s difficulties with his college peers as an inability to achieve equilibrium by assimilating new interactional experience within his existing schema. Dan was accustomed to functioning within a relatively small group of family and friends from his own cultural background, where roles were clearly defined. He could not easily adjust to the

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challenge of managing relationships among a much larger and more diverse student population, where the members’ motivations and worldviews were difficult to comprehend.

Another of Piaget’s central ideas is that cognitive development unfolds sequentially. Infants are unable to differentiate between “self” and the external world; the primary task in early cognitive development is the gradual reduction of such egocentricity, or self-centeredness. The child gradually learns to perform cognitive operations—to use abstract thoughts and ideas that are not tied to situational sensory and motor information. Piaget’s four stages of normal cognitive development are summarized in Exhibit 4.1.

Exhibit 4.1 ● Piaget’s Stages of Cognitive Operations Exhibit 4.1 ● Piaget’s Stages of Cognitive Operations

Stage Description

Sensorimotor stage (birth to 2 years)

The infant is egocentric; he or she gradually learns to coordinate sensory and motor activities and develops a beginning sense of objects existing apart from the self.

Preoperational stage (2 to 7 years)

The child remains primarily egocentric but discovers rules (regularities) that can be applied to new incoming information. The child tends to overgeneralize rules, however, and thus makes many cognitive errors.

Concrete operations stage (7 to 11 years)

The child can solve concrete problems through the application of logical problem-solving strategies.

Formal operations stage (11 to adulthood)

The person becomes able to solve real and hypothetical problems using abstract concepts.

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Information Processing Theory Cognitive theory has been very influential, but, as you might guess, it leaves many aspects of cognitive functioning unexplained. Whereas Piaget sought to explain how cognition develops, information processing theory offers details about how our cognitive processes (learning, memory, and environmental interaction) are organized (David, Miclea, & Opre, 2004; Oppenheimer & Kelso, 2015; Woolcott, 2013). This theory (actually there are several theories under the general heading) makes a clear distinction between the thinker and the external environment; each is an independent, objective entity in the processing of inputs and outputs. We receive stimulation from the outside and code it with sensory receptors in the nervous system. The information is first represented in some set of brain activities and is then integrated (by accommodation or assimilation) and stored for purposes of present and future adaptation to the environment. All of us develop increasingly sophisticated problem-solving processes through the evolution of our cognitive patterns, which enable us to draw attention to particular inputs as significant. We continue to experience cognitive development in adulthood, with age- and experience-related changes in memory, cognition, and the brain. It should be noted that Dan’s auditory processing deficit did not affect the nature of his cognitions. Information processing is a sensory theory in that it depicts information as flowing passively from the external world inward through the senses to the mind. Being interested in the structure of cognition, it views the mind as having distinct parts—including the sensory register, short-term memory, and long-term memory—that make unique contributions to thinking in a specific sequence. Interestingly, information processing theory has become important in the design of computer systems, which of course interact with their environments in complex ways. In contrast, a motor theory such as Piaget’s sees the mind as playing an active role in processing—not merely recording but actually constructing the nature of the input it receives. In Dan’s case, information processing theory would suggest that he lacks the schema adequate for adapting to his novel interpersonal situations. Cognitive theory would suggest that Dan’s cognitive biases were making his adjustment difficult.

Social Learning Theory According to social learning theory, we are motivated by nature to

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experience pleasure and avoid pain (Chavis, 2012). Social learning theory relies to a great extent on principles of conditioning, which assert that behavior is shaped by its reinforcing or punishing consequences (operant conditioning) and antecedents (classical conditioning). Albert Bandura (1977b) developed the principle of vicarious learning, or modeling, through which behavior is also acquired by witnessing how the actions of others are reinforced. Social learning theorists acknowledge that thoughts and emotions exist but understand them as behaviors in need of explaining rather than as primary motivating factors.

Social learning theorists, unlike other social behavioral theorists, assert that thinking takes place between the occurrence of a stimulus and our response. They call this thought process cognitive mediation. The unique patterns we learn for evaluating environmental stimuli explain why each of us may adopt very different behaviors in response to the same stimulus— for example, why Dan’s reaction to the behavior of his peers is very different from how many of them might react to each other. Bandura takes this idea a step further and asserts that we engage in self-observations and make self-judgments about our competence and mastery. We then act on the basis of these self-judgments. Bandura (2001) criticizes information processing theory for its passive view of human agency, arguing that it omits important features of what it means to be human, including subjective consciousness, deliberative action, and the capacity for self- reflection. For example, Dan may have made some negative self- judgments about his competence to complete his premed studies that are affecting his functioning. Social workers should thus remain aware that there are many ways in which adults may learn, even in the context of social learning theory.

Photo 4.1 Information processing theory would suggest that the information these children are receiving from the book flows through their senses to their minds, which operate much like computers.

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©iStock/FatCamera

Theory of Multiple Intelligences Howard Gardner’s (1999, 2006, 2008) theory of multiple intelligences constitutes a major step forward in our understanding of how people come to possess different types of cognitive skills and how the same person is able to effectively use cognition and emotion in some areas of life but not others. In this theory, intelligence is defined as a “biopsychosocial potential to process information that can be activated in a cultural setting to solve problems or create products that are of value in a culture” (Gardner, 1999, p. 23). Intelligence includes the following:

The ability to solve problems one encounters in life The ability to generate new problems to solve The ability to make something or offer a service that is valued within one’s culture

Exhibit 4.2 ● Gardner’s Eight Intelligences Exhibit 4.2 ● Gardner’s Eight Intelligences

Linguistic intelligence. The capacity to use language to express what is on your mind and to understand other people. Linguistic intelligence includes listening, speaking, reading, and writing skills.

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Logical/mathematical intelligence. The capacity for mathematical calculation, logical thinking, problem solving, deductive and inductive reasoning, and the discernment of patterns and relationships. Gardner suggests that this is the type of intelligence addressed by Piaget’s model of cognitive development, but he does not think Piaget’s model fits other types of intelligence.

Visual-spatial intelligence. The ability to represent the spatial world internally in your mind. Visual-spatial intelligence involves visual discrimination, recognition, projection, mental imagery, spatial reasoning, and image manipulation.

Bodily kinesthetic intelligence. The capacity to use your whole body or parts of your body to solve a problem, make something, or put on some kind of production. Gardner suggests that our tradition of separating body and mind is unfortunate because the mind can be trained to use the body properly and the body trained to respond to the expressive powers of the mind. He notes that some learners rely on tactile and kinesthetic processes, not just visual and auditory processes.

Musical intelligence. The capacity to think in musical images, to be able to hear patterns, recognize them, remember them, and perhaps manipulate them.

Intrapersonal intelligence. The capacity to understand yourself, to know who you are, what you can do, what you want to do, how you react to things, which things to avoid, which things to gravitate toward, and where to go if you need help. Gardner says we are drawn to people who have a good understanding of themselves because those people tend not to make mistakes. They are aware of their range of emotions and can find outlets for expressing feelings and thoughts. They are motivated to pursue goals and live by an ethical value system.

Interpersonal intelligence. The ability to understand and communicate with others, to note differences in moods, temperaments, motivations, and skills. Interpersonal intelligence includes the ability to form and maintain relationships and assume

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various roles within groups and the ability to adapt behavior to different environments. It also includes the ability to perceive diverse perspectives on social and political issues. Gardner suggests that individuals with this intelligence express an interest in interpersonally oriented careers, such as teaching, social work, and politics.

Naturalist intelligence. The ability to recognize and categorize objects and processes in nature. Naturalist intelligence leads to talent in caring for, taming, and interacting with the natural environment, including living creatures. Gardner suggests that naturalist intelligence can also be brought to bear to discriminate among artificial items such as sneakers, cars, and toys.

Source: Based on Gardner, 1999, 2006, 2008.

In this theory, the brain is understood not as a single cognitive system but as a central unit of neurological functioning that houses relatively separate cognitive faculties. During its evolution, the brain has developed separate organs, or modules, as information-processing devices. Thus, all of us have a unique blend of intelligences derived from these modules. Gardner has delineated eight intelligences, which are described in Exhibit 4.2, although in his ongoing research he is considering additional possibilities. Some proponents of multiple intelligences have proposed spiritual or religious intelligence as a possible additional type, and Gardner (2006) has acknowledged that an “existential” intelligence (but not spiritual or religious) may be a useful construct. You may be interested to note that in one study, social work educators rated intrapersonal, interpersonal, and linguistic intelligences as the most important for social work practice, and the same educators rated bodily kinesthetic, musical, and spatial intelligences as important for culturally sensitive practice (Matto, Berry- Edwards, Hutchison, Bryant, & Waldbillig, 2006). Two intelligences, the linguistic (related to spoken and written language) and the logical- mathematical (analytic), are most consistent with traditional notions of intelligence.

The theory of multiple intelligences is sometimes criticized for being vague, having overlapping categories, and not being empirically validated by research (Waterhouse, 2010). Still, it has proven useful in understanding a person’s range of strengths and can even serve as a guide for social work practitioners in deciding on interventions that will

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maximize client motivation and participation (for example, art therapy for persons with strong visual-spatial intelligence) (Booth & O’Brien, 2008). Further, in one recent meta-analysis of 75 studies including elementary, high school, and college students in Turkey, it was shown that educational programs based on this theory produced significantly higher levels of student achievement (Bas, 2016).

One of the most positive implications of the theory of multiple intelligences is that it helps us see strengths in ourselves that lie outside the mainstream. For example, Dan has a strong logico-mathematical intelligence that contributes to his ability to master difficult physiological concepts. He may benefit from help, however, in further development of his intrapersonal and interpersonal domains, especially outside his cultural group.

Critical Thinking Questions 4.1

Why do you think social work educators rated intrapersonal, interpersonal, and linguistic intelligences as the most important for social work practice? Would you agree with that? Why or why not? Why do you think the same educators rated bodily kinesthetic, musical, and spatial intelligences as important for culturally sensitive practice? Would you agree with that? Why or why not? Shouldn’t all social work practice be culturally sensitive?

Theories of Moral Reasoning Morality is our sensitivity to, and perceptions of, what is right and wrong. It develops from our acquired principles of justice and ways of caring for others. Theories of moral reasoning are similar to those of cognitive development in that a sequential process is involved. Familiarity with these theories can help social workers understand how clients make decisions and develop preferences for action in various situations. Both issues are important in our efforts to develop goals with clients. The best- known theories of moral reasoning are those of Lawrence Kohlberg and Carol Gilligan. In reviewing these theories, it is important to keep in mind that they are based on studies of men and women in the United States. It is likely that moral development unfolds differently in other cultures, and though some such research is being done, more is needed to investigate these differences (Gardiner, 2018).

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Kohlberg (1969) formulated six stages of moral development, divided into three levels, which begin in childhood and unfold through adolescence and young adulthood (see Exhibit 4.3). His perspective is based on an individualistic notion of justice. The first two stages represent preconventional morality in which the child’s primary motivation is to avoid immediate punishment and receive immediate rewards. Conventional morality emphasizes adherence to social rules. A person at this level of morality might be very troubled, as Dan is, by circumstances that make him or her different from other people. Many people never move beyond this level to postconventional morality, which is characterized by a concern with moral principles transcending those of their own society.

One limitation of Kohlberg’s theory is that it does not take into account gender differences (his subjects were all male). In fact, he claims that women do not advance through all six stages as often as men. Addressing this issue, Gilligan (1982, 1988) notes that boys tend to emphasize independence, autonomy, and the rights of others in their moral thinking, using a justice-oriented approach. Girls, on the other hand, develop an ethic of care and interdependence that grows out of a concern for the needs of others rather than the value of independence. To account for this difference, Gilligan proposed the three stages of moral development listed in Exhibit 4.4. Her stages place greater emphasis than Kohlberg does on the ethic of care and are meant to more accurately describe the moral development of females. These differences extend throughout life (Dakin, 2014). We see in the next chapter how Gilligan’s work has influenced feminist psychology.

Exhibit 4.3 ● Kohlberg’s Levels and Stages of Moral Development

Stage Description

Preconventional level

Stage 1: Heteronomous morality

Accepting what the world says is right

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Stage 2: Instrumental purpose

Defining the good as whatever is agreeable to the self and those in the immediate environment

Conventional level

Stage 3: Interpersonal experiences

Seeking conformity and consistency in moral action with significant others

Stage 4: The societal point of view

Seeking conformity and consistency with what one perceives to be the opinions of the larger community

Postconventional level

Stage 5: Ethics Observing individual and group (societal) rights

Stage 6: Conscience and logic

Seeking to apply universal principles of right and wrong

Exhibit 4.4 ● Gilligan’s Three Stages of Moral Development Exhibit 4.4 ● Gilligan’s Three Stages of Moral Development

Stage Description

Survival orientation

Egocentric concerns of emotional and physical survival are primary.

Conventional care

The person defines as right those actions that please significant others.

Integrated care

A person’s right actions take into account the needs of others as well as the self.

Research findings on gender differences in moral reasoning are inconsistent. Some research indicates that boys do tend to emphasize

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justice principles, whereas girls emphasize caring, but these differences are not great (see, e.g., Malti, Gasser, & Buchmann, 2009; Redzic, 2015). Other researchers find no differences in the ways males and females reason about moral dilemmas (e.g., Donleavey, 2008; Hauser, Cushman, Young, Mikhail, & Jin, 2007). It is possible that gender differences in moral reasoning, when they do occur, are related to power differences and differences in the typical ethical dilemmas faced by males and females. In one revealing older study, a sample of men and women were asked to respond to a set of hypothetical scenarios in which they needed to assume positions of limited power as well as take on caregiving roles (Galotti, 1989). Under these conditions, the moral responses of men and women were similar.

Evidence has emerged that culture may have a greater influence on moral reasoning than gender does. Passini (2010), a Serbian researcher, argues that a community or culture’s assumptions about the nature of responsibility and group solidarity determine the basis of one’s moral reasoning. A trio of researchers from India (Sachdeva, Singh, & Medin, 2011) emphasize that all universalist theories of moral reasoning fail to allow for substantial variation in how one might conceptualize the moral domain. Gardiner (2018) argues that moral development does not follow a universal script across cultures and suggests that the ecological system in which early social interactions occur shapes moral thought and behavior. For understanding moral reasoning across cultures, Gardiner recommends the social constructionist theory of moral development proposed by Neff and Helwig (2002) and Haan (1991), who suggest that moral reasoning comes from the understanding of the interdependence of self and others that develops through social interactions. They propose that the most mature moral reasoner is the one who makes moral decisions that balance the person’s own needs and desires with those of others affected by the issue at hand. Haan found that people who are able to control their own emotions in order to think about possible solutions engage in higher levels of moral action than people who are not able to control their emotions. In this view, moral reasoning would take different forms in different cultures, based on different definitions of needs and desires. Even so, research has tended to support the idea that moral development unfolds in stages across cultures (Gibbs, Basinger, Grime, & Snarey, 2007).

Both Kohlberg’s and Gilligan’s stages of moral reasoning, like Piaget’s cognitive theory, assume an increasing ability to think abstractly as the

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person progresses through adolescence. The theories can also be seen as complementary, especially considering that both authors articulated respect for each other’s work (Jorgensen, 2006). With his great concern about individual achievement, along with a desire to care for his sister and mother, Dan seems to fall into Kohlberg’s stage of conventional morality and Gilligan’s stage of conventional care.

Theories of Cognition in Social Work Practice When theories of cognition first emerged in psychology, they represented a reaction against psychodynamic theories, which focused on the influence of unconscious thought. Many practitioners had come to believe that although some mental processes may be categorized as unconscious, they have only a minor influence on behavior. Rather, conscious thinking is the basis for almost all behavior and emotions (Walsh, 2014).

As we have seen, Piaget’s cognitive theory postulates that we develop mental schema, or general information-processing rules that become enduring, from past experiences. Schema are the basis for the ways we screen, discriminate, and code stimuli; categorize and evaluate experiences; and make judgments. Cognition is viewed as active—our minds do not merely receive and process external stimuli but are active in constructing the reality we seek to apprehend. We are “rational” to the extent that our schema, the basis for our perceptions, accommodate available environmental evidence and our decisions do not rely solely on preconceived notions about the external world. From the perspective of cognitive theory, the sources of our problems may involve accurate assessments of the environment (for which problem-solving interventions may be provided), cognitive deficits (lacking information about a situation) or cognitive misperceptions, or distortions (Murphy, 2004).

So long as our cognitive style helps us to achieve our goals, it is considered healthy. However, thinking patterns can become distorted, featuring patterns of bias that dismiss relevant environmental information from judgment, which can lead in turn to the maladaptive emotional responses described in Exhibit 4.5. These cognitive distortions are habits of thought that lead us at times to distort input from the environment and experience psychological distress (Beck, 2008).

Exhibit 4.5 ● Common Cognitive Distortions Exhibit 4.5 ● Common Cognitive Distortions

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Exhibit 4.5 ● Common Cognitive Distortions

Cognitive Error Description

Absolute thinking Viewing experiences as all good or all bad and failing to understand that experiences can be a mixture of both

Overgeneralization Assuming that deficiencies in one area of lifenecessarily imply deficiencies in other areas

Selective abstraction

Focusing only on the negative aspects of a situation and consequently overlooking its positive aspects

Arbitrary inference Reaching a negative conclusion about asituation with insufficient evidence

Magnification Creating large problems out of small ones

Minimization Making large problems small and thus notdealing adequately with them

Personalization Accepting blame for negative events withoutsufficient evidence

As a social worker, you could use cognitive theory to surmise that Dan is distressed because he subjectively assesses some of his life situations in a distorted manner. For example, arbitrary inferences may lead him to conclude that because other students do not share his perspectives on how they should behave, they do not respect his point of view. Because he concludes this, he may also conclude that he will continue to feel isolated from his peers, and this thought produces his emotional response of sadness.

To adjust his emotions and mood, Dan needs to learn to evaluate his external environment differently. He needs to consider changing some of the beliefs, expectations, and meanings he attaches to events, because they are not objectively true. He might conclude, for example, that people

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possess honest differences of opinion and that some of his peers appreciate him more than he assumes. He may even notice that their opinions are consistent with his more than he realizes. Cognitive theorists would make Dan’s thinking the primary target of change activity, assuming that cognitive change will in turn produce changes in his emotional states.

Cognitive theory is a highly rational approach to human behavior. Even though the theory assumes that some of a person’s beliefs are irrational and distorted, it also assumes that human beings have great potential to correct these beliefs in light of contradictory evidence. In clinical assessment, the social worker must assess the client’s schema and determine whether the source of his or her difficulties are rooted in cognitive deficits, distortions, or accurate assessment of a situation. During intervention, the social worker helps the client adjust his or her cognitive process to better facilitate the attainment of goals. As a result, the client will also experience more positive emotions. It is important to emphasize that clients are not encouraged to rationalize all their problems as involving faulty assumptions, for many challenges people face are due to oppressive external circumstances. Still, Dan’s belief that his family, former girlfriend, and peers do not value his feedback is an arbitrary inference. To help him overcome this distortion, the social worker could review the available evidence of that conclusion, helping Dan to understand that his significant others may often give consideration to his points of view even though they do not always accede to them.

Social learning theory takes the tendency in cognitive theory to deemphasize innate drives and unconscious thinking even further. Some practitioners in the social learning tradition make no attempt to understand internal processes at all and avoid making any inferences about them. Social workers who practice from the behavioral approach conceptualize thoughts and emotions as behaviors subject to reinforcement contingencies (Thyer, 2005). That is, we tend to behave in ways that produce rewards (material or emotional) for us. Thus, behaviors can be modified through the application of specific action-oriented methods, such as those listed in Exhibit 4.6. If Dan feels socially isolated due to his lack of skills at engaging in casual conversation, the social worker would first help him understand that improved social skills might help him feel more connected to his peers. Through behavioral rehearsal (step-by-step modeling and role-playing) Dan could learn how to informally interact with his classmates more effectively. His positive reinforcers might include the

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sense of interpersonal connection, a new sense of efficacy, and reduced anxiety.

The combination of assessing and intervening with a person’s thought processes, and then helping the client to identify and develop reinforcers for new ways of thinking and behaving, is known as cognitive-behavioral therapy (CBT). Most cognitive practitioners use cognitive-behavioral methods because it is important to help the client experience rewards for any changes he or she risks.

Exhibit 4.6 ● Four Behavioral Change Strategies Exhibit 4.6 ● Four Behavioral Change Strategies

Strategy Description

Desensitization Confronting a difficult challenge through a step-by-step process of approach and anxiety control

Shaping Differentially reinforcing approximations of a desired but difficult behavior so as to help the person eventually master the behavior

Behavioral rehearsal

Role-playing a desired behavior after seeing it modeled appropriately and then applying the skill to real-life situations

Extinction Eliminating a behavior by reinforcing alternativebehaviors

The more we learn about cognition, however, the more complex it becomes. For example, psychologist and economist Daniel Kahneman (2011) suggests that people place too much confidence in the rationality of their judgments. In fact, his research concludes that we all have built-in cognitive biases. One of these is that we are more driven to avoid pain than to experience pleasure, but more problematic is our “optimistic bias,” which generates a false sense that we have substantial control of our lives. This bias may be adaptive in an evolutionary sense, but as a result we fail to comprehend and take complexity into account in assessing past and present events, and our understanding of the world consists of small, not

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necessarily representative sets of observations. One implication of this bias is that we tend to be overconfident in our judgments; our “rational” minds generally do not account for the role of chance in events and thus falsely assume that future events will mirror past ones. Kahneman’s work provides a reminder that there is much to be learned about the nature of cognition and the potential for people to act “rationally.”

Critical Thinking Questions 4.2

How important do you think conscious thinking is in human behavior in general and for Dan Lee in particular? What do you think of Daniel Kahneman’s thesis that we place too much confidence in the rationality of our judgments?

Theories of Emotion Emotion is physiologically programmed into the human brain (see Chapter 3). Its expression is primarily mediated by the hypothalamus, whereas the experience of emotion is a limbic function. But emotion also involves a cognitive labeling of these programmed feelings, which is at least partially a learned process. That is, some emotional experience is an interpretation and not merely given by our physiological state. For example, two students might feel anxious walking into the classroom on the first day of a semester. The anxiety would be a normal reaction to entering a new and unfamiliar situation. However, one student might interpret the anxiety as a heightened alertness that will serve her well in adjusting to the new students and professor, whereas the other student might interpret the same emotion as evidence that she is not prepared to manage the course material. The first student may become excited, but the second student becomes distressed.

Many theorists distinguish between primary and secondary emotions (Greenberg, 2011; Parkinson, Fischer, & Manstead, 2005). Primary emotions may have evolved as specific reactions with survival value for the human species. They mobilize us, focus our attention, and signal our state of mind to others. There is no consensus on what the primary emotions are, but they are usually limited to anger, fear, sadness, joy, and anticipation. Secondary emotions are more variable among people and are socially acquired. They evolved as humans developed more sophisticated

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means of learning, controlling, and managing emotions to promote flexible cohesion in social groups. Secondary emotions may result from combinations of primary emotions, and their greater numbers also imply that our processes of perception, though largely unconscious, are significant in labeling them. These emotions include (but are not limited to) envy, jealousy, anxiety, guilt, shame, relief, hope, depression, pride, love, gratitude, and compassion (Lazarus, 2007).

The autonomic nervous system is key to our processing of emotion (Esperidiao-Antonio et al., 2017). This system consists of nerve tracts running from the base of the brain, through the spinal cord, and into the internal organs of the body. It is concerned with maintaining the body’s physical homeostasis. Tracts from one branch of this system, the sympathetic division, produce physiological changes that help make us more alert and active. These changes are sustained by the release of hormones from the endocrine glands into the bloodstream. Parasympathetic system nerve tracts produce opposite, or calming, effects in the body. The two systems work together to maintain an appropriate level of physical arousal.

Still, psychologists have debated for more than a century the sources of emotion. Theories range from those that emphasize physiology to those that emphasize the psychological or the purely social context, and they give variable weight to the role of cognition.

Physiological Theories of Emotion A theory of emotion developed more than a century ago by the psychologist William James (1890) speculated that our bodies produce automatic physiological reactions to any stimulus. We notice these reactions and then attempt through cognition to make sense of them. This “making sense” involves labeling the emotion. Thus, emotion follows cognition, which itself follows the physiological reaction to a stimulus. The original theory stated that a distinct emotion arises from each physiological reaction.

Photo 4.2 Here a boy experiences joy from the kiss of his mother.

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A few decades later, another theory (Cannon, 1924) argued that physiological arousal and the experience of emotion are unrelated. Our physiological responses to a stimulus are nonspecific and only prepare us for a general fight-or-flight response (to confront or avoid the stimulus). This response in itself has nothing to do with the experience of emotion because any particular physiological activity may give rise to different emotional states and may not even involve our emotions at all. Thus, a separate process of perception produces our feeling of emotion. Emotion derives from the associations we make based on prior attempts to understand the sensation of arousal.

Physiology-based theories of emotion lost favor in the mid-20th century, but recent brain research is once again suggesting a strong link between physiological processes and emotion. The differential emotions theory (Magai, Consedine, Krivoshekova, Kudadjie-Gyamfi, & McPherson, 2006) asserts that emotions originate in our neurophysiology and that our personalities are organized around “affective biases.” All of us possess the primary emotions of happiness, sadness, fear, anger, and interest/excitement. These emotions are instinctual, hardwired into our brains, and the source of our motivations. When our emotions are activated, they have a pervasive influence on our cognition and behavior. A key theme in this theory is that emotions influence cognition, a principle opposite to that stressed in cognitive theory.

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For example, Dan has a persistent bias toward sadness, which may reflect some personal or material losses that occurred long before he started college. His episodes of sadness produce the temporary physical responses of a slowing down and decreased general effort. The sadness thus allows Dan time to reevaluate his needs and regain energy for more focused attempts to reach more achievable goals. It is also a signal for others to provide Dan with support. (You can certainly recall times when the sadness of another person prompted your own empathic response.) Of course, it is likely that “appearing sad” may have been more functional for Dan in his home community, where he was more consistently around people who knew and took an interest in him. In contrast, the emotion of anger tends to increase a person’s energy and motivate behavior intended to overcome frustration. Furthermore, it signals others to respond with avoidance, compliance, or submission so that the person may resolve the problem. Dan becomes angry rather frequently, and his sullen demeanor clearly encourages his peers, but not necessarily his family, to give him space.

Researchers have speculated for decades about the precise locations of emotional processing in the brain. Much has been learned about structures that participate in this process, and it is clear that many areas of the brain have a role (Esperidiao-Antonio et al., 2017). Furthermore, it is now widely accepted that cultural patterns shape the ways in which environmental input is coded in the brain (Shepherd, 2014).

As suggested in Chapter 3, the brain may be conceived as having three sections: hindbrain, midbrain, and forebrain. The hindbrain is the oldest of these and is sometimes called the reptilian brain. It consists of the brain stem and cerebellum and is responsible for involuntary life support functions. The midbrain is located just above the brain stem. It represents a second level of brain evolution, more advanced than the hindbrain. It includes the limbic system, a group of cell structures and the center of activities that create emotions. The forebrain is more focused on the external environment and on “rational” functions. It is the center of emotion, memory, reasoning, abstract thought, and judgment, and it integrates diverse brain activities. All of these sections have a role in the processing of emotion that researchers are only beginning to understand in depth.

The physiology of emotion begins in the thalamus, a major integrating

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center of the brain. Located in the forebrain, the thalamus is the site that receives and relays sensory information from the body and from the environment to other parts of the brain. Any perceived environmental event travels first to the thalamus and then to the sensory cortex (for thought), the basal ganglia (for movement), and the hypothalamus (for feeling). The amygdala, part of the limbic system, is key in the production of emotional states. There are in fact two routes to the amygdala from the thalamus. Sensations that produce primary emotions described earlier may travel there directly from the thalamus, bypassing any cognitive apparatus, to produce an immediate reaction that is central to survival. Other inputs first travel through the cortex, where they are cognitively evaluated prior to moving on to the limbic system and amygdala to be processed as the secondary emotions.

Culture and the characteristics of the individual may influence the processing of stimulation because the cognitive structures (schema) that interpret this stimulation may, through feedback loops to the thalamus, actually shape the neural pathways that will be followed by future stimuli. In other words, neural schema tend to become rigid patterns of information processing, shaping subsequent patterns for making sense of the external world.

Richard Davidson’s research has focused on the neurological processes underlying emotion, and he perceives the interactions between the prefrontal cortex and amygdala as significant in this regard (Davidson & Begley, 2012). Through brain imaging research he has found that the greater the number of connections between the amygdala and prefrontal cortex, the better we tend to be at managing our emotions. As one example, activity in the left prefrontal cortex is higher in persons who are more resilient to negative emotions, and from this Davidson infers that the left prefrontal cortex sends inhibitory messages to the amygdala.

Davidson claims that we all have different neurologically determined emotional styles that determine how we react to experiences in our lives and how likely we are to have particular moods (see Exhibit 4.7). The interrelation between the prefrontal cortex and amygdala plays a major role in determining these emotional styles. People with fewer connections tend to be less effective emotional regulators, making them more irritable, quick-tempered, and less able to manage their emotions in a healthy way. Davidson further cites research suggesting that genes associated with

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emotional styles can gradually change their expression based on our environments, behaviors, and life experiences.

Exhibit 4.7 ● Davidson’s Six Components of Emotional Style Exhibit 4.7 ● Davidson’s Six Components of Emotional Style

Resilience. How quickly we recover from negative emotions.

Outlook. The duration of our positive emotions.

Context. The degree to which we modulate our emotional responses in a manner appropriate to the context (for example, not directly taking out our work-related anger on the boss).

Social intuition. Our sensitivity to social cues, including all verbal and nonverbal expressions, that reflects our ability to understand and empathize with other people’s emotional worlds.

Self-awareness. The extent to which we are aware of emotional signals within our own bodies and minds. The more aware we are of our emotions, the better we will manage them.

Attention. The extent to which we can focus our attention on one thing at a time rather than becoming easily distracted.

Exhibit 4.8 ● Psychological Views of the Source of Emotion

Source: Adapted from Ellsworth, 1991.

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Psychological Theories of Emotion Perhaps the most contentious debates about the role of cognition in emotion have taken place among psychological theorists. As Exhibit 4.8 shows, some psychologists have considered emotion as primary, and others have considered cognition as primary. Psychological theories in the social behavioral perspective, somewhat like physiology-based theories, assume an automatic, programmed response that is then interpreted as emotion, perhaps first consciously but eventually (through habit) unconsciously.

Psychoanalytic Theory

Freud’s landmark work, The Interpretation of Dreams, first published in 1899, signaled the arrival of psychoanalytic theory. Freud’s theories became prominent in the United States by the early 1900s, immediately influencing the young profession of social work, and were a dominant force through the 1950s. Psychoanalytic thinking continues to be influential in social work today, although in adapted forms, through the theories of ego psychology, self psychology, object relations, and relational theory, among others. A more contemporary umbrella term for these theories is psychodynamic theory.

The basis of psychoanalytic theory is the primacy of internal drives and unconscious mental activity in human behavior. Sexual and aggressive drives are not “feelings” in themselves, but they motivate behavior that will presumably gratify our impulses. We experience positive emotions when our drives are gratified and negative emotions when they are frustrated. Our conscious mental functioning takes place within the ego, that part of the personality responsible for negotiating between internal drives and the outside world. It is here that cognition occurs, but it is influenced by those unconscious impulses that are focused on drive satisfaction.

In psychoanalytic thought, then, conscious thinking is a product of the drives from which our emotions also spring. By nature, we are pleasure seekers and “feelers,” not thinkers. Thoughts are our means of deciding how to gratify our drives. Defense mechanisms (see Chapter 5) result from our need to indirectly manage drives when we become frustrated, as we frequently do in the social world, where we must negotiate acceptable

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behaviors with others. The need to manage drives also contributes to the development of our unconscious mental processes. According to psychoanalytic theory, personal growth cannot be achieved by attending only to conscious processes. We need to explore all our thoughts and feelings to understand our essential drives. Change requires that we uncover unconscious material and the accompanying feelings that are repressed, or kept out of consciousness.

Let us grant, for example, that Dan has a normal, healthy drive for pleasure. He may also be angry with his father for breaking up the family, providing it with limited resources and leaving him in a responsible position at such a young age. This anger might be repressed into unconsciousness, however, because Dan is also emulating his father professionally and may believe, due to his cultural background, that it is not permissible for a child to be angry with a parent. Dan’s unconscious anger, having been turned inward at himself, may be contributing to his frustrations and inability to experience joy. An analytical social worker might suspect from Dan’s presentation that he experiences this anger but is not aware of it. The social worker might try to help Dan uncover the feeling by having him reflect on his family history in detail, in a safe clinical environment. With the insights that might result from this reflection, Dan’s anger may become conscious, and he can then take direct measures to work through it.

Ego Psychology

Ego psychology, which emerged in the 1930s (Goldstein, 2009; Schamess & Shilkrit, 2016), takes a more balanced perspective on the influences of cognition and emotion in social functioning. As an adaptation of psychoanalytic theory, it signaled a reaction against Freud’s heavy emphasis on drives and highlighted the ego’s role in promoting healthy social functioning. Ego psychology represents an effort to build a holistic psychology of normal development. It was a major social work practice theory throughout much of the 20th century because of its attention to the environment as well as the person, but it has fallen out of favor somewhat because of its lack of emphasis on the nature of relationships.

In ego psychology, the ego is conceived of as present from birth and not as derived from the need to reconcile drives within the constraints of social living, as psychoanalytic theory would say. The ego is the source of our

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attention, concentration, learning, memory, will, and perception. Both past and present experiences are relevant in influencing social functioning. The influence of the drives on emotions and thoughts is not dismissed, but the autonomy of the ego, and thus conscious thought processes, receives greater emphasis than in psychoanalytic theory. The ego moderates internal conflicts, which may relate to drive frustration, but it also mediates the interactions of a healthy person with stressful environmental conditions.

If we experience sadness, then, it is possible that we are having internal conflicts related to drive frustration. It is also possible that we are experiencing person–environment conflicts in which our coping efforts are not effective; the negative emotion may result from a frustration of our ability to manage an environmental stressor and thus arise from cognitive activities. Dan may be experiencing both types of conflict. His anger at the lack of adequate nurturance in his early family history may have been turned inward and produced a moderate depression. At the same time, the mismatch between his personal needs for mastery and the demands of the academic environment may be contributing to his negative feelings.

Attribution Theory: A Cognitive Perspective

Attribution theory was the first of the psychological theories of emotion to give primacy to cognition as a producer of emotions (Schacter & Singer, 1962). Attribution theory holds that our experience of emotion is based on conscious evaluations we make about physiological sensations in particular social settings. We respond to situations as we understand them cognitively, which leads directly to our experience of a particular emotion. For example, Dan has often experienced anxiety, but he interprets it differently in dealing with his family (frustration due to their lack of perceived loyalty) and his fellow students (being ridiculed). Attribution theory also notes that the social setting determines the type of emotion experienced; the physiological response determines the strength of the reaction. In other words, the nature of the social setting is key to the process of emotional experience.

Richard Lazarus (2006) has proposed a three-part psychological theory of emotion based on appraisals of situations. He suggests that emotion develops when we assess a situation as somehow relevant to a personal value or life concern. First, we make an unconscious appraisal of whether

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a situation constitutes a threat. This appraisal is followed by coping responses, which may be cognitive, physiological, or both and may be conscious or unconscious. Once these coping mechanisms are in place, we reappraise the situation and label our associated emotion. This process implies that our feelings originate with an automatic evaluative judgment. We decide whether there is a threat, take immediate coping action to deal with it, and then take a closer look to see exactly what was involved in the situation. At the end of this process, we experience a specific secondary emotion.

A major life concern for Dan is feeling secure in his interpersonal environments. He feels secure in familiar environments (such as his hometown, at his church, and with his family) but feels threatened in unfamiliar places. When he walks into a new classroom, he experiences anxiety. The feeling seems to Dan to be automatic, because his need for security is threatened in the situation. His means of coping is to ignore the other students, neither speaking to nor making eye contact with them, and to sit in a relatively isolated area of the room. Dan then makes at least a partly conscious appraisal that the room is occupied with strangers who are judging him in negative ways. Dan labels his emotion as resentment because he concludes that his classmates are incorrectly perceiving him as socially inferior.

Critical Thinking Questions 4.3

We have just looked at three types of theories of emotion: physiological theories, psychological theories, and attribution theory. What did you find most interesting about these different ways of thinking about emotion? Which ideas did you find most appealing? Most convincing? Explain.

Theory of Emotional Intelligence

Emotional intelligence is a person’s ability to process information about emotions accurately and effectively and, consequently, to regulate emotions in an optimal manner (Goleman, 2005). It includes self-control, zest and persistence, and the abilities to motivate oneself, understand and regulate one’s own emotions, and read and deal effectively with other people’s feelings. The idea of integrating the emotional and intellectual systems was considered contradictory for many years. Emotions deal with

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narrow informational content and specific events that are seen as changeable and unique. The intellect is related to patterns and regularities, but recently psychologists have determined that emotional stimulation is necessary for activating certain schematic thought patterns.

Emotional intelligence involves recognizing and regulating emotions in ourselves and other people. It requires emotional sensitivity, or the ability to evaluate emotions within a variety of social circumstances. A person who is angry but knows that certain expressions of anger will be counterproductive in a particular situation, and as a result constrains his or her expressions of anger, is emotionally intelligent. On the other hand, a person with this same knowledge who behaves angrily in spite of this awareness is emotionally unintelligent.

People are not necessarily equally emotionally intelligent about themselves and other people. We may be more emotionally intelligent about other people than we are about ourselves, or vice versa. The first possibility helps to explain why some people, social workers included, seem to be better at giving advice to others than to themselves.

Emotional intelligence requires an integration of intellectual and emotional abilities. Recognizing and regulating emotions requires emotional self- awareness and empathy, but it also necessitates the intellectual ability to calculate the implications of behavioral alternatives. To understand how and why we feel as we do, and other people feel as they do, demands emotional awareness and intellectual reasoning. Emotional intelligence is more important to excellence in many aspects of life than pure intellect because it includes intellect plus other capacities. In one meta-analysis including almost 20,000 participants it was found that emotional intelligence correlates with both physical health and mental health (Martins, Ramalho, & Morin, 2010).

There is no necessary relationship between emotional intelligence and emotional intensity. Emotional intelligence includes the capacity to regulate and use emotions, which may in fact favor a type of detachment not typical of emotionally expressive people. As we have already seen, Dan generally lacks emotional self-awareness, and he displays a flat emotional style with most people.

Social Theories of Emotion

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Social theories of emotion also take the view that perception, or the interpretation of a situation, precedes emotion. These interpretations are learned, and as such they become automatic (unconscious or preconscious) over time. Social theories emphasize the purpose of emotion, which is to sustain shared interpersonal norms and social cohesion. Two social theories are considered here.

James Averill’s (2012) social constructionist theory states that emotions can be understood as socially constructed, transitory roles. They are socially constructed because they originate in our appraisals of situations, transitory in that they are time limited, and roles because they include a range of socially acceptable actions that may be performed in a certain context. We organize and interpret our physiological reactions to stimuli with regard to the social norms involved in the situations where these reactions occur. Emotions permit us, in response to these stimuli, to step out of the conventional social roles to which people not experiencing the emotion are held. For example, in our culture, we generally would not say that we wish to harm someone unless we were feeling anger. We would generally not lash out verbally at a friend or spouse unless we felt frustrated. We would generally not withdraw from certain personal responsibilities and ask others for comfort unless we felt sad. Our display of those emotions helps other people to make sense of our inner state and subsequent actions. Because of the social functions of emotions, we often experience them as passions, or feelings not under our control. Experiencing passion permits unconventional behavior because we assume that we are somehow not “ourselves,” not able to control what we do at that moment. Our society has adopted this mode of thinking about emotions because it allows us to distance ourselves from some of our actions. Emotions are thus legitimized social roles or permissible behaviors for persons in particular emotional states. They allow for individualistic functioning in the context of social expectations.

George Herbert Mead (1934), the originator of symbolic interaction theory, took a somewhat different view. He suggested that emotions develop as symbols for communication. He believed that humans are by nature more sensitive to visual than to verbal cues. Emotional expressions are thus particularly powerful in that they are apprehended visually rather than verbally. Our emotional expression is a signal about how we are inclined to act in a situation, and others can adjust their own behavior in response to our perceived inclinations. Dan’s lack of eye contact and

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physical distancing from others are manifestations of his anxiety. Other persons, in response, may choose either to offer him support or, more likely in a classroom or lab setting, to avoid him if they interpret his expressions as a desire for distance. Dan was accustomed to people noticing his sadness at home, and responding to it by reaching out to him, but in the faster-paced, more impersonal context of the university culture, this was not happening. One reason he may be continuing contact with his ex-girlfriend is that, despite their differences, she perceives and affirms his sadness.

Theories of Emotion in Social Work Practice The preceding theories are useful in assessment and intervention with clients because they enhance the social worker’s understanding of the origins of emotional experiences and describe how negative emotional states may emerge and influence behavior. The social worker can help the client develop more positive emotional responses by providing insight or corrective experiences. What follows, however, is a theory that is even more precise in identifying the processes of emotional experience.

L. S. Greenberg (2012) has offered an emotion-focused practice theory that may be helpful in social work interventions. Greenberg asserts that all primary emotions—those that originate as biologically based rapid responses—are adaptive. Every primary emotion we experience has the purpose of helping us adjust our relationship with an environmental situation to enhance coping. Secondary emotions emerge from these primary emotions as a result of cognitive mediation. From this perspective, problems in social functioning may occur in one of four scenarios, summarized in Exhibit 4.9.

From this perspective, it is the unconscious or preconscious (mental activity that is out of awareness but can be brought into awareness with prompting) appraisal of situations in relation to our needs that creates emotions. Furthermore, as Mead (1934) pointed out, we experience our emotions as images, not as verbal thoughts. Emotions are difficult to apprehend cognitively, and in our attempts to do so, we may mistake their essence. The bad feelings that trouble us come not from those primary emotional responses, which, if experienced directly, would tend to dissipate, but from defensive distortions of those responses. We tend to appraise situations accurately with our primary emotions, but our

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frustration in achieving affective goals can produce distortions. Thus, in contrast to the assumptions of cognitive theory, distortions of thought may be the result of emotional phenomena rather than their cause.

Exhibit 4.9 ● Four Sources of Emotion-Based Problems in Social Functioning Exhibit 4.9 ● Four Sources of Emotion-Based Problems in Social

Functioning

1. A primary emotion may not achieve its aim of changing our relationship with the environment to facilitate adaptation.

2. We may, prior to awareness of a primary emotion, deny, distort, avoid, or repress it and thus become unable to constructively address our person— environment challenge.

3. We may develop cognitive distortions, or irrational “meaning construction” processes, that produce negative secondary emotions.

4. We may regulate our appropriate emotional experiences poorly, by either minimizing or not maintaining control over them.

Consider Dan’s distress as an example. Perhaps he accurately perceives wariness in others (due to his standoffish demeanor). His need to be in control is threatened by this appraisal, and the intensity of his reaction to this frustration becomes problematic, making it hard for him to concentrate on his studies. His emotional patterns, resulting from Source 3 and Source 4 in emotion-focused theory, evoke his tendencies at times to become confrontational almost to the point of verbal abuse.

Personal reality, then, may be as much a product of emotion as cognition. In any situation, the meanings we construct may automatically determine our conscious responses. It is when we directly experience primary emotions that we are functioning in an adaptive manner.

In emotion-focused practice, the social worker attempts to activate the person’s primary emotional reactions, making them more available to awareness within the safety of the social worker–client relationship and making secondary emotional reactions amenable to reflection and change when necessary. Emotional reactions, cognitive appraisals, and action

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tendencies may then be identified more clearly by the client. Affective needs can be identified, and a new sense of self may emerge along with an improved capacity for self-direction.

From this perspective, a social worker could help Dan understand that he carries much anger at his family because of their long-term lack of adequate support for his emotional development. Dan could be encouraged within the safety of the social worker–client relationship to experience and ventilate that anger and gain insight into his pattern. Once Dan can consciously identify and experience that negative emotion, he may be less incapacitated by the depression, which is a secondary emotion resulting from his suppression of anger. He might then have more energy to devote to his own social and academic goals and to develop new ways of interacting with others in the university setting.

Cognitive/Emotional “Disorders” As social workers, we are reluctant to label people as having cognitive or emotional “disorders.” Instead, we conceptualize problems in social functioning as mismatches in the fit between person and environment. Still, in our study of the psychological person, we can consider how problems are manifested in the client’s cognitive and emotional patterns.

Many social workers are employed in mental health agencies and use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association [APA], 2013) to make diagnoses as part of a comprehensive client assessment (see Chapter 5 for details). The DSM has been the standard resource for clinical diagnosis in the United States for more than 65 years. The manual provides clear descriptions of diagnostic categories so that practitioners of all disciplines can diagnose, communicate about, and treat people with mental and emotional disorders. The DSM includes 20 chapters of disorders that address, among others, neurodevelopmental (such as autism spectrum disorder), schizophrenia spectrum, bipolar, depressive, anxiety, obsessive-compulsive, trauma, dissociative, eating, elimination, sleep-wake, disruptive, substance-related, neurocognitive (such as Alzheimer’s disease), personality, and paraphilic disorders, as well as sexual dysfunctions and gender dysphoria. It is important to recognize that the DSM provides a medical perspective on human functioning. There is tension between the social work profession’s person-in-environment perspective and the requirement in many settings

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that social workers use the DSM to “diagnose” mental, emotional, or behavioral disorders in clients (Corcoran & Walsh, 2016). This is discussed further in Chapter 5.

With this brief introduction, we can consider four examples of disorders selected from the DSM to illustrate how either cognitive or emotional characteristics may predominate in a client’s symptom profile, even though both aspects of the psychological person are always present.

Two disorders that feature cognitive symptoms are obsessive- compulsive disorder and anorexia nervosa. Obsessive-compulsive disorder is characterized by persistent thoughts that are experienced as intrusive, inappropriate, unwelcome, and distressful. The thoughts are more than excessive worries about real problems, and the person is unable to ignore or suppress them. In anorexia nervosa, an eating disorder, the person becomes obsessive about food, thinking about it almost constantly. The person does not maintain a reasonable body weight because of distorted beliefs about physical appearance and the effects of food on the body. Two disorders that feature emotional symptoms are persistent depressive disorder (PDD) and agoraphobia. PDD, a mood disorder, is characterized by a lengthy period of depression. It features the emotion of sadness, which tends to persist regardless of external events. Agoraphobia is an anxiety disorder characterized by fear. The person is afraid to be in situations (such as crowds) or places (such as large open areas) from which escape might be difficult or embarrassing. The person must restrict his or her range of social mobility out of fear of being overwhelmed by anxiety for reasons that are not consciously clear.

As a social worker, you might note that Dan displays symptoms of obsessive-compulsive disorder. He experiences persistent and unwanted ideas and thoughts that significantly intrude on his desire to do or think of other things. He does not, however, experience compulsions or illogical impulses to perform certain behaviors (such as repeatedly checking to see if his apartment door is locked). You might thus conclude that Dan’s problems are primarily cognitive. However, Dan’s cognitive patterns have contributed to, and been affected by, his development of negative emotions. His difficulties at school sustain his chronic anxiety, and his distorted beliefs about the attitudes of others contribute to his sadness at

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being isolated from them. It is rarely the case that only cognitive factors or only emotional factors are behind a client’s problems.

Critical Thinking Questions 4.4

Some research suggests that emotional intelligence is more important to career success than intelligence measured as IQ. Does that make sense to you? Why or why not? How can we enhance our own emotional intelligence? How could you help Dan enhance his emotional intelligence? How helpful do you think it would be for Dan’s social worker to make a clinical diagnosis using the DSM-5?

The Self It remains for us to integrate elements of cognition and emotion into a cohesive notion of the self. This is a difficult task—one that may, in fact, be impossible to achieve. All of us possess a sense of self, but it is difficult to articulate. How would you define self? Most of us tend to think of it as incorporating an essence that is more or less enduring. But beyond that, what would you say? Thinkers from the fields of philosophy, theology, sociology, psychology, and social work have struggled to identify the essence of the self, and they offer us a range of perspectives: the self as a soul, an unfolding of innate potentials, an organizing activity, a cognitive structure, a process of shared symbolic activity, or a flow of experience. Cultural psychologists suggest that all these perspectives assume an independent self, but in many cultures of the world, the self is an interdependent one that cannot be detached from the context of human relationships (Markus & Kitayama, 2010).

The Self as a Soul Understanding the self as a soul appeals to those who see their essence as constant throughout life and perhaps transcending their physical being (Crabbe, 2012). It is certainly true that most of us experience ourselves as more than just bodies; as an “entity” that is consistent across time. This idea is based on certain spiritual traditions (see Chapter 6), and though widely shared, it does not easily lend itself to examination in terms of changing configurations of person and environment. If the self as soul is constant, and apart from the material environment, it may not be

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substantively influenced by interactions with that environment. Still, the idea of a soul has merit within social work (and other professions). The contrasting notion of physicalism asserts that there may eventually be a complete explanation of human beings in terms of the atoms and molecules in their bodies. Without a spiritual framework, the value of human life may be reduced to the value that society places on certain kinds of people with regard to how much they contribute to its functioning.

The Self as Unfolding Potentials According to person-centered theory, every human being is a unique biological organism, born with inherent, organically based potentials and ideally striving to lead a life in which the sense of “self” is consistent with those potentials (Rogers, 1986). Put another way, all of us are born with a genetic blueprint to which specific substance is added as our lives progress, depending on social and environmental circumstances. Our core tendency is to actualize our inherent potentials, which Rogers terms the striving toward self-actualization. Further, all potentials serve the maintenance and enhancement of life.

The actualizing tendency is not consciously known to a person until the self-concept emerges. Thus, many of us often find it difficult to appreciate our actualizing tendencies on the intuitive grounds of our experiences. Further, this is a conscious, fluid, and unfolding self, one that is experienced and defined differently throughout life. In fact, it resembles the concept of self presented by narrative theory (described shortly). Our inherent potentials are genetically determined, but our self-concept is socially determined and based in part on our experience of approval or disapproval from others.

The Self as Organizing Activity The concept of self as an organizing activity incorporates the notions of action, initiative, and organization. We certainly experience ourselves as capable of initiating action, and the sense of organization emerges as we synthesize our activities and experiences. Psychoanalytic theory and ego psychology are consistent with these ideas because they conceptualize the ego as the organizer of drives and mediator of internal and external conflicts. Your “ego,” which incorporates cognitive and emotional

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elements, is largely (but not completely) your conception of “who you are.” It is the “you” who thinks, feels, and acts in a reasonably consistent manner. It is everything you do to reflect, plan, and act in ways that allow you to “fit in” more or less adequately with the environments in which you live. More formally, the ego is the part of one’s personality that is responsible for negotiating between internal needs and the demands of social living. It is where cognition occurs, but unconscious mental processes also influence conscious thinking. The ego organizes the drives in response to external restrictions on their satisfaction and is responsible for defensive functions, judgment, rational thinking, and reality awareness.

The ego is largely, although not entirely, conscious, whereas the other portions of the mind—including the id (the source of drives) and the superego (our sense of ideal behavior)—remain outside awareness and thus cannot be apprehended as part of our sense of self. Healthy human behavior is enhanced by bringing unconscious mental activity into conscious awareness, so we can have more choices and solve problems more rationally.

The Self as Cognitive Structure The self as a cognitive structure is accepted as at least part of most accounts of the self. All of us are in touch (to varying degrees) with our conscious thinking processes and may come to accept them as representing our essence. This cognitive self includes self-representations that develop within our schema. The self as thinker implies that action and emotion originate in thought.

Within cognitive theory there are no assumed innate drives or motivations that propel us to act in particular ways. We develop patterns of thinking and behavior through habit, but these patterns can be adjusted as we acquire new information. Recall that these schema are our internalized representation of the world, or patterns of thought, action, and problem solving. They are the necessary biases with which we view the world, based on our early learning. Flexible schema are desirable, but all schema tend to be somewhat rigid. Our assumptions and related strategies are not “correct” or “incorrect” as much as they are “functional” or “nonfunctional” for our ability to achieve our goals. Schema can change, but not always easily.

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This self may be consistent with the view of reality as a human construction. As thinkers, our sense of self evolves as we actively participate in processing stimuli and define our realities in accordance with our perceptions. The cognitive self is thus interactional and dynamic, not static.

The Self as Shared Symbolic Experience The self can be understood as the product of symbols that we negotiate and share with other people in our culture. The theory of symbolic interactionism seeks a resolution to the idea that person and environment are separate (Carter & Fuller, 2016). It stresses that we develop a sense of meaning in the world through interaction with our physical and social environments, which include other people but also all manifestations of cultural life. The mind represents our capacity to respond subjectively to external stimuli through conceptualizing, defining, symbolizing, valuing, and reflecting. Through social interaction, interpretation of symbols (objects and ideas with shared cultural meanings), and the filtering processes of the mind, we acquire meaning about the world and ourselves.

The sense of self develops from our perceptions of how others perceive us. It is a role-taking process at odds with the psychoanalytic view that the self involves internal drives. Symbolic interactionism suggests that we define ourselves through the attitudes and behavior of others toward us and ultimately from the standards of our society. Our sense of self changes with the changing expectations of others about how we should behave, think, and feel. The medium through which these processes occur is language. Words are symbols, and language is a product of the shared understandings of people within a culture. Thus, social interaction involves an ongoing negotiation of the meanings of words among persons. Consciousness and the sense of self become possible through language as we learn to talk to ourselves, or think, using these symbols.

Communicators must share an understanding of the cultural norms and rules governing conduct for their interaction to proceed coherently. Symbolic interactionism suggests that socialization is a highly dynamic process that continues throughout life and consists of the creation of new meanings, understandings, and definitions of situations through social interaction. We change as we bring structure to ambiguous social situations to solve problems. This concept of self includes both the I and

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the me (Vryan, Adler, & Adler, 2003). The I is the conscious self—what we are aware of in self-reflection and what actively processes information and solves problems. This self emerges as we become objects of our own thoughts. It develops through the influence of significant others—persons who have immediate influence on our self-definitions. The me, on the other hand, incorporates thoughts, feelings, and attitudes internalized over time and beneath the level of ready awareness. The me is influenced by generalized others—the types of people whose expectations have come to guide our behavior over time.

By guidance and example, an individual may become involved in a community of supportive individuals whose role expectations strengthen the self-concept. The sense of self as competent in specific situations may improve, and the sense of having a substantial role as a member of a social group may also develop. Dan’s sense of himself as needing to be a high achiever may have originated in messages he received from his family, relatives, neighbors, teachers, and peers early in life. Those significant others may have acted toward him in ways that encouraged him to assume dominant roles. Still, interacting with the people around him today (generalized others) who have more flexible expectations for Dan might influence him to enact different behaviors and eventually achieve greater social competence. If these alternative social actions became prevalent in his life, Dan’s me would experience change as well. He might come to think of himself as more of an “equal” peer rather than one who is always smarter.

The Self as a Flow of Experience The concept of self as an ongoing process of experience is incorporated in the philosophy and practice theory of existentialism (Burston & Frie, 2006; Krill, 1996; Van Deurzin & Adams, 2016). People who assume the existential viewpoint hold that there is no standard or “correct” human nature; we are all unique and unable to be categorized. What we are is a subjective and ever-changing notion. The self is never any “thing” at a single point in time, because we are defined by the process of becoming, a process for which there is no end point. The self is always in process. Our essence is defined by our freedom to make choices and our need to discover or create meaning (sometimes called will or drive) for ourselves. The self unfolds as we make commitments to ideals outside ourselves (Frankl, 1988).

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Photo 4.3 Some see the self as an ongoing process of experience. The play and exploration of these schoolchildren contribute to their developing self-concepts.

©iStock/Rawpixel

Existential philosophy is often seen as a pessimistic view of reality because it emphasizes human loneliness, but it does remind us of our uniqueness and the idea that we can always make choices about the directions our lives will take. However negatively Dan sees the world, for example, he need not necessarily maintain that perspective. He can and will always make choices that will make him a different person—that is, a different self. If Dan can recognize this (it won’t happen quickly), he can perhaps make those choices that will enable him to define himself differently.

The self as a flow of experience is also consistent with narrative theory. Its major premise is that all of us are engaged in an ongoing process of constructing a life story, or personal narrative, that determines our understanding of ourselves and our positions in the world (Baldwin, 2013). Narrative theory holds that human development is inherently fluid, that there are no developmental “milestones” we should experience to maximize our chances for a satisfying life. Instead, it is the stories we learn to tell about ourselves and about others that create our psychological and social realities. These life narratives are co-constructed with the narratives of significant people in our family, community, and culture.

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According to narrative theory, all personal experience is fundamentally ambiguous, and we arrange our lives into stories to give our lives coherence and meaning. These stories do not merely reflect our lives— they shape them! As we develop a dominant “story line” (and self- concept), our new experiences are filtered in or out depending on whether they are consistent with the ongoing life narrative. Many problems in living are related to life narratives that exclude certain possibilities for future action.

A value of narrative practice is that of empowering clients, helping them to gain greater control over their lives. Narrative theory is unique in its conceptualization of problems as, at least in part, by-products of cultural practices that are oppressive to the development of functional life narratives. In this sense, it is a “therapy of advocacy.” Although some argue that narrative interventions may not be well suited for client problems related to basic needs such as food, shelter, safety, and physical health, they are certainly suitable for issues related to self-concept, interpersonal relationships, and personal growth. From this perspective, we might want to help Dan understand that his sense of self has been strongly influenced by certain cultural traditions that demand he function as a head of household. Understanding the arbitrary nature of this assumption may be an important step toward Dan’s becoming able to focus on his broader range of strengths and thereby achieve more of his personal goals.

These theories of the self represent only a partial overview. Many people believe that the self can only be defined in relation to others, and though this theme has been addressed here, it receives more attention in the next chapter.

Critical Thinking Questions 4.5

How do you define the self? You just read about six ways of thinking about self. Which of these ways makes the most sense to you? Which one comes closest to the way you think about your self? How important is culture in influencing the nature of the self? Does religion or spirituality play a role in the development of self? If so, how?

Implications for Social Work Practice

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The study of the psychological person as a thinking and feeling being and as a self has many implications for social work practice.

Be alert to the possibility that practice interventions may need to focus on any of several systems, including family, small groups, organizations, and communities. The person’s transactions with all these systems affect psychological functioning. During assessment, remember that developmental theories have limited applicability to members of diverse populations and be open to interpersonal differences with regard to patterns of thinking, feeling, and morality. Where appropriate, help individual clients to develop a stronger sense of competence through both ego-supportive (strengthening) and ego- modifying (changing) interventions. Where appropriate, help individual clients to enhance problem- solving skills through techniques directed at both cognitive reorganization and behavioral change. Where appropriate, help individual clients strengthen their sense of self by bringing balance to emotional and cognitive experiences. Help clients consider their strengths in terms of the unique sets of intelligences they may have and show how these intelligences may help them address their challenges in unique ways. Where appropriate, encourage clients to become involved in small- group experiences that assist them to understand and change their thoughts, emotions, and behaviors. Help clients assess their transactions with formal organizations and the effects of these transactions on their psychological functioning. Help clients assess and make necessary changes in their transactions with the community.

Key Terms accommodation (cognitive) 110 affect 109 assimilation (cognitive) 110 attribution theory 121 cognition 109 cognitive mediation 111 cognitive operations 110

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conventional morality 113 differential emotions theory 118 ego 120 ego psychology 120 emotion 109 emotional intelligence 121 information processing theory 111 mood 109 multiple intelligences 111 narrative theory 127 postconventional morality 113 preconscious 123 preconventional morality 113 primary emotions 117 psychoanalytic theory 120 psychology 109 schema 110 secondary emotions 117 self 125 symbolic interactionism 126 unconscious 109

Active Learning 1. Reread the case study at the beginning of this chapter. As you read,

what do you see as the driving force of Dan’s behavior as he struggles with earning admission to medical school? Is it cognition? Is it emotion? What patterns of thinking and feeling might Dan have developed from his cultural background? What theories presented in the chapter are most helpful to you in thinking about this, and why?

2. Howard Gardner has proposed a theory of multiple intelligences and suggests that each profession must decide which intelligences are most important to its work. Working in small groups, discuss which of Gardner’s eight intelligences are most important for doing social work. Are some intelligences more important in some social work settings than in others? Develop a list of criteria for admission to your social work program based on multiple intelligences.

3. What is your own perspective on the nature of the self? How does this affect your work with clients when you consider their potential for change?

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Web Resources

American Psychoanalytic Association: www.apsa.org

Founded in 1911, the American Psychoanalytic Association is the oldest national psychoanalytic organization in the nation. It is a professional organization for psychoanalysts and focuses on education, research, and membership development.

Association for Behavioral and Cognitive Therapies: www.abct.org

ABCT is a multidisciplinary organization committed to the advancement of scientific approaches to the understanding and improvement of human functioning through the investigation and application of behavioral, cognitive, and other evidence-based principles to the assessment, prevention, and treatment of human problems and the enhancement of health and well-being.

Association for Moral Education: www.amenetwork.org

AME was founded in 1976 to provide an interdisciplinary forum for professionals interested in the moral dimensions of educational theory and practice. The association is dedicated to fostering communication, cooperation, training, curriculum development, and research that links moral theory with educational practice. It supports self-reflective educational practices that value the worth and dignity of each individual as a moral agent in a pluralistic society.

The Cognitive Science Society: www.cognitivesciencesociety.org

The mission of the Cognitive Science Society is to promote cognitive science as a discipline and to foster scientific interchange among researchers in various areas of study, including artificial intelligence, linguistics, anthropology, psychology, neuroscience, philosophy, and education. The society is a nonprofit professional organization, and its activities include sponsoring an annual conference and publishing the journals Cognitive Science and TopiCS.

Emotional intelligence, social intelligence, ecological intelligence: http://danielgoleman.info/topics/emotional-intelligence

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http://www.apsa.org

http://www.abct.org

http://www.amenetwork.org

http://www.cognitivesciencesociety.org

http://danielgoleman.info/topics/emotional-intelligence

This is the website and blog of Daniel Goleman, author of Emotional Intelligence: Why It Can Matter More Than IQ and Social Intelligence: The New Science of Human Relationships.

Howard Gardner: http://howardgardner.com

The website of Howard Gardner of Harvard Graduate School of Education includes information about his and others’ research on multiple intelligences.

Narrative Therapy Centre of Toronto: www.narrativetherapycentre.com

Site contains information on narrative therapy, events and training, articles and books, and links to other websites on narrative therapy.

The Social and Affective Neuroscience Society: www.socialaffectiveneuro.org

SANS is committed to research investigating the neural basis of social and affective processes. The society, founded in 2008 and comprising over 400 members, promotes social and affective neuroscience by holding an annual meeting each year and maintaining a list serve for members as a forum for job advertisements, conferences, and other news of interest to the social neuroscience community.

The Society for the Study of Symbolic Interaction: https://sites.google.com/site/sssinteraction

The SSSI is an international professional organization interested in the study of a wide range of social issues with an emphasis on identity, everyday practice, and language. Symbolic interactionism is the society’s theoretical foundation and holds that people’s selves are purposeful and creative social products.

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http://howardgardner.com

http://www.narrativetherapycentre.com

http://www.socialaffectiveneuro.org

https://sites.google.com/site/sssinteraction

5 The Psychosocial Person Relationships, Stress, and Coping

Joseph Walsh

Chapter Outline Learning Objectives Case Study 5.1: Dan’s Coping Strategies The Self in Relationships

Relational Theory Attachment Theory Impact of Early Nurturing on Development Feminist Theories of Relationships Social Identity Theory

The Concept of Stress Categories of Stress Stress and Crisis Traumatic Stress Vulnerability to Stress

Coping and Adaptation Biological Coping Psychological Coping Coping Styles Coping and Traumatic Stress Social Support

Virtual Support How Social Support Aids Coping How Social Workers Evaluate Social Support

Normal and Abnormal Coping The Medical (Psychiatric) Perspective Psychological Perspectives The Sociological Approach: Deviance The Social Work Perspective: Social Functioning

Implications for Social Work Practice Key Terms

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Active Learning Web Resources

Learning Objectives 5.1 Analyze one’s own emotional and cognitive reactions to a case study. 5.2 Describe four theories of self in relationships (relational, attachment, feminist, and social identity). 5.3 Summarize the role of stress, crisis, and traumatic stress in human behavior. 5.4 Analyze different styles of coping and adaptation in relation to stress. 5.5 Provide examples of how social support aids coping. 5.6 Critique four approaches to normal and abnormal coping (medical, psychological, sociological, and social work). 5.7 Apply knowledge of self in relationship, stress, and coping to recommend guidelines for social work engagement, assessment, intervention, and evaluation.

Case Study 5.1 Dan’s Coping Strategies To summarize more specifically how Dan (whom you met in Chapter 4) was functioning, and how Spencer tried to help him, we begin this chapter with a discussion of the intervention process.

Dan’s goal was to be able to focus on his studies so that he could perform well academically and achieve admission to medical school. He was an intelligent student who had done well through most of his academic career, but for the past year he had been preoccupied with obsessional thoughts about not being able to resolve personal “slights” from his mother, younger sister, and university peers. (He felt comfortable among his Chinese American friends, who included the people in his church congregation and a former girlfriend who lived back home, an hour away.) When Dan experienced “rejection” from his family or peers, he became angry, and later sad, thinking that if those persons only understood the “rationality” of his admonitions and advice, they would see his point of view and admit that they were “wrong” in their perceptions of the interpersonal issue. Further, Dan would only feel vindicated if they apologized for their behaviors toward him.

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Spencer, while validating Dan’s feelings, believed that his goals were unrealistic. He hoped Dan would eventually come to perceive that his influence over others was limited, that people might respect him even as they did not always agree with his advice, and, most basically, that people have different ideas regarding what is best for them. He shared his concerns with Dan, who was willing to consider other ways of assessing situations despite feeling skeptical of the utility of this process. Spencer used some psychodynamic and cognitive interventions during their year of working together, but he experienced most success with a series of behavioral interventions.

Spencer helped Dan to use relaxation techniques and to consider the environments in which he was best able to focus on his studies. They determined, for example, that Dan was best able to concentrate during the middle of the day and when there were people around him. They set up a schedule of study in the medical library, where Dan could sit at a table with other students (whom he did not necessarily know). Spencer rehearsed deep- breathing activities with Dan, which helped calm his anxieties, and he further suggested that Dan study after a physical workout, when his body was calmer (Dan enjoyed swimming). Spencer also suggested that physical activity might help him release some of his anger after an interpersonal conflict.

Dan never articulated openly that his ideas about the appropriate behavior of others were anything but “correct,” but over time he reported fewer conflicts with his sister, mother, and peers, and his study habits and grades improved to the point that he was admitted to medical school. After a year of weekly sessions Dan decided to terminate because of his busy medical school schedule. During their final session together, he said to Spencer, “I don’t know how much I’ve gotten out of this, but I know you tried to help, and I appreciate that.”

Reviewing the intervention with his supervisor, Spencer regretted that he had felt such frustration with Dan, but he felt he had been able to contain those feelings. Further, despite Dan’s ongoing misgivings about the quality of the intervention, he had continued meeting with Spencer for a full year and eventually demonstrated behaviors evident of improvement. It seemed that Dan had reached a higher level of adaptability even though it wasn’t so apparent to him.

The Self in Relationships In this chapter, we focus on how the psychological person manages

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challenges to social functioning, particularly stress. We look at the common processes by which we all try to cope with the stresses we experience in life. As Dan understood, but had trouble managing, the ability to form, sustain, and use significant relationships with other people is a key to the process of successful coping and adaptation. With this theme in mind, we begin by considering several theories that address the issue of how we exist in the context of relationships, including the relational, attachment, feminist, and social identity theories, and evidence demonstrating the importance of early nurturing in the ability to build relationships throughout life.

Relational Theory In recent years, an integration of the psychodynamic and interpersonal theoretical perspectives (which focus on relationships as the driving force of personality development) has come to be called relational theory (Berzoff, 2016). In relational theory the basic human tendency (or drive) is for relationships with others, and our personalities are structured through ongoing interactions with others in the social environment. In this theory there is a strong value of recognizing and supporting diversity in human experience, avoiding the pathologizing of differences, and enlarging traditional conceptions of gender and identity.

Relational theory assumes that all patterns of behavior are learned in the give-and-take of relational life and are adaptive ways of negotiating experience in the context of our need to elicit care from, and provide care for, others. Serious relationship problems are seen as self-perpetuating because we all have a tendency to preserve continuity in our interpersonal worlds. What is new is threatening because it lies beyond the bounds of our experience in which we recognize ourselves as cohesive beings.

For social work practice, the relational perspective enriches the concept of empathy by adding the notion of mutuality between the social worker and client. The ability to participate in a mutual relationship through empathic communication contributes to the client’s growth. Contrary to traditional analytic notions, the relational social worker expresses a range of thoughts and feelings “in the moment” with the client to facilitate their mutual connection. Intervention focuses on here-and-now situations in the client’s life, including those involving the social worker and client. Current social work literature reflects diverse views regarding the degree to which

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practitioners should self-disclose with their clients, but the general consensus calls for the worker to maintain a neutral, objective persona (McKenzie, 2011). In relational theory, however, the more the worker expends energy on keeping parts of herself or himself out of the process, the more rigid and less genuine he or she will be with the client. Relational theorists encourage the social worker’s natural, authentic manner of engagement, the strategic use of self-disclosure, and the encouragement of the client to regularly comment on the intervention process. The social worker also tries to avoid relegating the two parties into dominant and subordinate roles.

To expand on these points, relational theory incorporates a major focus on the intersubjective basis of self-development (Storolow, 2013). There is a mutual recognition of the self and the other as people with unique experiences and perspectives, and each person influences the other in conscious and unconscious ways. This does not imply a neglect of appropriate boundaries, for the social worker must maintain a clear sense of self while engaged in the emotional and cognitive integration necessary for empathy to be effective. The intervention process features many enactments, or discussions about the ways the social worker and client are relating to one another. Through this process the client gradually becomes able to recognize other people’s uniqueness, developing capacities for sensitivity and a tolerance of difference. The client is freed from the “pull” of problematic relationship patterns.

Researchers who investigate evidence-based practice techniques do not always focus on the significance of the social worker–client relationship, but there is considerable evidence of its importance in literature reviews. Sommers-Flanagan (2015) developed a practice model based on such a review that incorporates the factors of congruence and genuineness, the working alliance, unconditional positive regard or radical acceptance, empathic understanding, the ability to manage relationship ruptures, and managing countertransference. Cameron’s (2014) common factors model includes the social worker factors of well-being, acceptance, genuineness, and empathy, and the social worker–client interactional factors of relationship engagement, engagement in change work, productive direct and indirect communication, and collaboration. The assumptions of relational theory are also consistent with the findings of the American Psychological Association (APA) on the significance of the social worker– client relationship. The APA has systematically evaluated the significance

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of the practitioner–client relationship in determining intervention effectiveness and concluded that several relationship variables used in practice were demonstrably effective (the alliance in individual and family therapy; cohesion in group therapy; empathy; and collecting client feedback), and others were probably effective (attention to goal consensus, collaboration, and positive regard) (Norcross & Wampold, 2011). Three other relationship elements (congruence/genuineness, repairing alliance ruptures, and managing countertransference) were deemed promising.

Photo 5.1 Relationships with significant others are resources for coping with stress.

Attachment Theory To understand how we develop our initial relationship patterns, it may be useful to consider one model of parent–child attachment here. All children seek proximity to their parents, and they develop attachment styles suited to the types of parenting they encounter. Ainsworth and her colleagues (Ainsworth, Blehar, & Waters, 1978) identified three infant attachment styles—secure, anxious-ambivalent, and avoidant types. A fourth attachment style has been identified more recently—the disorganized type

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(Madigan, Moran, & Pederson, 2006).

Securely attached infants act somewhat distressed when their parent figures leave but greet them eagerly and warmly upon return. Parents of secure infants are sensitive and accepting. Securely attached children are unconcerned about security needs and are thus free to direct their energies toward nonattachment-related activities in the environment. Infants who are not securely attached must direct much of their attention to maintaining attachments to inconsistent, unavailable, or rejecting parents, rather than engaging in exploratory behaviors. Because these children are only able to maintain proximity to the parents by behaving as if the parents are not needed, the children may learn not to express needs for closeness or attention.

Anxious-ambivalently attached infants are distraught when their parent figures leave. Upon their parent’s return, these infants continue to be distressed even as they want to be comforted and held. These children employ “hyperactivation” strategies. Their parents, though not overtly rejecting, are often unpredictable and inconsistent in their responses. Fearing potential caregiver abandonment, the children maximize their efforts to maintain close parental attachments and become hypervigilant for threat cues and any signs of rejection.

Avoidantly attached infants seem to be relatively undisturbed both when their parent figures leave and when they return. These children want to maintain proximity to their parent figures, but this attachment style enables the children to maintain a sense of proximity to parents who otherwise may reject them. Avoidant children thus suppress expressions of overt distress and, rather than risk further rejection in the face of attachment figure unavailability, may give up on their proximity-seeking efforts.

The disorganized attachment style is characterized by chaotic and conflicted behaviors. These children exhibit simultaneous approach and avoidance behaviors. Disorganized infants seem incapable of applying any consistent strategy to bond with their parents. Their conflicted and disorganized behaviors reflect their best attempts at gaining some sense of security from parents who are perceived as frightening. When afraid and needing reassurance, these children have no options but to seek support from a caregiver who is frightening. The parents may be either hostile or fearful and unable to hide their apprehension from their children. In either case, the child’s anxiety and distress are not lessened, and one source of

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stress is merely traded for another.

Although children with disorganized attachments typically do not attain senses of being cared for, the avoidant and anxious-ambivalent children do experience some success in fulfilling their needs for care.

If you are concerned that your own early relationships might have been problematic, don’t worry. Relational theorists do not assert that caregivers need to be perfect (whatever that might be), only that they communicate a sense of caring and permit the child to develop a sense of self (Elkins, 2016). Even if early attachments are problematic, a person’s ability to develop trusting relationships can always be improved, sometimes with therapy.

Cultural psychologists argue that most Western psychological theories assume an independent, autonomous self as the ideal self-in-relationship (de Carvalho, Seidl-de-Moura, Martins, & Vieria, 2014). They suggest that in many cultures of the world, including Asian, African, Latin American, and southern European cultures, the ideal self is an interdependent self that recognizes one’s behavior as influenced, even determined, by the perceived thoughts, expectations, and feelings of others in the relationship. Markus and Kitayama (2003) note that in U.S. coverage of the Olympics, athletes are typically asked about how they personally feel about their efforts and their success. In contrast, in Japanese coverage, athletes are typically asked, “Who helped you achieve?” This idea of an interdependent self is consistent with relational theory, as well as feminist perspectives on relationships.

You may have experienced romantic relationships with varying degrees of intensity, and you may wonder how those processes fit with attachment theory themes. Romantic love has many definitions, but it is generally agreed to include passion and sexual attraction (for initial bonding), attachment with intimacy (to generate interdependence), and commitment (to keep partners together and suppress the search for other mates) (Fletcher, Simpson, Campbell, & Overall, 2015). It is thus shaped in part by attachment styles but features additional characteristics as well.

Romantic love is a cultural and perhaps an evolutionary development in the human species to provide a motivating force for bonding related to birthing and raising children. It features distinct emotional, behavioral, hormonal (testosterone and estrogen), and neurological (oxytocin)

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processes that support pair-bonding, which is a positive predictor of health and survival in both offspring and adults. Certain social phenomena such as arranged marriages, polygamy, divorce, and infidelity may represent cultural differences in romance. (Gay and lesbian couples were recently considered deviant in our own culture but are now legally able to conceive and raise children in the United States and some other countries.)

Because it is tied to reproductive functions, however, romantic love is not permanent in all its manifestations. Shared feelings of passion between committed couples tend to diminish over time, although at different rates. Infatuation is not necessarily associated closely with attachment style, so when people have come together as committed couples in this pair- bonding way, the compatibility of their underlying attachment styles eventually becomes more significant in determining the strength and duration of their relationship (Heffernan, Fraley, Vicary, & Brumbach, 2012).

Impact of Early Nurturing on Development We have been looking at theories that deem relationships to be important throughout our lives. Turning to both human and animal research, we can find physiological evidence that, as suggested by relational and attachment theory, the quality of our early relationships is crucial to our lifelong capacity to engage in healthy relationships and even to enjoy basic physical health.

A large body of research is devoted to studying the links between early life experiences and physical and mental health risks. Back in 1998 results of a large-scale Adverse Childhood Experiences (ACEs) study indicated that five categories of such experiences (physical, sexual, or emotional abuse; physical or emotional neglect; violence against the mother; living with household members who were substance abusers, mentally ill or suicidal, or ever imprisoned; and parental separation or divorce) were associated with negative adult health behaviors and diseases such as alcoholism, drug abuse, depression, suicide attempts, smoking, poor self-rated health, sexually transmitted diseases, physical inactivity, obesity, and a variety of other adult diseases (Felitti et al., 1998). Those with more than four childhood risk factors were especially susceptible to those negative outcomes. The implications of that major study still guide the research of professionals who work with children (e.g., Amaya-Jackson, 2016). It is

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clear that relational elements of our early environments permanently alter the development of central nervous system structures that govern our autonomic, cognitive, behavioral, and emotional responses to stress (Cacioppo, Cacioppo, Capitanio, & Cole, 2015). These findings support the lifelong significance of specific relationship interactions.

Animal models are common in this research, tracing the physiological aspects of rat and monkey stress responses all the way down to the level of gene expression (Boufleur et al., 2013; Novak, Fan, O’Dowd, & George, 2013). It has been found that highly groomed young rats (pups) develop more receptors in their brains for the substances that inhibit the production of corticotrophin-releasing hormone (CRH), the master regulator of the stress response. As a result of the tactile stimulation they received from mothers, the pups’ brains develop in a way that lowers their stress response—not only while being groomed but throughout life. When the rats are switched at birth to different mothers, the pups’ brain development matched the behavior of the mothers who reared them, not their biological mothers. Furthermore, high-licking and high-grooming (nurturing) mother rats change their behavior significantly when given a substance that stimulates the hormonal effects of chronic stress, raising their CRH and lowering oxytocin, a hormone related to the equanimity many human mothers feel after giving birth. That is, under the influence of these stress hormones, the high-nurturing mothers behaved like the low-nurturing mothers, and their offspring grew up to have the same stress responses.

You may be familiar with the tradition of research on the nurturing practices of rhesus monkeys. Research continues in this area (Asher, Michopoulos, Reding, Wilson, & Toufexis, 2013). In some of these experiments, monkeys are separated from their mothers at age intervals of 1 week, 1 month, 3 months, and 6 months and raised in a group of other monkeys that includes a different mother. The infants who are separated later (3 or 6 months) exhibit normal behavior in the new setting. Those separated earlier, however, show a variety of abnormalities. The monkeys separated at 1 month initially exhibit a profound depression and refuse to eat. Once they recover, they show a deep need for attachments with other monkeys and also show great anxiety during social separation whenever they feel threatened. The monkeys separated at 1 week showed no interest in social contact with other monkeys, and this behavior did not change as they grew older. Autopsies of these monkeys showed changes in brain development. The timing of separation from the primary caregiver seems

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to be significant to their later development. These findings in monkeys may have a sad counterpart in human children who are separated at early ages from their mothers.

Although much of this research is being conducted with rats, monkeys, and other animals, it has clear implications for human development. The concept of neuroplasticity, introduced in Chapter 3 in this book, is significant here (Cohen, Quarta, Bravi, Granato, & Minciacchi, 2017; Mandolesi et al., 2017). Humans may have a window of opportunity, or a critical period for altering neurological development, but this window varies, depending on the area of the nervous system. Even through the second decade of life, for example, neurotransmitter and synapse changes are influenced by internal biology, but perhaps by external signals as well. In other words, the brain is not a static organ.

Much research currently under way explores the relationship between the processes of attachment and specific neurological development in young persons (Feldman, 2017). Persistent stress in an infant or toddler results in an overdevelopment of areas of the brain that process anxiety and fear, and the underdevelopment of other areas of the brain, particularly the frontal cortex. Of particular concern to one leading researcher (Schore, 2002, 2017) is the impact of the absence of nurturance on the orbitofrontal cortex (OFC) of the brain. Chronic levels of stress contribute to fewer neural connections between the prefrontal cortex and the amygdala, a process significant to psychosocial functioning. The OFC is particularly active in such processes as our concentration, judgment, and ability to observe and control internal subjective states. Further, the frontal cortex is central to our emotional regulation capacity and our experience of empathy. The amygdala, part of the limbic system (as discussed in the previous chapter), is attributed with interpreting incoming stimuli and information and storing this information in our implicit (automatic) memory. The amygdala assesses threat and triggers our immediate responses to it (the fight, flight, or freeze behaviors). A reduction in neural connections between these two areas suggests that the frontal cortex is not optimally able to regulate the processing of fear, resulting in exaggerated fear responses.

Stress can clearly affect brain development, but there is evidence that the first few years of life are not all-important, given the role of resilience influences (Richards, Lewis, Sanderson, Deane, & Quimby, 2016). According to these authors, five strengths exhibited by resilient youth

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include social competence, problem-solving skills, critical consciousness, autonomy, and a sense of purpose. Environmental factors associated with resilience include involvement in prosocial organizations, mentors, successful school experiences, competent peer friends, supportive family members, and a close bond with a primary caregiver.

In summary, research indicates that secure attachments play a critical role in shaping the systems that underlie our reactivity to stressful situations. When infants begin to form specific attachments to adults, the presence of warm and responsive caregivers begins to buffer or prevent elevations in stress hormones, even in situations that distress the infant. In contrast, insecure relationships are associated with higher CRH levels in potentially threatening situations. Secure emotional relationships with adults appear to be at least as critical as individual differences in temperament in determining stress reactivity and regulation.

Still, there is much to be learned in this area. Many people subjected to serious early life traumas become effective, high-functioning adolescents and adults. Infants and children may be resilient and have many strengths that can help them overcome these early life stresses. A systematic review by Slopen, McLaughin, and Shonkoff (2014) found that psychosocial interventions with children can in fact restore their stress-reducing cortisol levels. Researchers are challenged to determine whether interventions such as foster care can remedy the physical, emotional, and social problems seen in children who have experienced poor nurturing and early problems with separation.

We now consider several social influences on one’s sense of attachment to persons outside the family.

Critical Thinking Questions 5.1

Imagine that you are the social worker working with Dan Lee. How would you respond to Dan’s statement: “I don’t know how much I’ve gotten out of this, but I know you tried to help and I appreciate that”? What thoughts and emotions would you have on hearing this evaluation? What would you say to Dan in response to the evaluation? What guidance can you draw from relational theory? What are the policy implications of research on the impact of early nurturing on development?

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Feminist Theories of Relationships The term feminism does not refer to any single body of thought. It refers to a wide-ranging system of ideas about human experience developed from a woman-centered perspective. Among the psychological theories are psychoanalytic feminism (Layton, 2016) and gender feminism (Hare- Mustin, 2017). We focus on these two as we consider how feminism has deepened our capacity for understanding human behavior and social interaction. All these theorists begin from the position that women and men approach relationships differently and that patriarchal societies consider male attributes to be superior. You will find further discussion of gender in Chapter 8, Cultures.

Psychoanalytic feminists assert that women’s ways of acting are rooted deeply in women’s unique ways of thinking. Some of these gender differences may be biological, but they are certainly influenced by cultural and psychosocial conditions. Feminine behavior features gentleness, modesty, humility, supportiveness, empathy, compassion, tenderness, nurturance, intuitiveness, sensitivity, and unselfishness. Masculine behavior is characterized by strength of will, ambition, courage, independence, assertiveness, hardiness, rationality, and emotional control. Psychoanalytic feminists assert that these differences are largely rooted in early childhood relationships. Because women are the primary caretakers in our society, young girls tend to develop and enjoy ongoing relationships with their mothers that promote their valuing of relatedness as well as other feminine behaviors. For young boys, on the other hand, the mother is eventually perceived as fundamentally different, particularly as they face social pressures to begin fulfilling male roles. The need to separate from the mother figure has long-range implications for boys: They tend to lose what could otherwise become a learned capacity for intimacy and relatedness.

Gender feminists tend to be concerned with values of separateness (for men) and connectedness (for women) and how these lead to a different morality for women. Carol Gilligan (1982; see also the section on theories of moral reasoning in Chapter 4 of this book) is a leading thinker in this area. She elucidated a process by which women develop an ethic of care rather than an ethic of justice, based on the value they place on relationships. Gender feminists believe that these female ethics are equal to male ethics, although they have tended in patriarchal societies to be

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considered inferior. Gilligan asserts that all of humanity would be best served if both sets of ethics could be valued equally. Other gender feminists go further, however, arguing for the superiority of women’s ethics. For example, Noddings (2002, 2005) asserts that war will never be discarded in favor of the sustained pursuit of peace until the female ethic of caring, aimed at unification, replaces the male ethic of strenuous striving, aimed at dividing people.

All psychological feminist theories promote the value of relationships and the importance of reciprocal interpersonal supports. Dan was raised to be achievement- and task-oriented. These are admirable characteristics, but they represent traditional male perspectives. Dan’s inclinations for interpersonal experience may have been discouraged, which was harmful to his overall development.

Social Identity Theory Social identity theory is a stage theory of socialization that articulates the process by which we come to identify with some social groups and develop a sense of difference from others (Haslam, 2014). This is especially important to consider because the population in the United States and many other countries is becoming increasingly diverse. During the past decade, Hispanic and Asian populations have increased by 43% in the United States, compared with total population growth of 9.7% (U.S. Census Bureau, 2013). It is estimated that by 2050 Latinos will make up 25%, and Asians 8%, of the nation’s population.

Social identity development can be an affirming process that provides us with a lifelong sense of belonging and support. I might feel good to have membership with a Roman Catholic or Irish American community. Because social identity can be exclusionary, however, it can also give rise to prejudice and oppression. I may believe that my race is more intelligent than another or that persons of my cultural background are entitled to more social benefits than those of another.

Social identity development proceeds in five stages. These stages are not truly distinct or sequential, however, and people often experience several stages simultaneously.

1. Naïveté. During early childhood, we have no social consciousness.

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We are not aware of particular codes of behavior for members of our group or any other social group. Our parents or other primary caregivers are our most significant influences, and we accept that socialization without question. As young children, we do, however, begin to distinguish between ourselves and other groups of people. We may not feel completely comfortable with the racial, ethnic, or religious differences we observe, but neither do we feel fearful, superior, or inferior. Children at this stage are mainly curious about differences.

2. Acceptance. Older children and young adolescents learn the distinct ideologies and belief systems of their own and other social groups. During this stage, we learn that the world’s institutions and authority figures have rules that encourage certain behaviors and prohibit others, and we internalize these dominant cultural beliefs and make them a part of our everyday lives. Those questions that emerged during the stage of naïveté are submerged. We come to believe that the way our group does things is normal, makes more sense, and is better. We regard the cultures of people who are different from us as strange, marginal, and perhaps inferior. We may passively accept these differences or actively do so by joining organizations that highlight our own identity and (perhaps) devalue others.

3. Resistance. In adolescence, or even later, we become aware of the harmful effects of acting on social differences. We have new experiences with members of other social groups that challenge our prior assumptions. We begin to reevaluate those assumptions and investigate our own role in perpetuating harmful attitudes toward differences. We may feel anger at others within our own social group who foster these irrational attitudes. We begin to move toward a new definition of social identity that is broader than our previous definition. We may work to end our newly perceived patterns of collusion and oppression.

4. Redefinition. Redefinition is a process of creating a new social identity that preserves our pride in our origins while perceiving differences with others as positive representations of diversity. We may isolate from some members of our social group and shift toward interactions with others who share our level of awareness. We see all groups as being rich in strengths and values. We may reclaim our own group heritage but broaden our definition of that heritage as one of many varieties of constructive living.

5. Internalization. In the final stage of social identity development, we

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become comfortable with our revised identity and are able to incorporate it into all aspects of our life. We act unconsciously, without external controls. Life continues as an ongoing process of discovering vestiges of our old biases, but now we test our integrated new identities in wider contexts than our limited reference group. Our appreciation of the plight of all oppressed people, and our enhanced empathy for others, is a part of this process. For many people, the internalization stage is an ongoing challenge rather than an end state.

For all ethnic groups, higher levels of ethnic identity are associated with higher levels of self-esteem, purpose in life, and self-confidence (Rogers- Sirin & Gupta, 2012). Further, ethnic identity is associated with lower levels of depression among White, African American, and Asian youth. Social identity theory is sometimes used, however, to explain a process by which those who most strongly identify with their groups may come to hold less favorable attitudes about dissimilar groups (Verkuyten, 2016).

Another theory, multicultural theory, proposes more positively that affirmations toward one’s group, particularly with regard to ethnicity, should correspond with higher levels of acceptance toward dissimilar groups (Sue, Rasheed, & Rasheed, 2016). Ethnic identity is defined as a sense of belonging to an ethnic group and the part of one’s thinking, perceptions, feelings, and behavior that is due to group membership (Romanucci-Ross, De Vos, & Tsude, 2006). This sense of belonging is supported by shared heritage, values, traditions, and often languages. Two dimensions of ethnic identity include identity achievement, the developmental process of exploring and committing to one’s identity, and affirmation and belonging, the sense of pride and emotional attachment a person feels for his or her ethnic group (Ghavami, Fingerhut, Peplau, Grant, & Wittig, 2011). The importance of race and ethnicity to a person’s identity, sometimes referred to as centrality (Charmaraman & Grossman, 2010), represents a relatively stable perception of the significance one attributes to his or her racial and ethnic background. Those who face greater racial adversity attribute higher centrality to racial aspects of their identities. In the United States, ethnic identity tends to be strongest among African American persons, followed by Asians and multiethnic adolescents. You will see more discussion of ethnic identity in Chapter 8, Cultures.

Critical Thinking Questions 5.2

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Give some thought to social identity theory. With what social groups do you identify? How did you come to identify with these groups? How might your social identities affect your social work practice?

The Concept of Stress One of the main benefits of good nurturing is, as you have seen, the way it strengthens our ability to cope with stress. Stress can be defined as any event in which environmental or internal demands tax our adaptive resources. Stress may be biological (a disturbance in bodily systems), psychological (cognitive and emotional factors involved in the evaluation of a threat), and even social (the disruption of a social unit). Dan experienced psychological stress, of course, as evidenced by his negative feelings resulting from marginalization and perceived rejection, but he also experienced other types of stress. He experienced biological stress because, in an effort to attend all his classes and study every day, he did not give his body adequate rest. As a result, he was susceptible to colds, which kept him in bed for several days each month and compounded his worries about managing coursework. Dan also experienced social stress, because he was functioning in a social system that he perceived to be threatening, and he had few positive relationships there.

Categories of Stress Child development scholars identify three types of stress experiences that have very different impacts on physical and emotional development in young children: positive stress, tolerable stress, and toxic stress (Shonkoff, Boyce, & McEwen, 2009).

1. Positive stress is characterized by moderate and temporary increases in one’s heart rate, blood pressure, and stress hormone levels. These changes occur in response to the challenges involved in dealing with the many types of frustration that are common and expected in childhood, such as dealing with minor physical injuries, managing conflicts with parents and friends, or struggling with school work. Experiencing and managing positive stress is an important part of healthy development when experienced in the context of stable adult relationships. With adaptive responses, the stress response system soon returns to its normal levels.

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2. Tolerable stress refers to a physical state that might possibly disrupt neural circuits in the brain but is offset by supportive relationships that facilitate adaptive coping. The precipitants of this kind of stress are more serious than those involved with positive stress and may include the experience of possibly traumatic events such as the death of a loved one or a move away from home. Still, the stressor occurs during a limited time span, enabling protective relationships to help bring the child’s stress-response system back to baseline.

3. Toxic stress has the most deleterious effects on a child’s nervous system and refers to the strong, frequent, and perhaps prolonged activation of the stress response system in the absence of adequate adult protection. Some risk factors include physical and emotional abuse or neglect and other forms of family instability or violence. Toxic stress disrupts nervous system function for extended periods of time and may lead to stress-management systems that are persistently fragile throughout life.

Here is another way to think about stress. In an analysis of the relationship between stress and emotion, Lazarus (2007) makes a distinction among three types of psychological stress: harm, threat, and challenge:

1. Harm. A damaging event that has already occurred. Dan minimized interactions with his classmates during much of the semester, which may have led them to decide that he is aloof and that they should not try to approach him socially. Dan has to accept that this rejection happened and that some harm has been done to him as a result, although he can learn from the experience and try to change in the future.

2. Threat. A perceived potential for harm that has not yet happened. This is probably the most common form of psychological stress. We feel stress because we are apprehensive about the possibility of the negative event. Dan felt threatened when he walked into a classroom during the first semester because he had failed once before and, further, anticipated rejection from his classmates. We can be proactive in managing threats to ensure that they do not in fact occur and result in harm to us.

3. Challenge. An event we appraise as an opportunity rather than an occasion for alarm. We are mobilized to struggle against the obstacle, as with a threat, but our attitude is quite different. Faced with a threat, we are likely to act defensively to protect ourselves. Our

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defensiveness sends a negative message to the environment: We don’t want to change; we want to be left alone. In a state of challenge, however, we are excited, expansive, and confident about the task to be undertaken. The challenge may be an exciting and productive experience for us. Because Dan has overcome several setbacks in his drive to become a physician, he may feel more excited and motivated than before when resuming the program. He might be more aware of his resilience and feel more confident.

Stress has been measured in several ways (Aldwin & Wenner, 2009; Lazarus, 2007). One of the earliest attempts to measure stress consisted of a list of life events, uncommon events that bring about some change in our lives—experiencing the death of a loved one, getting married, becoming a parent, and so forth. The use of life events to measure stress is based on the assumption that major changes, even positive ones, disrupt our behavioral patterns.

Stress has also been measured as daily hassles, common occurrences that are taxing—standing in line waiting, misplacing or losing things, dealing with troublesome coworkers, worrying about money, and many more. It has been established that in many cases an accumulation of daily hassles takes a greater toll on one’s coping capacities than do more severe but relatively rare life events, for example, among professional first responders (Larsson, Berglund, & Ohlsson, 2016).

Sociologists and community psychologists also study stress by measuring role strain—problems experienced in the performance of specific roles, such as romantic partner, caregiver, or employee. Research on caregiver burden is one example of measuring stress as role strain (Campbell, McCoy, Hoffman, & O’Neil, 2014).

Social workers should be aware that as increasing emphasis is placed on the deleterious effects of stress on the immune system, our attention and energies are diverted from the possibility of changing societal conditions that create stress and toward the management of ourselves as persons who respond to stress. For example, it is well documented that the experience of discrimination creates stress for many African Americans. With the influence of the medical model, we should not be surprised when we are offered individual or biomedical solutions to such different social problems as discrimination, working motherhood, poverty, and road rage. It may be that the appeal of the stress concept is based on its diverting

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attention away from the environmental causes of stress. This is why social workers should always be alert to the social nature of stress.

Stress and Crisis A crisis is a major upset in our psychological equilibrium due to some harm, threat, or challenge with which we cannot cope (James & Gilliland, 2013). The crisis poses an obstacle to achieving a personal goal, but we cannot overcome the obstacle through our usual methods of problem solving. We temporarily lack either the necessary knowledge for coping or the ability to focus on the problem, because we feel overwhelmed. A crisis episode often results when we face a serious stressor with which we have had no prior experience. It may be biological (major illness), interpersonal (the sudden loss of a loved one), or environmental (unemployment or a natural disaster such as a flood or fire).

Photo 5.2 This woman is experiencing psychological stress; she is challenged by the task at hand and may or may not feel equal to the task.

Crisis episodes occur in three stages:

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1. Our level of tension increases sharply. 2. We try and fail to cope with the stress, which further increases our

tension and contributes to our sense of being overwhelmed. We are particularly receptive to receiving help from others at this time.

3. The crisis episode ends, either negatively (unhealthy coping) or positively (successful management of the crisis).

Crises can be classified into three types (Kanel, 2015; Lantz & Walsh, 2007). Developmental crises occur when events in the normal flow of life create dramatic changes that produce extreme responses. Examples of such events include going off to college, college graduation, the birth of one’s child, a midlife career change, and retirement from work. People may experience these types of crises if they have difficulty negotiating the typical developmental challenges outlined by Erikson (1968). Situational crises refer to uncommon and extraordinary events that a person has no way of forecasting or controlling. Examples include physical injuries, sexual assault, loss of a job, major illness, and the death of a loved one. Existential crises are characterized by escalating inner conflicts related to issues of purpose in life, responsibility, independence, freedom, and commitment. Examples include remorse over past life choices, a feeling that one’s life has no meaning, and a questioning of one’s basic values or spiritual beliefs.

Dan’s poor midterm grades during his first semester of taking courses that would help him qualify for medical school illustrate some of these points. First, he was overwhelmed by the negative emotions of anger and sadness. Then he occasionally retreated to church and his hometown, where he received much-needed support from his friends, mother, and sister. Finally, as the situation stabilized, Dan concluded that he could try to change some of his behaviors to relieve his academic-related stress.

Traumatic Stress Although a single event may pose a crisis for one person but not another, some stressors are so severe that they are almost universally experienced as crises. The stress is so overwhelming that almost anyone would be affected. The term traumatic stress is used to refer to events that involve actual or threatened severe injury or death, of oneself or significant others (American Psychiatric Association, 2013). Three types of traumatic stress have been identified: natural (such as flood, tornado, earthquake) and

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technological (such as nuclear) disasters; war and related problems (such as concentration camps); and individual trauma (such as being raped, assaulted, or tortured) (Aldwin & Wenner, 2009).

The experience of trauma can be defined as an emotional state of discomfort resulting from memories of a catastrophic experience that shatters the person’s sense of protection from harm, rendering him or her acutely vulnerable to stressors (Mahoney & Markel, 2016). The trauma may be experienced as a single event (a traffic accident or sexual assault), as chronic and repetitive (as with ongoing child abuse or the continual crises associated with refugee status), or as a secondary event, from knowing about the event happening to a significant other person. Chronic, repetitive trauma is referred to as complex trauma. It is important to understand that the experience of a traumatic event does not necessarily imply that the person will be traumatized afterward. The precipitating event is always severe, but the individual may have more or less success coping with it based on available supports and resources, such as friends and family, crisis counselors, or a constitutional hardiness (Lemma, 2010).

Social work’s interest in the effects of trauma on social functioning, while always considerable, has increased over the past 20 years because so much more has become known about its physical and psychological effects and their association with potential long-term negative outcomes for those who experience it. Families, significant others, and in some cases communities (in cases of acting-out behavior) may also be negatively affected (Sangalang & Vang, 2016). In positive or tolerable stress situations, the same physical reactions occur, but only temporarily and to a lesser degree, and they do not typically result in the complete dismantling of a person’s inner world.

This is not a chapter on the biological person, but it is useful to briefly review here how trauma affects the nervous system (Evans & Coccoma, 2014). Physiologically, intense stress raises the levels of certain chemicals in the body that put the nervous system into a state of high alert. Although helpful for managing the stress event, high cortisol levels moving through the body make it hard for the person to attend to important activities of daily living such as processing information, eating, or sleeping. Ideally, once the threat has passed, the cortisol activity shuts down, enabling the body to resume its prior state of effective functioning. In extreme conditions, however, the cortisol fails to adequately shut down the body’s

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responses to the trauma, leading to ongoing activation and negative effects on the person’s emotional and physical states.

The heightened negative feelings and somatic processes induced by stress are due to chaotic biochemical reactions in parts of the brain that are responsible for processing social and emotional information, bodily states, and attachment. The thalamus in the midbrain registers messages as dangerous. The amygdala in the higher brain hijacks ordinary processes of information processing and broadcasts distress. The hippocampus, the center of emotional processing, is flooded with emotionally laden stimuli that are laid down negatively as body memories. The sympathetic nervous system is responsible for the fight-or-flight response. When this is activated the body is primed for quick action and may run or demonstrate considerable strength. The parasympathetic system releases opioids that contribute to decreased blood pressure and a state of numbness or emotional paralysis. The simultaneous activation of all these systems produces a state of frozen watchfulness and creates problems with self- soothing and disorganized attachment. Some trauma survivors may develop post-traumatic stress disorder (PTSD), which is discussed later in this chapter.

Some occupations—particularly those of emergency workers such as police officers, firefighters, disaster relief workers, and military personnel in war settings—involve regular exposure to traumatic events that most people do not experience in a lifetime. The literature about the stress faced by emergency workers refers to these traumatic events as critical incidents and the reaction to them as critical incident stress (Pack, 2013). Emergency workers, particularly police officers and firefighters, may experience threats to their own lives and the lives of their colleagues, as well as encounter mass casualties. Emergency workers may also experience compassion stress, a feeling of deep sympathy and sorrow for another who is stricken by misfortune, accompanied by a strong desire to alleviate the pain (Kapoulitsas & Corcoran, 2015). Any professionals who work regularly with trauma survivors are susceptible to compassion stress. Many social workers fall into this category.

Vulnerability to Stress Many social work practitioners and researchers use a biopsychosocial risk and resilience framework for understanding how people experience and

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manage stress (Corcoran & Walsh, 2016). Although the biological and psychological dimensions relate to the individual, the social aspect of the framework captures the positive or adverse effects on the family, community, and wider social culture. The processes within each dimension interact, prompting risks for stress and impaired coping and the propensity toward resilience, or the ability to function adaptively despite stressful life circumstances. Risks can be understood as hazards occurring at the individual or environmental level that increase the likelihood of impairment. Protective mechanisms involve the personal, family, community, and institutional resources that generate and support individuals’ aptitudes and abilities while diminishing the possibility of problem behaviors. These protective influences may offset or buffer against risk and are sometimes the converse of risk. For instance, at the individual level, poor physical health presents risks, whereas good health is protective. The biopsychosocial framework provides a theoretical basis for social workers to conceptualize human behavior at several levels and can assist them in identifying and bolstering strengths as well as reducing risks. The framework offers a balanced view of systems in considering risks and strengths, as well as recognizing the complexity of individuals and the systems in which they are nested.

Individual factors encompass the biological and psychological realms. Within biology these include genes, temperament, physical health, developmental stage, and intelligence. At the psychological level it is useful to examine one’s sense of self-efficacy, self-esteem, and coping strategies. Social mechanisms include the family and household; the experience of dangerous or traumatic events; the neighborhood; and societal conditions, including poverty, ethnicity, and access to health care.

Within the risk and resilience perspective, social workers can complete comprehensive assessments to determine the nature of their clients’ problems. Knowledge of the risk and protective influences helps social workers focus interventions on the relevant areas of the client’s life. Finally, the strengths perspective encourages social workers to build on the client’s areas of real or potential resilience in recovering from, or adapting to, mental disorders and in so doing help the client develop a greater sense of self-efficacy.

Critical Thinking Questions 5.3

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Why do you think we easily get diverted from thinking about societal conditions that create stress and come, instead, to focus on helping individuals cope with stress? How does such an approach fit with social work’s commitment to social justice?

Coping and Adaptation Our efforts to master the demands of stress are referred to as coping. Coping includes the thoughts, feelings, and actions that constitute these efforts. One method of coping is adaptation, which may involve adjustments in our biological responses, perceptions, or lifestyle.

Biological Coping The traditional biological view of stress and coping, developed in the 1950s, emphasizes the body’s attempts to maintain physical equilibrium, or homeostasis, which is a steady state of functioning (Baffy & Loscalzo, 2014; Selye, 1991). Stress is considered the result of any demand on the body (specifically, the nervous and hormonal systems) during perceived emergencies to prepare for fight (confrontation) or flight (escape). A stressor may be any biological process, emotion, or thought.

In this view, the body’s response to a stressor is called the general adaptation syndrome. It occurs in three stages:

1. Alarm. The body first becomes aware of a threat. 2. Resistance. The body attempts to restore homeostasis. 3. Exhaustion. The body terminates coping efforts because of its

inability to physically sustain the state of disequilibrium.

The general adaptation syndrome is explained in Exhibit 5.1.

In this context, resistance has a different meaning than is generally used in social work: an active, positive response of the body in which endorphins and specialized cells of the immune system fight off stress and infection. Our immune systems are constructed for adaptation to stress, but the cumulative wear and tear of multiple stress episodes can gradually deplete our body’s resources. Common outcomes of chronic stress include stomach and intestinal disorders, high blood pressure, heart problems, and

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emotional problems. If only to preserve healthy physical functioning, we must combat and prevent stress.

This traditional view of biological coping with stress came from research that focused on males, either male rodents or human males. Since 1995, the federal government has required federally funded researchers to include a broad representation of both men and women in their study samples. Consequently, recent research on stress has included female as well as male participants, and gender differences in responses to stress have been found.

Research suggests that females of many species, including humans, respond to stress with “tend-and-befriend” rather than the “fight-or-flight” behavior described in the general adaptation syndrome (Cardoso, Ellenbogen, Serravalle, & Linnen, 2013; Steinbeis, Engert, Linz, & Singer, 2015). That is, under stressful conditions, females have been found to protect and nurture their offspring and to seek social contact. The researchers suggest a possible biological basis for this gender difference in the coping response. More specifically, they note a large role for the hormone oxytocin, which plays a role in childbirth but also is secreted in both males and females in response to stress. High levels of oxytocin in animals are associated with calmness and increased sociability. Although males as well as females secrete oxytocin in response to stress, there is evidence that male hormones reduce the effects of oxytocin. This is thought to, in part, explain the gender differences in response to stress.

Exhibit 5.1 ● The General Adaptation Syndrome

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Psychological Coping The psychological aspect of managing stress can be viewed in two ways. Some theorists consider coping ability to be a stable personality characteristic, or trait; others see it instead as a transient state—a process that changes over time, depending on the context (Fatima & Tahir, 2013).

Those who consider coping to be a trait see it as an acquired defensive style. Defense mechanisms are unconscious, automatic responses that enable us to minimize perceived threats or keep them out of our awareness entirely. Exhibit 5.2 lists the common defense mechanisms identified by ego psychology (discussed in Chapter 4). Some defense mechanisms are considered healthier, or more adaptive, than others. Dan’s denial of his need for intimacy, for example, did not help him meet his goal of developing relationships with peers. But through the defense of sublimation (channeling his need for intimacy into alternative and socially acceptable outlets), he has been an effective and nurturing tutor for numerous high school science students.

Exhibit 5.2 ● Common Defense Mechanisms Exhibit 5.2 ● Common Defense Mechanisms

Defense Definition Example

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Mechanism Definition Example

Developmentally Earlier

Acting out

Direct expression of impulses to avoid tension that would result from their postponement.

An adolescent steals money from her mother to buy alcohol and gets into constant arguments with her older sister who tries to monitor her behavior.

Denial

Negating an important aspect of reality that one may actually perceive.

A woman with anorexia acknowledges her actual weight and strict dieting practices but firmly believes she is maintaining good self-care by dieting.

Projection

Attributing unacceptable thoughts and feelings to others.

A man does not want to be angry with his girlfriend, so when he is upset with her, he avoids owning that emotion by assuming she is angry at him.

Regression

Resuming behaviors associated with an earlier developmental stage or level of functioning in order to avoid present anxiety. The behavior may or may not help to resolve the anxiety.

A young man throws a temper tantrum as a means of discharging his frustration when he cannot master a task on his computer. The startled computer technician, who had been reluctant to attend to the situation, now comes forth to provide assistance.

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Splitting

The tendency to see the good and bad aspects of the self or others as separate; to see the self and others as alternately “all good” or “all bad.”

A primary school child “hates” his teacher when reprimanded and “loves” his teacher for praise and behaves accordingly.

Developmentally Later

Displacement

Shifting feelings about one person or situation onto another.

A student’s anger at her professor, who is threatening as an authority figure, is transposed into anger at her boyfriend, a safer target.

Intellectualization

Avoiding unacceptable emotions by thinking or talking about them rather than experiencing them directly.

A person talks to her counselor about the fact that she is sad but shows no emotional evidence of sadness, which makes it harder for her to understand its effects on her life.

Isolation of affect

Consciously experiencing an emotion in a “safe” context rather than the threatening context in which it was first unconsciously experienced.

A person does not experience sadness at the funeral of a family member but the following week weeps uncontrollably at the death of a pet hamster.

Rationalization

Using convincing reasons to justify

ideas, feelings, or

A student copes with the guilt normally associated

with cheating on an exam

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Rationalization

Using convincing reasons to justify ideas, feelings, or actions so as to avoid recognizing true motives.

guilt normally associated with cheating on an exam by reasoning that he was too ill the previous week to prepare as well as he wanted.

Reaction formation

Replacing an unwanted unconscious impulse with its opposite in conscious behavior.

A person cannot bear to be angry with his boss, so after a conflict he convinces himself that the boss is worthy of loyalty and demonstrates this by volunteering to work overtime.

Repression

Keeping unwanted thoughts and feelings entirely out of awareness.

A son may begin to generate an impulse of hatred for his father, but because the impulse would be consciously unacceptable, he represses the hatred and does not become aware of it.

Somatization

Converting intolerable impulses into somatic symptoms.

A person who is unable to express his negative emotions develops frequent stomachaches as a result.

Undoing

Nullifying an undesired impulse with an act of reparation.

A man who feels guilty about having lustful thoughts about a coworker tries to make amends to his wife by purchasing a special gift for her.

Most “Mature” Defenses

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Sublimation

Converting an impulse from a socially unacceptable aim to a socially acceptable one.

An angry, aggressive young man becomes a star on his school’s debate team.

Humor

The expression of painful or socially unacceptable feelings without discomforting the person who is being humorous or (often) the recipient.

An employee manages her discomfort at being in a supervisory meeting by making self-deprecating jokes.

Sources: Adapted from Goldstein, 1995; Schamess & Shilkret, 2016.

Those who see coping as a state, or process, observe that our coping strategies change in different situations. After all, our perceptions of threats, and what we focus on in a situation, change. The context also has an impact on our perceived and actual abilities to apply effective coping mechanisms. From this perspective, Dan’s use of denial of responsibility for relationship problems would be adaptive at some times and maladaptive at others. Perhaps his denial of needing support from classmates during the first academic semester helped him focus on his studies, which would help him achieve his goal of receiving an education. During the summer, however, when classes are out of session, he might become aware that his avoidance of relationships has prevented him from attaining interpersonal goals. His efforts to cope with loneliness might also change when he can afford more energy to confront the issue.

The trait and state approaches can usefully be combined. We can think of coping as a general pattern of managing stress that allows flexibility across diverse contexts. This perspective is consistent with the idea that cognitive schemata develop through the dual processes of assimilation and accommodation, described in Chapter 4.

Coping Styles Another way to look at coping is based on how the person responds to

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Coping Styles Another way to look at coping is based on how the person responds to crisis. Coping efforts may be problem focused or emotion focused (Rajaei, Khoynezhad, Javanmard, & Abdollahpour, 2016). The function of problem-focused coping is to change the situation by acting on the environment. This method tends to dominate whenever we view situations as controllable by action. For example, Dan was concerned about his professors’ insensitivity to his learning disability (auditory processing disorder). When he took action to educate them about it and explain more clearly how he learns best in a classroom setting, he was using problem- focused coping. In contrast, the function of emotion-focused coping is to change either the way the stressful situation is attended to (by vigilance or avoidance) or the meaning to oneself of what is happening (reappraisal). The external situation does not change, but our behaviors or attitudes change with respect to it, and we may thus effectively manage the stressor. When we view stressful conditions as unchangeable, emotion-focused coping may dominate. If Dan learns that one of his professors has no empathy for students with learning disabilities, he might avoid taking that professor’s courses in the future or decide that getting a good grade in that course is not as important as being exposed to the course material.

U.S. culture tends to venerate problem-focused coping and the independently functioning self and to distrust emotion-focused coping and what may be called relational coping. Relational coping takes into account actions that maximize the survival of others—such as our families, children, and friends—as well as ourselves (Bekteshi & Kayser, 2013). Feminist theorists propose that women are more likely than men to employ the relational coping strategies of negotiation and forbearance, and some research gives credence to the idea that women are more likely than men to use relational coping (e.g., Kim, Han, Trksak, & Lee, 2014). It is important to recognize that all of us use any or several of these mechanisms at different times. None of them is any person’s sole means of managing stress. As social workers, we must be careful not to assume that one type of coping is superior to another. Power imbalances and social forces such as racism and sexism affect the coping strategies of individuals. We need to give clients credit for the extraordinary coping efforts they may make in hostile environments.

We might note that Dan used many problem-focused coping strategies to

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also tried with limited success to control his moods through force of will.

Exhibit 5.3 ● Coping Styles Among Social Work Students

I don’t need to tell you that college students face many predictable stressors when attending to the demands of academic work. A few years ago, I wanted to learn more about how students use both problem- and emotion-focused coping strategies in response to stress. I surveyed social work students in several Human Behavior in the Social Environment

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ago, I wanted to learn more about how students use both problem- and emotion-focused coping strategies in response to stress. I surveyed social work students in several Human Behavior in the Social Environment courses at my large urban university, at the beginning of an academic year, about their anticipated stressors and the ways they might cope with them. The results of this informal survey are outlined in Exhibit 5.3. The students chose problem- and emotion-focused coping strategies almost equally—a healthy mix (although they may not have been forthcoming about some socially “unacceptable” strategies).

Given our discussion in Chapter 4 of conceptions of the self, it may be interesting to review a stress/coping model that focuses on the tripartite self (Gaertner et al., 2012; Hardie, 2005). This model proposes that the self includes three domains, the relational (experiencing the self most fully in relationships), individual (a strong sense of independence, autonomy, and separateness), and collective (a preference for social group memberships), and that the relative strength of a person’s domains will guide his or her preferences for coping styles. Those with a well-developed self in all three domains will possess a full range of coping options, and those with a more limited self-experience will have fewer. A person with a sense of self that encompasses three domains will also experience more sources of stress, but this model suggests that when a source of stress matches one’s developed self-domain, coping will be most effective. That is, if a highly relational person experiences relational stress (such as a conflict with a friend), he or she will be inclined to address the issue in a manner that is likely to be effective. Dan, on the other hand, has a stronger sense of an “independent” self than others, so when he experiences interpersonal conflict, his range of available coping strategies is limited due to the mismatch. And though Dan is attached to persons from his cultural group, he has a limited sense of a broader collective self and thus tends to have limited judgment or skill in how to deal with conflict with representatives of other social groups (including his school peers).

Coping and Traumatic Stress People exhibit some similarities between the way they cope with traumatic stress (described earlier) and the way they cope with everyday stress, but there are some significant differences (Kramer & Landolt, 2010; Szabo, Warnecke, Newton, & Valentine, 2017). Because people tend to have much less control in traumatic situations, their primary emotion-focused

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importance, and transformation in personal identity is common. Further, the process of coping tends to take a much longer time, months or even years.

Although there is evidence of long-term negative consequences of traumatic stress, trauma survivors sometimes report positive outcomes as well. Studies have found that 34% of Holocaust survivors and 50% of rape survivors report positive personal changes following their experiences with traumatic stress (Koss & Figueredo, 2004). A majority of children who experience such atrocities as war, natural disasters, community violence, physical abuse, catastrophic illness, and traumatic injury also recover, demonstrating their resilience (Husain, 2012; Le Brocque, Hendrikz, & Kenardy, 2010).

However, many trauma survivors experience a set of symptoms known as post-traumatic stress disorder (PTSD) (American Psychiatric Association, 2013). These symptoms include the following:

Exposure to actual or threatened death, serious injury, or sexual violence either directly, by witnessing it, or by learning about it Persistent reliving of the traumatic event: intrusive, distressing recollections of the event; distressing dreams of the event; a sense of reliving the event; intense distress when exposed to cues of the event Persistent avoidance of stimuli associated with the traumatic event: avoidance of thoughts or feelings connected to the event; avoidance of places, activities, and people connected to the event; inability to recall aspects of the trauma; loss of interest in activities; feeling detached from others; emotional numbing; no sense of a future Negative alterations in cognition or mood after the event, such as memory problems, negative emotions, and distorted beliefs about the event (such as self-blame) Persistent high state of arousal: difficulty sleeping, irritability, difficulty concentrating, excessive attention to stimuli, exaggerated startle response

Several factors related to the traumatic event put a person at risk for PTSD, including a higher degree and intensity of exposure to the event, a higher degree of physical violation, longer duration of the event, greater frequency of the experience, a greater sense of unpredictability and vulnerability, a closer relationship with the offender (if there is one), younger age, and an unsupportive social environment (Dalenberg, 2014).

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frequency of the experience, a greater sense of unpredictability and vulnerability, a closer relationship with the offender (if there is one), younger age, and an unsupportive social environment (Dalenberg, 2014).

Symptoms of post-traumatic stress disorder have been noted as soon as 1 week following the traumatic event or as long as 20 years after (Middleton & Craig, 2012). It is important to understand that the initial symptoms of post-traumatic stress are normal and expectable and that PTSD should only be considered a disorder if those symptoms do not remit over time and result in serious, long-term limitations in social functioning. It is also important to understand that persons with PTSD can recover from the disorder. It is difficult to determine how often this occurs, but in one large- scale study of persons with PTSD who received 12 weeks of cognitive- behavioral intervention 56% achieved symptom remission in 5 months or less, 27% achieved remission in 15 months or less, and only 17% showed continued impairment after 9 months (Galatzer-Levy et al., 2013). Children and older adults have the most trouble coping with traumatic events. A strong system of social support helps to prevent or to foster recovery from post-traumatic stress disorder. Besides providing support, social workers may be helpful by encouraging the person to discuss the traumatic event and by providing education about support groups.

A person who experiences significant trauma may benefit from social work interventions that attend to both the cognitive and emotional aspects of mental life discussed in Chapter 4 (Black, Woodworth, Tremblay, & Carpenter, 2012; McCrea, Guthrie, & Bulanda, 2016). The goal of intervention should be to help the person move from a state of relative fear and powerlessness to one of positive agency and heightened assertiveness. It is essential for the social worker to first develop a relationship of trust with the person and provide a safe and secure base from which he or she can begin to face the trauma. Through the recognition of appropriate social supports and gradual encouragement of affective expression the client may begin to regain a sense of emotional control. The client can learn to manage the negative physical sensations associated with feelings of stress through relaxation and other mindfulness exercises. Eventually the person will feel secure enough to become able to reflect on the trauma and its meaning more directly. The social worker can help the client become aware of the differences between safe and unsafe situations, develop new self-care skills, practice safety skills, learn and practice appropriate problem-solving and emotional coping skills, and become better able to

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What biases do you have about how people should cope with discrimination based on race, ethnicity, gender, sexual orientation, and so on? How might the coping strategy need to change in different situations, such as receiving service in a restaurant, being interviewed for a job, or dealing with an unthinking comment from a classmate?

Social Support In coping with the demands of daily life, our social supports—the people we rely on to enrich our lives—can be invaluable. Social support has many definitions, but it can be understood as the interpersonal interactions and relationships that provide us with assistance or feelings of attachment to persons we perceive as caring (Razurel, Kaiser, Sellenet, & Epiney, 2013). The following are three types of social support resources worthy of a social work provider’s attention (Walsh, 2000):

1. Material support: food, clothing, shelter, and other concrete items 2. Emotional support: interpersonal support 3. Instrumental support: services provided by casual contacts such as

grocers, hairstylists, and landlords

Some authors add “social integration” support to the mix, which refers to a person’s sense of belonging. That is, simply belonging to a group, and having a role and contribution to offer, may be an important dimension of support (Lu & Hampton, 2017). This is consistent with the “main effect” hypothesis of support, discussed shortly.

Our social network includes not just our social support but all the people with whom we regularly interact and the patterns of interaction that result from exchanging resources with them (Gillieatt et al., 2015). Members of your own social network might include some student peers, your coworkers, the school librarians, and the Starbucks barista. Network relationships often occur in clusters (distinct categories such as nuclear family, extended family, friends, neighbors, community relations, school, work, church, recreational groups, and professional associations). Network relationships are not synonymous with support; they may be negative or positive. But the scope of the network does tend to indicate our potential for obtaining social support. Having supportive others in a variety of clusters indicates that we are supported in many areas of our lives, rather than being limited to relatively few sources. Our personal network

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positive. But the scope of the network does tend to indicate our potential for obtaining social support. Having supportive others in a variety of clusters indicates that we are supported in many areas of our lives, rather than being limited to relatively few sources. Our personal network includes those from the social network who, in our view, provide us with our most essential supports (Ellwardt, van Tilburg, Aartsen, Wittek, & Stevernik, 2015).

Exhibit 5.4 displays Dan’s social network. He is supported emotionally as well as materially by his family members, with whom he keeps in regular contact, although the relationship with his father is strained. Dan particularly looks to his sister for understanding and emotional support, while at the same time being critical of her failure to be adequately supportive of him. Dan does not see his grandmother except for the trips he takes to China every 3 or 4 years, but he feels a special closeness to her and writes to her regularly. Dan has had an on-again, off-again relationship with his girlfriend Christine, who lives 1 hour away in his hometown and keeps in touch with him primarily by e-mail and text messaging. Their communications are civil, and Dan seems to enjoy giving her advice when she needs to make certain decisions about her jobs and daily living activities. Dan has instrumental relationships with his landlord and several other tenants in his apartment building, and one neighbor is a friend with whom he has lunch or dinner every few weeks. Dan is further instrumentally connected with several other students because they represent consistency in his life and are casually friendly and supportive. This is also true of two peers with whom he performs volunteer work in the medical center lab. It is apparent from Dan’s social network that he receives most of his emotional support from peers at the church where he attends services and social activities every Sunday.

In total, Dan has 19 people in his social support system, representing seven clusters. He identifies 9 of these people as personal, or primary, supports. It is noteworthy that 7 of his network members provide only instrumental support, which is important but the most limited type. We cannot determine based on numbers whether Dan’s support system is adequate to meet his needs, because people are very different in the desired nature of their supports. Still, the social worker might explore with Dan his school, neighborhood, and work clusters for the possibility of developing more active or meaningful supports.

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across the life span who experience a lack of adequate social support are at risk for many adverse health consequences, including an earlier death (Holt-Lunstad, Smith, Baker, Harris, & Stephenson, 2015). Interestingly, feelings of loneliness and social isolation take a greater emotional toll on younger adults compared to those over 65.

Virtual Support

I don’t need to tell you, of course, that much social support is now provided through connective technologies that allow people to be in contact without being physically present with one another. Facebook, Skype, e-mail, blogging, tweets, and texts put people in touch with one another instantaneously, regardless of where they are or what they are doing. Although there is much to be admired about these developments, and they clearly allow us to be in touch with significant others we might never otherwise see, they also create the potential for us to reduce the frequency of, and even our desire for, face-to-face contacts and thus redefine the nature of relationships, support, and intimacy. Indeed, the number of people with whom people physically interact has fallen in recent years, and research has produced mixed findings regarding the effects of social media use on perceived social support. For example, in two large-scale national studies, it was found that social media contacts produced an increased perception of social support for many, but not all, people and that the heaviest users of social media may in fact perceive less support than those with less frequent use (Lu & Hampton, 2017; Shensa, Sidani, Lin, Bowman, & Primak, 2016).

Dan, like many of his peers, spent several hours per day on the Internet communicating with others; in his case it was primarily through e-mail. Spencer believed this was a mixed blessing for his client, because although it did help Dan feel connected to his support system, it prevented any efforts he might otherwise expend for intimate interaction with people whose lives physically intersected with his own. Turkle (2011, 2015), among others, is concerned about the unpredictable ways social technology may alter the nature of our relationships. As one disconcerting yet very real example of this process, she writes at length about the coming use of robots to provide people with major interpersonal support, existing as their full-time companions. She is also concerned about the use of electronic communication as a substitute for face-to-face interaction, arguing that face-to-face interaction is “where we develop the capacity for

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use of robots to provide people with major interpersonal support, existing as their full-time companions. She is also concerned about the use of electronic communication as a substitute for face-to-face interaction, arguing that face-to-face interaction is “where we develop the capacity for empathy” (Turkle, 2015, p. 3).

Exhibit 5.4 ● Dan’s Social Network Exhibit 5.4 ● Dan’s Social Network

Network Cluster Network Member Type of Support

Family of origin

Mother* Material and emotional

Father* Material and emotional

Sister* Emotional

Extended family

Grandmother (Taiwan)*

Emotional

Intimate friends Christine (girlfriend)* Emotional

Neighborhood

Landlord Instrumental

Alan Instrumental, emotional

Perry Instrumental

Jason Instrumental

School

Lucy Instrumental

Joan Instrumental

Spencer* Emotional

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Church

Chen* Emotional

Michelle* Emotional

Garrett* Emotional

Ming Emotional

Russell Emotional

* = Identified as close personal support.

How Social Support Aids Coping

As noted earlier, the experience of stress creates a physiological state of emotional arousal, which reduces the efficiency of our cognitive functions. When we experience stress, we become less effective at focusing our attention and scanning the environment for relevant information. We cannot access the memories that normally bring meaning to our perceptions, judgment, planning, and integration of feedback from others. These memory impairments reduce our ability to maintain a consistent sense of identity.

Social support helps in these situations by acting as an “auxiliary ego.” Our social support—particularly our personal network—compensates for our perceptual deficits, reminds us of our sense of self, and monitors the adequacy of our functioning. Here are 10 characteristics of effective support (Caplan & Caplan, 2000):

1. Nurtures and promotes an ordered worldview 2. Promotes hope 3. Promotes timely withdrawal and initiative 4. Provides guidance 5. Provides a communication channel with the social world 6. Affirms one’s personal identity 7. Provides material help 8. Contains distress through reassurance and affirmation 9. Ensures adequate rest

10. Mobilizes other personal supports

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6. Affirms one’s personal identity 7. Provides material help 8. Contains distress through reassurance and affirmation 9. Ensures adequate rest

10. Mobilizes other personal supports

Some support systems are formal (service organizations), and some are informal (such as friends and neighbors). Religion, which attends to the spiritual realm, also plays a distinctive support role. This topic is explored in Chapter 6.

Two schools of thought have emerged around the question of how we internalize social support (Gottlieb & Bergen, 2010).

1. Main effect model. Support is seen as related to our overall sense of well-being. Social networks provide us with regular positive experiences, and within the network a set of stable roles (expectations for our behavior) enables us to enjoy stability of mood, predictability in life situations, and recognition of self-worth. We simply don’t experience many potential stressors as such, because with our built-in sense of support, we do not perceive situations as threats.

2. Buffering model. Support is seen as a factor that intervenes between a stressful event and our reaction. Recognizing our supports helps us to diminish or prevent a stress response. We recognize a potential stressor, but our perception that we have resources available redefines the potential for harm or reduces the stress reaction by influencing our cognitive, emotional, and physiological processes.

Most research on social support focuses on its buffering effects, in part because these effects are more accessible to measurement. Social support as a main effect is difficult to isolate because it is influenced by, and may be an outcome of, our psychological development and ability to form attachments. The main effect model has its roots in sociology, particularly symbolic interaction theory, in which our sense of self is said to be shaped by behavioral expectations acquired through our interactions with others. The buffering model, more a product of ego psychology, conceptualizes social support as an external source of emotional, informational, and instrumental aid.

Perceived support is consistently linked to positive mental health, which is typically explained as resulting from objectively supportive actions that

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& Andrews, 2016). This form of regulation is primarily relational in that the types of people and social interactions that help recipients are mostly a matter of personal taste. Dan reports that he receives emotional support from nine people, but he is not necessarily drawn to these people to the same degree, which is partly why he does not experience adequate social support.

How Social Workers Evaluate Social Support

There is no consensus about how social workers can evaluate a client’s level of social support. The simplest procedure is to ask for the client’s subjective perceptions of support from family and friends (Tinajero, Martinez-Lopez, Rodriguez, Guisande, & Paramo, 2015). An example of a more complex procedure involves measuring eight indicators of social support: available listening, task appreciation, task challenge, emotional support, emotional challenge, reality confirmation, tangible assistance, and personal assistance (Rosenfeld & Richman, 2003). One practical model for social work practice includes three social support indicators (Uchino, 2009):

1. Listing of social network resources. The client lists all the people with whom he or she regularly interacts.

2. Accounts of supportive behavior. The client identifies specific episodes of receiving support from others in the recent past.

3. Perceptions of support. The client subjectively assesses the adequacy of the support received from various sources.

In assessing a client’s social supports from this perspective, the social worker first asks the client to list all persons with whom he or she has interacted in the past 1 or 2 weeks. Next, the social worker asks the client to draw from that list the persons he or she perceives to be supportive in significant ways (significance is intended to be open to the client’s interpretation). The client is asked to describe specific recent acts of support provided by those significant others. Finally, the social worker asks the client to evaluate the adequacy of the support received from specific sources and in general. On the basis of this assessment, the social worker can identify both subjective and objective support indicators with the client and target underused clusters for the development of additional social support.

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asks the client to evaluate the adequacy of the support received from specific sources and in general. On the basis of this assessment, the social worker can identify both subjective and objective support indicators with the client and target underused clusters for the development of additional social support.

Normal and Abnormal Coping Normality is characterized by conformity with our community and culture. We can be deviant from some social norms, so long as our deviance does not impair our reasoning, judgment, intellectual capacity, and ability to make personal and social adaptations (Rashed & Bingham, 2014). Most people readily assess the coping behaviors they observe in others as “normal” or “abnormal.” But what does normal mean? We all apply different criteria. The standards we use to classify coping thoughts and feelings as normal or abnormal are important, however, because they have implications for how we view ourselves and how we behave toward those different from us (Francis, 2013). For example, Dan was concerned that other students at the university perceived him as abnormal because of his ethnicity and social isolation. Most likely, other students did not notice him much at all. It is interesting that, in Dan’s view, his physical appearance and demeanor revealed him as abnormal. However, he was one of many Asian American students at the university, and his feelings were not as evident to others as he thought.

Social workers struggle just as much to define normal and abnormal as anybody else, but their definitions may have greater consequences. Misidentifying someone as normal who has a mental illness may forestall needed interventions; misidentifying someone as abnormal may create a stigma or become a self-fulfilling prophecy. To avoid such problems, social workers may profitably consider how four disciplines define normal.

The Medical (Psychiatric) Perspective One definition from psychiatry, a branch of medicine, states that we are normal when we are in harmony with ourselves and our environment. Significant abnormality in perceived thinking, behavior, and mood may even classify as a mental disorder. In fact, the current definition of mental disorder used by the American Psychiatric Association (2013), which is

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occupational functioning. This represents a medical perspective, only one of many possible perspectives on human behavior, although it is a powerful, socially sanctioned one. The medical definition focuses on underlying disturbances within the person and is sometimes referred to as the disease model of abnormality. This model implies that the abnormal person must experience changes within the self (rather than create environmental change) in order to be considered “normal” again.

In summary, the medical model of abnormality focuses on underlying disturbances within the person. An assessment of the disturbance results in a diagnosis based on a cluster of observable symptoms. Interventions, or treatments, focus on changing the individual. The abnormal person must experience internal, personal changes (rather than induce environmental change) in order to be considered normal again. Exhibit 5.5 summarizes the format for diagnosing mental disorders as developed by psychiatry in the United States and published in the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013). Many people in the helping professions are required to follow this format in mental health treatment facilities, including social workers.

Psychological Perspectives One major difference between psychiatry and psychology is that psychiatry tends to emphasize biological and somatic interventions to return the person to a state of normalcy, whereas psychology emphasizes various cognitive, behavioral, or reflective interventions. That is, through their own decisions and determination, and sometimes with the help of a professional, the person can change certain problematic (abnormal) characteristics into more adaptable, functional (normal) ones.

Exhibit 5.5 ● DSM-5 Classification of Mental Disorders Exhibit 5.5 ● DSM-5 Classification of Mental Disorders

• Record the mental disorder, beginning with the problem most responsible for the current evaluation. Many diagnoses also contain subtypes or specifiers (for example, “mild,” “moderate,” and “severe”) for added diagnostic clarity.

• When uncertain if a diagnosis is correct, the social worker should

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• When uncertain if a diagnosis is correct, the social worker should use the “provisional” qualifier, which means he or she may need additional time or information to be confident about the choice.

• More than one diagnosis can be used for a client, and medical diagnoses should also be included if they are significant to the client’s overall condition. Social workers cannot make medical diagnoses, of course, but they can be included if they are noted in a client’s history or the client reports their existence.

• If a person no longer meets criteria for a disorder that may be relevant to his or her current condition, the qualifier “past history” can be used, although this would not be the primary diagnosis. For example, if a woman seeks help for depression while she is pregnant, it may be important to note if she had an eating disorder history.

• Social and environmental problems that are a focus of clinical attention may also be included as part of the diagnosis. A chapter in the DSM titled “Other Conditions That May Be a Focus of Clinical Attention” includes a list of conditions (known as “Z-codes”) that are not considered formal diagnoses but can be used for that descriptive purpose.

Psychological theory is quite broad in scope, but some theories are distinctive in that they postulate that people normally progress through a sequence of life stages. The time context thus becomes important. Each new stage of personality development builds on previous stages, and any unsuccessful transitions can result in abnormal behavior—that is, a deviant pattern of coping with threats and challenges. An unsuccessful struggle through one stage implies that the person will experience difficulties in mastering subsequent stages.

One life stage view of normality well known in social work is that of Erik Erikson (1968), who proposed eight stages of normal psychosocial

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negotiating one or more of the five preceding developmental phases or challenges, and reviewing this would be an important part of his intervention.

From this perspective, Dan’s experience of stress would not be seen as abnormal, but his inability to make coping choices that promote positive personal adaptation would signal psychological abnormality. For example, at the university, he was having difficulty with relationship development and support seeking. He avoided social situations such as study groups, recreational activities, and university organizations in which he might learn more about what kinds of people he likes, what interests he might share with them, and what insecurities they might share as well. From a stage theory perspective, Dan’s means of coping with the challenges of intimacy versus isolation might be seen as maladaptive, or abnormal.

The Sociological Approach: Deviance The field of sociology offers a variety of approaches to the study of abnormality, or deviance, one of which is derived from symbolic interactionism. It states that those who cannot constrain their behaviors within role limitations that are acceptable to others become labeled as deviant. Thus, deviance is a negative label assigned when one is considered by a majority of significant others to be in violation of the prescribed social order (Mustaine, 2015). Put more simply, we are unable to grasp the perspective from which the deviant person thinks and acts; the person’s behavior does not make sense to us. We conclude that our inability to understand the other person’s perspective is due to that person’s shortcomings rather than to our own rigidity, and we label the behavior as deviant. The deviance label may be mitigated if the individual accepts that he or she should think or behave otherwise and tries to conform to the social order. It should be emphasized, however, that sociologists are increasingly using the term positive deviance to describe those persons whose outstanding skills and characteristics make them “outliers” in a constructive sense (LeMahieu, Nordstrum, & Gale, 2017).

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From this viewpoint, Dan would be perceived as abnormal, or deviant, only by those who had sufficient knowledge of his thoughts and feelings to form an opinion about his allegiance to their ideas of appropriate social behavior. He might also be considered abnormal by peers who had little understanding of his Asian American cultural background. Those who knew Dan well might understand the basis for his negative thoughts and emotions and, in that context, continue to view him as normal in his coping efforts. However, it is significant that Dan was trying to avoid intimacy with his university classmates and work peers so that he would not become well known to them. Because he still views himself as somewhat deviant, he wants to avoid being seen as deviant (or abnormal) by others, which in his view would lead to their rejection of him. This circular reasoning poorly serves Dan’s efforts to cope with stress in ways that promote his personal goals.

Exhibit 5.6 ● Erikson’s Stages of Psychosocial Development Exhibit 5.6 ● Erikson’s Stages of Psychosocial Development

Life Stage Psychosocial Challenge SignificantOthers

Infancy Trust versus mistrust Maternalpersons

Early childhood

Autonomy versus shame and doubt Parental persons

Play age Initiative versus guilt Family

School age Industry versus inferiority Neighborhood

Adolescence Identity versus identitydiffusion Peers

Young adulthood Intimacy versus isolation Partners

Adulthood Generativity versus self-absorption Household

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The Social Work Perspective: Social Functioning The profession of social work is characterized by the consideration of systems and the reciprocal impact of persons and their environments (the bio-psycho-social-spiritual perspective) on human behavior. Social workers tend not to classify individuals as abnormal. Instead, they consider the person-in-environment as an ongoing process that facilitates or blocks one’s ability to experience satisfactory social functioning. In fact, in social work, the term normalization refers to helping clients realize that their thoughts and feelings are shared by many other individuals in similar circumstances (Hepworth, Rooney, Rooney, & Strom-Gottfried, 2017).

Three types of situations are most likely to produce problems in social functioning: stressful life transitions, relationship difficulties, and environmental unresponsiveness (Gitterman, 2009). Note that all three are related to transitory interactions of the person with other persons or the environment and do not rely on evaluating the client as normal or abnormal.

Social work’s person-in-environment (PIE) classification system formally organizes the assessment of individuals’ ability to cope with stress around the four factors shown in Exhibit 5.7: social functioning problems, environmental problems, mental health problems, and physical health problems. Such a broad classification scheme helps ensure that Dan’s range of needs will be addressed. James Karls and Maura O’Keefe (2008), the authors of the PIE system, state that it “underlines the importance of conceptualizing a person in an interactive context” and that “pathological and psychological limitations are accounted for but are not accorded extraordinary attention” (p. x). Thus, the system avoids labeling a client as abnormal. At the same time, however, it offers no way to assess the client’s strengths and resources.

With the exception of its neglect of strengths and resources, the PIE assessment system is appropriate for social work because it was specifically developed to promote a holistic biopsychosocial perspective on human behavior. For example, at a mental health center that subscribed to psychiatry’s DSM classification system, Dan might be given a diagnosis of adjustment disorder or persistent depressive disorder, and his auditory processing disorder might also be diagnosed. With the PIE system, the social worker would, in addition to addressing mental and physical health

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to psychiatry’s DSM classification system, Dan might be given a diagnosis of adjustment disorder or persistent depressive disorder, and his auditory processing disorder might also be diagnosed. With the PIE system, the social worker would, in addition to addressing mental and physical health concerns, assess Dan’s overall social and occupational functioning, as well as any specific environmental problems. For example, Dan’s problems with the student role that might be highlighted on PIE Factor I include his isolation, the high severity of his impairment and its 6-month to a year’s duration, and the inadequacy of his coping skills. His environmental stressors on Factor II might include a deficiency in affectional support, of high severity, with a duration of 6 months to a year. Assessment with PIE provides Dan and the social worker with more avenues for intervention, which might include personal, interpersonal, and environmental systems.

Exhibit 5.7 ● The Person-in-Environment (PIE) Classification System

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Critical Thinking Questions 5.5

How important is virtual support to you? Which types of virtual support are the most meaningful to you? What have you observed about how technology is affecting the way people give and receive social support? What do you see as the contributions of the medical, psychological, sociological, and social work perspectives on normal and abnormal coping? What do you see as the downsides of each of these

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perspectives?

Implications for Social Work Practice Theory and research about the psychosocial person have a number of implications for social work practice, including the following.

Always assess the nature, range, and intensity of a client’s interpersonal relationships. Help clients identify their sources of stress and patterns of coping. Recognize the possibility of particular vulnerabilities to stress and the social and environmental conditions that give rise to stress. Help clients assess the effectiveness of particular coping strategies for specific situations. Use the risk and resilience framework to understand the nature of a client’s resources, assets, and limitations. Where appropriate, help clients develop a stronger sense of competence in problem solving and coping. Identify specific problems and related skill-building needs, teach and rehearse skills, and implement graduated applications to real-life situations. Where appropriate, use case management activities focused on developing a client’s social supports through linkages with potentially supportive others in a variety of social network clusters. Recognize families as possible sources of stress as well as support. Recognize the benefits that psychoeducational groups, therapy groups, and mutual-aid groups may have for helping clients cope with stress. Where appropriate, take the roles of mediator and advocate to attempt to influence organizations to be more responsive to the needs of staff and clients. Where appropriate, take the roles of planner and administrator to introduce flexibility into organizational policies and procedures so that agency–environment transactions become mutually responsive. For clients who experience stress related to inadequate community ties, link them to an array of formal and informal organizations that provide them with a greater sense of belonging in their communities. When working with persons in crisis, attempt to alleviate distress and facilitate a return to the previous level of functioning. Assess with clients the meaning of hazardous events, precipitating

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factors of hazardous events, and potential and actual support systems. When working with persons in crisis, use a here-and-now orientation and use tasks to enhance support systems. Help clients to connect current stress with patterns of past functioning and to initiate improved coping methods. As the crisis phase terminates, review with the client the tasks accomplished, including new coping skills and social supports developed.

Key Terms adaptation 142 coping 142 crisis 139 daily hassles 139 defense mechanisms 143 emotion-focused coping 145 general adaptation syndrome 142 homeostasis 142 personal network 149 person-in-environment (PIE) classification system 154 post-traumatic stress disorder (PTSD 147) problem-focused coping 145 relational coping 145 relational theory 132 role strain 139 social identity theory 137 social network 148 social support 148 state 143 stress 138 trait 143 traumatic stress 141

Active Learning 1. You have been introduced to four ways of conceptualizing normal and

abnormal coping: mental disorder, psychosocial development, deviance, and social functioning. Which of these ways of thinking

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about normality and abnormality are the most helpful to you in thinking about Dan’s situation? For what reasons?

2. Think of your own social support network. List all persons you have interacted with in the past month. Next, circle those persons on the list whom you perceive to be supportive in significant ways. Describe recent acts of support provided by these significant others. Finally, evaluate the adequacy of the support you receive from specific sources and in general. What can you do to increase the support you receive from your social network?

3. Consider several recent situations in which you have used problem- focused or emotion-focused coping strategies. What was different about the situations in which you used one rather than the other? Were the coping strategies successful? Why or why not? How does the tripartite conceptual framework help you to understand your choice of strategy?

Web Resources

The Ainsworth Attachment Clinic and the Circle of Security: www.theattachmentclinic.org/index.html

The Mary Ainsworth Attachment Clinic provides evaluation, intervention planning, and consultation for children who have experienced significant challenges or disruptions to their relationships or attachment bonds with parents or other caregivers. The evaluation and treatment protocols used for families with attachment-caregiving concerns require extensive training and certification and are available for Virginia communities only through the Attachment Clinic.

Feminist Theory Website: www.cddc.vt.edu/feminism/enin.html

This website, provided through Virginia Tech University, provides research materials and information for students, activists, and scholars interested in women’s conditions and struggles around the world. The goals of the website are to encourage a wide range of research into feminist theory and to encourage dialogue between women (and men) from different countries around the world, practices that will hopefully result in new connections, new ideas, and new information about feminist theory and women’s movements.

Institute of Contemporary Psychotherapy and Psychoanalysis:

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http://www.theattachmentclinic.org/index.html

http://www.cddc.vt.edu/feminism/enin.html

www.icpeast.org

This site contains information on conferences, training, and links to other resources on contemporary self and relational psychologies.

Jean Baker Miller Training Institute (JBMTI): www.jbmti.org

The JBMTI at the Wellesley Centers for Women is the home of relational-cultural theory (RCT), which posits that people grow through and toward relationships throughout the life span and that culture powerfully impacts relationship. JBMTI is dedicated to understanding the complexities of human connections as well as exploring the personal and social factors that can lead to chronic disconnection.

MedlinePlus: Stress: www.nlm.nih.gov/medlineplus/stress.html

Site presented by the National Institute of Mental Health presents links to the latest news about stress research, coping, disease management, specific conditions, and stress in children, seniors, teenagers, and women.

MIT Initiative on Technology and Self: www.mit.edu/~sturkle/welcome.html

The goal of the MIT Initiative on Technology and Self is to be a center for research and reflection on the subjective side of technology and to raise the level of public discourse on the social and psychological dimensions of technological change. The initiative features seminars, work groups, conferences, research, and publications.

National Center for Post-Traumatic Stress Disorder: www.ptsd.va.gov

Site presented by the National Center for PTSD, a program of the U.S. Department of Veterans Affairs, contains facts about PTSD, information about how to manage the traumatic stress of terrorism, and recent research.

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http://www.icpeast.org

http://www.jbmti.org

http://www.nlm.nih.gov/medlineplus/stress.html

http://www.mit.edu/~sturkle/welcome.html

http://www.ptsd.va.gov

6 The Spiritual Person

Michael J. Sheridan

Chapter Outline Learning Objectives Case Study 6.1: Caroline’s Challenging Questions Case Study 6.2: Naomi’s Health Crisis Case Study 6.3: Matthew’s Faith Journey Case Study 6.4: Trudy’s Search for the Sacred Case Study 6.5: Leon’s Two Worlds Case Study 6.6: Jean-Joseph’s Serving the Spirits Case Study 6.7: Amira’s Quest for Self Case Study 6.8: Beth’s Framework for Living The Spiritual Dimension

The Meaning of Spirituality Spirituality in the United States and Globally

Theories of Spiritual Development Fowler’s Stages of Faith Development Transpersonal Theory Wilber’s Integral Theory of Consciousness Summary and Critique of Fowler’s and Wilber’s Theories

The Role of Spirituality in Social Work Spirituality and Human Diversity

Race and Ethnicity Sex and Gender Sexual Orientation Other Aspects of Diversity

Spirituality and the Human Experience Problems in Living Individual and Collective Well-Being

Spiritual Assessment Implications for Social Work Practice Key Terms Active Learning Web Resources

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Learning Objectives 6.1 Compare one’s own emotional and cognitive reactions to eight case studies. 6.2 Compare the definitions of spirituality and religion. 6.3 Describe the major contributions of Fowler’s and Wilber’s theories of human spirituality. 6.4 Give examples of the impact of spirituality and religion in the lives of oppressed groups and people coping with different problems of living. 6.5 Demonstrate how to gather information about a client’s religious or spiritual history. 6.6 Apply knowledge of human spirituality to recommend guidelines for social work engagement, assessment, intervention, and evaluation.

Case Study 6.1 Caroline’s Challenging Questions Caroline, who grew up in a large, close-knit family in North Carolina, is in her first year of college at a university in another state where she is encountering all kinds of new experiences. A devout Christian, Caroline is a member of a Baptist church back home, where her family has attended for generations. She was very involved in her home church, singing in the choir and actively engaged in several youth programs. Most of her high school friends attended her church, so she was more than a little uncomfortable when she learned that her roommate, Ruth, was Jewish. Caroline has met a number of other students who are from different faiths or who say that they don’t belong to a church at all. This has been a new and challenging experience for her.

At first she tried to stay away from anyone who wasn’t Christian, but she struggled with this because so many of her non-Christian classmates seemed like nice people and she really wanted to have friends. All sorts of questions began to emerge in her mind, like How can they not believe in Jesus Christ? and I wonder what they do believe? and What will happen to them in the afterlife if they are not saved? These questions only grew as she took a comparative religions class where she learned about faiths that she had never heard of before. In one class exercise, she was paired with another student from Turkey who said she was Muslim. At first, Caroline was anxious about talking with her, but as they moved through the exercise, she began to feel that they were more alike than different. They both were from very religious

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families, their faith was important to them personally, and they both were struggling with all the different perspectives that they were encountering in college. Later on that day, Caroline realized that if she had been born in Turkey, she would probably be a Muslim, too. This thought both intrigued and unsettled her. More and more, she is asking herself, What do I really believe and why?

Case Study 6.2 Naomi’s Health Crisis Naomi is a 42-year-old mother of three children who are 10, 7, and 3 years old. Naomi discovered a lump in her breast a couple of weeks ago, and she and her husband, David, have been anxiously awaiting news regarding test results. When the diagnosis of cancer finally comes, they are both stunned and frightened but pull themselves together for the sake of the children. Naomi begins the long journey of doctors, surgery, chemotherapy, and radiation treatments while simultaneously trying to maintain family life and a part-time job as best she can. David takes on new duties as a more active parent and homemaker while still going to his full-time job. He struggles with his own fears and anger about what is happening, initially not sharing these with Naomi because he is determined to be her “rock.”

Naomi and David are members of Temple Shalom, a local Reform Jewish congregation, which they joined after their first child was born. When they were growing up, Naomi’s family were members of a Reform congregation, whereas David’s family expressed their Jewish heritage in more secular and cultural terms, gathering annually for a Passover Seder but not attending services except occasionally on Yom Kippur. Naomi had not regularly attended services after her bat mitzvah, but both she and David decided that they wanted to be part of a spiritual community for their children. They had heard good things about the temple in their neighborhood and decided to explore it. They liked its open, welcoming atmosphere; its liberal viewpoints on social issues; and its active engagement in social action in the community. They both enjoy the weekly connection with other adults and are happy with the religious classes that their children attend. Recently, Naomi and David have been engaged in weekly Shabbat Torah study sessions, to deepen their understanding of Jewish sacred texts.

Now that Naomi is facing this health crisis, both she and David are feeling a bit lost and are searching for answers. Although friends have been supportive, both of their families live far away, and their short visits and phone calls only provide minimal comfort. One night, when they both can’t sleep, Naomi and David begin to share their doubts and fears with one

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another, even admitting that they feel angry with God and are wondering if there is such a thing as God at all. Naomi finally suggests, “I think it would help to talk with Rabbi Shapiro and some of the people we’ve met at Temple Shalom.” David agreed and added that they should also explore the Jewish Healing Network that was described in the bulletin last week.

Case Study 6.3 Mathew’s Faith Journey Matthew will be 70 next month—a fact that is hard for him to believe. He’s been a widower for 5 years now since he lost his wife, Betty, who died of a sudden heart attack. The first few years following her death were rough, but Matthew made it through with the help of his sons and their families, and members of his Catholic parish, which he has been attending for 40 years. His faith has always been very important to him, even though he has struggled with periods of doubt and confusion—the latest following Betty’s death. At one point when he was younger, he considered leaving the church, when disagreements about doctrine and rumblings about the new priest were causing uproar in the congregation. He even visited several other denominations to see if they were a better fit for him. But after much reflection and conversation with Betty, Matthew decided to stick with his commitment to the Catholic faith and his parish saying, “No church is perfect, and this is where I truly belong.”

For the past couple of years, he has been actively involved with the outreach activities of the church, working on the Food Bank and Affordable Housing committees. Recently, he has been a member of the Interfaith Dialogue Program, which promotes respect and mutual understanding across religious and cultural perspectives. Matthew finds the panel discussions, conferences, and interfaith community projects both challenging and invigorating. He’s particularly looking forward to an upcoming conference on the role of interfaith dialogue in advancing world peace. He’s also been involved with the National Religious Partnership for the Environment (NRPE), a Judeo- Christian association composed of many faiths that focuses on environmental stewardship. As a result of these activities, Matthew has also been reading a number of books on different religions and is struck with the similar themes that are reflected in the teachings of very diverse traditions. He is beginning to feel a new sense of purpose for his life, which both surprises and delights him as he heads into his seventies. Some of his friends have asked him if his involvement with the Interfaith Dialogue Program is making him question his own religion, but Matthew says, “No, quite the opposite. I feel more deeply connected to my faith as I understand more about other religions. It’s not that I think mine is right and theirs is wrong, but I appreciate and respect

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other religions, while still knowing that mine is right for me.”

Case Study 6.4 Trudy’s Search for the Sacred Trudy is a 35-year-old single woman living in Berkeley, California—which is a long way from the little town in Arkansas where she lived until she left home at 18. She’s lived in several places since then, searching for a new home that feels right to her. She thinks she may have finally found it. A new job in a health food store, a small but comfortable and affordable apartment, a great yoga class, and a welcoming Buddhist Sangha (community) of like- minded people all make her feel like she’s finally found what she’s been looking for.

Trudy’s early years were not easy ones. Her father was an alcoholic who flew into rages when drunk, which happened more often as the years went by. It was not an unusual event for someone in her family to be physically hurt during these episodes. Trudy, her mother, and her two sisters were afraid of her father and “walked around on eggshells” most of the time to avoid triggering his angry spells. Trudy found refuge in the woods in back of her house and in books, which she devoured because they took her to places beyond her current reality. She could stay curled up in a nook of her favorite tree for hours, transporting herself to somewhere else—anywhere else. She promised herself she would leave as soon as she finished high school.

Life since then has not been easy either. Trudy was briefly married in her twenties to a man who also had a hard time controlling his anger and began to drink more and more as problems in the marriage began to emerge. Trudy even found herself turning to alcohol as a way of numbing her pain, which really scared her. With the support of some friends, she finally left the marriage and was off again, searching for a new home. After a couple of other relationships that didn’t work out, Trudy decided to avoid men and increasingly became isolated from all social ties. But in her new home in Berkeley, she finds that she likes the people who attend her Sangha and likes even more the fact that they don’t share a lot of personal information, focusing more on spiritual practices. She loves the group meditation and the dharma talks and has made a commitment to increased periods of solitary meditation when she is at home. Trudy is now rising at 4:00 a.m. to meditate for 3 hours before she has to get ready for work, and she meditates an additional 2 hours most evenings. Her reading is now totally focused on books about spirituality, which support her quest to rise above personal concerns and her ego to become an enlightened being. Although Trudy was not exposed to a particular religious tradition during childhood, the search

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for spiritual development is now her highest priority.

Case Study 6.5 Leon’s Two Worlds Leon is a 23-year-old man who is feeling torn in two. He is the oldest son in a family with five kids and the mainstay of his mother’s life. Regina became a widow 8 years ago when her husband, Rodney, was killed in an accident at the mill yard where he worked. Since then, she’s leaned heavily on Leon for help with his brothers and sisters and as a major contributor to the family’s finances. He is also the one she confides in the most, sharing things with him that she once shared with her husband. The whole family also relies heavily on their African Methodist Episcopal (AME) church for both social support and spiritual nurturance.

Leon has grown up in the church and loves the fellowship and the joyous feeling that comes over him as he sings and worships on Sundays. But it is also a place that increasingly troubles him, as he has finally admitted to himself that he is gay. He has denied this for years, trying hard to follow church teachings about homosexuality being a sin and something that can be overcome with the help of God. He has prayed and prayed to God to change him, but this has not worked. Leon is now battling despair, as he fears that he will always be caught between his love for his faith and his church and a longing to be who he truly is. The idea of telling his mother about his sexual orientation seems unthinkable, but he’s not sure how long he can go on living a lie. He knows he will have to leave the church if it ever becomes known that he is gay. That possibility also seems unthinkable. He has been feeling more and more depressed, to the point where his mother keeps asking him what’s wrong. He’s even had thoughts of suicide, which frighten him. In his nightly prayers to God he asks, “Why must I lose you to be who I am?”

Case Study 6.6 Jean-Joseph’s Serving the Spirits Jean-Joseph is a 50-year-old man, originally from Haiti, who came with his family to the United States 10 years ago. He and his family were adherents of the Roman Catholic faith in Haiti and now attend a Catholic church near their new home. Jean-Joseph’s family members are also believers in Vodoun (known by most Westerners as Voodoo), which is widely practiced in Haiti and often integrated with belief in Catholicism. Most Roman Catholics who are active in this spiritual tradition refer to it as “serving the spirits.” Although this belief system holds that there is only one God, Bondje, who

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created the universe, he is considered to be too far away for a personal relationship with humans. Instead, believers in Vodoun center on Loa, or spirits of ancestors, animals, natural forces, and good and evil spirits. Family Loa are spirits who are seen to protect their “children”—the Haitian people —from misfortune. Jean-Joseph and his family regularly participate in rituals to feed the Loa food and drink, and offer them other gifts.

Recently, a Loa visited Jean-Joseph in a dream, telling him that his youngest son was ill and needed healing. His son Emmanuel had indeed been listless for days, not wanting to eat or play, and his parents were very worried about him. Jean-Joseph decided that they needed to take him to a Mambo, a Vodoun priestess, who could mediate between the human and spirit worlds to diagnose and treat Emmanuel’s illness. The Mambo agreed to perform a healing ceremony, which was held at a hounfour, or Vodoun temple, around a poteau-mitan, a center pole where the spirits can communicate with people. A veve, or pattern of cornmeal unique to the Loa who was the focus of the ceremony, was created on the floor, and an altar was decorated with candles, pictures of Christian saints, and other symbolic items. A goat was also sacrificed for the ceremony. The Mambo and her assistants began to chant and dance, accompanied by the shaking of rattles and beating of drums. Finally, the Mambo was possessed by the Loa and fell down. The Loa then spoke through the Mambo and told the family how to treat the distressed spirit that was causing Emmanuel’s illness. After the ceremony, the Mambo gave Jean-Joseph an herbal remedy to give to his son and instructions on how to continue feeding the spirit of the Loa until Emmanuel was healed. The family also prayed to the Christian God and Catholic saints to bring healing to Emmanuel.

Case Study 6.7 Amira’s Quest for Self Amira is the middle child of a Pakistani American family that emigrated to the United States over 30 years ago and settled in a Pakistani Muslim neighborhood in New Jersey. Her father, Kamil, owns an appliance store; her mother, Farida, and her older sister, Nadia, frequently help run the store along with three other employees. Her younger brother, Nasif, is a sophomore in high school and helps out with the store on the weekends. During college, Amira helped out too as she was living at home, but now that she has completed her undergraduate degree, she has her own apartment in Washington, DC. This was a monumental change for both Amira and her family, for it is considered unusual in her community for a young woman to be living on her own before marriage. But Amira has consistently been the “odd one” in her family, chafing at what was expected of her by her family

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and community. She has many memories of arguments with her parents about what she should wear and how she should behave. From an early age, Amira had big dreams of becoming a doctor and living an independent life where she could make her own choices.

Although Amira’s parents have been generally supportive of her goals for higher education, they also expected her to be married by her early twenties. Now that she is 22, earlier conflicts about proper dress and respect for traditions have been replaced with threats of an arranged marriage. Amira reports that her parents have no real understanding of what is required to get into and complete medical school. However, they have allowed her to attend a 1-year premedical program to enhance her chances of getting into medical school as long as she returns home for frequent visits and keeps in touch with her mother on a daily basis. Although not happy with these requirements, Amira is adhering to them so she can pursue her goals.

Another area of potential conflict is religion. Amira is struggling with the realization that she does not believe much of what she was taught as a child and does not feel a strong connection to the Muslim faith of her family. She says, “I know I believe in God, but not the God that my family does. And I definitely do not believe what they say is the role of women. But I can’t let them know any of this, as I would be married off to someone who would make me a ‘proper Muslim woman.’ I’m not sure I want to be married at all, but if I do, I want to be in love with my husband and have him treat me as an equal—and respect my work.” She further states that she is confused about what place she wants faith to have in her life, for she enjoys certain aspects of it. She sighs and says, “I guess I’ll figure all that out later—after I have my medical degree.”

Case Study 6.8 Beth’s Framework for Living Beth grew up as the only child of parents who were very clear about not wanting their child to be “brainwashed by religion.” Beth’s mother, Sarah, had been the daughter of a Presbyterian minister but had not spoken to her father for several years before he died over conflicts about her leaving the church. Beth’s father, Sam, was raised by two union organizer parents who had not been involved with any particular religious faith throughout their lives. Both Sarah and Sam felt strongly that everyone needed a strong code of personal ethics, and they felt confident they could give Beth a solid “framework for living” that didn’t involve religion. Instead they taught Beth to be honest and fair and to “always walk a mile in someone else’s shoes” before she judged anyone.

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Beth didn’t think much about religion during her growing-up years except when it came up in school or when she became aware that a few of her friends’ families were very religious. She tended to feel more comfortable with kids from more secular families like hers, but she didn’t let this stop her from making friends with kids from more religious families as well. As Beth grew older she relied more and more on her parents’ framework for living to help her navigate challenges, like when some of her friends wanted her to go shoplifting with them or when other friends cheated on an exam. In both cases, she didn’t go along with her friends, but she didn’t tell on them either —telling herself that she didn’t really know what it was like to walk in their shoes and she shouldn’t judge them. She had many long talks with her father about the importance of having personal integrity and caring about social injustices that others faced. She also loved to hear him tell stories of his parents’ union organizing days when they “fought the system” and sometimes won. So when it came time to choose her major in college she chose political science, and when she graduated she became a union organizer for the SEIU (Services Employees International Union). Her first job was as a field organizer in West Virginia, focused on organizing nursing home, home care, hospital, and other social service employees. The hours were long and the work was tough, but she felt she was living from a place of integrity and making the world a better place.

She recently became close friends with Karen, another field organizer, who shared with Beth that her commitment to workers’ rights was grounded in her deep Catholic faith—something Beth found surprising because she hadn’t thought of religious people as being very concerned about the struggles ordinary people face. She began to wonder if she needed to rethink her views about “all those religious people.” Was it time to walk a bit in their shoes?

The Spiritual Dimension The stories presented in the eight case studies could be viewed through many different lenses. Social work’s biopsychosocial framework would be helpful in understanding many facets of these cases. Knowledge of the biological components of health certainly would be useful in understanding the circumstances of Naomi’s health crisis and Jean- Joseph’s attempts at healing his son’s illness. Psychological perspectives would shed light on Caroline’s discomfort with encountering different beliefs, Matthew’s deepening faith perspective, Trudy’s search for a home and a different sense of self, Leon’s despair at being torn between his faith and his sexual identity, Amira’s struggle with finding her own way, and

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Beth’s views about religious people. Social theories of family dynamics, ethnicity and culture, social movements, socioeconomic class, and social institutions would yield invaluable information about all the people in these cases, providing a wider frame for understanding their individual lives.

However, the biopsychosocial framework omits an important dimension of human existence: spirituality. This omission seems antithetical to social work’s commitment to holistic practice. What would be gained if we added a spiritual lens in our attempt to understand Caroline’s challenging questions, Naomi’s health crisis, Matthew’s faith journey, Trudy’s search for the sacred, Leon’s two worlds, Jean-Joseph’s serving of the spirits, Amira’s path, and Beth’s framework for living? And how would this perspective help you as a social worker provide holistic and effective service in working with them? Keep these questions and all of the stories in mind as you read the rest of the chapter.

The Meaning of Spirituality The concept of spirituality is often confused with religion, and writers in social work and related fields point to a number of attempts to delineate these terms and distinguish them from one another. Canda and Furman (2010) provide a detailed discussion of how the two terms are understood in social work and related fields, including medicine, nursing, and psychology. They also report findings from a series of national studies they have conducted in the United States, the United Kingdom, Norway, and New Zealand, which show relative consistency across countries. Specifically, the top six descriptors of spirituality across geographic locales were “meaning, personal, purpose, values, belief, and ethics.” Similar congruence was found for the term religion, where the top six descriptors selected in all of the countries were “belief, ritual, community, values, prayer, and scripture” (p. 67). Drawing from these studies and additional research in the helping professions, Canda and Furman propose the following definitions for these two concepts.

Spirituality is “a process of human life and development

focusing on the search for a sense of meaning, purpose, morality, and well-being; in relationship with oneself, other people, other beings, the universe,

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and ultimate reality however understood (e.g., in animistic, atheistic, nontheistic, polytheistic, theistic, or other ways); orienting around centrally significant priorities; and engaging a sense of transcendence (experienced as deeply profound, sacred, or transpersonal)” (p. 75).

Religion is “an institutionalized (i.e., systematic and organized) pattern of values, beliefs, symbols, behaviors, and experiences that involves

spirituality; a community of adherents; transmission of traditions over time; and community support functions (e.g., organizational structure, material assistance, emotional support, or political advocacy) that are directly or indirectly related to spirituality” (p. 76).

Thus, the term spirituality is generally used in the social work literature to mean a broader concept than religion in that spiritual expression may or may not involve a particular religious faith or religious institution. But some writers have pointed out that for persons affiliated with certain faith perspectives, the two terms cannot be separated from one another, or religion is considered to be the broader construct, subsuming spirituality (Pals, 1996; Praglin, 2004). Others propose that the separation of the two terms in social work has resulted in discrimination against particular religious worldviews, especially those of evangelical or conservative faiths (Hodge, 2002; Ressler & Hodge, 2003). Clearly, there is a need for continued exploration and dialogue about definitional issues. Regardless of how the scholarly definition of these terms evolves, it is important as social workers to always inquire about and honor the client’s definition of spirituality and religion and use the term that is most acceptable and relevant for that person, family, or community.

For the sake of clarity, it should be noted that when the term spirituality is used in the current chapter, it is meant to convey spirituality as the broader concept, inclusive of both religious and nonreligious expressions. Occasionally, the two terms are used together in the same sentence (e.g., “gathering religious or spiritual information”). In this case, the reader should recognize that both are included in order to be applicable regardless of whether persons identify themselves as primarily religious, primarily spiritual, both religious and spiritual, or neither.

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Regardless of the precise words used to capture the meaning of spirituality, the term brings to mind many related themes. Exhibit 6.1 lists 20 symbolic themes of spirituality identified by Patrick O’Brien (1992). Which themes do you think are most applicable to the eight case studies presented at the beginning of this chapter?

Spirituality in the United States and Globally The current spiritual landscape in the United States reveals both common threads and a colorful array of unique patterns. Recent Gallup polls (Gallup News, 2017) report that in 2016 89% of people in the United States say they believe in God or a universal spirit, 75% report that religion is either “very important” or “fairly important” in their life, and 37% report attending religious services weekly or almost weekly. These statistics indicate a strong thread of spirituality in the United States. However, expressions of both religious and nonreligious spirituality have become increasingly diverse, making the United States likely the most religiously diverse country in the world today, with more than 1,500 different religious groups (Parrillo, 2009; Pew Forum on Religion & Public Life, 2008).

Exhibit 6.1 ● Symbolic Themes of Spirituality Exhibit 6.1 ● Symbolic Themes of Spirituality

1. Morality, ethics, justice, and right effort

2. The nature and meaning of self and the intention and purpose of human existence

3. Interconnection; wholeness; alignment; and integration of persons, place, time, and events

4. Creativity, inspiration, and intuition

5. Altruistic service for the benefit of others

6. The mystery and wonder woven into nature, the universe, the unknown

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7. Sociocultural-historical traditions, rituals, and myths

8. Virtues (such as compassion, universal love, peace, patience, forgiveness, hope, honesty, trust, faith)

9. Mystical, altered states of consciousness

10. Sexuality

11. Openness, willingness, surrender, and receptivity

12. The power of choice, freedom, and responsibility

13. Special wisdom or revealed knowledge

14. Prayer, meditation, and quiet contemplation

15. Answers to pain, suffering, and death

16. Identity and relation to the metaphysical grounds of existence, ultimate reality, and life force

17. The relationship of cause and effect regarding prosperity or poverty

18. Beliefs or experiences related to intangible reality or the unobstructed universe

19. The path to enlightenment or salvation

20. Sensitive awareness of the earth and the nonhuman world Source: Adapted from O’Brien, 1992.

This diversity is due, in part, to ongoing schisms and divisions among many of the organized religions historically present within the United States. For example, the number of Christian denominations alone grew from 20 to more than 900 from 1800 to 1988 (Melton, 1993). In addition, there has been a significant rise in other spiritual traditions with each new influx of immigrants from other parts of the world. They have brought not

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only faiths recognized as major religions (e.g., Islam, Buddhism, Confucianism, Hinduism) but also various forms of spiritualism, folk healing, and shamanism (e.g., Santeria, espiritismo, Vodoun, curanderismo, santiguando, krou khmer, and mudang). This trend is further augmented by a growing interest in Eastern and Middle Eastern religions (e.g., Islam, Buddhism, and Hinduism) and earth-based spiritualities (e.g., neopaganism, goddess worship, and deep ecology). There has also been a revived or more visible involvement in traditional spiritual paths within Indigenous communities, as increasing numbers of Native Americans or First Nations peoples explore their tribal traditions or combine these traditions with faith in Christianity. Many of these “new” religions are among the fastest growing in the United States, although their overall numbers are still relatively small. Exhibit 6.2 shows the religious affiliation of the U.S. adult population in 2014, as well as changes in this profile since 2007 (Pew Research Center, 2015a).

Exhibit 6.2 ● Change in Religious Affiliation of U.S. Adult Population, 2007–2014

Religious Affiliation 2007

2014

Change*

Christianity 78.4 70.6 –7.8

Jewish 1.7 1.9 -

Muslim 0.4 0.9 +0.5

Buddhist 0.7 0.7 -

Hindu 0.4 0.7 +0.3

Other world religions** <0.3 0.3 -

Other faiths** 1.2 1.5 +0.3

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Unaffiliated 16.1 22.8 +6.7

Don’t know/refused 0.8 0.6 –0.2 Source: Adapted from Pew Research Center, 2015a. America’s Changing Religious Landscape. www.pewforum.org/files/2015/05/RLS-08-26-full-report.pdf.

* The “change” column displays only statistically significant changes; blank cells indicate that the difference between 2007 and 2014 is within the margin of error.

** The “other world religions” category includes Sikhs, Baha’is, Taoists, Jains, and a variety of other world religions. The “other faiths” category includes Unitarians, New Age religions, Native American religions, and a number of other non-Christian faiths.

It should be noted that estimates of members of any particular religious group vary widely depending on the source, data collection methods, and definition of “adherents” (e.g., self-identified, formal membership, or regular participant). For example, in the United States, figures for adherents of Islam range from 1 million to 8 million; adherents of Judaism from 1 million to 5 million; adherents of Buddhism from 1 million to 5 million; and adherents of Wicca and neopaganism from 10,000 to 770,000 (Canda & Furman, 2010; Kosmin & Keysar, 2009; Parrillo, 2009).

Most recently, three major trends in religious affiliation were identified in a 2016 survey by the Public Religion Research Institute (PRRI) (Jones & Cox, 2017), which explored the intersection of religious identity with race, ethnicity, age, and other demographic variables (see Exhibit 6.3). First, there has been a noted decline in White Christian identity. Although over 80% of Americans identified as White Christians in 1976, only 43% of the country identify as such today. In total, fewer than half (23) of all 50 states currently have majority White Christian populations compared to 39 states in 2007. Declines are evident from 2006 to 2016 for White evangelical Protestants (from 23% to 17%), White mainline Protestants (from 18% to 13%), and White Catholics (16% to 11%). This trend is due in part to the aging of White Christians; only slightly more than 1 in 10 White evangelical Protestants (11%), White Catholics (11%), and White mainline Protestants (14%) are under the age of 30. An exception to these shifts is found within Latter Day Saints (Mormons)

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http://www.pewforum.org/files/2015/05/RLS-08-26-full-report.pdf

where there is little evidence to suggest that they are experiencing similar declines; currently at 1.9% of the American population (identical to earlier studies), with 23% being under the age of 30.

Exhibit 6.3 ● U.S. Religious Landscape

Source: Jones, R. P., & Cox, D. (2017). America’s changing religious identity: Findings from the 2016 American Values Atlas. Washington, DC: Public Religion Research Institute. https://www.prri.org/wp-content/uploads/2017/09/PRRI-

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Religion-Report.pdf.

A second trend noted by the PRRI 2017 study is the growth of non- White Christians. In 1991, only 17% of all Protestants were non- White; today, one third (33%) of all Protestants are persons of color. However, there is considerable variation in racial and ethnic diversity among different Protestant denominations. For example, only a small number of Lutherans, Methodists, Presbyterians, and Episcopalians are persons of color, ranging from 8% for Lutherans to 20% for Episcopalians. Larger percentages of persons of color are found within Pentecostals (42% Black or Hispanic), Baptists (35% Black or Hispanic), and nondenominational Protestants (23% Black or Hispanic). A considerable shift is also evident among Catholics. Over 8 in 10 (87%) of all Catholics were White in 1991; today 45% identify as non-White, with the greatest majority of these being Hispanic (36%).

The third major trend reported by the study is the continued rise of the religiously unaffiliated. Those who identify as “atheist,” “agnostic,” or “nothing in particular” have roughly tripled since the 1990s and now comprise 24% of the population, slightly higher than the 23% reported by the Pew Research Center in 2014 (Litka, 2015). It is important to note that there are differences in how people within this group identify. Although 14% state that they are “atheist” and 13% identify as “agnostic,” 16% state that they are “religious persons” but not affiliated with a particular religion. And the largest percentage (58%) among this group simply identify as “secular.” Although younger Americans (ages 18–29) are more likely to be religiously unaffiliated than older Americans (age 65 or older), the relationship between age and unaffiliated status is not completely linear and the group in general is older today than it was a generation ago. Today, 34% of the unaffiliated are under the age of 30, but nearly 3 in 10 (29%) are at least 50 years old. It is important to note that unaffiliated may not mean that spirituality is not important to this group of adults. Among unaffiliated Americans, 68% say they believe in God, 58% say they feel a deep connection with nature and the earth, 37% identify as “spiritual” but not “religious,” and 21% report praying every day. Additionally, most of the religiously unaffiliated think “churches and other institutions benefit society by strengthening

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https://www.prri.org/wp-content/uploads/2017/09/PRRI-Religion-Report.pdf

community bonds and aiding the poor” (Pew Research Center Religion & Public Life, 2012, para. 4).

Moreover, there appears to be increasing fluidity in religious affiliation. Data on changes from one major religious tradition to another (e.g., from Protestantism to Catholicism or from Judaism to no religion) show that 34% of U.S. adults have changed their affiliation from that of their childhood (Pew Research Center, 2015a). A significant part of religious switching is due to the growth of the unaffiliated, as “nearly one-in-five American adults (18%) were raised in a religion and are now unaffiliated, compared with just 4% who have moved in the other direction” (Pew Research Center, 2015a, p. 33), representing a leaving/joining ratio of 4.2 to 1. This contrasts with several groups of the religiously affiliated. For example, for every new convert to Christianity there has been a loss of four former Christians who no longer affiliate with the Christian religion. Catholicism has experienced the greatest net loss; there are currently more than six former Catholics for every one convert (ratio of 6.5 to 1). Both mainline Protestant denominations and historically Black Protestant denominations also show a net loss, with a 1.7 to 1 ratio for mainline Protestants and 1.6 to 1 ratio for historically Black Protestants. A major exception to this pattern is evangelical Protestantism, which has gained more adherents through religious switching than it has lost with a ratio of 1 to 1.2. Hindus, Muslims, and Jews have the highest percentages of retention of adherents at 80%, 77%, and 75%, respectively. Beyond religious switching, another key factor in religious fluidity is intermarriage with 28% of American adults currently married or living with a partner who has a different religious affiliation than their own.

Photo 6.1 Spirituality is understood and expressed differently by individuals but is generally associated with a person’s search for meaning.

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As tempting as it is to make overarching statements based on statistics concerning belief in God and religious identification—for example, that the U.S. population is highly religious—we must be cautious in drawing specific conclusions because the picture changes depending on the particular indicator. The percentage of U.S. adults who say they seldom or never attend religious services has increased from 42% in 2006 to 48% in 2016, while those who attend at least weekly has fallen from 31% to 26% (Gallup News, 2017). Although traditional measures of religiosity are down, some measures of spirituality are up. In 1994, an estimated 58% of the U.S. population said they felt the need to experience spiritual growth in their lives; by 2001, this percentage was 80% (Gallup, 2002; Gallup & Lindsay, 1999). More recently, almost 6 in 10 Americans (59%) report that they feel a deep sense of spiritual peace and well-being at least once a week, up from 52% in 2007. And nearly half (46%) say they often feel a deep sense of wonder about the universe, also a 7-point jump over 7 years (Pew Research Center, 2015b). Even religious “nones” have become more likely to report these experiences in recent years, increasing from 38% to 45%, with a 17-point jump among self- described atheists (Masci & Lipka, 2016). Qualitative studies (Bender, 2010; Mercadante, 2014; Roof, 1999) have shown that

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although the diverse pathways to spiritual growth reported by many Americans may emphasize individual exploration and personal experience, they also involve communal sharing—albeit often outside of traditional religious institutions (e.g., yoga centers, meditation groups, mind–body classes). Furthermore, these approaches may more closely reflect Ulrich Beck’s (1992) understanding of spirituality as attending to the development of positive human qualities—such as generosity, gratitude, a capacity for awe and wonder, an appreciation of the interconnectedness among all beings, and deeper awareness and insight—as much as or even more than a search for any divine form of transcendence.

It is important to consider all these data within the context of global statistics (see Exhibit 6.4). Although adherents of Christianity remain the highest proportion of the population in the United States, worldwide they composed only 31.2% of the global population in 2015, with the remainder self-identifying with other traditions: Muslims (24.1%), unaffiliated (16%), Hindus (15.1%), Buddhists (6.9%), folk religions (5.7%), Jews (0.2%), and other religions (less than 0.8%). However, projections of religious growth globally predict a different scenario, with Muslims having the greatest increase to 31.1% by 2060, placing them close to the projected percentage of Christians (31.8%). Percentages for all other adherents are expected to remain the same or drop. It is interesting to note that although the percentage of unaffiliated in the United States is projected to be 25.6% by 2060, globally the percentage is predicted to shrink to 13% (Pew Research Center Religion & Public Life, 2017a).

Exhibit 6.4 ● Global Religions, 2015

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Source: Pew Research Center Religion and Public Life, 2017a. The Changing Global Religious Landscape. www.pewforum.org/2017/04/05/the-changing-global-religious- landscape/.

Note: Folk religionists include followers of African traditional religions, Chinese folk religions, Native American religions, and Australian Aboriginal religions.

It is also prudent to understand the impact of globalization on religious or spiritual diversity both within and outside of the United States. Globalization is used here to refer to “the worldwide diffusion of practices, expansion of relations across continents, reorganization of social life on a global scale, and a growth of a shared global consciousness” (Lechner, as quoted in Swatos, 2005, p. 320). Simply put, it is our growing sense of the world being “a single place” (Robertson, 1992). As with other aspects of human life, globalization is also increasing our awareness of the many religious and spiritual traditions in the world and the role they play in various conflicts, both between and within countries.

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http://www.pewforum.org/2017/04/05/the-changing-global-religious-landscape/

Lester Kurtz (2016) posits three factors—modernism, multiculturalism, and modern technologies of warfare—significant to understanding religious conflict today. First, modernism, based on scientific, industrial, and technological revolutions, has had an ongoing contentious relationship with religious perspectives and institutions since the beginning of the 17th century, when church authorities charged Galileo with heresy for stating that the earth revolved around the sun. Present-day examples include debates regarding evolution versus creationism and intelligent design; the question of when life begins and ends; the ethics of stem cell research and genetic manipulation; the proper codes of behavior, especially sexual behavior; the rightful roles of women in society; the correct way to raise children; and the appropriate place of religion in the political sphere. Thus, this tension between science and religion continues during our current postmodern times as scientific and secular thought compete with religious traditions and doctrine as the authority for “truth” and moral guidelines for contemporary life.

Second, multiculturalism increasingly requires us to recognize myriad worldviews and ways of life, within the United States and globally. This pluralistic reality stands in contrast to unilateral belief systems, both religious and cultural, which have historically provided what Peter Berger (1969) calls a “sacred canopy,” or the security and certainty of one view of the universe, one answer to profound and mundane questions, and one approach to organizing individual and collective life. Such a unified perspective is difficult to maintain as individuals and whole cultures are increasingly exposed to a religious and spiritual “marketplace” of diverse belief systems and practices, which often challenge the basic tenets previously held as absolute.

The potential for conflict is inherent in both modernism and multiculturalism, conflict that becomes especially deadly when combined with the third aspect of globalization—the dispersion of modern technologies of warfare. Violent conflict, often intertwined with religious issues, has been part of human history for thousands of years. But in the current period of globalization, the cost of such conflict has grown unimaginably high because our arsenal now includes nuclear, biological, and chemical weapons of mass destruction as opposed to stones, clubs, and other primitive weapons. As Kurtz and Kurtz (2016) succinctly state, “Given the destructive

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capabilities of modern weaponry and the consequent necessity for peaceful coexistence, the potential for religious traditions to promote either chaos or community becomes a crucial factor in the global village” (pp. 290–291).

In light of this complex and ever-changing picture, social workers gain very little real understanding of a person by simply knowing his or her primary religious affiliation. First, religious affiliation may or may not hold great significance for the person, and identification with a religion alone does not indicate depth of involvement. Second, belief, practice, and involvement can be quite varied, even among adherents of the same spiritual tradition or among members of the same family, kinship group, or faith community—even if they all self-identify as Methodist or Muslim or Wiccan. Third, some people feel connected to multiple spiritual perspectives simultaneously, such as a combination of Judaism and Buddhism or traditional Indigenous spiritual beliefs and Christianity. Fourth, the meaning of religious or spiritual affiliation may change across the life course; a person may feel more or less connected to a particular tradition at different points in his or her life. And finally, the meaning of a person’s religious or spiritual affiliation must be understood within his or her broader historical, sociopolitical, and cultural context in order for its full significance to be realized. It is important to understand the range of spiritual influences (both religious and nonreligious) that may contribute to anyone’s life story and the larger collective realities that impact that story at any particular point in time.

Photos 6.2a & 6.2b Religion involves the patterning of spiritual beliefs and practices into social institutions; different cultures focus their beliefs around different central figures.

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Critical Thinking Questions 6.1

At the beginning of the chapter, you read about the spiritual and religious beliefs of eight people. With which of the stories were you most comfortable? For what reasons? With which of the stories were you least comfortable? For what reasons? How

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comfortable are you with the idea of including the spiritual person in social work’s understanding of human behavior? What do you like about the idea? What don’t you like about the idea?

Theories of Spiritual Development The idea that spirituality is an important dimension of human behavior is not a new one in social work or in other helping professions. Although Sigmund Freud (1928) asserted that all religious and spiritual beliefs were either illusions or projections of unconscious wishes, many other early behavioral science theorists viewed the role of spirituality differently.

Notably, Carl Jung, a student of Freud’s, differed with his former teacher and mentor in regard to the topic of spirituality. Jung’s (1933) theory of personality includes physical, mental, and spiritual selves, which all strive for unity and wholeness within each person. In Jung’s (1959/1969) view, an important archetype (a universal unconscious idea) is “the Spirit” (p. 214). Jung further proposed that the evolution of consciousness and the struggle to find a spiritual outlook on life were the primary developmental tasks in midlife. If this task is successfully accomplished, the result is individuation, which Jung defined as “the moment when the finite mind realizes it is rooted in the infinite” (as quoted in Keutzer, 1982, p. 76).

Robert Assagioli (1965, 1973) also emphasized the spiritual dimension in his approach known as psychosynthesis. His understanding of the human psyche included the constructs of “higher unconscious” or “superconscious” as the source of creativity and spirituality. In Assagioli’s view, some psychological disturbances are best understood as crises of spiritual awakening rather than symptoms of psychopathology. In such cases, the responsibility of the therapist is to facilitate the client’s exploration of spiritual possibilities while dealing with the difficulties such awakenings can engender. As Assagioli (1989) defined it, “‘spiritual’ refers not only to experiences traditionally considered religious but to all the states of awareness, all the human functions and activities which have as their common denominator the possession of values higher than average” (p. 30, italics in original).

A third major contributor to early formulations on spirituality and human behavior was Abraham Maslow, founder of humanistic psychology. Maslow (1971) described spirituality as an innate and key element in

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human nature. In his study of optimally functioning people, he characterized people at the top of his hierarchy as “transcendent self- actualizers” and described them as having (among other traits) a more holistic view of life; a natural tendency toward cooperative action; a tendency to be motivated by truth, goodness, and unity; a greater appreciation for peak experiences; an ability to go beyond their ego self to higher levels of identity; and more awareness of the sacredness of every person and every living thing. Maslow later came to believe that even this definition was not adequate to explain the highest levels of human potential. Near the end of his life, he predicted the emergence of a more expansive understanding of human behavior: “a still ‘higher’ Fourth Psychology; transpersonal, trans-human, centered in the cosmos, rather than in human needs and interests, going beyond humanness, identity, self- actualization, and the like” (as quoted in Wittine, 1987, p. 53). This transpersonal perspective is discussed later, but first let’s look at the eight cases in light of James Fowler’s theory of spiritual development.

Fowler’s Stages of Faith Development James Fowler’s (1981, 1995) theory of faith development grew out of 359 in-depth interviews conducted from 1972 to 1981 in Boston, Chicago, and Toronto. The sample was overwhelmingly White (97.8%), largely Christian (over 85%), evenly divided by gender, and widely distributed in terms of age (3.5 years to 84 years). Each semistructured interview consisted of more than 30 questions about life-shaping experiences and relationships, present values and commitments, and religion. After the responses were analyzed, interviewees were placed in one of six faith stages. Fowler found a generally positive relationship between age and stage development; as age increased, so did the tendency for persons to be in higher stages. However, only a minority of persons revealed characteristics of Stages 5 or 6, regardless of age.

To Fowler (1996), faith is broader than religious faith, creed, or belief. It can, in fact, be expressed even by people who do not believe in God or a higher power. Instead, faith is viewed as a universal aspect of human existence,

an integral, centering process, underlying the formation of beliefs, values, and meanings that (1) gives coherence and

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direction to people’s lives, (2) links them in shared trusts and loyalties with others, (3) grounds their personal stances and communal loyalties in a sense of relatedness to a larger frame of reference, and (4) enables them to face and deal with the limited conditions of life, relying upon that which has the quality of ultimacy in their lives. (p. 56)

Thus, Fowler’s definition of faith is more aligned with the definition of spirituality given at the beginning of this chapter and is clearly distinguished from more specific notions of particular beliefs or religious traditions.

Another important concept in Fowler’s theory is the ultimate environment (also known as the ultimate reality or simply the ultimate)— the highest level of reality. Faith is not only your internal image of the ultimate environment but also your relationship with that image. Your view of the ultimate environment—as personal or impersonal, trustworthy or not dependable, capable of dialogue or silent, purposeful or based on chance—and your relationship with it is an evolving, dynamic process strongly influenced by your experiences throughout the life course. Thus, Fowler’s faith is best understood as a verb, or a way of being, versus a noun, or a thing that is unchangeable.

Fowler’s stages of faith development should not be viewed as goals to be achieved or as steps necessary for “salvation.” Rather, they help us understand a person’s values, beliefs, and sense of meaning and help us better appreciate the tasks, tensions, and challenges at various points in life. They also reveal increasing capacity in terms of cognitive functioning; moral reasoning; perspective taking; critical reflection and dialectical thought; understanding of symbols, myths, and rituals; deeper faith commitments; and openness to and acceptance of difference. Here is a brief description of Fowler’s faith stages.

Prestage: primal faith (infancy). If consistent nurturance is experienced, the infant develops a sense of trust and safety about the universe and the divine. Negative experiences produce images of the ultimate as untrustworthy, punitive, or arbitrary. Stage 1: intuitive-projective faith (early childhood, beginning about age 2). The young child’s new tools of speech and symbols give rise to fluid and magical thoughts, based on intuition and imagination.

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Faith is fantasy-filled and imitative and can be powerfully influenced by examples, actions, stories of significant others, and familial and cultural taboos. Stage 2: mythic-literal faith (middle childhood, beginning about age 6, and beyond). The child begins to take on stories, beliefs, and practices that symbolize belonging to his or her community. There is a high degree of conformity to community beliefs and practices. The ability to participate in concrete operational thinking allows distinction between fantasy and reality. There is increased capacity to take the perspective of others, and ideas about reciprocity and fairness become central. Stage 3: synthetic-conventional faith (adolescence and beyond). For many adolescents, the capacity for abstract thinking and manipulation of concepts affects the process of developing faith as well as overall identity. Authority is perceived as external and is found in traditional authority figures, but there is an increased influence of peers, school and work associates, the media, and popular culture. Beliefs and values are often deeply felt but not critically examined or systematically reflected on. Symbols are not perceived as literally as in Stage 2. Stage 4: individuative-reflective faith (young adulthood and beyond). Beginning in young adulthood, many people experience an increased responsibility for their own commitments, lifestyles, beliefs, and attitudes. Previously held creeds, symbols, and stories are demythologized through critical analysis. The ultimate becomes more explicit and personally meaningful, and symbols are reshaped into more powerful conceptualizations. Stage 5: conjunctive faith (midlife and beyond). A minority of adults begins in midlife to rework the past and become open to voices of the “deeper self.” They develop the capacity for “both/and” versus “either/or” thinking and come to tolerate ambiguity and paradox, taking into account and looking for balance in such polarities as independence and connection and determinism and free will. They recognize that there are many truths and engage in critical examination of their own beliefs, myths, and prejudices. They expand their definition of community and their sense of connection and responsibility to others. Stage 6: universalizing faith (midlife and beyond). A very small minority of adults develops the capacity to truly embrace paradox. They develop an enlarged awareness of justice and injustice. The

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vision of truth is expanded to recognize partial truths. Symbols, myths, and rituals are appreciated and cherished at a deeper level. Divisions within the human family are felt with vivid pain because of the recognition of the possibility of the inclusive union of all beings. They lead selfless lives of service and action for justice aimed at the transformation of humankind.

Now let us consider the stories revealed in the eight case studies through the lens of Fowler’s faith stages, based on both his early research and later theoretical refinements. In Fowler’s model, our early experiences set the stage for later faith development. Given what we know about the eight people described in the case studies, it is probably safe to assume that most of them were able to develop at least a “good enough” fund of basic trust and mutuality during the Prestage: primal faith for later development of a relationship with the ultimate. A possible exception to this is Trudy, whose early years were marked by parental substance abuse and violence. It would be important to know when these problems first appeared within her family and how much they interfered with her initial bonding with her mother and father, for these factors would be influential in both her ability to trust and her internal sense of the ultimate as she moves through her life.

None of the eight case studies tells us much about the development of early images of the ultimate environment during Stage 1: intuitive- projective faith. However, we can speculate that these images were probably drawn from each person’s particular faith affiliation. For Caroline, Matthew, and Leon, these initial conceptions of the divine would have been grounded within their particular Christian denominations, Naomi would have developed her sense of the ultimate as it was reflected in her Jewish faith, and Amira’s sense of the divine would have been based on examples, modes, actions, and stories that she experienced in her family’s belief in Islam. Jean-Joseph’s sense of the ultimate would have been influenced by a combination of Catholic symbols, narratives, and rituals and the spiritual beliefs and practices of Vodoun. Trudy and Beth were not raised in any particular religious tradition but found meaning and purpose in other ways. Trudy found solace in nature, and Beth found significance through social justice activities. It would be important to talk with both of them about how their early experiences affected their sense of what they held to be most important in their lives and to not assume their lack of exposure to organized religion meant they had no early images or experiences with the ultimate, for spirituality is experienced and expressed

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through both religious and nonreligious means. In working with all eight people, we would want to understand how this process of image making was handled by their families and others in their lives and how much support they were given for their own intuition and imagination during this time.

If Fowler had interviewed any of the eight during middle childhood, he more than likely would have seen many of the aspects of Stage 2: mythic- literal faith reflected in this group. It would be important to understand the role of their childhood spiritual communities in shaping each person’s sense of the world and his or her place in it. It would be particularly useful to explore the stories and narratives they remember from that time, especially as they transmitted values, attitudes, and norms for behavior. For example, discussing with Leon what he understood as his church’s core principles relative to sin and redemption would be invaluable in comprehending his current struggle. It would also be important to understand the messages Caroline received regarding her own religion as the only true faith. For Naomi, Jean-Joseph, and Amira, it would be key to talk about how their communities handled being believers of a nondominant (or “other”) religion in a culture where Christianity is the dominant faith and is generally seen as “the norm.” For Beth, it might mean understanding the meaning of the stories she heard about her grandparents’ experiences as union organizers. For all eight people, it would be vital to explore what helped create a sense of order and meaning at this stage of life and what provided a sense of guidance and belonging.

The events that occur during adolescence generally have a significant effect on faith development during Stage 3: synthetic-conventional faith, for this is the point where people are heavily engaged in the process of identity development, including spiritual identity. It is also a time when the person’s world is greatly expanded, bringing diverse and complex ideas and experiences regarding all of life. Adolescents must make coherent meaning from all the different messages they receive from family, school, work, media, and the larger sociocultural realm. A person’s faith understanding can help synthesize various values and viewpoints and provide a basis for forming a stable identity and worldview. There is a tendency to construct one’s faith through conforming to a set of values and beliefs that are most familiar and to defer to whatever authority is most meaningful. As two people most recently in this life stage, both Caroline and Leon illustrate the strong impetus to form a faith identity that provides

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a solid sense of self and a feeling of belonging to a particular group. For both of them, the faith of their families and their home churches were highly instrumental in this process. Beth and Amira are also in the midst of developing an identity. For Beth this identity is composed of attributes of personal integrity and commitment to actions grounded in the socially conscious, ethical framework of her family. Amira is focused on forging an identity based on her career goals, while attempting to set aside issues of religious identity. For all of them, entry into the next stage of life brought questions regarding the beliefs and values of these key social institutions and an urge to explore beyond what they had previously known.

If we look at Caroline’s, Leon’s, Beth’s, and Amira’s lives as they move into Stage 4: individuative-reflective faith, we see young people grappling with key questions about themselves and their belief systems. Caroline’s experiences at college have opened the door to considering different worldviews, which she handles with an approach-avoidance strategy. On the one hand, she is troubled by her experience with others who believe and practice differently from the way she does, but on the other hand, she is increasingly curious about these differences. For Leon, the struggle is more difficult, as he is attempting to live with values, attitudes, and beliefs that tell him a core aspect of his identity is unacceptable. Beth is being challenged to reconsider whether she has misperceptions or even biases about people who are religious and the possible positive role religion might play in societal change. Amira is struggling to find her own way, including how to define herself as a Muslim, a woman, and a young professional. For all these young adults, the task ahead is to construct a unique, individual self (identity) and outlook (ideology) from previously held conventional beliefs and develop an approach to faith that is both personal and workable. It is important to recognize that this task does not exclude Beth as a nonreligious person, because “faith” in Fowler’s (1996) terms involves developing “an integral, centering process, underlying the formation of beliefs, values, and meanings” for living one’s life—whether or not this is found through a particular religious orientation (p. 56). Thus, the process at this point for all three young people requires a level of critical reflection and a capacity to struggle with conflicts and tensions that were not yet fully developed in the previous stage. As a social worker, you would want to facilitate this process while being mindful of the social work principles of self-determination and empowerment.

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Naomi and David provide another example of individuative-reflective faith, even though they are considerably older than Caroline, Leon, and Beth. When they were in their late teens and early 20s, their identity formation led them to a more secular worldview, as Naomi lessened her involvement with her faith and David continued to base his identity and outlook on more humanistic understandings of self and the world. But the creation of a family caused them both to reconsider the role of Judaism in their lives as they realized their desire for a spiritual community. As their children grew, their involvement with their temple has provided the personal and workable framework characteristic of this phase. That framework is now being challenged by Naomi’s illness and is leading both her and David to a deeper reflection of their faith. Social work with this couple would involve supporting this reflection, as well as exploring with them possible supports they could receive from their rabbi and larger faith community in dealing with Naomi’s health crisis.

According to Lownsdale (1997), only 1 in 6 adults reflect characteristics of Stage 5: conjunctive faith. Of our eight life stories, only Matthew’s provides glimpses of this faith stage. Although there is not much information about Matthew’s internal reflection on the paradoxes of life (a key criterion of conjunctive faith), we do know that he was able to work through the loss of his wife, and other losses that inevitably come with aging, to embrace a new chapter in his life. As a social worker, you might find it useful to explore with Matthew his understanding of life’s paradoxes (such as God being both personal and abstract and life being both rational and mysterious) and talk with him about any previously unrealized parts of himself that are now emerging. What is apparent in Matthew’s story is his enthusiastic willingness to acknowledge and honor multiple faith perspectives, while being open to new depths within his own spirituality. We also see him engaging in service for others and concern for the natural world. All these activities suggest a perspective that goes beyond egocentric and ethnocentric views to a more worldcentric (identification with the entire global human family) and ecocentric (identification with the whole ecosphere, of which humans are only one part) way of being in the world. As a result of these commitments, he is experiencing a renewed sense of purpose, meaning, and connection in his life. All of these are characteristic of persons of conjunctive faith, which brings a broader social consciousness, a passion for social justice, and a wider and deeper understanding of the sacred.

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It is clear that none of the eight people reflects the self-sacrificial life of Fowler’s Stage 6: universalizing faith. Persons at this stage are exceedingly rare, perhaps two to three individuals per thousand (Lownsdale, 1997). Given the exceptional nature of such persons, it is not surprising that the eight case studies do not reveal examples of this faith stage. Some might point to Trudy’s total immersion in spiritual practices as evidence of this stage, but another perspective on her development is offered later in this chapter during discussion of transpersonal theory.

Finally, we must address Jean-Joseph’s spiritual path, which includes a syncretism (combination) of Catholicism and Vodoun, or “serving the spirits.” If a social worker embedded in dominant Western culture assessed his faith development solely from the standpoint of this context, he or she might determine that Jean-Joseph falls within an early stage, either mythic- literal or perhaps even intuitive-projective. This determination would no doubt lead to a conclusion that this 50-year-old man is an example of underdeveloped faith and may lead to interventions aimed at helping him give up his “primitive and immature” beliefs and practices for a worldview seen as more appropriate for mature adults. If this were the stance taken by a practitioner, he or she would be showing ethnocentric and religiocentric bias, as well as cultural insensitivity. Viewed within his sociocultural context, Jean-Joseph is exhibiting a faith stage that could be more accurately determined to be at least synthetic-conventional, given its congruence with the spiritual beliefs and practices of his Haitian culture. Upon further exploration with him—with an open mind, respect, and humility for the limits of one’s knowledge about his religion—a social worker may discover that Jean-Joseph displays characteristics of higher stages of faith development. This highlights the need for social workers to constantly be aware of their own lack of knowledge and their internalized biases when working with religious and spiritual traditions unfamiliar to them, in order to engage in culturally sensitive service respectful of those traditions (Weaver, 2011).

Transpersonal Theory As noted previously, Maslow predicted the emergence of a fourth level of human behavior theory that would account for higher levels of development. Au-Deane Cowley (1993, 1996) describes the emergence of this fourth level in her discussion of the four major therapeutic approaches that have emerged over the past century, each developed in response to our

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understanding of human behavior and human needs at the time.

1. First force therapies are based on psychodynamic theories of human behavior. The prime concern of these therapies is dealing with repression and resolving instinctual conflicts by developing insight.

2. Second force therapies evolved from behavioral theories. These therapies focus on learned habits and seek to remove symptoms through various processes of direct learning.

3. Third force therapies are rooted in existential/humanistic/experiential theories. They help the person deal with existential despair and seek the actualization of the person’s potential through techniques grounded in immediate experiencing.

4. Fourth force therapies, based on transpersonal theories, specifically target the spiritual dimension. They focus on helping the person let go of ego attachments—identifications with the mind, body, and social roles—and transcend the self through various spiritually based practices. (Cowley, 1996)

The fourth force builds on the previous three forces and thus incorporates existing knowledge concerning human behavior within its framework. What differentiates the fourth force—the transpersonal approach—from other theoretical orientations is the premise that some states of human consciousness and potential go beyond our traditional views of health and normality. These states explicitly address the spiritual dimension of human existence (Cowley & Derezotes, 1994).

The term transpersonal literally means “beyond” or “through” the “persona” or “mask” (Wittine, 1987). When applied to theories of human behavior, transpersonal means going beyond identity tied to the individual body, ego, or social roles to include spiritual experience or higher levels of consciousness. The self is experienced as in unity with all others. A major focus of transpersonal theory is on “humanity’s highest potential” (Lajoie & Shapiro, 1992, p. 91). Increasingly recognized is the relevance of a transpersonal orientation to the realm of everyday life as well, including the “lower end’’ of human functioning. Thus, transpersonal practice approaches must “include the whole—not just the high end of human experience but the very personal realm of ordinary consciousness as well” (Cortright, 1997, p. 13). Several branches of transpersonal thought are currently recognized, including Jungian psychology; depth or archetypal psychology; spiritual psychology; positive psychology; psychosynthesis;

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and approaches based on the writings of Abraham Maslow, Stanislav Grof, Ken Wilber, Michael Washburn, Frances Vaughan, Roger Walsh, Jorge Ferrer, and Charles Tart, among others. A major objective of all transpersonal theories is to integrate spirituality within a larger framework of human behavior. One key application of transpersonal theory is as a conceptual underpinning for theories that address spiritual development. The following provides an overview of one of the best-known transpersonal theories of spiritual development developed by Ken Wilber.

Wilber’s Integral Theory of Consciousness Ken Wilber first published his transpersonal theory of development in 1977 in The Spectrum of Consciousness but has continued to develop and refine his model in numerous writings. His work reflects a unique integration of biology, history, psychology, sociology, philosophy, and religion. It is rooted in both conventional Western knowledge and contemplative-mystical traditions of Eastern religions and other spiritual perspectives. Wilber (2006) currently refers to his approach as an “integral theory of consciousness.” He identifies it as “integral” because it explores human development across four quadrants or vantage points (interior- individual, exterior-individual, interior-collective, and exterior-collective) and through three levels of consciousness (prepersonal, personal, and transpersonal). Within each quadrant, the three levels of consciousness unfold in a way that reflects the unique properties of that particular quadrant. Wilber sees the ultimate goal of human development (at the individual and collective levels) as evolving to a higher, nondual level of consciousness well integrated into personal and societal functioning. This requires movement through the three stages of spiritual development, marked by increasingly complex, comprehensive, and inclusive understandings of spirituality and expanded consciousness about reality. It is Wilber’s depiction of human development within the quadrant of interior of individuals that is the major contribution of his model to theories of spiritual development.

Wilber (2006) agrees with other transpersonal theorists that consciousness spans from prepersonal to personal to transpersonal. This overall spectrum is reflected in the world’s major spiritual traditions and is referred to as the “great chain of being” (matter to body to mind to soul to spirit). Wilber points out that because this process is not strictly linear, it is best understood as a “great nest of being” in that it is really a series of

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enfolding and unfolding spheres or spirals. In other words, spirit transcends but includes soul, which transcends but includes mind, which transcends but includes body, which transcends but includes matter. This process of incorporation is rooted in the concept of a holon, or “that which, being a whole in one context, is simultaneously a part in another” (Wilber, 1995, p. 18, italics in original). Thus, Wilber refers to his spectrum of consciousness as a holarchy (rather than a hierarchy), because it reflects an ordering of holons (or increasing levels of complexity and wholeness) throughout the developmental process. It may be helpful to visualize this as a set of Russian nesting dolls, with each larger doll both including and going beyond the smaller ones. With each larger level (or doll), one expands consciousness or awareness of reality and develops a larger repertoire of individual and social functioning.

The six levels of consciousness at the prepersonal and personal phases in Wilber’s theory are very similar to the first five of Fowler’s faith stages and are not presented in detail here. A review of the levels of prepersonal and personal phases of consciousness should sound familiar to students of conventional approaches to human development. In contrast, the levels of the transpersonal phase (and the language used to describe them) are most likely unfamiliar to those not well versed in contemplative Eastern ideas about human development. However, this synthesis of both conventional and contemplative approaches and the inclusion of higher-order levels of development is Wilber’s primary contribution to our attempts to understand human behavior.

As one moves into the transpersonal or transegoic phase, the world and life in general are perceived in more holistic and interconnected terms. There is movement from an egocentric and ethnocentric perspective to a worldcentric and ecocentric grasp of the complete interdependence of all things in the cosmos. There is also the realization that the self is more than a body, mind, and culture-bound social roles and an awareness of a self that exists beyond time-space limits or ego boundaries. This realization facilitates a growing understanding of how all beings are unified within a singular or nondual ultimate reality. As people move further into the transpersonal or transegoic phase, they retain all the capacities developed during previous levels and incorporate these functions into expanded consciousness experienced at higher, transpersonal levels. The three transpersonal levels are described next. As you read through each one, focus on what the descriptions say about a person’s level of consciousness

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at each level. In other words, what is the person perceiving or what are they aware of beyond the ordinary states of reality (waking, sleeping, dreaming) common to most people?

1. Level 7 (psychic or nature mysticism) is characterized by a continuing evolution of consciousness as the observing self develops more and more depth. Wilber refers to this evolving inner sense as the witness, because it represents an awareness that moves beyond ordinary reality (sensorimotor, rational, existential) into the transpersonal (beyond ego) levels. A distinguishing spiritual experience at this level is a strong interconnectedness of self with nature. For example, a person may temporarily become one with a mountain or bird or tree. This type of experience is not psychotic fusion—the person is still very clear about his or her own personal boundaries—but it is a strong awareness of communion with the natural world. At this point, one’s higher self becomes a world soul and experiences nature mysticism. Because of this powerful experience of connection and identification, there is a natural deepening of compassion for all living things, including nature itself.

2. Level 8 (subtle or deity mysticism) is characterized by an awareness of more subtle processes than are commonly experienced in gross, ordinary states of waking consciousness. Examples of such processes are interior light and sounds; awareness of transpersonal archetypes; and extreme states of bliss, love, and compassion. At this point, even nature is transcended, yet it is understood as a manifest expression of the ultimate. One’s sense of connection and identification is extended to communion with a deity, or union with God, by whatever name. Thus, consciousness at this level is not just nature mysticism—union with the natural world—but gives way to deity mysticism—union with the divine. This level of consciousness can be experienced in many forms, often rooted in the person’s personal or cultural history. For example, a Christian may feel union with Christ, whereas a Buddhist might experience connection with the Buddha.

3. Level 9 (causal or formless mysticism) transcends all distinctions between subject and object (even self and God). The witness is experienced as pure consciousness and pure awareness, prior to the manifestation of anything. Thus, this level is said to be timeless, spaceless, and objectless. As Wilber (1996) describes it, “Space, time, objects—all of those merely parade by. But you are the Witness, the pure Seer that is itself pure Emptiness, pure Freedom, pure Openness,

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the great Emptiness through which the entire parade passes, never touching you, never tempting you, never hurting you, never consoling you” (p. 224). This level is pure formless mysticism, in that all objects, even God as a perceived form, vanish into pure consciousness. This level of consciousness is sometimes referred to as “full Enlightenment, ultimate release, pure nirvana” (Wilber, 1996, p. 226). But it is still not the final story.

Wilber also proposes a Level 10 (nondual), which is characterized by disidentification with even the witness. The interior sense of being a witness disappears, and the witness turns out to be everything that is witnessed. At this level, emptiness becomes pure consciousness itself. There is no sense of two, there is only one (hence the name nondual). Essentially, the person’s awareness has moved beyond nature, deity, and formless mysticism to nondual mysticism. Furthermore, it is not really a level among other levels but is rather the condition or reality of all levels. It is simultaneously the source, the process, and the realization of consciousness. Wilber does not depict the nondual as a separate level in his illustration of the structures of consciousness because it represents the ground or origin of all other levels—the paper on which the figure is drawn.

With this model, Wilber is proposing that the personal phase of development, with its achievement of strong ego development and self- actualization, is not the highest potential of human existence, although a necessary point along the way. Rather, the ultimate goal of human development is the transpersonal or transegoic phase—beyond ego or self to self-transcendence and unity with the ultimate reality. The capacity for attaining the highest levels of consciousness is seen as innate within each human being, although Wilber acknowledges that very few people reach the higher transpersonal levels.

Wilber (2000a, 2006) stresses that practitioners need to be able to correctly identify the correct phase of development in order to provide the most appropriate intervention and support to clients. If not accurately identified, there is the probability of what Wilber (1995, 2000b) calls the “pre/trans fallacy,” which occurs when a problem at a transpersonal level (such as a spiritual awakening) may be treated as if it were a prepersonal or personal disorder (a psychotic episode or existential crisis) or vice versa.

Let’s revisit Trudy’s story to better understand what Wilber is talking

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about here. Trudy is currently focusing most of her time and energy toward developing her spiritual self in order to achieve enlightenment. She is meditating 5 hours a day, is engaged with a daily yoga practice, and limits her reading and interpersonal contacts to those she identifies as spiritual. Given that most transpersonal theorists and spiritual leaders would agree that engagement in some type of spiritual practice is helpful for spiritual growth, one might characterize Trudy’s behavior as that of a disciplined, spiritual seeker and perhaps assume that she is moving into the transpersonal phase of development. But there is evidence in her story that Trudy is caught up in spiritual bypassing, a term first coined by John Welwood (2000), which he describes as “the tendency to use spiritual practice to bypass or avoid dealing with certain personal or emotional ‘unfinished business’” (p. 11). Welwood states that persons struggling with life’s developmental challenges are particularly susceptible to spiritual bypassing, as they attempt to find themselves by giving themselves up—or prematurely trying to move beyond their ego to self-transcendence, ignoring their personal and emotional needs. This attempt to create a new “spiritual” identity in order to avoid the pain of working through unresolved psychosocial issues does not work and frequently causes additional problems.

Trudy’s story reflects the possibility of three of the eight manifestations of spiritual bypassing discussed by Sheridan (2017): avoidance/repression of undesirable or painful emotions; fear of intimacy, closeness, and vulnerability; and spiritual obsession/addiction. (The five other faces of spiritual bypassing include quest for perfection or compulsive goodness; fear of individuation and avoidance of responsibility/accountability; spiritual narcissism or ego inflation; blind faith in charismatic leaders/teachers; and flight into humanitarian causes.) As Trudy’s social worker, you would want to do a thorough assessment, taking into account the substantial unresolved trauma and losses in her life. To ignore these issues and focus only on supporting her quest for enlightenment would be to commit Wilber’s pre/trans fallacy and miss the possibility of spiritual bypassing and mistakenly assume that she was at a high level of spiritual development. As a responsible and ethical social worker, you would help her address these unresolved issues at the personal, and perhaps even prepersonal, level while maintaining respect for her spiritual perspective. You would also help her discern the appropriate role of her spiritual practices in support of her overall growth and development. Consulting with a spiritual teacher or a transpersonal practitioner, with Trudy’s

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permission, also might be helpful in this case.

Likewise, if a practitioner identifies a client’s spiritual practices as signs of a serious problem simply because they are unfamiliar or seem “strange,” he or she would be moving to the other side of Wilber’s pre/trans fallacy— treating potentially spiritual or transpersonal experiences as if they were psychological disorders at the prepersonal or personal level. The potential for this type of error is evident in the case of Jean-Joseph and his family. If this family sought help from conventional health care services, while also following traditional spiritually based healing processes, as a social worker your task would be to help the family and the medical professionals find a way to work together. This is not always an easy task, as is poignantly illustrated in Anne Fadiman’s (1998) book, The Spirit Catches You and You Fall Down, which tells the tragic story of a Hmong child with epilepsy who becomes brain-dead because of the failure of professionals to understand unfamiliar spiritual worldviews and negotiate cultural differences. This true account highlights the critical need for social workers to develop the knowledge, values, and skills of spiritually sensitive practice in order to serve clients from diverse spiritual traditions.

Summary and Critique of Fowler’s and Wilber’s Theories Both Fowler’s and Wilber’s models of individual spiritual development reflect fourth force theory in that they incorporate the first three forces (dynamic, behavior, and existential/humanistic/experiential theories). In fact, Fowler and Wilber use many of the same theorists (e.g., Piaget, Kohlberg, Maslow) as foundations for their own work, and both are delineating higher and more transcendent levels of human development than have been previously proposed by Western theories. In later writings, both theorists also offer additional conceptual formulations at the larger sociocultural levels (Fowler, 1996; Wilber, 2000b).

The major difference between the two models in terms of individual development is that Wilber provides more substance and specification than Fowler does about what transpersonal levels of development look like and how they evolve. Wilber also provides more detailed descriptions of the potential pitfalls of spiritual development than Fowler, who provides only a general overview of the possible dangers or deficits of development at

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each of his faith stages. However, Fowler provides more specification about the content and process of spiritual development at the prepersonal and personal phases. In terms of their utility for social work practice, we could say that Fowler’s model is more descriptive and Wilber’s is more prescriptive. Both theories have been critiqued in a number of areas. An overview of these critiques is presented next.

First, as developmental models, Fowler’s and Wilber’s models are open to the criticisms of all developmental perspectives, including charges of dominant-group bias. Such perspectives do not pay enough attention to social, economic, political, and historical factors and the role of power dynamics and oppression in human development. Developmental perspectives are also said to convey the idea that there is only one right way to proceed down the developmental path and thus display an ethnocentrism often rooted in middle-class, heterosexual, cisgender, Anglo-Saxon, male life experience.

Both Fowler and Wilber might counter by pointing out that familial, cultural, and historical contexts are considered in their models. Wilber, in particular, would highlight the extensive use of cross-cultural knowledge in the development of his theory and point to the cessation of ethnocentrism as a major characteristic of his later stages of consciousness. He would also stress the integral nature of his more current theoretical developments, which pay equal attention to exterior impacts on spiritual development as to interior aspects (Wilber, 2000b, 2001, 2006). Both theorists would also support the notion of many paths in spiritual development, although they would say that these many paths have common features in their evolution.

A second critique of both theories is their relative lack of attention to the spiritual capacities and potentialities of children, focusing more on the emergence of spiritual issues in adulthood. This is due to the assertion that higher levels of cognitive functioning (capacity for formal operations and abstract thought) are necessary to fully experience and incorporate spiritual experience. A number of writers have contested this assertion, proposing that childhood is a unique time of enhanced, not diminished, spiritual awareness (Coles, 1990; Hay, Nye, & Murphy, 1996; Levine, 1999). They base this viewpoint on in-depth interviews with children ranging in age from 6 to 11 (Hay & Nye, 2006), which often revealed a richness and depth regarding spirituality that is generally not expected of

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people of this age, including a variety of spiritual experiences and epiphanies such as archetypical mythical dreams; visionary experiences; profound insights about self-identity, life, and death; and heightened capacities for compassion for all living things. Results from a national survey of seasoned social workers who work with children and adolescents reveal that practitioners generally see the relevance of religion and spirituality in the lives of children and that they encounter youth who present spiritual issues in practice (Kvarfordt & Sheridan, 2007).

Wilber (2000a) concedes that children can have a variety of spiritual experiences, including peak experiences that provide glimpses of the transpersonal realm, but he states that these incidents are experienced and incorporated within the child’s prepersonal or personal stage of development. Regardless of the developmental level, there clearly is a need for further exploration of children’s spirituality in order to understand their unique spiritual experiences, developmental processes, and needs. Similarly, there is also a need to revisit assumptions about the spiritual experiences and capacities of adults who have lower cognitive functioning, either congenitally or as a result of injury.

A third critique concerns empirical investigation of the theories. Although Fowler’s model was developed through an inductive research process and Wilber’s formulations are grounded in a synthesis of many lines of research and philosophical analysis, there is an ongoing need for empirical verification of both models. Empirical exploration of Fowler’s faith stages has provided both support and critique for his framework (see Slee, 1996; Streib, 2005, for reviews of this work). Similarly, there have been more than 150 articles published on integral theory (Esbjörn-Hargens, 2010), providing both support and challenge to some of the theory’s key tenets. The fact that findings are not conclusive regarding Fowler’s and Wilber’s theories is understandable, given the difficulties of empirical investigation in such an abstract realm. It is difficult enough to operationalize and measure such concepts as formal operational cognition or self-esteem; the challenge of investigating faith development or transcendence is even more daunting. Nonetheless, strategies from both positivist and constructivist research approaches are currently available to study interior states and subjective experiences of meaning as well as biophysical manifestations of different states of consciousness. (See Chapter 1 for a review of positivist and interpretist research approaches.) As is true for all theories of human behavior, transpersonal models such as Fowler’s and

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Wilber’s need to be specifically tested and refined through the research process. This research also must be replicated with different groups (defined by sex and gender, age, race, ethnicity, socioeconomic status, geopolitical membership, and the like) in order to explore the universality of the models.

In conclusion, both Fowler and Wilber provide perspectives beyond our traditional biopsychosocial framework that allow us to better understand human development and functioning, and they suggest a direction for working with people from diverse spiritual perspectives. Their theories are major contributions to human behavior theory. However, we also need viable practice theories and practice models that explicitly address the spiritual dimension. There have been promising developments in this area. Examples include Smith’s (1995) transegoic model for dealing with death and other losses; Cowley’s (1999) transpersonal approach for working with couples and families; Hickson and Phelps’s (1998) model for facilitating women’s spirituality; and Clark’s (2007) model for working with spirituality, culture, and diverse worldviews. There are also practice models that directly integrate spirituality within biopsychosocial approaches. Examples are Almaas’s (1995, 1996) diamond approach, which incorporates object relations and body sensing within Sufism, and Grof’s (2003; Grof & Bennett, 1992) holotropic breathwork model, which combines bodywork and altered states of consciousness to address unresolved psychological issues from earlier points in development. Finally, Cortright (1997) provides a good overview of how a transpersonal orientation can be generally incorporated within psychoanalytic and existential therapies, and Mikulas (2002) offers a practice approach that integrates a transpersonal perspective with behavioral approaches. All of these developments reflect a synthesis of transpersonal with earlier therapeutic modalities (first, second, and third force therapies). As with human behavior theories of spiritual development, these practice theories and models also must be tested and continually refined to determine their utility and applicability for a wide range of client situations.

Critical Thinking Questions 6.2

Fowler and Wilber both think of spirituality in terms of development to higher levels of faith or consciousness over time. Do you think this is a helpful way to think about spirituality? Explain. Is it a helpful way to think about your own spiritual life? Explain. Do you see any cultural

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biases in either of the theories? Explain.

The Role of Spirituality in Social Work Canda and Furman (2010) outline five broad historical phases that trace the development of linkages between spirituality and social work in the United States. An overview of these phases is presented next.

1. Indigenous precolonial period. This period includes the thousands of years when Indigenous cultures in North America employed a variety of spiritually based approaches to healing and mutual support. These practices, discussed in greater detail later in the chapter, focused beyond human welfare to include the well-being of other living beings and the earth itself. Many of these traditional ways continue into the present, both outside of and within social work (Baskin, 2006; Brave Heart, 2001; Bucko & Iron Cloud, 2008).

2. Sectarian origins. This phase began with the colonial period and lasted through the first 20 years of the 20th century. Early human services, institutions, and social welfare policy were significantly influenced by Judeo-Christian worldviews on charity, communal responsibility, and social justice (Lowenberg, 1988; Popple & Leighninger, 2005). At this time, there were also competing explanations of human behavior: on the one hand, an emphasis on distinguishing individual moral blame or merit (e.g., the worthy versus unworthy poor) and on the other hand, a focus on social reform and social justice (e.g., Jewish communal service and Christian social gospel). Human service providers typically had a strong spiritual foundation for their work but offered service through nonsectarian means (e.g., Jane Addams and the settlement house movement). Indigenous, African American, and Spanish and French Catholic spiritual perspectives also contributed to the evolution of social work during this time frame (Martin & Martin, 2002; Van Hook, Hugen, & Aguilar, 2001).

3. Professionalization and secularization. Beginning in the 1920s and continuing through the 1970s, social work began to distance itself from its early sectarian roots. This movement mirrored a shift within the larger society, which began to replace moral explanations of human problems with a scientific, rational understanding of human behavior. The social work profession increasingly relied on scientific

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empiricism and secular humanism as the major foundations for its values, ethics, and practice approaches (Imrie, 1984; Siporin, 1986). This period also witnessed social work’s reliance on a variety of emerging psychological and sociological theories (such as psychoanalytic, behavioral, and social functionalism), which did not recognize the spiritual dimension as significant either for understanding human behavior or as a focus for practice. However, several religiously affiliated agencies continued to provide social services (e.g., Catholic Social Services, Jewish Family Services, Lutheran Social Services, the Salvation Army). Nonsectarian spiritual influences were also felt, including principles of 12-step programs; humanistic, existential, and Jungian thought; and ideas about human development drawn from Eastern religions (Robbins, Chatterjee, & Canda, 2012).

4. Resurgence of interest in spirituality. A renewed interest in the spiritual dimension began in the 1980s (Canda, 1997; Russel, 1998). Indicators of this new phase within the profession included a marked increase in the number of publications and presentations on the topic; the development of the national Society for Spirituality and Social Work (SSSW); and the first national conference on spirituality and social work, held in 1994. As part of this substantial activity, there was infusion of new and diverse perspectives on spirituality that influenced the profession, including Buddhism, Confucianism, Hinduism, Shamanism, Taoism, and transpersonal theory. This period differed from the earlier sectarian period in that it emphasized the need to address spirituality in a way that recognizes the value of diverse spiritual traditions and respects client self-determination (Canda, 1988; Sheridan, Bullis, Adcock, Berlin, & Miller, 1992). This trend toward reexamination and reintegration of spirituality within the profession corresponded with increased interest within the larger culture (Gallup & Lindsay, 1999).

5. Transcending boundaries. From 1995 to the present, the profession has witnessed an elaboration and expansion of prior trends. This includes the reintroduction of references to religion and spirituality in the Council on Social Work Education’s (CSWE) 1995 Curriculum Policy Statement and 2000 Educational Policy and Accreditation Standards after an absence of more than 20 years. The first international conference of the SSSW was held in 2000, with other national and international conferences increasingly including presentations on spirituality (e.g., National Association of Social

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Workers [NASW], CSWE’s Annual Program Meeting, International Federation of Social Workers [IFSW], International Association of Schools of Social Work [IASSW]). The Canadian Society for Spirituality and Social Work was established in 2002 and cohosts conferences with the U.S. SSSW. A recent development has been the establishment of CSWE’s Religion & Spirituality Clearinghouse in 2011, which provides curricular resources for social work educators. New postmodern perspectives on spirituality have also entered the arena, including feminist, ecophilosophical, postcolonial, and expanded transpersonal frameworks, which have broadened the focus of spirituality to include all peoples, all nations, all beings, and the planet itself, with special concern for marginalized and oppressed groups (Besthorn, 2001; Canda, 2005; Coates, 2003). There also has been exponential growth in empirical work during this period, including more than 50 studies of social work practitioners, faculty, and students (see Sheridan, 2004 and 2009, for reviews of this literature) and growing numbers of studies relative to direct practice with social work clients (see, for example, Beitel et al., 2007; Brown, Carney, Parrish, & Klem, 2013; Nelson-Becker, 2006). There also have been developments in integrating spirituality and macro practice (see, for example, Hugen & Venema, 2009; Rogers, 2009; Sheridan, 2013). Clearly, the focus has shifted from whether the topic should be included in the profession to how to integrate spirituality within social work practice in an ethical, effective, and spiritually sensitive manner (Canda & Furman, 2010; Canda, Nakashima, & Furman, 2004; Sheridan, 2009; Van Hook et al., 2001).

Regarding social work education, two major rationales have been proposed for including content on spirituality within undergraduate and graduate studies. Studies of social work educators (Sheridan, Wilmer, & Atcheson, 1994) and students (Sheridan & Amato-von Hemert, 1999) reveal general endorsement of these two rationales, as reflected in the following statements:

Religious and spiritual beliefs and practices are part of multicultural diversity. Social workers should have knowledge and skills in this area in order to work effectively with diverse client groups (90% of educators “strongly agree/agree”; 93% of students “strongly agree/agree”). There is another dimension of human existence beyond the

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biopsychosocial framework that can be used to understand human behavior. Social work education should expand this framework to include the spiritual dimension (61% of educators “strongly agree/agree”; 72% of students “strongly agree/agree”).

A number of publications address the relevance of spirituality for the profession in these two domains, and the range of this literature has become extensive. Thus, the following sections provide examples of writings that examine the role of spirituality relative to human diversity or the human condition. Readers are encouraged to use these as a starting place for further exploration.

Spirituality and Human Diversity Commitment to issues of human diversity and to oppressed populations is a hallmark of the social work profession. At various times in history, some branches of organized religion have played a negative or impeding role in the attainment of social justice for various groups. Examples include the use of religious texts, policies, and practices to deny the full human rights of persons of color; women; and gay, lesbian, bisexual, and transgender persons. At the same time, organized religion has a rich heritage of involvement in myriad social justice causes and movements, including the civil rights movement, the peace movement, the women’s movement, the gay rights movement, abolition of the death penalty, the antipoverty movement, and the deep ecology movement.

It is beyond the scope of this chapter to do an overall analysis of the role of religion in the struggle for social and economic justice. However, the following sections provide examples of the impact of both religious and nonreligious spirituality in the lives of oppressed groups as defined by race and ethnicity, sex and gender, sexual orientation, and other forms of human diversity.

Race and Ethnicity

Spirituality expressed in both religious and nonreligious forms has been pivotal in the lives of many persons of color and other marginalized ethnic groups. This brief discussion of spirituality and race/ethnicity emphasizes common experiences and themes in order to provide a general overview.

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However, remember that a great deal of diversity exists within these groups and that every person’s story is unique.

1. African Americans. In a survey conducted by the Pew Research Center’s Forum on Religion & Public Life (Sahgal & Smith, 2009), African Americans emerged as notably more religious than the general U.S. population based on a number of indicators. They have the highest percentage of religiously affiliated adults of all racial/ethnic groups (87%), and nearly 8 in 10 (79%) say that religion is very important in their lives, compared with 56% of all U.S. adults. Even the majority (72%) of African Americans who are not affiliated with any particular faith report that religion plays at least a somewhat important role in their lives, and almost half (45%) of this group say that it is very important. Furthermore, 53% report attending religious services at least once a week, 76% pray daily, and 88% declare that they are absolutely certain about the existence of God. Data from this survey show the majority of African Americans identifying as Protestant (78%), followed by Catholic (5%), and Jehovah’s Witness (1%). Four percent reported some other type of affiliation, and 12% identify as unaffiliated. African Americans account for about one fourth of adherents to Islam in the United States (Pew Forum, 2008), including membership in Sunni Islam or other mainstream Islamic denominations, the Nation of Islam, or smaller Black Muslim sects (Haddad, 1997). Black churches, in particular, have historically been a safe haven for African Americans facing racism and oppression, as well as an important source of social support, race consciousness and inspiration, leadership training, human services, and empowerment and social change (Logan, 2001; Taylor, Chatters, & Levin, 2004). The legacy of slavery and the integrated heritage of African and African American spiritual values have emphasized collective unity and the connection of all beings (Nobles, 1980). Afrocentric spirituality stresses the interdependence among God, community, family, and the individual. Its central virtues include beneficence to the community, forbearance through tragedy, wisdom applied to action, creative improvisation, forgiveness of wrongs and oppression, and social justice (Paris, 1995). Kwanzaa is an important nonsectarian Afrocentric spiritual tradition developed by Maulana Karenga in the 1960s as a mechanism for celebrating and supporting African and African American strengths and empowerment. Seven principles represent the core values of Kwanzaa: umoja (unity), kujichagulia

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(self-determination), ujima (collective work and responsibility), ujamaa (collective economics), nia (purpose), kuumba (creativity), and imani (faith) (Karenga, 1995). Many writers stress the importance of paying attention to the role of spirituality in its various forms when working with African American clients, families, and communities (see, for example, Banerjee & Canda, 2009; Bennett, Sheridan, & Richardson, 2014; Freeman, 2006; Stewart, Koeske, & Pringle, 2007).

2. Latino(a) Americans. This category includes people with ties to 26 countries in North, South, and Central America; the Caribbean; and Europe (Spain). Thus, the categorizing of these peoples under a reductionist label such as Latino(a) or Hispanic denies the considerable diversity within this population. Keeping this in mind, the majority (58%) of Latino(a) Americans are Roman Catholic, but there is also a large and growing number (23%) of Protestants among this group. Almost 5% report other religious affiliations, including Muslim and Jewish, and 14% are unaffiliated (Pew Forum, 2008). In addition, many Latino(a) people follow beliefs and practices that represent a blending of Christian, African, and Indigenous spiritual traditions (Canda & Furman, 2010; Castex, 1994). Latino(a) American spirituality has been strongly affected by factors related to colonialism (Costas, 1991). This history includes military, political, economic, cultural, and religious conquest, forcing many Indigenous peoples to take on the Catholicism of their conquerors. Many traditional places of worship, spiritual texts, beliefs, and practices were destroyed, repressed, or blended with Catholic traditions (Canda & Furman, 2010). Today, Christian Latino(a) faith has several central features: a personal relationship with God that encompasses love and reverence as well as fear and dread; an emphasis on both faith and ritual behavior; belief in the holiness of Jesus Christ as savior, king, and infant God; special reverence shown to Mary as the mother of God; recognition of saints as models of behavior and as benefactors; significance of sacred objects as both symbols of faith and transmitters of luck or magic; and special events and celebrations, such as saints’ feast days, Holy Week, Christmas Eve, feasts of the Virgin, and life passages (e.g., baptisms, first communions, confirmations, coming-of-age ceremonies, weddings, and funerals) (Aguilar, 2001; Ramirez, 1985). In addition to mainstream religions, a number of African and Indigenous spiritual healing traditions continue to be practiced by some Latino(a) groups today, including

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curanderismo, santiguando, espiritismo, Santeria, and Vodoun (Delgado, 1988; Paulino, 1995). Social workers need to understand the importance of both religious institutions and folk healing traditions when working with Latino(a) populations. These various expressions of spirituality serve as important sources for social support, coping strategies, means of healing, socialization and maintenance of culture, and resources for human services and social justice efforts (Aranda, 2008; Burke, Chauvin, & Miranti, 2005; Faver & Trachte, 2005).

3. Asian Americans and Pacific Islanders. This population represents many cultures, including Chinese, Filipino, Japanese, Korean, Asian Indian, Vietnamese, Hawaiian, Cambodian, Laotian, Thai, Hmong, Pakistani, Samoan, Guamanian, and Indonesian (Healey & Stepnick, 2017). These different peoples are affiliated with a wide range of spiritual traditions, including Hinduism, Buddhism, Islam, Confucianism, Sikhism, Zoroastrianism, Jainism, Shinto, Taoism, and Christianity (Tweed, 1997). In the United States, 27% of this group is Protestant, 17% Catholic, 14% Hindu, 9% Buddhist, and 4% Muslim. Approximately 6% report other religious affiliations, and 23% are unaffiliated (Pew Forum, 2008). There is much diversity within these various religious traditions as well, making it particularly difficult to discuss common elements of spiritual beliefs or practices. However, several themes can be discerned: the connection among and the divinity of all beings; the need to transcend suffering and the material world; the importance of displaying compassion, selflessness, and cooperation; the honoring of ancestors; a disciplined approach to life and spiritual development; and a holistic understanding of existence (Canda & Furman, 1999; Chung, 2001; Singh, 2001). Both religious institutions and traditional practices have been helpful to a variety of Asian and Pacific Islander immigrants and refugees and their descendants. For example, many southeast Asian refugee communities have established Buddhist temples and mutual assistance associations, which provide social, physical, mental, and spiritual resources (Canda & Phaobtong, 1992; Morreale, 1998; Timberlake & Cook, 1984), and the Korean church has been an essential provider of social services and community development efforts (Boddie, Hong, Im, & Chung, 2011; Choi & Tirrito, 1999). Some Asian Americans and Pacific Islanders also use Indigenous healers, such as the Cambodian krou khmer, the Korean mudang, the Hmong spirit medium, and the Hawaiian kahuna (Canda & Furman,

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1999; Canda, Shin, & Canda, 1993). As with other groups, there is an emerging literature stressing the importance of attending to spirituality in practice with clients from this large and diverse cultural population (Chung, 2001; Diwan, Jonnalagadda, & Balaswamy, 2004; Hodge, 2004; Hurdle, 2002; Leung & Chan, 2010; Tan, 2006). In addition, several writers have proposed incorporating concepts and practices from Asian spiritual traditions into mainstream social work practice, including meditation (Keefe, 1996; Logan, 1997), Zen- oriented practice (Brandon, 1976), body-mind-spirit integration approaches (Leung, Chan, Ng, & Lee, 2009), and yoga (Fukuyama & Sevig, 1999).

4. Native Americans. Native Americans, or First Nations peoples, originally numbered in the millions and were members of hundreds of distinct tribes or nations, each with its own language, heritage, and spiritual traditions (Healey & Stepnick, 2017). As part of the effort to “humanize and civilize” Native Americans, Congress regularly appropriated funds for Christian missionary efforts beginning in 1819 (U.S. Commission on Human Rights, 1998). American Indian boarding schools were a major component of these efforts, where children were forbidden to wear their native attire, eat their native foods, speak their native language, or practice their traditional religion and were often severely punished for failure to adhere to these prohibitions (Haig-Brown, 1988; Snipp, 1998). Through a long history of resistance and renewal, however, Indigenous spiritual traditions have persisted and are being restored and revitalized (Swift, 1998). Various expressions of Native American spirituality have several common themes: the inseparability of spirituality from the rest of life; connection to and responsibility for the earth and all her creatures; the sacredness of all things, including animals, plants, minerals, and natural forces; the values of balance, harmony, and connectedness; the importance of extended family and community; and the use of myth, ritual, and storytelling as spiritual practices (Duran & Duran, 1995; Matheson, 1996; Yellow Bird, 1995). Many of these values are of increasing appeal to non-Indigenous people, producing great concern among Native American people regarding appropriation of their customs, ceremonies, rituals, and healing practices (Kasee, 1995; LaDue, 1994). This cross-tradition borrowing of spiritual practices requires sensitivity, respect, competence, and permission in such matters (Canda & Yellow Bird, 1996). Social workers also should become informed regarding ongoing efforts to

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protect Native American cultural and religious freedoms, including issues related to sacred lands, free exercise of religion in correctional and educational institutions, repatriation of human remains and sacred objects held in museums and scientific institutions, and protection of sacred and cultural knowledge from exploitation and appropriation (Harvard Pluralism Project, 2005). Many service providers also call for sensitivity and awareness of the effects of historical trauma on Native Americans and recommend the integration of traditional practices for more effective service delivery (Chong, Fortier, & Morris, 2009; Limb & Hodge, 2008; Skye, 2002; Weaver, 2011). In addition, Indigenous worldviews and spiritual practices have application to social work in general (Canda, 1983; Voss, Douville, Little Soldier, & Twiss, 1999).

It is important to remember the experience of other groups that have been more extensively assimilated into the dominant culture of the United States (e.g., Irish, Italian, and Jewish Americans). Many of these groups also have histories of discrimination and religious intolerance, the effects of which are felt by succeeding generations. Since the terrorist attacks of September 11, 2001, we in the United States have witnessed increased discrimination and oppressive acts against Muslim Americans, especially those of Middle Eastern descent (Crabtree, Husain, & Spalek, 2008; Pew Research Center, 2009). Given this atmosphere and the growing Muslim population within the United States, it is imperative that social workers develop sensitivity and competence in working with Muslim clients. Indeed, social workers must be sensitive to the particular history and spiritual traditions of all racial and ethnic groups.

Photo 6.3 Native American dance is a cultural and highly spiritual form of expression.

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Sex and Gender

Women are more likely than men to report that they are religious, church- affiliated, and frequent users of prayer; are certain in their belief of God; feel close to God; hold a positive view of their church; and are more religiously engaged (Pew Forum, 2008). Women also are the majority of members in most religious bodies in the United States and play important roles in the life of many religious communities (Braude, 1997).

However, in several denominations, women’s participation has been significantly restricted, prohibiting them from holding leadership positions or performing certain religious rites and ceremonies. In addition, women members of traditional Judeo-Christian and Islamic faiths generally experience conceptualizations and symbols of the divine as masculine, suggesting that men are closer to (and thus more like) God than women (Reuther, 1983). In response to this, some scholars are calling for increased ordination of women and more women in leadership positions in order to create a more woman-affirming environment within religious institutions (Roberts & Yamane, 2016).

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Although most women who belong to mainstream denominations report being generally satisfied with their affiliations (Corbett, 1997), some struggle with the patriarchal aspects of their faith. One study conducted in- depth interviews of 61 women ages 18 to 71 who were affiliated with Catholic, United Methodist, Unitarian Universalist, or Jewish congregations (Ozorak, 1996). Most (93%) perceived gender inequality within their religions. Sixteen percent viewed these inequalities as appropriate, and thus accepted them; 8% left their faith in reaction to this issue and others. The remainder coped by using behavioral strategies (e.g., requesting equal treatment; requesting gender-inclusive language; substituting feminine words, images, or interpretations; participating in feminist activities), cognitive strategies (e.g., focusing on positive aspects of the religion, comparing their faith favorably to others, emphasizing signs of positive change), or a combination of both behavioral and cognitive mechanisms.

Christian and Jewish feminist theologians have made efforts to emphasize the feminine heritage of conventional faiths, and some Christian and Jewish denominations have increased opportunities for women in both lay leadership roles and clerical positions (Canda & Furman, 2010). There also has been a movement toward alternative women’s spiritualities. Some women have become involved in spiritual support groups or explored other religious traditions, such as Buddhism (Carnes & Craig, 1998; Holm & Bowker, 1994). Others have pursued feminist-identified theology, such as Goddess worship (Manning, 2010), Wicca (Starhawk, 1979; Warwick, 1995), Jewish feminism (Breitman, 1995), or Christian womanist spirituality (Jackson, 2002). These spiritual traditions emphasize the feminine aspect of the divine; the sacredness of women’s bodies, rhythms, and life cycles; the power and creativity of women’s spirituality; a connection to earth-centered practices; and the care of all people and the planet (Kidd, 1996; Martin, 1993; Ochshorn & Cole, 1995; Warwick, 1995). Some men are also turning to alternative spiritual traditions to overcome religious experiences and conceptions of God and masculinity they feel have been detrimental to them (Kivel, 1991; Warwick, 1995).

Sexual Orientation

Nonheterosexual and noncisgender persons are often linked together as the LGBTQ (lesbian, gay, bisexual, transgender, queer) community. It should be noted, however, that transgender persons may identify themselves as

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heterosexual, bisexual, or homosexual; therefore, transgender status is a matter of sex and gender, not sexual orientation. However, as a group, transgender persons have much in common with gay men, lesbians, bisexual, and queer individuals when it comes to experiences with oppression and thus are included with these groups in this discussion of spirituality.

As an oppressed population, LGBTQ persons have suffered greatly at the hands of some groups affiliated with organized religion. Some egregious examples are the pronouncement by certain religious leaders that AIDS is a “punishment for the sins” of LGBTQ persons and the picketing of funerals of victims of antigay hate crimes by religiously identified individuals. More pervasively, many LGBTQ members of various faiths have had to struggle with religious teachings that tell them their feelings and behaviors are immoral or sinful. A growing body of literature reveals the serious impacts of religious rejection and abuse experienced by many LGBTQ persons, resulting in spiritual loss, depression, internalized shame, substance abuse, and thoughts of suicide (e.g., Barton, 2010; Hansen & Lambert, 2011; Super & Jacobson, 2011), as well as various strategies used to resolve the conflict between gender identity and faith (Levy & Lo, 2013). Other studies show LGBTQ persons remaining connected to their faith despite negative experiences and relying on spirituality as an important source of coping and support (e.g., Bozard & Sanders, 2011; Murr, 2013; Yarhouse & Carr, 2012). In particular, involvement in gay- affirming congregations has been shown to provide significant benefits to LGBTQ persons facing conflict between their sexual and religious identities (Sherry, Adelman, Whilde, & Quick, 2010).

Every major religious and spiritual tradition has LGBTQ adherents. Furthermore, there are religious rationales within Christianity, Islam, Judaism, Buddhism, Confucianism, and Taoism for tolerance of nonheterosexual orientations, even though historically these religions have privileged heterosexuality (Ellison & Plaskow, 2007). There are also associations within every major religion that go beyond tolerance to work for full inclusion of LGBTQ persons. Examples include the following: Affirmation—United Methodists for Lesbian, Gay, Bisexual & Transgender Concerns; Association of Welcoming & Affirming Baptists; Integrity (Episcopal); Dignity USA (Catholic); Lutherans Concerned; More Light Presbyterians; United Church of Christ Coalition for Lesbian, Bisexual, Gay and Transgender Concerns; World Congress of Gay,

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Lesbian, Bisexual, and Transgender Jews: Keshet Ga’avah; Al-Fatiah (Muslim); Gay Buddhist Fellowship; the Gay and Lesbian Vaishnava Association (Hindu); and Seventh Day Adventist Kinship. There are also denominations that generally identify themselves as “open and gay affirming,” including Metropolitan Community Church, Society of Friends (Quakers), United Church of Christ, Unitarian Universalism, and Reform and Reconstructionist branches of Judaism.

LGBTQ persons who grow up in less tolerant religious communities experience considerable tension between their faith and their sexuality. They, and others close to them, must decide how to respond to this tension. Canda and Furman (2010) identify four alternative ideological responses that are evident within Christianity but are also applicable to other faiths. The first three refer to the faith’s stance on nonheterosexual orientation, and the fourth refers to a possible stance that LGBTQ persons or LGBTQ allies may take regarding organized religion:

1. Condemn homosexuality and homosexual persons. 2. Accept homosexual persons but reject homosexual behavior. 3. Affirm and accept LGBTQ persons at every level. 4. Reject the faith’s position relative to LGBTQ persons and depart from

the faith.

These four responses have implications for both LGBTQ persons and social work practitioners. For LGBTQ persons, involvement with religious institutions characteristic of the first response exacerbates both the direct and internalized oppression that most experience as a result of living in a society that privileges heterosexual orientation and views any other sexual expression as deviant or “less than.” At the other end of the spectrum, involvement with congregations that display the third response of affirmation and acceptance would allow the LGBTQ person to honor both his or her sexual identity and faith commitments. The middle position of accepting the person but rejecting the behavior would most likely maintain the tension and internal conflict that an LGBTQ person experiences when an important part of his or her identity is “not welcome at the table.” The final reaction, leaving one’s faith, is unsatisfactory for many LGBTQ persons who want to be involved with communal religious experiences and desire a spiritual community welcoming of their whole self. For others, it represents a choice that is self-affirming and liberating.

Regarding social work practitioners, Canda and Furman (2010) point out

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that the first response is clearly antithetical to social work values and ethics, whereas the third position is congruent with ethical standards of practice. The second response brings up questions concerning how this stance will affect the practitioner’s work with LGBTQ clients. It is challenging enough to affirm a positive self-identity and possess confidence and self-assurance as an LGBTQ person in a heterosexist and homophobic society without experiencing negative attitudes from one’s social worker. If the practitioner cannot transmit the level of empathy and respect for LGBTQ persons and their sexual orientation required by the NASW Code of Ethics, referral to another practitioner is warranted. Furthermore, the practitioner needs to engage in a process of reflection and self-examination in order to be able to move toward a more positive and ethical response to LGBTQ clients. Social workers who themselves have left a faith tradition (the fourth response) due to disagreement with teachings on sexual orientation, or any other issue, also need to be vigilant that they are not transmitting negative and disrespectful attitudes toward religious clients, whether they are LGBTQ or heterosexual.

It also is important to respect the unique spiritual journeys that individual LGBTQ persons may take. If you were working with Leon as he struggles with the conflict between his church and his sexual identity, it would be important to work collaboratively with him to discern what option was best for him, providing him information about alternatives while maintaining respect for his self-determination. As Barret and Barzan (1996) point out, regardless of the individual decisions LGBTQ persons make regarding religion, the process of self-acceptance is a spiritual journey unto itself.

Other Aspects of Diversity

The issues and implications relative to spirituality that pertain to race and ethnicity, sex and gender, and sexual orientation apply to other forms of human diversity as well. For example, some religious teachings have interpreted disability as a punishment for the sins of the person or family (Miles, 1995; Niemann, 2005) or as a means for nondisabled persons to acquire spiritual status through expressions of pity and charity (Fitzgerald, 1997). Conversely, spirituality has been noted as both a significant means of coping and a vehicle toward positive self-definition for persons with disabilities (Hurst, 2007; Parish, Magana, & Cassiman, 2008; Swinton, 2012).

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Spirituality and age is another area that has been widely addressed. Both religious and nonreligious forms of spirituality are important sources of social support for older persons and a pathway for coping, ongoing development, and successful aging (Hedberg, Brulin, & Alex, 2009; Lee, 2011). In addition, spirituality is viewed as an essential foundation for healthy development among young people (Hay & Nye, 2006; Roehlkepartain, King, Wagener, & Benson, 2006). Research has shown spirituality to be a significant protective factor against substance abuse, premature sexual activity, and delinquency for children and adolescents (Smith & Denton, 2005). Other research highlights the potential for the religious or spiritual abuse and neglect of youth (Bottoms, Nielsen, Murray, & Filipas, 2003; Kvarfordt, 2010). As our understanding of the interaction between religious and nonreligious spirituality and other forms of human diversity increases, social work will be in a better position to work sensitively, competently, and ethically with many diverse groups and communities.

Critical Thinking Questions 6.3

With globalization, we have more regular contact with people of diverse religious and spiritual beliefs. How much religious and spiritual diversity do you come in contact with in your everyday life? How comfortable are you with honoring different religious and spiritual beliefs? How have you seen religious and spiritual beliefs used to discriminate against some groups of people? How have you seen religious and spiritual beliefs used to promote social justice?

Spirituality and the Human Experience Social workers deal with every aspect of the human experience. They simultaneously focus on solving problems in living while supporting optimal human functioning and quality of life. The literature regarding spirituality in these two areas is immense, with significant development in social work, psychology, nursing, medicine, rehabilitation counseling, pastoral counseling, marital and family counseling, and other helping disciplines. The following discussion highlights examples of this continually evolving knowledge base. Similar to the previous discussion of spirituality and diversity, this brief overview will serve readers as an entry point to this expanding literature.

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Problems in Living

It is difficult to find an area related to problems in living in which spirituality is not being explored. For example, much has been written about the link between spirituality and mental health. Various indicators of spirituality—such as religious commitment, involvement in spiritual or religious practices, and level of religiosity or spirituality—have been shown to have an inverse relationship with depression, anxiety, hopelessness, suicide, and other mental health problems while showing a positive relationship with self-esteem, self-efficacy, hope, optimism, life satisfaction, and general well-being (Koenig, 2005; Mueller, Plevak, & Rummans, 2001; Pargament, 1997).

Similar influences are found between spirituality and physical health, with spirituality linked to a variety of better health outcomes (Koenig, King, & Carson, 2012; Matthews et al., 1998). Various propositions have been investigated to explain the exact mechanisms of this relationship. Findings suggest that religion and spirituality benefit physical health through their support of health-promoting behaviors and discouragement of risk behaviors, whereas others indicate possible biological processes that mediate the negative impacts of stress and support healthy immune functioning (Mueller et al., 2001; Ray, 2004; Segerstrom & Miller, 2004). Specific spiritual practices, such as mindfulness-based stress-reduction techniques, have shown positive outcomes in several areas, including chronic pain, anxiety disorders, recurrent depression, psoriasis, and general psychological well-being (Grossman, Niemann, Schmidt, & Walach, 2004; Williams, Teasdale, Segal, & Kabat-Zinn, 2007), as well as benefits to the immune system (Davidson et al., 2003).

For both mental and physical health problems, religion and spirituality have been noted as major means of coping (Koenig, 2005; Koenig et al., 2012). In an extensive review of the social and behavioral science literature, Oakley Ray (2004) cites spirituality as one of four key factors significantly linked to positive coping, along with knowledge, inner resources, and social support. The specific benefits of spiritually based coping include relieving stress, retaining a sense of control, maintaining hope, and providing a sense of meaning and purpose in life (Koenig, 2001, 2005).

Higher levels of social support through religious and spiritual networks

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also play a significant role in positive coping with health issues (Perry, 1998; Reese & Kaplan, 2000). Both religious and nonreligious forms of spirituality have proven helpful to persons coping with caregiving demands related to health problems of family members (Bennett et al., 2014; Vickrey et al., 2007). Similar effects are noted for coping with poverty (Greeff & Fillis, 2009; Parish et al., 2008) and homelessness (Ferguson, Wu, Dryrness, & Spruijt-Metz, 2007; Lindsey, Kurtz, Jarvis, Williams, & Nackerud, 2000).

Still another body of scholarship explores spirituality and substance abuse. Both religiosity and spirituality have been noted as protective factors in this area for both adults and children (Smith & Denton, 2005; Wills, Yaeger, & Sandy, 2003). In addition, the spiritual dimension as a key factor in recovery from substance abuse has long been recognized in self- help groups such as Alcoholics Anonymous, Narcotics Anonymous, and other treatment approaches (Hsu, Grow, Marlatt, Galanter, & Kaskutas, 2008; Streifel & Servaty-Seib, 2009).

There is also a growing literature addressing the role of spirituality in understanding and dealing with the effects of various types of trauma— including physical and sexual abuse and assault (Bowland, Biswas, Kyriakakis, & Edmond, 2011; Walker, Reid, O’Neill, & Brown, 2009); domestic and community violence (Benavides, 2012); serious injury and natural disasters (Ashkanani, 2009; Johnstone, Yoon, Rupright, & Reid- Arndt, 2009; Tausch et al., 2011); incarceration (Redman, 2008; Sheridan, 1995); and ethnic trauma, war, displacement, and terrorism (Drescher et al., 2009; Markovitzky & Mosek, 2005; Meisenhelder & Marcum, 2009). Certain spiritually oriented interventions, such as the use of ceremony and ritual, appear to have particular utility in helping persons recover from trauma and loss (Cairns, 2005).

Finally, nowhere has spirituality been viewed as more relevant than in the area of death and dying. Religious and spiritual issues often arise at the end of life, and thus practitioners need to be able to deal with these issues effectively (MacKinlay, 2006; Nelson-Becker, 2006). Spiritual sensitivity is also needed in working with those grieving the loss of loved ones (Winston, 2006) or facing divorce or other kinds of loss (Coholic, 2011; Marsh, 2005).

Individual and Collective Well-Being

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Spirituality also has a role to play in regard to social work’s focus on supporting and enhancing optimal human functioning and quality of life. This role is evident at all levels of human systems, including the individual, family, community, organizational, and societal spheres. The following discussion identifies key points of this influence on well-being at both the individual and collective levels.

At the individual level, interest in wellness, holistic health, and the mind– body connection has exploded in recent years, as evidenced by increasing numbers of workshops and retreats, weekly groups, self-help books, and media reports on the topic. Furthermore, there has been a marked increase in the use of complementary and alternative medicine (CAM), sometimes referred to as “integrative medicine,” which includes “an array of health care approaches with a history of use or origins outside of mainstream medicine” (National Center for Complementary and Alternative Medicine [NCCAM], 2016). These approaches, which often are grounded in spiritual traditions and a holistic understanding of the human condition, include homeopathy and naturopathic medicine; acupuncture; massage therapy; mindfulness or transcendental meditation; movement therapies; relaxation techniques; spinal manipulation; Tai chi and Qi gong; yoga; healing touch; hypnotherapy; and Ayurvedic and traditional Chinese medicine (NCCAM, 2016).

More than 1,200 research projects have been funded by NCCAM, which is the lead agency under the National Institutes of Health (NIH) charged with investigating the efficacy of these approaches for both physical and mental health. Many of these studies have found positive effects of various CAM modalities, while also identifying approaches that are ineffective. Regardless of the scientific results, Americans are increasingly using CAM processes and products. Findings from a 2007 national survey reveal that approximately 50% of Americans used some form of alternative or complementary medicine (Barnes, Bloom, & Nahin, 2008), compared with 34% in 1990 (Williamson & Wyandt, 2001). There is a rise in the use of CAM by physical health and mental health practitioners as well. In a study of social work practitioners, over 75% of the sample reported either direct use or referral to mind–body techniques or community health alternatives in work with their clients (Henderson, 2000).

In related research, investigations are uncovering the specific mechanisms of the mind–body connection. In a meta-analysis of 30 years of research,

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findings show clear linkages between psychological stress and lowered immune system functioning, the major biological system that defends the body against disease (Segerstrom & Miller, 2004). In another review of 100 years of research, Oakley Ray (2004) reports mounting evidence that stressors affecting the brain are harmful to the body at both a cellular and molecular level, and they diminish a person’s health and quality of life. In addition, intriguing results are coming out of research on the “neurobiology of consciousness.” Several studies have shown demonstrable links between subjective experiences reported during meditation and noted alterations in brain function (e.g., EEG patterns, gamma activity, phase synchrony), as well as evidence of neuroplasticity (transformations of the brain) in long-term meditators (Lutz, Dunne, & Davidson, 2007). Taken together, these investigations suggest that many of our core mental and emotional processes not only are pivotal in maintaining optimal health but also affect our capacity for personal happiness and compassion for others. Results from the consciousness studies suggest that positive workings of the mind are trainable skills through practices such as meditation. This possibility has significant implications for both individual and communal well-being.

As a result of this research, a growing number of articles in the professional literature also promote the use of wellness or mind–body approaches for both clients and practitioners. Examples include the development of specialized wellness programs (Clark, 2002), the use of stress management and relaxation techniques (Finger & Arnold, 2002; McBee, Westreich, & Likourezos, 2004), and the use of mindfulness meditation and yoga (Bell, 2009; Brantley, Doucett, & Lindell, 2008; Lee, Ng, Leung, & Chan, 2009). Many of these approaches are rooted in spiritual traditions, especially Eastern traditions.

There also has been a great deal of recent development concerning spirituality and work. Much of this literature focuses on the search for “right livelihood,” or the conscious choice of work consistent with one’s spiritual values and supportive of ongoing spiritual growth (Sinetar, 2011). Other writers exploring the role of spirituality in the workplace discuss such issues as use of power, management style, workplace environment, and integrating spiritual values with overall work goals (Roberson, 2004; Smith, 2006). The social work enterprise itself has been the subject of such interest. Examples include Canda and Furman’s (2010) identification of principles for spiritually sensitive administration of human service

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organizations and Chamiec-Chase’s (2009) focus on measuring social workers’ integration of spirituality in the workplace.

The connection between spirituality and creativity is another area being addressed by a variety of writers. Much of this writing emphasizes the potential that linking spirituality and creativity has for healing as well as nurturing self-expression and optimal development. Examples include use of the visual arts (Coholic, 2011); journaling, poetry, and creative writing (Wright, 2005); music and sound (Campbell, 1997; Goldman, 1996); and movement and dance, drama, and other performing arts (Pearson, 1996; Wuthnow, 2001). Engaging in the creative process seems to facilitate spiritual growth and well-being by encouraging the person to go beyond ego limitations, surrender to process, and tap into spiritual sources of strength and self-expression (Mayo, 2009).

Spirituality is also emerging as an important factor in the optimal functioning of various human collectives. In social work with couples and families, paying attention to the spiritual dimension of family life is viewed as important not only for the religiously affiliated but for the nonaffiliated as well (Duba & Watts, 2009; Walsh, 2009a). It has been identified as an important component in working with couples and families relative to a wide range of issues, including discord (Hunler & Gencoz, 2005), challenges of adoption and parenting (Belanger, Copeland, & Cheung, 2009; Evans, Boustead, & Owens, 2008), health issues (Cattich & Knudson-Martin, 2009), death and loss (Walsh, 2009b), and building on family strengths and resilience (Anderson, 2009; Bell-Toliver & Wilkerson, 2011; Gale, 2009; Hames & Godwin, 2008).

The literature also notes the role of spirituality in community-based and social change initiatives. Examples include community health promotion programs (Clark, 2002), collective action and social justice efforts (Hill & Donaldson, 2012; Hutchison, 2012), services to rural communities (Furman & Chandy, 1994; Johnson, 1997), and other types of community- focused practice (Garland, Myers, & Wolfer, 2008; Obst & Tham, 2009; Pargament, 2008). Social workers are also becoming acquainted with the newly emerging “spiritual activism” movement, which goes beyond a focus on political and economic forces as primary mechanisms for social change to incorporate a spiritual framework for activism. Emerging principles of this new model include such themes as recognition of interdependence, acceptance of not knowing, openness to suffering, and

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outer change requiring inner work (Sheridan, 2014). This more holistic approach is viewed as having greater potential for achieving liberation and social justice than previous efforts embedded in a conflict perspective.

At the organizational level, President George W. Bush developed a White House Office of Faith-Based and Community Initiatives in 2003, and President Barack Obama reconfigured a White House Office of Faith- Based and Neighborhood Partnerships in the first month of his administration. At the time of this writing, President Donald Trump’s administration is developing 13 Centers for Faith-Based and Neighborhood Partnerships across federal agencies, including the Agency for International Development, Agriculture, Commerce, Corporation for National and Community Service, Education, Environmental Protection Agency, Health and Human Services, Homeland Security, Housing and Urban Development, Justice, Labor, Small Business Administration, and Veteran Affairs.

Regardless of the current status of this office, the proliferation of congregational and faith-based social services, which began with the George W. Bush administration in 2001, is being closely followed and evaluated by social work scholars. Some note positive opportunities and outcomes as a result of this trend, whereas others point to negative and unanticipated consequences (Belcher, Fandetti, & Cole, 2004; Boddie & Cnaan, 2006; Netting, O’Connor, & Singletary, 2007; Thomas, 2009). Although faith-based organizations clearly have an important role to play in the provision of social services, there is a need for ongoing research on the impact of these organizations for both clients and social workers employed in such agencies (Smith & Teasley, 2009).

Finally, spirituality is being increasingly identified as a needed force in nurturing and sustaining life beyond the circle of the human family to include all living beings and our planet that is home to all. Growing numbers of religious congregations, both conservative and progressive, are identifying stewardship of the planet as part of their commitment to God’s creation (National Religious Partnership for the Environment, 2018). Many writers are pointing to the critical link between our capacity to view all of nature as sacred and the mounting issues of environmental degradation, climate change, and ecojustice for vulnerable and marginalized populations (Berry, 2009; Coates, 2007; Dylan & Coates, 2012; Jenkins, 2008). This spiritually grounded perspective challenges us

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to redefine the meaning of community and reenvision our rightful place in the “sacred hoop” of life.

In sum, spirituality in both its religious and nonreligious forms holds much potential for promoting well-being and quality of life at all levels of the human experience, as well as for helping the profession address the problems and possibilities inherent in the human condition.

Critical Thinking Questions 6.4

A study of social work practitioners in 2000 found that more than 75% of the sample reported either direct use of mind–body techniques or referral to community health practitioners who use complementary and alternative medicine (CAM). What CAM practices do you use in your own life? What CAM practices do you expect to incorporate into your own practice? To what types of CAM practitioners do you expect to make referrals?

Spiritual Assessment Given the important role of spirituality in understanding both human diversity and human experience, it has become evident that gathering information about a client’s religious or spiritual history and assessing spiritual development and current interests are as important as learning about biopsychosocial factors. Assessment needs to go beyond the surface features of faith affiliation (such as Protestant, Catholic, Jewish, or Muslim) to include deeper facets of a person’s spiritual life (Sheridan, 2002). For example, talking with Caroline about where she is in her unfolding spiritual development would be helpful in supporting her exploration of different faith perspectives. Asking Matthew what brings him meaning, purpose, and connection right now would be valuable in assisting him in the next chapter of his life. And in working with Leon, it would be useful to know what aspects of his current religious affiliation are the most important and meaningful to him as he struggles with the conflicts regarding his faith and his sexual identity. None of this knowledge would be gleaned by a simple response to “What is your current religious affiliation?”

Social workers also need to assess both the positive and negative aspects of clients’ religious or spiritual beliefs and practices (Canda & Furman,

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2010). For example, Naomi and David’s understanding of the meaning of illness may be either helpful or harmful in dealing with Naomi’s health crisis; Trudy’s current spiritual practices may be supportive or detrimental to her physical, emotional, and social well-being; and Jean-Joseph’s synthesis of Catholic and Vodoun beliefs and practices may be very positive for his personal and family life but may be problematic in his interactions with the wider social environment. Assessing the role and impact of all these factors would be important areas for exploration in developing a spiritually sensitive relationship with any of these individuals.

A growing number of assessment instruments and approaches are available to help social workers. These include brief screening tools, which can provide an initial assessment of the relevance of religion or spirituality in clients’ lives. Examples include the HOPE (Anandarajah & Hight, 2001), the FICA (Puchalski & Romer, 2000), the MIMBRA (Canda & Furman, 2010), and the Brief RCOPE (Pargament, Koenig, & Perez, 2000). There are also several more comprehensive assessment tools that focus on religious/spiritual history and current life circumstances. For example, Bullis (1996) developed a spiritual history that includes questions about individuals, their parents or guardians, and their spouses or significant others. Canda and Furman (2010) provide a discussion guide for a detailed spiritual assessment, which covers spiritual group membership and participation; spiritual beliefs, activities, experiences, and feelings; moral and value issues; spiritual development; spiritual sources of support and transformation; spiritual well-being; and extrinsic/intrinsic styles of spiritual propensity.

Exhibit 6.5 ● Examples of Questions for Implicit Spiritual Assessment

1. What nourishes you spiritually—for example, music, nature, intimacy, witnessing heroism, meditation, creative expression, sharing another’s joy?

2. What is the difference between shame and guilt? What are healthy and unhealthy shame and guilt?

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3. What do you mean when you say your spirits are low? Is that different from being sad or depressed?

4. What is an incident in your life that precipitated a change in your belief about the meaning of life?

5. What helps you maintain a sense of hope when there is no immediate apparent basis for it?

6. Do you need forgiveness from yourself or someone else?

7. What currently brings a sense of meaning and purpose to your life?

8. Where do you go to find a sense of deep inspiration or peace?

9. For what are you most grateful?

10. What are your most cherished ideals?

11. In what way is it important or meaningful for you to be in this world (or in this situation)?

12. What are the deepest questions your situation raises for you? Sources: Canda & Furman, 2010; Titone, 1991.

There are also examples of more implicit assessment approaches, which do not directly include a reference to religion or spirituality but are composed of open-ended questions that tap into spiritual themes, such as those identified by Titone (1991) and Canda and Furman (2010). (See Exhibit 6.5 for examples of these kinds of questions.) A number of other creative, nonverbal strategies for gathering such information have also been developed, including the use of spiritual timelines (Bullis, 1996); spiritual lifemaps, genograms, ecomaps, and ecograms (Hodge, 2005); and spiritual trees (Raines, 1997). Finally, Lewandowski and Canda (1995) and Canda and Furman (2010) provide questions for assessing the helpful or harmful impacts of participating in spiritual groups or organizations (e.g., satisfaction with leadership style, methods of recruitment, response to members leaving the group).

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Assessment must also be able to distinguish between a religious/spiritual problem and a mental disorder. Peteet, Lu, and Narrow’s 2011 book Religious and Spiritual Issues in Psychiatric Diagnosis provides guidance in this area. Spiritual problems may include distress due to mystical experiences, near-death experiences, spiritual emergence/emergency, or separation from a spiritual teacher (Turner, Lukoff, Barnhouse, & Lu, 1995). This framework would be helpful in understanding any extraordinary or mystical experiences that Trudy, Jean-Joseph, or any of the other people in the case studies might share with you. Accurate assessment of such an occurrence can help determine whether the experience needs to be integrated and used as a stimulus for personal growth or whether it should be recognized as a sign of mental instability.

Critical Thinking Questions 6.5

How comfortable are you in discussing religious and spiritual themes with others? Which of the questions in Exhibit 6.5 would you be comfortable asking a client? Which would you be comfortable answering?

Implications for Social Work Practice Spiritually sensitive social work practice involves gaining knowledge and skills in the areas discussed in this chapter, always keeping in mind that this approach must be grounded within the values and ethics of the profession. The following practice principles are offered as guidelines for effective and ethical social work practice in this area.

Maintain clarity about your role as a spiritually sensitive practitioner, making a distinction between being a social worker who includes a focus on the spiritual dimension as part of holistic practice and being a religious leader or spiritual director. Be respectful of different religious or spiritual paths and be willing to learn about the role and meaning of various beliefs, practices, and experiences for various client systems (individuals, families, groups, communities). Critically examine your own values, beliefs, and biases concerning religion and spirituality and be willing to work through any unresolved or negative feelings or experiences in this area that may

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adversely affect your work with clients. Inform yourself about both the positive and negative role of religion and spirituality in the fight for social justice by various groups and be sensitive to this history in working with members of oppressed and marginalized populations. Develop a working knowledge of the beliefs and practices frequently encountered in your work with clients, especially those of newly arriving immigrants/refugees or nondominant groups (for example, Buddhist beliefs of southeast Asian refugees, spiritual traditions of First Nations peoples). Conduct comprehensive spiritual assessments with clients at all levels and use this information in service planning and delivery. Acquire the knowledge and skills necessary to employ spiritually based intervention techniques appropriately, ethically, and effectively. Seek information about the various religious and spiritual organizations, services, and leaders pertinent to your practice and develop good working relationships with these resources for purposes of referral and collaboration. Engage in ongoing self-reflection about what brings purpose, meaning, and connection in your own life and make disciplined efforts toward your own spiritual development, however you define this process.

Key Terms ecocentric 175 faith 172 faith stages 172 first force therapies 175 fourth force therapies 175 ideology (personal) 174 levels of consciousness 176 religion 165 second force therapies 175 spiritual bypassing 178 spirituality 165 states of consciousness 180 third force therapies 175

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transpersonal approach 176 ultimate environment 172 worldcentric 175

Active Learning 1. Consider any of the case studies presented at the beginning of the

chapter. Using either Fowler’s stages of faith development or Wilber’s integral theory of consciousness as the conceptual framework, construct a timeline of the person’s spiritual development. Trace the overall growth patterns through the different stages, including any ups and downs, as well as plateau periods. Identify the significant points or transitions you consider pivotal to the person’s spiritual development.

How would this information help you to better understand the person’s story and overall development? How would this information help you work with him or her as a social worker at various points in his or her life? What would your own spiritual timeline look like, including patterns throughout various stages and significant points or transitions that were particularly significant for your own growth and development?

2. Select a partner for this exercise. This chapter provides a brief overview of the spiritual diversity in the United States. Given both your knowledge and experiences with different spiritual traditions, both religious and nonreligious, address the following questions. Take a few moments to reflect on each question before answering it. Partners should take turns answering the questions.

To which spiritual perspectives do you have the most positive reactions (e.g., are in the most agreement with, feel an appreciation or attraction toward, are the most comfortable with, find it easiest to keep an open mind and heart about)? What is it about you that contributes to these reactions (e.g., previous knowledge, personal experiences, messages from family or larger culture)? To which perspective do you have the most negative reactions (e.g., are in the most disagreement with, feel a repulsion or fear about, are the most uncomfortable with, find it most difficult to keep an open mind and heart about)? What is it about you that contributes to these reactions (e.g., previous knowledge, personal experiences, messages from family or larger culture)? What impact(s) might your reactions (both positive and negative) have on work with clients (especially with those who may hold

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different spiritual perspectives from yourself)? What personal and professional “work” on yourself is suggested by your positive and/or negative reactions?

3. Select a partner for this exercise. Together select one of the open-ended questions listed in Exhibit 6.5 to consider as it applies to your own lives. After a few moments of quiet reflection, write your response to the question, allowing yourself to write freely without concern for the proper mechanics of writing (e.g., spelling, grammar). Then sit with what you’ve written, reading it over with fresh eyes. When you’re ready, share this experience with your partner, sharing as much or as little of what you’ve written as you feel comfortable with. Then talk together about the following questions:

What was the experience like of answering this question and then reading the response to yourself (e.g., easy, difficult, exciting, anxiety-producing, confirming)? Are there previous times in your life when you considered this question? Did you share your thoughts about it with others? If so, what was that like? What is it like to do that now with your partner? Can you see yourself asking this kind of a question with a client? What do you think that experience might be like for both the client and yourself?

Web Resources

Adherents.com: www.adherents.com

Site not affiliated with any religious, political, educational, or commercial organization. Contains a comprehensive collection of more than 41,000 statistics on religious adherents, geography citations, and links to other major sites on diverse religious and spiritual traditions.

Association of Religion Data Archives: www.thearda.com

Site sponsored by the Lilly Endowment, the John Templeton Foundation, and Pennsylvania State University. Provides more than 350 data files on U.S. and international religions using online features for generating national profiles, maps, overviews of church memberships, denominational heritage trees, tables, charts, and other summary reports.

Canadian Society for Spirituality and Social Work:

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http://www.adherents.com

http://www.thearda.com

www.spiritualityandsocialwork.ca

Site includes information about the activities of this society, links to other websites, and other resources.

Pew Research Center: Religion & Public Life: http://pewforum.org

Site sponsored by the larger Pew Research Center. Functions as both a clearinghouse for research and other publications related to issues at the intersection of religion and public affairs and also a virtual town hall for discussion of related topics.

Religious Tolerance: www.religioustolerance.org

Site presented by the Ontario Consultants on Religious Tolerance, an agency that promotes religious tolerance as a human right. Contains comparative descriptions of world religions and diverse spiritual paths from Asatru to Zoroastrianism and links to other related sites.

Virtual Religion Index: www.virtualreligion.net/vri

Site presented by the Religion Department at Rutgers University. Contains analysis and highlights of religion-related websites and provides links to major sites for specific religious groups and topics.

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http://www.spiritualityandsocialwork.ca

http://pewforum.org

http://www.religioustolerance.org

http://www.virtualreligion.net/vri

Part III The Multiple Dimensions of Environment

Social workers have always recognized the important role the environment plays in human behavior and, equally important, have always understood the environment as multidimensional. The social work literature has not been consistent in identifying the significant dimensions of environment, however. Although all dimensions of environment are intertwined and inseparable, social scientists have developed specialized literature on several specific dimensions. Both the environment and the study of it become more complex with each new era of technological development, making our efforts to understand the environment ever more challenging.

The eight chapters in Part III provide you with an up-to-date understanding of the multidisciplinary theory and research about dimensions of environment. The section begins with Chapter 7 on an important dimension often overlooked in the social work literature, the physical environment. Next comes Chapter 8, which demonstrates how we all live at the intersection of multiple cultures and considers the processes by which cultures change. Chapter 9 explores the macro environment, focusing on contemporary trends in social structure and social institutions, placing U.S. trends in a global context. Chapters 10 and 11 cover the smaller-scale configurations of families and small groups. Part III ends with Chapters 12, 13, and 14 on the moderate-size configurations of formal organizations, communities, and social movements. In Part II, you learned about the multiple dimensions of persons. When you put that together with the knowledge gained about multiple dimensions of environments, you will be better prepared to understand the situations you encounter in social work practice. This prepares you well to think about the changing configurations of persons and environments across the life course—the subject of the companion volume to this book, The Changing Life Course.

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7 The Physical Environment

Elizabeth D. Hutchison

Chapter Outline Learning Objectives Case Study 7.1: Ben Watson’s Changing Experience With the Physical Environment Theories of Human Behavior and the Physical Environment

Stimulation Theories Control Theories

Privacy Personal Space Territoriality Crowding

Behavior Settings Theories Ecocritical Theories

The Natural Environment Benefits and Costs of Human Interaction With the Natural Environment Environmental and Ecological Justice

The Built Environment Technology Healing Environments Urban Design and Health

Place Attachment Homelessness Accessible Environments for Persons With Disabilities Implications for Social Work Practice Key Terms Active Learning Web Resources

Learning Objectives

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7.1 Analyze one’s own emotional and cognitive reactions to a case study. 7.2 Summarize four categories of theories about the relationship between the physical environment and human behavior (stimulation, control, behavior settings, and ecocritical). 7.3 Give examples of the benefits and cost of time spent in the natural environment. 7.4 Give examples of the impact of the built environment on human behavior. 7.5 Recognize the role of place attachment in human behavior. 7.6 Suggest policy options for the social problem of homelessness. 7.7 Demonstrate an ability to evaluate specific built environments for their accessibility for people with disabilities. 7.8 Apply knowledge of the relationship between the physical environment and human behavior to recommend guidelines for social work engagement, assessment, intervention, and evaluation.

Case Study 7.1 Ben Watson’s Changing Experience With the Physical Environment Author’s Note: Ben Watson narrates his own story.

I finished my final semester in the Bachelor’s of Architecture Program, and a couple of friends and I decided to spend a few days doing some rock climbing before graduation. I already had a job lined up with a small architecture firm down in North Carolina. Things were looking good.

It doesn’t take but a minute to change things forever. I fell 500 feet and knew, as soon as I came to, that something was very wrong. My legs were numb, I couldn’t move them, and I had terrific pain in my back. My friends knew not to move me, and one stayed with me while the other went for help.

I don’t remember much about the rescue, the trip to the nearest hospital, or the medivac to the closest trauma center. In my early days at the trauma hospital, I saw lots of medical people, but I vividly remember the doc who told me that I had an incomplete spinal cord injury, that I would have some sensation below my lesion but no movement. I didn’t really believe it. Movement was what I was all about. I spent 5 months in the hospital and rehabilitation center, and I gradually began to understand that my legs were not going to move. I was depressed, I was angry (furious really), and for 1 week I wanted to give up. My parents and my brothers pulled me through.

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They showered me with love but were firm when I tried to refuse rehabilitation treatments. Oh yeah, some of my friends were terrific also. When things get rough, you learn who your real friends are. I also appreciated a chance to talk with the rehab social worker about my grief over this unbelievable turn in my life. It was good to talk with him because he wasn’t dealing with his own grief about my situation the way my family and friends were.

I left rehab with my new partner, a sophisticated titanium wheelchair, and went home to live with my parents. They rearranged the house so that I could have the first-floor bedroom and bath. I appreciated the assistance from my parents and brothers, and my friends made heroic efforts to get me out of the house. As we did so, I began to learn the importance of the word access. The first time my friends took me out, we wanted to go to a bar; after all that’s what 20-something guys do. My friends called around to find a nearby bar that would be accessible to me and my wheelchair. That turned out to be tougher than they thought. Did you ever notice how many bars require dealing with stairs? Finally, they were assured that one bar was accessible— well, actually, nobody wanted to say their place wasn’t accessible, given the law and all, plus most folks haven’t given any thought to what that really means. So, my friends had to run through a set of questions about stairs, ramps, size of doors, etc., to make their own determination about accessibility. One question they didn’t think to ask was whether there were stairs leading to the bathroom. So, we went out drinking, but I was afraid to drink or eat because I couldn’t get to the bathroom.

After several months at home, I began to get restless and wanted to get on with my life. After my accident, the architecture firm down in North Carolina had told my parents that they would still be interested in having me work for them when I was strong enough. So, I began to talk with my parents about making the move to North Carolina. They understood that I needed to get on with my life, but they worried about me moving 350 miles away. I was still dependent on them for a lot of personal care, but I was gradually learning to do more for myself.

I knew from my interviews that the architecture firm was accessible by wheelchair—it was in a relatively new building with a ground-level entrance, a spacious elevator, wide doors, and accessible bathrooms. With some trepidation my dad drove me down to look for housing. There were plenty of new apartment complexes, but we found that everybody, not just people with disabilities, wants ground-floor apartments with the open architectural features that make wheelchair mobility so much easier. After a lot of calls, we found a one-bedroom apartment that I could afford. I immediately loved the location in a part of the city where there was a lot happening on the

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streets, with shops, restaurants, and a movie theater. The apartment was attractive, convenient, and accessible, but most important it was mine. I was finally beginning to feel like an adult. I would have my privacy, but the open floor plan would allow me to have friends over without feeling cramped. And I loved the abundance of windows that would allow for good natural lighting from the sun. I couldn’t afford to get my own car with hand controls yet, but the apartment luckily was only a short cab ride from my office.

My father and brothers helped me make the move, and my grandmother came for a visit to add some charming decorating touches. I hired a personal assistant to help me get ready in the mornings—well, actually, my parents paid him for the first few months, until I could get my finances worked out.

Given my profession, it is good that I still have excellent function of my upper body, particularly my hands. My colleagues at work turned out to be good friends as well as good colleagues. And I never paid much attention to issues of accessibility in my design studios at school, but I have become the local expert on accessible design.

I learned a lot about accessible design from some of my own frustrating experiences. I have been lucky to develop a close set of friends, and we have an active life. My friends and I have learned where the streets are that don’t have curb cuts, which bars and restaurants are truly accessible, where the “accessible” entry is really some dark-alley back entrance, and to watch out for retail doorways blocked by displays of goods.

My friends and I travel, and I find some airline personnel handle me and my wheelchair well while some are disastrous—imagine being rolled over on the ramp, with an audience no less. The natural environment was always an important part of my life—it provides beauty and serenity—and my friends and I could write a book about all the wonderful hiking trails that are wheelchair accessible. In the past year, however, I have become deeply concerned about the damage I see humans doing to the natural environment and have been considering how I might join forces with other folks concerned about our human responsibility to care for the natural environment. As I have researched this on the Internet, I have also been learning about issues of environmental justice—how some communities are suffering more than others from the health consequences of industrial and agricultural practices that put toxins into the soil, water, and air. That gives me something else to think about. I hope you’ll think about it, too.

Theories of Human Behavior and the Physical

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Environment As with most stories we hear as social workers, Ben Watson’s is a multidimensional story of person and environment interactions over time. It presents issues of life course development, family and friend relationships, physical disability, a struggle for emotional well-being, and interactions with formal organizations. And, of course, a supremely important dimension of this unfolding story is the physical environment. Ben’s story reminds us that all human behavior occurs in a physical context, and it also reminds us of the impact that human behavior has on the physical environment.

Jane Addams, founder of the U.S. settlement house movement, recognized a robust relationship between the physical environment and public health. She was concerned about urban overcrowding, sanitation, and factory inspection, and she ran for and was elected to be neighborhood sanitation inspector in 1895 (Addams, 1910). Throughout most of its history, however, the social work profession has paid little attention to the physical environment; its person and environment construct considered the social environment but ignored the physical environment. In the 1970s, Carel Germain proposed an ecological model of social work, which she and colleague Alex Gitterman called the life model (see Gitterman & Germain, 2008). This model recognized the physical environment as an important dimension of the person and environment construct (see Germain, 1981). In recent years, some social work scholars, like scholars in other behavioral science disciplines, have begun to pay attention to robust findings about the relationship between human well-being and the physical environment (see Gray, Coates, & Hetherington, 2013). Since the Council on Social Work Education (2015) included the advancement of environmental justice as a core social work competency in its latest Educational Policy and Accreditation Standards, a number of articles on the physical environment and environmental justice have appeared in social work journals (for example, see Nesmith & Smyth, 2015; Philip & Reisch, 2015; Pyles, 2017; Teixeira & Krings, 2015). Canadian social workers Akesson, Burns, and Hordyk (2017) recently argued that social work’s emphasis on human behavior in the context of social environments has resulted in an unfortunate neglect of the physical environment context of human behavior. I could not agree more with this argument. When I was working on the first edition of this book in the 1990s, I received consistent feedback from reviewers that a chapter on the physical

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environment was out of place in a social work textbook. I have not received similar feedback for the last two editions of this book.

The relationship between human behavior and the physical environment is a multidisciplinary study that includes contributions from the social, behavioral, and health sciences of psychology, sociology, geography, anthropology, neuroscience, and public health, as well as from the design disciplines of architecture, landscape architecture, interior design, and urban and regional planning. This chapter gives you some ways of thinking about the relationship between human behavior and the physical environment as you begin to consider the role the physical environment plays in the stories of the individuals and social groups you encounter in practice. When thinking about human interactions with the physical environment, it is important to consider both the natural and the built environments, and both of these aspects of the physical environment are examined in this chapter.

Four broad categories of theory about human behavior and the physical environment are introduced in this chapter: stimulation theories, control theories, behavior settings theories, and ecocritical theories. Each of these categories of theory, and the research they have stimulated, provides useful possibilities for social workers to consider as they participate in person– environment assessments and consider possibilities for intervention at multiple levels of person and environment interactions. The ecocritical perspective is raising interesting and important new questions about the social work profession’s responsibilities to the natural environment. Exhibit 7.1 presents the key ideas and important concepts of these four types of theories.

Stimulation Theories Have you thought about how you would react to the abundance of sunlight in Ben Watson’s new apartment or the activity on his street? That question is consistent with stimulation theories, which focus on the physical environment as a source of sensory information essential for human well- being. The stimulation may be light, color, heat, texture, or scent, or it may be buildings, streets, forests, and parks. Stimulation theorists propose that patterns of stimulation influence thinking, feelings, social interaction, and health.

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Stimulation varies by amount—intensity, frequency, duration, number of sources—and by type. Stimulation theories based on theories of psychophysiological arousal assume that moderate levels of stimulation are optimal for human behavior (Gifford, 2014). Thus, both stimulus overload (too much stimulation) and restricted environmental stimulation (once called stimulus deprivation) have a negative effect on human behavior. Theorists interested in the behavioral and health effects of stimulus overload have built on Han Selye’s work regarding stress (see Chapter 5).

Exhibit 7.1 ● Four Categories of Theories About the Relationship Between the Physical Environment and Human Behavior Exhibit 7.1 ● Four Categories of Theories About the Relationship

Between the Physical Environment and Human Behavior

Theories Key Ideas ImportantConcepts

Stimulation theories

The physical environment is a source of sensory information essential for human well-being.

Patterns of stimulation influence thinking, emotions, social interaction, and health.

Stimulus overload

Restricted environmental stimulation

Control theories

Humans desire control over their physical environments.

Some person—environment configurations provide more control over the physical environment than others.

Privacy

Personal space

Territoriality

Crowding

Behavior settings

Consistent, uniform patterns of behavior occur in particular settings.

Behaviors of different persons in the

Behavior settings

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theories same setting are more similar than the behaviors of the same person in different settings.

Staffing

Ecocritical theories

All elements of nature and the physical world are interconnected.

Humans have no more value than other forms of nature.

Nondominant groups bear the burdens of environmental hazards.

Deep ecology

Ecofeminism

Environmental sustainability

Some stimulation theories focus on the direct, concrete effect of stimulation on behavior; others focus on the meanings people construct regarding particular stimuli. In fact, people respond to both the concrete and the symbolic aspects of their physical environments. A doorway too narrow to accommodate a wheelchair has a concrete effect on the behavior of a person in a wheelchair; it will also have a symbolic effect, perhaps contributing to the person’s feelings of exclusion and stigma. You probably will have a very different emotional reaction to a loud bang depending on whether it occurs during a street riot or at a New Year’s Eve party; your understanding of the meaning of the noise has a strong influence on your reaction. In this case, your response is primarily symbolic. Stimulation theories alert social workers to consider the quality and intensity of sensory stimulation in the environments where their clients live and work.

Environmental design scholars have begun to incorporate recent advances in neuroscience research to understand how people’s brains respond to different types of stimulation in physical environments (see Andric & Hasson, 2015; Eberhard, 2008; Rassia & Pardalos, 2012). Their goal is to use this knowledge to design environments that support brain development and functioning for the general population as well as for groups with special needs, such as premature newborns and persons with Alzheimer’s disease (Zeisel, 2006, 2009). Neuroscientists are also working with architects and environmental psychologists to learn what aspects of the physical environment stimulate emotional and physical healing (Rassia & Pardalos, 2012; Sternberg, 2009).

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Sternberg, 2009).

Control Theories The ability to gain control over his physical environment is a central theme of Ben Watson’s story. In that way, the story is a good demonstration of the ideas found in control theories. Control theories focus on the issue of how much control we have over our physical environments and the attempts we make to gain control (Gifford, 2014). Four concepts are central to the work of control theorists: privacy, personal space, territoriality, and crowding. Personal space and territoriality are boundary regulating mechanisms that we use to gain greater control over our physical environments.

Privacy

Altman (1975, p. 18) defines privacy as “selective control of access to the self or to one’s group.” This definition contains two important elements: Privacy involves control over information about oneself as well as control over interactions with others. Virginia Kupritz (2003) has extended Altman’s work by making a distinction between speech or conversational privacy (being able to hold conversations without being overheard) and visual privacy (being free of unwanted observation). Al-Bishawi, Ghadban, and Jørgensen (2017) add physical privacy and olfactory privacy. Contemporary innovations in communication technologies have introduced new concerns about having control over information with respect to oneself and one’s group and about how to balance, among other things, national security with rights to privacy. Privacy when using social media is a frequent topic of articles in the journal Computers in Human Behavior (see, for example, Child & Starcher, 2016; Hallam & Zanella, 2017; Lankton, McKnight, & Tripp, 2017).

Some of us require more privacy than others, and some situations stimulate privacy needs more than other situations. Ben Watson was accustomed to sharing a house with his university pals and didn’t mind the lack of privacy that came with that situation. He felt differently about lack of privacy in his parents’ home after rehab and was eager for a more private living situation, even though his privacy in some areas would be compromised by his need for a personal care assistant.

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walls or screens, to create private spaces increases as societies become more complex. She particularly notes the strong emphasis that European American culture places on partitioned space, both at home and at work (see Duvall-Early & Benedict, 1992). More recent research supports this idea; for example, college students in the United States have been found to desire more privacy in their residence halls than Turkish students (Kaya & Weber, 2003). The situation appears to be different when it comes to privacy in online communications, however. For example, researchers have found college students in China and Japan to be more concerned about privacy in online communications than college students in the United States (Lowry, Cao, & Everard, 2011; Maynard & Taylor, 1996).

Here are two more examples of how cultural values shape ideas of privacy. In an exploratory study of Chinese older people’s perceptions of privacy in residential care homes, Low, Lee, and Chan (2007) found that most study participants reported that privacy was unnecessary, focusing instead on unity, harmony, and meeting the collective needs of the majority, values that are considered to be a part of Chinese culture. They did, however, value psychological privacy (the ability to control their own cognitive and emotional processes) and social privacy (the ability to manage their own social contacts and interactions with others) more than physical privacy, accepting the need to receive physical care. Another example of how cultural values shape ideas of privacy come from two studies of the relationship between women’s privacy and the built environment in Muslim communities (Al-Bishawi et al., 2017; Rahim, 2015). These researchers note the Muslim ideal that women should have privacy from men with whom they have no familial relationship. They describe how elements of architecture in old Muslim villages managed women’s privacy —elements such as high windows on homes and roof gardens where women could socialize with other women without being seen from the street. They conclude that as Muslim communities became more urbanized, architects did not typically consider the need for women’s privacy, and women have had to find other ways to maintain privacy, with more extensive veiling being one solution.

One research team has examined the privacy concerns of people with visual impairments (Ahmed et al., 2017). They found that the most common privacy concern, noted by a majority of study participants, was other people eavesdropping on their conversations or looking over their shoulders at the private information they were sharing from smartphones

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other people eavesdropping on their conversations or looking over their shoulders at the private information they were sharing from smartphones and other communication devices. This concern arises because of their compromised ability to know when other people are close by. Of specific concern was the need to provide health information with health care staff in waiting rooms where they are not sure if other people are present. The study participants also reported loss of privacy when they need to ask other people for assistance with tasks such as filling out medical forms or loan applications, or how to find the restroom. Like Ben Watson, people with other types of disabilities also face some loss of privacy, including physical privacy.

Researchers have examined the physical attributes of workplace offices that satisfy the privacy needs of the U.S. workforce. In recent decades employers have limited personal space of employees, using open-plan cubicles, based on the belief that such open-plan arrangements will facilitate communication among employees, as well as on a desire to cut costs. The consistent finding is that employees are not satisfied with the level of privacy in open-plan arrangements (see Lee, 2010). There is also evidence that employees tend to communicate less when they feel they cannot control the privacy of communications (Kupritz, 2003). Personal space and territoriality are two mechanisms for securing privacy.

Personal Space

Personal space, also known as interpersonal distance or body buffer zone, is the physical distance we choose to maintain in interpersonal relationships, a space into which others cannot intrude without provoking discomfort. Recent research emphasizes that personal space is not stable but contracts and expands with changing interpersonal circumstances and variations in physical settings (Gifford, 2014). We tend to require more space in the back and front of us than at the side of us (Gifford, 2009). The distance we desire when talking with a best friend is smaller than the distance we prefer when talking with distant friends and acquaintances, and smaller yet than when talking with strangers (Smith & Faig, 2014). The desired distance for any of these interpersonal situations is likely to expand in small spaces or in situations in which we do not perceive that we have control (Iachini et al., 2016; Sinha & Mukherjee, 1996). We will want to recognize our own personal space requirements in different work situations and be sensitive to the personal space requirements of our

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Variations in personal space are also thought to be related to age, gender, and culture. Personal space requirements have been found to increase with age until early adulthood, but one research team found that young adults prefer a larger space when interacting with elderly people than when interacting with children or other young adults (Iachini et al., 2016). One research project found that, in shopping malls in the United States and Turkey, adolescents interacting with other adolescents kept the largest interpersonal distance of any age group (Ozdemir, 2008). Males have often been found to require greater personal space than females, and research indicates that the largest interpersonal distances are kept in male-male pairs, followed by female-female pairs, with the smallest interpersonal distances kept in male-female pairs (Ozdemir, 2008). However, recent research indicates that, in general, women prefer greater personal space when interacting with men than men prefer when interacting with women (see Schienle, Wabnegger, Schöngassner, & Leutgeb, 2015). And recent neuroimaging studies have found that both males and females respond with greater discomfort when their personal space is invaded by a male than if it is invaded by a female (Wabnegger, Leutgeb, & Schienle, 2016).

In The Hidden Dimension, Edward Hall (1966) reported field research indicating that members of contact-oriented, collectivist cultures (e.g., Latin, Asian, Arab) prefer closer interpersonal distances than members of noncontact-oriented, individualist cultures (e.g., northern European, North American). More recent research has supported this suggestion; for example, pairs in Turkish malls have been observed to interact more closely than pairs in U.S. malls (Ozdemir, 2008), but within-culture differences in interpersonal distance preferences have also been noted (Evans, Lepore, & Allen, 2000). There is some evidence that people require less personal space when interacting with people they consider to be like themselves in some important category (Novelli, Drury, & Reicher, 2010).

In recent years, researchers have examined personal space desires in different groups of people and found a number of groups that desire larger than average personal space. These groups include people high in introversion (Park, 2015), adults with insecure attachment style (Kaitz, Bar-Haim, Lehrer, & Grossman, 2004), physically abused children (Vranic, 2003), individuals diagnosed with schizophrenia (Holt et al., 2015), individuals diagnosed with autism spectrum disorder (Kennedy & Adolphs, 2014), and violent offenders (Schienle, Wabnegger, Leitner, &

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2015), individuals diagnosed with autism spectrum disorder (Kennedy & Adolphs, 2014), and violent offenders (Schienle, Wabnegger, Leitner, & Leutgeb, 2017). A study of combat veterans in Croatia found that veterans diagnosed with PTSD preferred significantly larger interpersonal distance than veterans without PTSD (Bogovic, Mihanovic, Jokic-Begic, & Svagelj, 2014). Both groups of veterans maintained greater interpersonal distance when approached by a man than when approached by a woman. The veterans with PTSD required greater distance when they were approached from behind whereas the veterans without PTSD required greater distance when approached from the front.

Youth with a diagnosis of Williams syndrome have been found to fail to regulate their use of personal space in accordance with the familiarity of different relationships. They are often found to invade the personal space of people with whom they interact (Lough, Flynn, & Riby, 2016).

Photo 7.1 Personal space and territoriality are two mechanisms for securing privacy.

©iStock/jorgeantonio

The discussion of personal space has been updated by researchers who are raising questions about how personal space is affected by digital technology. Perhaps you have been interested, as I have been, with how

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while using our cell phones, but I have been surprised to sit very close to strangers in public spaces who are using cell phones to “break up” with a partner or to try to straighten out a credit problem. I tend to give more space for these types of encounters. Some researchers have examined how much personal space people need when using automatic teller machines and other technology where private information is stored and found that people report larger desired space than the space actually provided (Shu & Li, 2007). Researchers are also investigating how personal space applies to virtual worlds such as Second Life and computer games and finding that people tend to keep and protect a space around their avatars in much the same way they do in the “real” world (see Amaoka, Laga, Yoshie, & Nakajima, 2011). Developers of artificial intelligence systems are concerned about active personal space (APS) in human–robot interactions; they want to program service robots in such a way that they do not invade the personal space of humans (Banik, Gupta, Habib, & Mousumi, 2013).

Neuroscientists have begun investigating brain functioning involved in personal space, but little is known at this point (see Holt et al., 2014, 2015; Schienle et al., 2017; Wabnegger et al., 2016). Early evidence suggests that the parietal-frontal network (Holt et al., 2014, 2015; Wabnegger et al., 2016) and the insula (Schienle et al., 2017) may be involved. One research team found that the amygdala is activated when one feels one’s personal space is being intruded upon (Wabnegger et al., 2016). This is not surprising, given the discussion in Chapters 2 and 5 about the important role the amygdala plays in assessing threat.

Critical Thinking Questions 7.1

Have you given much thought to your need for private space? Do you have sufficient privacy in your home and work environments to feel some sense of control over who has access to you and your interpersonal interactions? Do the clients at your field agency have private space? What have you observed about how people deal with privacy issues when using cell phones? When using social media of various types?

Photo 7.2 Both geographical boundaries and shared ideas provide a sense of security to individuals, and both can become a source of conflict.

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conflict.

Territoriality

Personal space is a concept about individual behavior and the use of space to control the interpersonal environment. Territoriality refers primarily to the behavior of individuals and small groups as they seek control over physical space (Taylor, 1988), but recently, the concept has also been used to refer to attempts to control objects, ideas, roles, and relationships (Brown, Lawrence, & Robinson, 2005; Gifford, 2014). Territoriality leads us to mark, or personalize, our territory to signify our “ownership” and to engage in a variety of behaviors to protect it from invasion. The study of animal territoriality has a longer history than the study of human territorial behavior. For humans, there is much evidence that males are more territorial than females, but there is also some contradictory evidence (Kaya & Burgess, 2007; Kaya & Weber, 2003). For example, in crowded living conditions in Nigerian university residence halls, female students appeared to use more territorial strategies to cope whereas male students used more withdrawal strategies (Amole, 2005). By their mid-teens, many youth want some territory of their own, as is sometimes demonstrated with graffiti, tagging, and gang behavior (Pickering, Kintrea, & Bannister, 2012). This can lead to conflicts with adults when teens occupy a space that adults do not think the teens “own,” a space such as the front of a

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Irwin Altman (1975) classified our territories as primary, secondary, and public. A primary territory is one that evokes feelings of ownership that we control on a relatively permanent basis and that is vital to our daily lives. For most of us, our primary territories include our home and place of work. Secondary territories are less important to us than primary territories, and control of them does not seem as essential to us; examples might be our favorite table at Starbucks, our favorite cardio machine at the gym, or our favorite seat in the classroom (Costa, 2012). Public territories are open to anyone in the community, and we generally make no attempt to control access to them—places such as public parks, public beaches, sidewalks, and stores. For people who are homeless and lack access to typical primary territories, however, public territories may serve as primary territories.

Much of the literature on territoriality draws on the functionalist sociological tradition, emphasizing the positive value of territorial behavior to provide order to the social world and a sense of security to individuals (Taylor, 1988). We know, however, that territorial behavior can also be the source of conflict, domination, and oppression. Brown & Zhu (2016) found that in the workplace the most defensive forms of territoriality—such as locking the door to one’s office—are resented by coworkers who often view people using such territorial behaviors as less powerful and poorer performers. Recently, it has been suggested that globalization is reducing territoriality among nation-states (Kythreotis, 2012). And, indeed, globalization does blur national boundaries, but ongoing national conversations about “securing our borders” are prime examples of territorial behaviors, and wars are still being fought to protect both geographical boundaries and ideas.

Crowding

Crowding has sometimes been used interchangeably with density, but environmental psychologists make important distinctions between these terms. Density is the number of persons per unit area of a space. Crowding is the subjective feeling of having too many people around. Crowding is not always correlated with density; the feeling of being crowded seems to be influenced by an interaction of personal, social, and cultural as well as physical factors. For example, in one study the perception of crowding was associated with density among older adults living with extended families in India, but perceived social support in

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perception of crowding was associated with density among older adults living with extended families in India, but perceived social support in high-density environments buffered the perception of crowding and decreased personal space requirements (Sinha & Nayyar, 2000). Researchers (Evans et al., 2000) have compared different ethnic groups that live in high-density housing in the United States. They found that Latin American and Asian American residents tolerate more density before feeling crowded than Anglo Americans and African Americans. These researchers also found, however, that all four ethnic groups experienced similar psychological distress from crowding. Another research team found that Middle Eastern respondents were less likely to perceive high- density retail situations as crowded than their North American counterparts (Pons, Laroche, & Mourali, 2006).

Research has also found gender differences in response to crowding. Women living in crowded homes are more likely to be depressed whereas men living in crowded homes demonstrate higher levels of withdrawal and violence (Regoeczi, 2008). In crowded elementary school classrooms, girls’ academic achievement and boys’ classroom behavior are adversely affected (Maxwell, 2003).

Crowding has been found to have an adverse effect on child development (Evans & Saegert, 2000) and on school completion (Lopoo & London, 2016). It has also been found to be associated with poor task performance, negative feelings, elevated blood pressure and neuroendocrine hormone activity (Gifford, 2014; Paulus & Baum, 2010), poor compliance with mental health care (Menezes Scazufca, Rodrigues, & Mann, 2000), increased incidence of tuberculosis (Baker, Das, Venugopal, & Howden- Chapman, 2008; Wanyeki et al., 2006), and aggressive behavior and health problems in prison inmates (Lawrence & Andrews, 2004; Paulus & Baum, 2010).

Behavior Settings Theories Would you expect to observe the same behaviors if you were observing Ben Watson in different settings—for example, his parents’ home, his apartment, running errands in his neighborhood, at work, at a party with friends, or on an outing in the natural environment? My guess is that you would not. A third major category of theories about the relationship between human behavior and the physical environment is behavior

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always tied to a specific place, and the setting may have a more powerful influence on behavior than characteristics of the individual (Scott, 2005).

Behavior settings theory was developed by Roger Barker (1968), who, unexpectedly, found that observations of different persons in the same setting were more similar than observations of the same person in different settings. For example, your behavior at a musical festival is more similar to the behavior of other festival attendees than it is to your own behavior in the classroom or at the grocery store. Barker suggested that programs— consistent, prescribed patterns of behavior—develop and are maintained in many specific settings. For example, when you enter a grocery store, you grab a cart, travel down aisles collecting items and putting them in the cart, and take the cart to a checkout counter where you wait while store employees tabulate the cost of the items and bag them. Imagine how surprised you would be if you went into the grocery store to find everybody kicking soccer balls! Behavioral programs are created conjointly by individuals and their inanimate surroundings, and behavior settings are distinctive in their physical-spatial features as well as their social rules.

Behavior settings theory has been extended to explain behavior in settings other than physical behavior settings, more specifically to explain behavior in virtual behavior settings such as chat rooms and blogs (Blanchard, 2004; Stokols & Montero, 2002). This line of inquiry is interested in how interaction in such virtual behavior settings is integrated, or not, with the place-based settings in which it occurs, such as home, workplace, or Internet café.

Behavior settings as conceptualized by Barker had a static quality, but Allan Wicker (2012) has more recently written about the changing nature —the life histories—of behavior settings. Some settings disappear (have you spent time at a library card catalogue lately?), and some become radically altered. These days, that trip to the grocery store often involves getting your own reusable grocery bags from the car before entering the store (or making a trip back to the car to get them when you are almost at the store door). It may also include running your own items through a scanner and bagging them yourself. Wicker (2012) argues that behavioral scientists must pay attention to the larger contexts of settings, which often belong to networks that include a number of other settings. The grocery store where I shop has a very similar layout to other grocery stores in my

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belong to networks that include a number of other settings. The grocery store where I shop has a very similar layout to other grocery stores in my city and other cities.

Community psychologist Edward Seidman (2012) argues that focusing on the setting, rather than the individual, as the location for change opens the way for a wealth of interventions. Behavior settings theory has implications for social work assessment and intervention. It suggests that patterns of behavior are specific to a setting and, therefore, that we must assess settings as well as individuals when problematic behavior occurs. Behavior settings theory also suggests that the place where we first learn a new skill helps re-create the state necessary to retrieve and enact the skill. When assisting clients in skill development, we should pay particular attention to the discontinuities between the settings where the skills are being “learned” and the settings where those skills must be used.

Another key concept in behavior settings theory is the level of staffing (Barker, 1968; Brown, Shepherd, Wituk, & Meissen, 2007). Different behavior settings attract different numbers of participants, or staff. It is important to have a good fit between the number of participants and the behavioral program for the setting. Overstaffing occurs when there are too many participants for the behavioral program of a given setting; understaffing occurs when there are too few participants. A growing body of research also suggests that larger settings tend to exclude more people from action, and smaller settings put pressure on more people to perform. The issue of appropriate staffing, in terms of number of participants, for particular behavioral programs in particular behavior settings has great relevance for the planning of social work programs. Indeed, behavior settings theory and the issue of optimal staffing have been used to understand the benefits of member participation in consumer-run mental health organizations (Brown et al., 2007).

Ecocritical Theories In Chapter 2, we wrote about ecological theory in the systems perspective, a theory that focuses on the relationships and interactions between living organisms and their environments. This theory emphasizes the interdependence and mutual influence of organisms and their environments. In the past 2 decades, ecological theory has been extended in several disciplines to take a more critical view of human interactions

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attention to the ways that human behavior degrades and destroys the natural world, the unequal burden of environmental degradation on different groups, and ethical obligations that humans have to nonhuman elements of the natural environment. These are issues that Ben Watson has begun to be concerned about. Given space limitations, this discussion touches on two such theories developed in the last quarter of the 20th century: deep ecology and ecofeminism.

Deep ecology is both a theory and a social movement. Its roots are traced to Norwegian philosopher Arne Naess who contrasted deep ecology with the “shallow ecology” of other environmentalists, which he criticized for being concerned about the natural environment only to the extent that it has a negative effect on human interests (Baard, 2015). Deep ecology emphasizes the total interconnectedness of all elements of the natural and physical world and the inseparability of human well-being and the well- being of planet Earth. It argues for the intrinsic value of all life forms, for the valuing of ecological diversity, and for the responsibility of humans to respect the rest of nature and live in ways that have minimal impact on the well-being of other life forms. It calls attention to the way that current human interactions with the natural environment are unsustainable, leading to global warming, atmospheric pollution, and other forms of environmental degradation that put the long-term survival of all elements of nature at risk. What distinguishes deep ecology from other theories discussed in this book is that it is ecocentric (earth centered) rather than anthropocentric (human centered). It insists on a nonhierarchical form of justice, in which humans do not control or have dominance over nature. Humans have no more value than other forms of nature. Deep ecologists note that some cultures have long held the view that ethical decision making must respect the interests of the natural world. Fred Besthorn (2012) has been a strong voice recommending that deep ecology is the theory that social workers should use to think about human–environment interactions. He suggests that from the perspective of deep ecology, social work should focus on “person with environment,” rather than “person and environment” (Besthorn, 2012).

Ecofeminism, also both a theory and a social movement, took shape about the same time as deep ecology, in the 1970s, but its roots go back much further (Buckingham, 2015). Although there are different strains of ecofeminism, the approach is best described as a feminist approach to environmental ethics. Ecofeminists see domination, exploitation, and the

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ecofeminism, the approach is best described as a feminist approach to environmental ethics. Ecofeminists see domination, exploitation, and the development of hierarchies as part of a patriarchal logic that undergirds both social and environmental degradation. They suggest that nature and women, as well as other groups such as children, late-life adults, and people of color, have been conceptualized as separate and inferior in order to legitimate dominance over them by an elite male-dominant social order (Gaard, 2011; Phillips, 2016). Dominance over rather than living in harmony with nature and other people becomes the goal. More than the deep ecologists, they call attention to the ways that women and other nondominant groups bear the burdens of environmental hazards such as toxic waste. Many ecofeminists argue that radical, not incremental, change to socioeconomic structures is necessary to address escalating social and environmental problems (Phillips, 2016). Susan Mann (2011) argues that the intersection of feminism and environmentalism is not new, noting that throughout the Progressive Era in the United States, women played important roles in both wildlife conservation and activism to promote clean air, water, and food for people living in urban centers. As noted earlier, pioneer social worker Jane Addams was such a woman.

Critical Thinking Questions 7.2

What have you observed about the impact of the physical environment on your behavior and the behavior of others? How well do stimulation theories, control theories, or behavior settings theories account for the influence of the physical environment on your behavior and the behavior of other people you know? What do you think of the deep ecology argument that humans have no more value than other forms of nature?

The Natural Environment If I asked you to engage in a relaxation exercise by picturing yourself in your favorite place, where would that be? Research shows that places in the natural environment—that part of the environment made up of all living and nonliving things naturally occurring—are among people’s favorite places (White, Pahl, Ashbullby, Herbert, & Depledge, 2013). This is, of course, not true for all people, but it appears to be true for the majority of people in all cultures (Wolsko & Hoyt, 2012). One brain

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between human behavior and the natural environment has been in the stimulation theory tradition—looking for ways in which aspects of the natural environment affect our thinking, feeling, social interaction, and health. At a time of great international concern about the damage being done to the natural environment by human endeavors, ecocritical theorists are calling for humans to rethink their relationship with the natural environment.

Benefits and Costs of Human Interaction With the Natural Environment Do you find that you feel refreshed from being in the natural environment —walking along the beach, hiking in the mountains, or even walking in your neighborhood? As it has for many people, the natural environment has always been a place of serenity for Ben Watson. There is a long tradition of research into the benefits of the natural environment for human behavior. In recent years, this research has been based on two theories developed by environmental psychologists. Attention restoration theory (ART) proposes that interacting with nature restores depleted cognitive resources (Kaplan & Berman, 2010). Psychophysiological stress recovery theory (PSRT) is interested in how interacting with nature helps people to recover emotionally and physiologically (Ulrich et al., 1991).

In general, this research finds many positive outcomes of time spent in the natural environment and suggests that you should consider the benefits of interacting with nature for both you and your clients. These benefits are summarized in Exhibit 7.2, but because of the extensive research in this area only a few of the recent findings are reported here.

Exhibit 7.2 ● Benefits of Time Spent in the Natural Environment (Based on Stimulation Theory Research) Exhibit 7.2 ● Benefits of Time Spent in the Natural Environment

(Based on Stimulation Theory Research)

• Engaging children’s interest

• Improving children’s attention skills

• Stimulating children’s imagination

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• Stimulating children’s imagination

• Stimulating activity and physical fitness

• Increasing productivity

• Enhancing creativity

• Decreasing impulsivity

• Providing intellectual stimulation

• Aiding recovery from mental fatigue

• Improving concentration

• Increasing working memory

• Enhancing group cohesiveness and community cooperation

• Fostering tranquility and serenity

• Fostering a sense of oneness or wholeness

• Fostering a sense of control

• Fostering recovery from surgery

• Lowering heart rate, blood pressure, and muscle tension

• Improving emotional states, such as calmness, relaxation, and vitality

• Contributing to cognitive and emotional improvements in persons diagnosed with major depressive disorder (MDD)

• Reducing psychophysiological stress

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There are consistent findings from research using a variety of methods that interaction with natural environments can restore depleted emotional and cognitive resources (see White et al., 2013, for a review of these findings). Our interaction with nature can help to recharge our attentional capacities (Felsten, 2009; Ulset, Vitaro, Brendgen, Bekkhus, & Borge, 2017), reduce psychophysiological stress (Bloom et al., 2017; Kjellgren & Buhrkall, 2010), and enhance emotional states (Beute & de Kort, 2014; Bowler, Buyung-Ali, Knight, & Pullin, 2010; Greenwood & Gatersleben, 2016). These findings of benefit from interaction with the natural environment have been supported even when controlling for individual characteristics, being alone or with a group, type of activities, and length of interaction. It is not clear which aspects of the natural environment provide benefit, but research indicates that environments with water have the greatest positive effect (Barton & Pretty, 2010; Karmanov & Hamel, 2008). Interactions with woodlands and mountains have also been found to have a positive effect (White et al., 2013), and there is considerable evidence that interactions with domestic and companion animals have emotional and physiological benefits for humans (Anderson, 2008). There is some evidence that late adolescents derive less benefit from time spent in nature than other age groups, and middle-aged people derive the greatest benefit (White et al., 2013).

A preponderance of the research has investigated the effects of interaction with nature in populations in good health, but recently researchers have been interested in whether nature has similar benefits for people with specific health concerns. Berman and colleagues (2012) studied the benefits of walking in nature, versus walking in an urban setting, for a group of people diagnosed with major depressive disorder (MDD). Participants were found to have improvements in memory span and positive emotion after both types of walks, but the improvements were significantly greater after the nature walks, and the effect sizes were larger than those found in populations without MDD. Kjellgren and Buhrkall (2010) studied a group of people identified as suffering from high stress and burnout and found improvements in stress level and energy after interaction with the natural environment. Walking in outdoor green spaces has been found to improve attention among children and adolescents with attention deficit disorder (ADD) (Taylor & Kuo, 2009; Ulset et al., 2017). Jiang (2014) reports that in China, as well as in Western societies, “therapeutic landscapes,” which he defines as green public spaces, benefit physical, emotional, and social health. Chinese research, however, is based

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Jiang (2014) reports that in China, as well as in Western societies, “therapeutic landscapes,” which he defines as green public spaces, benefit physical, emotional, and social health. Chinese research, however, is based on traditional Chinese medicine theories and focuses on medicinal plants.

Researchers have found synergistic effects between nature and physical activity, with moderate-intensity exercise in natural environments associated with the most positive effects (White et al., 2013). Thompson Coon et al. (2011) found that exercising in natural environments, compared with exercising indoors, was associated with greater revitalization and greater reduction in tension, confusion, anger, and depression. Research with individuals involved in both community gardening and backyard gardening indicates benefits that include a sense of tranquility, sense of control, and improved physical health (Shepard, 2013).

There is some evidence that you do not have to be active in the natural environment to derive benefits from it. Views of nature have been found to have positive benefits for cognitive and emotional functioning and to promote recovery from stress and surgery. Office workers have been found to experience less anger and stress when art posters with nature paintings are present (Byoung-Suk, Ulrich, Walker, & Tassinary, 2008). Indoor plants have also been found to be associated with improved attention in office settings (Raanaas, Evensen, Rich, Sjostrom, & Patil, 2011). Researchers have begun to explore whether views of nature are as beneficial as time spent in nature. In a study of participants identified as suffering from stress and burnout, Kjellgren and Buhrkall (2010) investigated the similarities and differences in reactions to 30 minutes of relaxation in a natural environment versus 30 minutes of relaxation while viewing a slide show of photographs of the same natural environment. They found that pulse and diastolic blood pressure were lower after relaxation in both the natural environment and the simulated natural environment. They also found that the two types of relaxation situations were equally efficient in stress reduction. However, relaxation in the natural environment produced greater improvement in energy, sense of well-being, and tranquility than relaxation in the simulated natural environment.

The findings just discussed are not surprising, given the distinctive place accorded to the natural environment in the cultural artifacts—music, art,

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a 2-million-year history of evolving in natural environments and have only lived in cities for a small fraction of that time and that therefore we are much better adapted to natural environments than built environments. On the other hand, Karmanov and Hamel (2008) suggest that physical environments, both natural and built, accumulate meanings over time, and their research suggests that these meanings can be changed through storytelling about the environments in which people find themselves. It is important to note that access to nature is not equally shared by all groups, and some researchers have noted that biophobia, fear of living things and aversion to nature, may develop when children have little to no interaction with the natural world (Zhang, Goodale, & Chen, 2014). This is often the case in highly urbanized environments.

The growing evidence of the psychophysiological benefits of time spent in nature is beginning to influence health policy and practice. Perhaps the best example of the use of this research to inform policy is a statement put out by the Faculty of Public Health, the standard-setting body for specialists in public health in the United Kingdom. This statement called for more use of walks in parks to treat mental illness, for general practitioners to consider providing advice about physical activity in the natural environment, for local authorities to provide more accessible green spaces, for full governmental support for programs to support physical activity in green spaces, and for major funding for research investigating the potential role of green space in preventing mental and physical ill health and reducing health inequalities (Faculty of Public Health, 2010). There is a growing call for ecotherapy, exposure to nature and the outdoors as a component of psychotherapy, as a major agenda for mental health promotion and treatment (see McGeeney, 2016; Wolsko & Hoyt, 2012). Proponents of ecotherapy propose such interventions as inquiring about clients’ relationships with the natural environment, assigning a walk in the park as homework, use of plants and photos of natural settings in therapist offices, nature guided mindfulness meditation, use of nature metaphors, and developing forest experiences for adolescents (Hayward, Miller, & Shaw, 2013; Kamitsis & Simmonds, 2017; Wolsko & Hoyt, 2012). The combination of green spaces with physical exercise has been found to be a particularly potent program for mood elevation in people experiencing symptoms of depression and anxiety (Mackay & Neill, 2010). This research indicates that the degree of perceived “greenness” of the environment has a greater influence than the intensity of the exercise on symptom relief, with the greater benefits coming from enhanced

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2010). This research indicates that the degree of perceived “greenness” of the environment has a greater influence than the intensity of the exercise on symptom relief, with the greater benefits coming from enhanced perception of greenness. Ecotherapy includes time spent with domestic and companion animals.

Ben Watson made special note of the ample sunlight in his apartment. Design innovations for older adults, particularly those with Alzheimer’s disease, are emphasizing the benefit of natural over artificial light (Brawley, 2006, 2009). However, the relationship between sunlight and human behavior is curvilinear, with benefit coming from increasing amounts until a certain optimum point is reached, after which increasing amounts damage rather than benefit. Excessive sunlight can have negative impacts, such as glare and overheating, and inadequate sunlight has been identified as a contributor to depression, sometimes referred to as seasonal affective disorder (SAD), in some persons (Kurlanski & Ibay, 2012). Sunlight penetration in indoor spaces is related to feelings of relaxation, with patches of sunlight as the optimum situation, and both too little and too much penetration decreasing the feeling of relaxation (Brawley, 2009).

Although the natural environment can be a positive force, it also has the potential to damage cognitive, emotional, social, and physical well-being. The relationship between sunlight and human behavior provides a clue. Too little sun causes harm, but so does too much sun. Water is a favorite environmental feature for many people, but too little water causes drought and too much water causes flooding. The natural environment provides sensory stimulation in an uncontrolled strength, and the patterns of stimulation are quite unstable. Extremely stimulating natural events are known as natural disasters, including such events as hurricanes, tornadoes, floods, earthquakes, volcanic eruptions, landslides, avalanches, tsunamis, and forest fires. Natural disasters are cataclysmic events—a class of stressors with great force, sudden onset, excessive demands on human coping, and large scope. There is growing concern that climate change is leading to more frequent natural disasters (Phalkey & Louis, 2016). Natural disasters have immediate effects on health and mortality, but they also have indirect long-term effects because they lead to disruptions in shelter, food supplies, income, and access to health care. Social workers play active roles in providing services to communities that have experienced natural disasters.

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humans doing to the natural environment and about how some communities are suffering more than others from the health consequences of industrial and agricultural practices that put toxins into the soil, water, and air. The social work profession has long been concerned about social justice, and as noted earlier, Jane Addams, founder of the U.S. settlement house movement, was a fierce advocate for environmental justice for the urban poor families of Chicago. She advocated for such environmental improvements as safe drinking water, improved sewage systems, decreased residential crowding, and safe and clean places for children to play (Addams, 1910). Throughout most of its history, however, the social work profession has paid little attention to the physical environment in its pursuit of social justice. But, like other social systems, the social work profession and its established organizations evolve, and a few years ago, the social work literature began to call attention to the issues that concern Ben Watson—issues related to the damage humans are doing to the natural environment and the unequal burden of that damage carried by different groups. Two important social work books were published in 2012 and 2013: Green Social Work: From Environmental Crises to Environmental Justice (Dominelli, 2012) and Environmental Social Work (Gray et al., 2013). The concerns raised by Ben Watson and the authors of these books are at the heart of two social movements—the environmental justice movement and the ecological justice movement. These movements share a concern about the ways in which human activities are exhausting natural resources and polluting air, water, and land. But they differ in one important way: The environmental justice movement is concerned about human rights in relation to degradation of the natural environment whereas the ecological justice movement is concerned about the rights of nature to be protected from human activity (Besthorn, 2013). For the first time, the Council on Social Work Education included the advancement of environmental justice as a core social work competency in its 2015 Educational Policy and Accreditation Standards (CSWE, 2015): Competency 3, “Advance human rights and social, economic, and environmental justice.”

Photo 7.3 The physical environment (both natural and human-made) impacts our behavior. Researchers have found a strong preference for elements of the natural environment and positive outcomes of time spent in nature.

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spent in nature.

Environmental justice is thought to occur when “(1) the burden of environmental hazards or degradation is shared equally across all demographic groups or communities, and (2) there is equal inclusion in decision-making processes” about environmental policies and action steps (Nesmith & Smyth, 2015, p. 485). At the global level, wealthy nations are exploiting the natural resources of poor nations, depleting those resources and exacerbating the poverty in those nations. The degradation of the world ecosystems is growing significantly worse, and the burdens of that degradation go increasingly to the most marginalized populations, poor people, people of color, older people, women, and children (Hetherington & Boddy, 2013). The people carrying the greatest burden of environmental degradation seldom have a seat at the table where environmental policies are developed (United Nations Human Rights, 2014).

This pattern of environmental injustice occurs in wealthy nations as well as poor nations. In the United States, there is considerable evidence that the toxic load of pollution from pesticides, fertilizers, and factories is generally heaviest in poor communities of color (Perkins, 2012), and considerable research establishes that such pollution is a risk factor for cancer and respiratory diseases. There is also clear evidence that hazardous

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communities (Perkins, King, & Varner, 2012). One research team found that brownfields—properties that are no longer operational because of the presence of hazardous substances—are much more likely to be located in poor and minority communities than in areas of higher socioeconomic status. They also found that brownfields are cleaned up much more slowly when they are located in communities with larger minority populations (Eckerd & Keeler, 2012). Similar patterns have been reported in the United Kingdom, Canada, the Netherlands, Scotland, Sweden, France, Germany, and Australia (Nesmith & Symth, 2015).

Since the 1980s, some activists in the environmental justice movement have referred to the situation discussed in the previous paragraph as environmental racism, a term used to refer to the process of placing environmental hazards in low-income or minority communities. In his book Clean and White: A History of Environmental Racism in the United States, Carl Zimring (2016) suggests that although some of the environmental hazards are new, environmental racism is not new in the United States. He traces a history in which people of color have been assigned the dirty work of the country: doing the laundry, cleaning up human waste, and junk collecting. He also discusses the way that racial anxiety and concerns about urban health became intertwined in the major cities with the influx of African Americans and immigrants.

Social justice and environmental justice become more and more tightly entwined; in many communities it is not possible to promote social justice without working on issues of environmental justice. That is certainly true in the Coachella Valley of California where I recently lived. At a community forum I attended in the eastern end of the valley, which is populated primarily by undocumented farm workers, community members reported that their greatest concerns are the lack of access to potable (drinkable) water; high levels of pesticides in the soil and groundwater; sewage sitting on top of the ground; and the impact of a nearby toxic waste treatment facility on soil, water, and air quality. If those are the community concerns, social workers should be collaborating with other community agencies to address those concerns. (You may know Coachella, California, as home to the huge music festival. The festival site sits in proximity to the conditions just described.) Air, water, and soil quality are three of the biggest environmental justice concerns at the local, national, and global levels.

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Philip and Reisch (2015) suggest six potential roles for social workers as they work to advance environmental justice.

1. Work with environmentally burdened communities, public health professionals, and urban planners to map environmental hazards as well as environmental resources such as green spaces—and use those maps to develop environmental enhancements desired by the community.

2. Develop interventions that link individual well-being, aspects of the physical environment, and collective action.

3. Organize and facilitate forums for community stakeholders to develop sustainable alternatives for proposed environmental projects.

4. Work with community members and other professionals to develop environmental impact studies and community health profiles.

5. Enhance public participation mechanisms and bring individual and community stories about unequal exposure to environmental hazards into the policymaking process.

6. Mobilize communities to engage in collective problem solving in a process of identifying community assets and community power relationships.

As suggested earlier, the ecological justice movement approaches environmental issues from the standpoint of the rights of nature, not the rights of humans. Adherents argue for humanity in service to nature rather than nature in service to humanity. The thrust of the 2013 book Environmental Social Work is that social workers need to move beyond anthropocentric (considering humans as the most important part of the universe) environmental justice to value ecological justice. They call for social work to reconsider its person and environment construct to develop a better balance between human and nature needs. Scientists in a number of disciplines are interested in understanding how people perceive their relationships with the natural environment and what motivates them to be concerned about protecting it (see Scannell & Gifford, 2013). Childhood exposure to nature and parental and peer influence have been found to be important influences on pro-environment attitudes and behaviors (Collado, Evans, & Sorrel, 2017; Zelenski, Dopko, & Capaldi, 2015). This line of inquiry has become the dominant theme in the Journal of Environmental Psychology. The track record of environment policy development and implementation is not good, and there are grave concerns about the pace of environmental degradation (Klein, 2014).

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Before leaving this discussion of environmental and ecological justice, it is important to consider how a global economic system that values unlimited growth and unsustainable exploitation of natural resources is taking precedence over both human rights and environmental protection (see Philip & Reisch, 2015; Pyles, 2017). Communities have little power to obtain concessions from corporations that wish to locate or expand in their area and are often forced to sacrifice environmental quality in the search for economic gains. Legislative and legal systems in the United States and international organizations like the World Trade Organization have been successful in containing environmental, health, and worker safety laws and in shielding corporations from liability in environmental degradation and disasters. Powerful players in the economic institution have successfully framed the issue as environmental quality versus economic growth. The environmental justice movement has responded by calling for sustainable development, meaning economic development that meets the needs of the present generations without compromising the ability of future generations to meet their needs. The ecological justice movement calls for an economic system that considers the needs of nature.

Critical Thinking Questions 7.3

What have you observed about how time spent in nature affects your emotions, cognitions, and behavior? How might social workers incorporate ecotherapy into their practice in different settings? Have you seen examples of this being done? How do you think social workers should be involved with environmental or ecological justice? What do you think about the ecological justice position that human needs should not take precedence over the needs of nature?

The Built Environment It is the uncontrollable quality of the natural environment that humans try to overcome in constructing the built environment—the portion of the physical environment attributable to human effort. The built environment includes tools, structures, buildings, and technologies of various sorts designed and built by humans to create comfort and controllability and to extend their abilities to meet goals. The built environment is produced by human behavior, and what humans build has a great effect on human behavior. Winston Churchill is often quoted as saying, “We shape our

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buildings, and afterwards our buildings shape us” (UK Parliament, 2017). This is true for all aspects of the built environment, whether buildings or technologies.

For several decades, environmental psychologists have been studying the impact of the built environment on such factors as mood, problem solving, productivity, and violent behavior. They have examined physical designs that encourage social interaction, sociopetal spaces, and designs that discourage social interaction, sociofugal spaces. Researchers have studied design features of such institutional settings as hospitals, psychiatric hospitals, state schools for persons with cognitive disabilities, colleges and universities, and correctional facilities. Recently they have been interested in workplace and office design. Exhibit 7.3 summarizes some of the key results of this line of inquiry. Late-20th-century developments in biomedical science, particularly new understandings of the brain and the immune system, have allowed more sophisticated analysis of how the built environment affects physical and mental health and can be a source of healing. In the past 2 decades, researchers have also been interested in how information, communication, and other assistive technologies are affecting human behavior.

Technology Ben Watson is in a partnership with his sophisticated titanium wheelchair. As I am working on this book, I am in partnership with my computer, which allows me to search for information (with soothing music in the background), put my thoughts into digital format that with time will be shared with you, and check my e-mail to see how contributing authors are progressing with their chapters. And, aided by my computer, my iPad, or my smartphone, in a few minutes I will take a break, view some photos of our recent family vacation, do a little online shopping, and check in to see what my Facebook friends have been doing lately. Since they first appeared on the earth, humans have used their cognitive capacities to build tools to manipulate and control the environment. Humans are not the only animals that have developed tools, but, to date, humans are the only animals to develop the types of complex tools resulting in rapid changes in our individual and collective behaviors. For the purposes of this discussion, technology is defined as the tools, machines, instruments, and devices developed and used by humans to enhance their lives. There are many types of technologies; examples include construction technology,

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industrial technology, information technology, communication technology, weapon technology, and medical technology. There is clear evidence that the pace of technological development is speeding up, as you may have noticed as your cell phone becomes obsolete very quickly these days.

Exhibit 7.3 ● Selected Research Findings About the Therapeutic Use of Architecture

Therapeutic Design Features Positive Behaviors

Tables with chairs instead of shoulder- to-shoulder and back-to-back seating

Large spaces broken into smaller spaces

Flowers and magazines placed on tables

Increase in both brief and sustained interaction

Special activity centers with partitions

Sleeping dormitories divided into two bedrooms with table and chairs

Long hallways broken up

Sound baffles added to high ceilings

Improved lighting, bright colors, and large signs added

Increase in social interaction

Decrease in passive and inactive behavior

Painted walls replacing bars

Carpeted floors

Conventional furniture with fabric upholstery

Visually interesting public areas

Decrease in violent behavior in correctional facilities

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Private rooms with outside windows

Solarium with exercise equipment

Open sleeping wards and dayroom turned into personal living spaces and a lounge

Increase in social interaction

Places for personal belongings provided

Personalized decorations

Decrease in stereotypical behavior

Increase in alert, purposive behavior

Institutional furniture replaced with noninstitutional furniture

Rugs, lamps, and draperies added

Control over lighting

Decrease in intrusive behaviors

Increase in use of personal space

Across time, and certainly since the industrial revolution, there have been proponents and critics of technological development. Proponents have had confidence that technology will benefit society. The most optimistic have believed that technology will allow humans to master all problems and control the future. Critics have argued that technology can limit our freedoms and have negative effects on our psychological health. And recently, the ecological justice movement has emphasized the ways in which new technologies destroy the natural environment. As with earlier technological revolutions, the rapid developments in information and communication technologies we are currently experiencing have both proponents and critics. Work by Ray Kurzweil and Sherry Turkle highlight some of the arguments on both sides.

Ray Kurzweil is an author, inventor, futurist, and director of engineering at Google. Among other things, he has invented an image scanner, a reading machine that allows people with visual impairments to have computer text read out loud, and a music synthesizer. He is, as you might guess, a great proponent of technology. In his 2012 book, How to Create a Mind: The Secret of Human Thought Revealed, Kurzweil enthusiastically reports that

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advancements in neurological science technologies are allowing us to understand our brains in more and more precise detail. This growing understanding will soon allow us to fix our brains when needed and vastly expand the powers of our own intelligence. He joyfully reminds us of the capacities of computers to route e-mails, produce an electrocardiogram, fly and land airplanes, and play games. He revels in the story of how the IBM computer Watson obtained a higher score on the game of Jeopardy than the best two human players in the world, answering questions based on 200 million pages of information in 3 seconds! He tells of work under way to develop a new version of Watson that will read vast amounts of medical literature and become a master diagnostician. He reminds us that we have artificial intelligence all around us with the digital brain that stores old memories, e-mail, text messaging, and Siri on the iPhone. He predicts that Google self-driving cars will have fewer accidents than human-driven cars. Kurzweil argues that we build these tools to extend our own reach and are producing and will continue to produce very powerful abilities. He predicts that humans will sooner or later create an artificial neocortex that has the range and flexibility of the human neocortex. He says that the machines of the future will appear to be conscious and come to be accepted as “conscious persons” (Kurzweil, 2012, p. 209).

Photo 7.4 Spanish entrepreneur Victor Rosich displays some of the old mobile phones purchased by his company Mobileswap, which recovers old phones through a network of distributors and sells them in Asian and African markets.

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Kyodo News/Getty Images

Sherry Turkle has a joint doctorate in sociology and personality psychology and is a clinical psychologist. She is professor of social studies and science and technology at the Massachusetts Institute of Technology. In her 2011 book Alone Together: Why We Expect More From Technology and Less From Each Other, Turkle reports on her research in two areas: human interaction with robots and human interaction with communication technologies. Although she finds some benefit to both types of human

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interactions, she is not optimistic about the way these technologies are reshaping human emotional life.

The first half of the book is based on her research on human interaction with sociable robots, a type of robot that has a body, can sense its environment and respond to it, has some understanding of humans, and can communicate and interact with humans. R2-D2 and WALL-E are part of our science fiction genre, but sociable robots are a part of our current world, as well as a part of tomorrow’s story. Turkle reminds us of our succession of attempts to build the perfect sociable robot: Zhu Zhu robot pet hamsters, Furby robot toys, and My Real Baby robot. She also reports on the current state of development of robot companions being used to break the isolation of children and older adults. She notes that enthusiasm for robots is especially strong in Japan, where robot companions are used routinely in elder care facilities. Turkle acknowledges that robots can provide comfort and break isolation, but her own sensibilities coincide with those of a child in one of her studies who commented, “Don’t we have people to do that?” She found that both children and older adults suggest that robots can be more dependable than people, and she worries that humans are not present enough to each other. She also worries that interactions with robots can become preferable to human–human interaction because robots are less complex than people. She wonders if her concerns are peculiarly American, noting that the enthusiasm for robots in Japan makes sense in a culture where it is commonplace to think of inanimate objects as having a life force. Reminiscent of Kurzweil’s suggestion that we will come to think of machines as “conscious persons,” Turkle (2011) finds that her research participants describe the robots with which they interact as “alive enough to love and mourn” (p. 29). She suggests that this raises new questions about what makes a person and what makes a relationship.

Turkle is equally unenthusiastic about our thoroughly networked lives, which she describes as “always wirelessly connected” and “living full-time on the net” (pp. 151–152). She notes that communication technologies allow us to live in multiple worlds at the same time, so that we may be sitting together but using our smartphones to be somewhere else. She tells one story of attending a memorial service where attendees were using the memorial service program to hide their cell phones while they texted during the service. She suggests that our communication devices create new freedoms and pleasures but also create compulsions to use them: I

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must check my e-mail first thing in the morning; I have 150 text messages that must be answered. She notes that we get anxious when we leave our cell phone at home—or worse, when we lose it. Turkle (2011) also writes about the part of human life lived in virtual space, creating virtual selves in Second Life, playing computer games, and interacting on social networking sites, suggesting that “we have moved from multi-tasking to multi-lifing” (p. 160), sometimes creating new selves to share in virtual environments. She is concerned about what is happening to human societies as people live in a “continual world of partial attention” (p. 160) and concludes that we have to find a way to live with the seductive technologies we have created and make them work to support our values and goals. In her 2015 book, Reclaiming Conversation: The Power of Talk in a Digital Age, Turkle argues that it is in face-to-face interactions that we develop the capacity for empathy, an idea that is supported by neuroscientists (see Sapolsky, 2017).

Kurzweil emphasizes that we develop technologies to extend our capabilities. This is especially true in the rapidly expanding field of assistive technology. Assistive technology is technology developed and used to assist individuals with physical impairments to perform functions that might otherwise be difficult or impossible. A tremendous variety of assistive technology is available today, including technology to assist with mobility, visual, hearing, and cognitive impairment; computer accessibility technology; and personal emergency response systems. Assistive technology can be as low-tech as colorful Post-it notes to serve as visual reminders for students who struggle with attention and organization or as high-tech as assistive robots for people with mobility impairments. Exhibit 7.4 provides a variety of examples of contemporary assistive technology but is not an exhaustive list of the rich array of available technologies. Unfortunately, the great majority of these technologies are quite expensive and beyond the reach of most people, and some have been more successful than others.

Healing Environments By many accounts, Roger Ulrich (1984) was the first researcher to measure the effects of the physical environment on physical health of hospital patients. He studied patients who had undergone gallbladder surgery and had different views out their hospital room windows. One group had views of a brown brick wall, and the other group had views of a

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small stand of trees. The patients who had views of the trees left the hospital almost a day sooner than the patients with views of a brick wall. They also required less pain medication, received fewer negative comments from the nurses, and had slightly fewer postoperative complications.

The idea that nature is important to healing is not new; indeed, it has been around for thousands of years (Sternberg, 2009). There is a long tradition in architecture that proposes a connection among nature, architecture, and health (Joye, 2007). In the 19th century, hospitals were built with large windows, even skylights, and often in beautiful natural settings (Joye, 2007; Sternberg, 2009). Clinics and hospitals were particularly designed to take advantage of natural light because it was thought that sunlight could heal. Some public health scholars argue, however, that as medical technology became more sophisticated, design of hospital space began to focus more on care of the equipment than on care of the patient (Sternberg, 2009). These public health scholars are calling attention to biomedical research that links physical environments and human health.

Exhibit 7.4 ● Current and Near-Future Examples of Assistive Technology for Persons With Physical Impairments

Assistive Technology Device(s)

Functions

iPads

iPads can be used to record lectures, upload books, provide easier Internet access, take pictures, use social media, and allow easy ways to operate other devices.

Voice recognition software and hardware

Voice recognition provides the ability to use personal computers by voice only. A voice- activated device can now be plugged into the wall to access the Internet via Wi-Fi to control devices such as lights, Internet, TV, phone, and thermostat by using the voice only—no buttons

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to push.

Augmentative and alternative communication

Communication methods can assist or replace speaking or writing for individuals who struggle to produce or comprehend spoken or written language, for example, a computer that can produce speech or pictures to expand ability to communicate.

Infrared technology to control environment and surroundings

Infrared (IR) technology allows a PC to be used remotely to control another device. IR receivers can now be attached to most any device.

Wheelchairs

Technology has vastly improved mobility with advances in wheelchair capabilities and ease of operation. The use of extendable reaching devices while in a wheelchair improves ability to reach items on shelves.

Visual aides

Use of large-print books on an iPad and talking computer software are helpful to people with low vision. Google’s Glass allows those with arm, hand, or finger impairments to wear a smartphone and operate it by voice in order to take pictures, use the phone, and search the net, all by voice command.

Robot suits/exoskeletons

Soon a “wearable robot suit” that attaches to legs and torso to allow a person with paraplegia to walk may be as common as wheelchairs.

Brain/computer interface technologies

Interfacing brain signals with technology allows robotic arms to assist or replace nonfunctional limbs.

An experimental robotic arm attached to an amputee with a prosthetic hand and fingers can

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Robotic arms and hands

be controlled by an amputee’s own nerves. Even more exciting is the ability of the hand and fingers to be able to stimulate the sense of feel and touch.

Adaptive sports equipment

Technology now allows those with body impairments to enjoy athletic activities such as skiing (sit skis, special chairs), biking (adapted bicycles), and rafting (special chairs); increased body movement capabilities (bionic limbs, exoskeletons to allow movement and retrain limb function); and accessible playgrounds (wheelchair-friendly surfaces, better-designed play equipment, ramps and larger swing chairs).

Medical devices and prosthetics

Hearing aids, prostheses, and pacemakers, to name just a few, have vastly improved with technological advances. Medication dispensers with alarms provide reminders and assistance in taking medication.

Based on his early research, Roger Ulrich, a behavioral scientist, has collaborated with architects, environmental psychologists, and public and private agencies and foundations to develop a field called evidence-based design, which uses physiological and health outcome measures to evaluate the health benefits of hospital design features (Center for Health Design, 2008; Ulrich, 2006). Following on the earlier work of Ulrich, researchers use such measures as length of stay; amount of pain medication; rates of health complications; and patient satisfaction, stress, and mood to evaluate design innovations. By 2006, 700 rigorous studies had been identified (Ulrich, 2006), and the Center for Health Design had been established to engage in ongoing hospital design innovations and evaluations. Two foci of this research are discussed here: noise and sunlight.

A great deal of international research has focused on hospital noise as an impediment to healing. This research consistently finds that hospital noise has continued to increase over the past 50 years and exceeds the guidelines recommended by the World Health Organization, 35 db(A) during the day and 30 db(A) at night (Eggerston, 2012; Hill & LaVela, 2015). Hospital

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noise comes from a variety of sources, including staff conversations; roommates; telephones; televisions; overhead paging; moving of bed rails; heating, air conditioning, and ventilation systems; and alarms, monitors, infusion pumps, and other medical equipment (Cunha & Silva, 2015; Fillary et al., 2015). The problem is exacerbated in hospitals that have hard, sound-reflecting floors and ceilings. It is also intensified in multibed rooms because of the activity of caring for multiple patients. Noise has been associated with high blood pressure and elevated heart rates, sleep loss, slower recovery from heart attack, higher incidence of rehospitalization, and negative physiological responses such as apnea and fluctuations in blood pressure and oxygen saturation in infants in neonatal intensive care (Brown, 2009; Eggerston, 2012; Joseph & Ulrich &, 2007). Preterm infants exposed to prolonged high levels of noise are at risk for hearing loss, impaired brain development, and speech and language problems (Brown, 2009). Excessive noise also contributes to staff fatigue and burnout (Eggerston, 2012).

A number of design innovations have been found to be effective in reducing hospital noise. These include single-bed rooms, replacing overhead paging with a noiseless system, covering neonatal incubators with blankets, and installing high-performance sound-absorbing ceiling tiles and floor carpets (Brown, 2009; Ulrich, 2006). These innovations have been found to be related to improved health outcomes and fewer rehospitalizations for patients as well as to improved staff satisfaction and home sleep quality (Sternberg, 2009). In addition, one recent study found that earplugs can improve the sleep of patients in the intensive care unit (Litton et al., 2016).

Other researchers point out that although some sounds are stressful, other sounds are soothing and can benefit healing. Brown, Rutherford, and Crawford (2015) note that “sounds such as rain, a breeze, the sea, moving water and songbirds can calm and create a sense of wellbeing by triggering the release of endorphins” (p. 1522). Iyendo (2016) reviews research about the positive impacts of music in medical settings. Music can calm and relax both patients and staff and play a role in reducing depression, pain, heart rate, and blood pressure. It can have a sedative effect on patients before and after surgery. He emphasizes, however, that music that is soothing to one person may be stressful to another person.

There is also growing evidence that 19th-century hospital designers were

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accurate in their belief that sunlight can heal. Beauchemin and Hays (1998) found that patients recovering from heart attacks in sunny hospital rooms had significantly shorter hospital stays and lower mortality than patients recovering in rooms without natural light. A more recent study in Korea had a similar finding; patients in rooms in the part of the hospital that gets the most sunlight had lengths of stay that ranged from 16% to 41% shorter than patients in other parts of the hospital (Choi, Beltran, & Kim, 2012). Another research team studied patients recovering from spinal surgery in one hospital and compared the experiences of patients in sunny rooms with the experiences of patients in rooms without sunlight. Patients in sunny rooms took 22% less pain medication and had 21% less medication costs than similar patients recovering in rooms without sunlight (Walch et al., 2005). The patients in the sunny rooms also reported less stress than patients in the rooms without sunlight. Hospital rooms with morning sunlight have also been found to reduce the hospital stay of patients with unipolar and bipolar depression (Benedetti, Colombo, Barbini, Campori, & Smeraldi, 2001). Exposure to sunlight is a key factor in regulating the circadian rhythm (Joseph, 2006). However, excessive sunlight can produce uncomfortable glare, and appropriate shades and blinds are essential in hospital rooms, preferably ones that can be controlled by the patient (Choi et al., 2012; Joseph, 2006). This is especially important for hospitals in desert communities (Sherif, Sabry, Wagdy, Mashaly, & Arafa, 2016).

Two groups of researchers, Roger Ulrich and Craig Zimring (2005) and Huisman, Morales, van Hoof, and Kort (2012), have reviewed the large array of evidence-based design research and reported design features that have been found to promote healing. Their combined findings are overviewed in Exhibit 7.5.

Critical Thinking Questions 7.4

Do you consider yourself a proponent or a critic of rapid advancements in information and communication technologies? Are you as optimistic as Ray Kurzweil? Why or why not? Are you as pessimistic as Sherry Turkle? Why or why not? Have you seen any evidence of evidence- based design in your visits to health care facilities?

Exhibit 7.5 ● Features of Evidence-Based Design for Health Care Settings Exhibit 7.5 ● Features of Evidence-Based Design for Health Care

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Exhibit 7.5 ● Features of Evidence-Based Design for Health Care Settings

Standardized rooms with standardized cues for staff

Single-occupancy rooms

Sound-absorbing ceiling tiles and floors

No slippery floors

Correct toilet and furniture height

Good air quality and ventilation

Adequate artificial and natural light (decreases staff errors)

Pleasant and comfortable patient rooms

Systems that provide patient control over bed position and room temperature, lighting, and sound

Gardens

Windows with nature views

Rooming-in spaces for families

Artwork on walls

Soothing music

Soothing colors

Spaces for family members to congregate for mutual support

Clear signage to assist with wayfinding Sources: Based on Huisman, Morales, van Hoof, & Kort, 2012, and Ulrich & Zimring,

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2005.

Photo 7.5 A long tradition in architecture proposes a connection among nature, architecture, and healing.

Urban Design and Health In 1950, 30% of the world’s population lived in urban areas; the percentage was up to 54% by 2014, and it is projected that by 2050 66% of the world’s population will live in urban areas. North America is currently the most urbanized region of the world with 82% of the population living in urban areas (United Nations. Department of Economic and Social Affairs, 2014). Prior to the early 20th century in the United States, public health experts focused on what they called “the urban penalty” for health and mortality. As city size increased, so did the death rate. Infectious diseases, such as tuberculosis, measles, small pox, and influenza, were the main cause of the urban penalty. Such diseases spread quickly in high- density environments. By the 1920s, improved sanitation and other public health measures had eliminated the urban penalty in the United States and other wealthy nations, but it still exists in very large cities in poorer nations and in the poorest sections of cities in wealthy nations (Bocquier, Madise, & Zulu, 2011; Kimani-Murage et al., 2014). The biggest threats to urban populations in the United States today are violent crime and pollution, the latter of which contributes to high rates of asthma

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(Sternberg, 2009).

In recent years, some public health officials have begun to suggest an increasing rural and suburban health penalty and an urban health advantage (see James, 2014; Vlahov, Galea, & Freudenberg, 2005). In 2007, New York City was declared the healthiest location in the United States. Life expectancy increased by 6.2 years from 1990 to 2007, compared with 2.5 years for the rest of the country (Sternberg, 2009). Even though rural areas tend to have more exposure to the elements of the natural environment so valued by humans, the rural health penalty is well supported by research (James, 2014). Poor employment opportunities and poor access to health care in contemporary rural communities are driving forces in the rural penalty. Evidence for an urban health advantage in relation to the suburbs is inconsistent (see Fan & Song, 2009). In her book The End of the Suburbs, Leah Gallagher (2013) provides evidence that, although a majority of people still live in the suburbs, the United States is experiencing a population shift from the suburbs to cities; people are moving to the city because they want access to city amenities— employment, social interaction, shopping, services of various kinds, and cultural and leisure activity—and to spend less time in their cars.

Considerable research has focused in recent years on urban sprawl and design features of suburban built environments that contribute to decreased physical activity. The researchers note the long distances suburban dwellers need to travel to work and to amenities, requiring more time spent in the car. These researchers have been particularly interested in whether suburban built environments contribute to obesity and the related health problems of cardiovascular disease and diabetes. The evidence is mixed on this question. Some researchers have found that urban sprawl is associated with being overweight and obesity (Garden & Jalaludin, 2009; Slater et al., 2010). A Canadian study found an association between urban sprawl and coronary heart disease in women (Griffin et al., 2013). Some researchers have found that compact rather than sprawling design of both urban and suburban areas is correlated with less obesity, heart disease, high blood pressure, and diabetes (Ewing, Meakins, Hamidi, & Nelson, 2014). Others have found no significant relationship between urban sprawl and obesity (Seliske, Pickett, & Janssen, 2012), and some suggest that any connection between urban sprawl and obesity can be explained by a selection process whereby more sedentary people choose more sprawling locations to live (Cao, Mokhtarian, & Handy, 2009). The research indicates that urban

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sprawl may have a more negative effect on the health of adults than it does on the health of children and youth.

In response to concerns about negative health effects of urban sprawl as well as concerns about harm to the environment caused by automobile use, the new urbanist designers are designing suburban towns and updating urban areas with several features known to contribute to walkability. These features include houses with front porches; neighborhood spots for congregation; sidewalks; short blocks; good lighting; amenities accessible by foot; public transportation; mixed-used areas, including residences, businesses, offices, and recreation centers; and bike paths, tennis courts, parks, and golf courses (Stevens & Brown, 2011). The hope is that these design features will contribute to resident activity and health and to environmental sustainability. Researchers have found these design features to be associated with more physical activity in the neighborhood, and one research team found that the relationship holds when controlling for preexisting preferences for activity level, the selection issue noted earlier (Grant, 2015; Stevens & Brown, 2011).

Lopez and Hynes (2006) enter this conversation with a more complicated story. They report that although it is true that obesity is associated with urban sprawl, inner-city populations have higher rates of obesity and inactivity than suburban dwellers. They suggest that different aspects of the physical environment are contributing to ill health for inner-city residents and making their neighborhoods unwalkable. Inner-city neighborhoods have some of the design features recommended by the new urbanist designers, features such as sidewalks, short blocks, and public transportation, but they have a set of barriers to walking that do not exist in suburbs, barriers such as hazardous waste sites, abandoned buildings, decaying sidewalks, disappearing tree canopies, and dilapidated school playgrounds and parks. For example, one study found that low-income neighborhoods are 4 times as likely as high-income neighborhoods to have hazardous waste facilities, power plants, and polluting industrial plants, and low-income minority neighborhoods are 20 times as likely as high- income neighborhoods to have these facilities (cited in Lopez & Hynes, 2006). Public health officials also warn that with the new types of infectious diseases whose spread is fueled by global warming, dense cities contribute to contagion (Sternberg, 2009).

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Place Attachment Have you ever been strongly attached to a specific place—a beloved home, a particular beach or mountain spot, or a house of worship? Place attachment—the process in which individuals and groups form bonds with places—is the subject of a growing literature (Lewicka, 2011). Research on place attachment conceptualizes it as a multidimensional phenomenon involving person, place, and psychological processes of attachment (Scannell & Gifford, 2010a). In terms of person, researchers explore how place attachment occurs at both the individual and group levels. At the individual level, place attachment develops out of personally important experiences. At the group level, attachment develops out of symbolic meanings shared by a group. In the context of place attachment, place is defined as a “space that has been given meaning through personal, group, or cultural processes” (Low & Altman, 1992, p. 5). In terms of the psychological processes of attachment, place attachment is usually discussed in terms of emotional bonding (see Morgan, 2010), but an interplay of emotions, cognitions, and behaviors appears to be what forges the people-place bond (Scannell & Gifford, 2010a).

When a strong place attachment develops, it has been suggested that the place has become an important part of the self, that we can’t think of who we are without some reference to the place (Bernardo & Palma-Oliveira, 2016; Rollero & Piccoli, 2010). When a particular place becomes an important part of our self-identity, this merger of place and self is known as place identity. Place attachment and place identity have been found to occur in several different categories of place. When Scannell & Gifford (2017) asked one Canadian sample to identify the types of places with which they had a sense of attachment, 14 types of places were identified. The most commonly identified types were house, outdoor area, city/town, and vacation place. We run into the concept of place attachment again in Chapter 13 when we discuss community as a dimension of environment. Place identity can develop where there is strong negative, as well as positive, place attachment, resulting in negative views of the self.

Recently, researchers have been interested in the psychological benefits of place attachment (see López-Mosquera & Sánchez, 2013; Scannell & Gifford, 2016, 2017). In one recent study, Scannell and Gifford (2017) identified 13 benefits of place attachment. The four most commonly identified benefits were memory support, sense of belonging, relaxation,

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and stimulation of positive emotions. Other identified benefits include activity support, comfort/security, personal growth, freedom, entertainment, connection to nature, practical benefits, privacy, and aesthetics.

Researchers have been interested in the distress and grief people experience when a place of attachment and identity is lost, particularly in situations of forced relocation (Scannell & Gifford, 2010a). We should pay particular attention to issues of disrupted place attachment and place identity when we work with immigrant and refugee families and families displaced by disaster. Another group that faces disruptions in place attachment are older adults who must leave their homes because of failing health (see Afshar, Foroughan, Vedadhir, & Tabatabaei, 2017; Kylén, Schmidt, Iwarsson, Haak, & Ekström, 2017; Soilemezi, Drahota, Crossland, Stores, & Costall, 2017). Broken place attachment has been associated with physical health problems, sadness, disorientation, longing, and lower grades in children (Scannell & Gifford, 2017). We should also consider the long-term consequences of early experiences, such as homelessness or frequent movement between foster homes, in which no stable place of attachment forms or that result in a negative place attachment.

Much of the research on place attachment has focused on the social aspects of the attachment, suggesting that we become attached to places because of the satisfying social relationships we experience in those places. Some researchers have begun to examine attachment to physical places, particularly to places in the natural environment. They are particularly interested in how attachment to places in nature affects behavior toward the natural environment. One research team (Scannell & Gifford, 2010b) found that attachment to the natural aspects of place contributes to pro- environmental behavior, but attachment to the social aspects of place, which they called civic place attachment, does not. Other research teams (see Cheng & Monroe, 2012; Collado, Staats, & Corraliza, 2013; Zelenski, Dopko, & Capaldi, 2015) have found that experiences in nature increase children’s attachment to nature, ecological beliefs, and willingness to engage in nature-friendly behavior.

Homelessness As suggested, place attachment can be quite problematic for people

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without homes. There are many definitions of homelessness, but for the purposes of this discussion, I use the 2011 definition of homeless used by the U.S. Department of Housing and Urban Development (HUD, 2011) to delineate who is eligible for HUD-funded homeless assistance. This definition includes the four broad categories presented in Exhibit 7.6. In general, people are homeless because they cannot find housing they can afford; there is a real and growing scarcity of affordable housing in the United States. HUD defines housing affordability as spending no more than 30% of monthly income on housing, but according to the Joint Center for Housing Studies of Harvard University (2017) 18.8 million U.S. households paid more than 50% of their annual income for housing in 2015. These households are considered to be severely burdened by housing costs.

Exhibit 7.6 ● Categories in the U.S. Department of Housing and Urban Development Definition of Homeless Exhibit 7.6 ● Categories in the U.S. Department of Housing and

Urban Development Definition of Homeless

1. People who are living in a place not meant for human habitation, in emergency shelter, in transitional housing, or are exiting an institution where they have temporarily resided for up to 90 days and were homeless immediately prior to entering that institution.

2. People who are losing their primary nighttime residence, which may include a motel or hotel or a doubled-up situation, within 14 days and lack resources or support networks to remain in housing.

3. Families with children or unaccompanied youth who are unstably housed and likely to continue in that state.

4. People who are fleeing or attempting to flee domestic violence, dating violence, sexual assault, stalking, or other dangerous or life- threating situations related to violence; have no other residence; and lack the resources or support networks to obtain other permanent housing.

Source: U.S. Department of Housing and Urban Development, 2011.

For the past decade or so, researchers have been using qualitative research

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methods to study how people who are homeless use public spaces and the attachments they form with those spaces. Casey, Goudie, and Reeve (2008) explored the strategies homeless women in England use to negotiate public spaces where they are generally not welcomed. The women reported carrying out day-to-day activities in “libraries, art galleries, museums, book shops, public toilets (on-street and in public buildings such as hospitals), business and retail parks, airports, parks, car parks, the space surrounding public and private buildings (steps, stairwells), and the streets” (p. 903). These spaces were used to eat, sleep, wash themselves, provide shelter from the weather, launder and change clothes, charge their mobile phones, and engage in leisure activities. The women also reported that they had to be strategic in the use of these spaces. Here are some examples. They reported that they were careful to use the public spaces at particular times of the day and to try to blend in with both their behaviors and their appearance. Some reported sleeping upright on benches rather than lying down so as not to appear to be sleeping. Others reported appearing to listen to CD music in the library in order to catch a nap, or reading a book in a bookshop while charging a mobile phone. The researchers found that some cities and localities had more permissive policies than others about the rights of homeless people to occupy public spaces.

In other research as well as the Casey et al. (2008) research, public libraries are often mentioned as public spaces frequented by people who are homeless. A study in central Michigan found that 58% of the homeless respondents reported visiting libraries at least once a week (Kelleher, 2013). The respondents reported using the library to read for entertainment, to use the Internet to look up information or to correspond with people, to study for classes or do homework, to look for a job or a place to live, and to watch movies and listen to music CDs. Libraries vary in their policies about providing library cards to homeless persons, with the requirement of a permanent address being a stumbling block in some libraries. Some public libraries are creating innovative programs to employ homeless patrons or to provide technology training or book clubs for them (Kelleher, 2013). Bunic (2013) describes public libraries in Croatia that have provided special training programs for homeless patrons, including computer and Internet training, job-seeking workshops, and workshops on the legal rights of people who are homeless. They have also engaged some homeless patrons in volunteer activities in the library.

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Other researchers have studied the ways that homeless people use public parks and the attachments they make to the parks. The findings of two such pieces of research indicate that parks in different cities are used in different ways, influenced in large part by the different ways that cities try to limit the rights of homeless persons to be present in public parks and the actions taken to remove them. Shaheen (2010) found a group of long-term homeless persons using Jackson Square in New Orleans’ French Quarter as both home and workplace. Some called the park home, even when they had housing in shelters and other places. Some slept on benches or on grassy areas. They called the network of homeless people that they interacted with in the park their “everyday family.” Some also used the park as their workplace, panhandling in the park; vending jewelry, art, and crafts; or reading tarot cards and palms for the tourists who also frequented the park. Like the women in the Casey et al. (2008) study, the homeless people in Jackson Square had strategies for being allowed to stay in the park: They tried to blend in with their dress and behavior; they frequented the park at certain times of day and for limited time; and they knew the patterns of police checks, sweeps, and arrests in the park.

Reitzes, Crimmins, Yarbrough, and Parker (2015) did a field investigation of the activities in a public downtown park in Atlanta. They found that a large group of homeless people, including a number of young adults, families, and women, tended to stay in the park several hours every day. Many of them expressed some place attachment to the park. They felt proprietary about the park but did not claim exclusive rights to it. They used the park to meet other homeless people and engage in social networking, information exchange, and simple entertainment. They used the park as a convenient and trustworthy place to share information about employment, housing, food distribution, and shelters. City officials often sent work crews to disrupt the places where the homeless persons congregated and discouraged churches and nonprofit organizations from engaging in food distribution in the park. The strategies used by the homeless community to avoid being removed from the park focused on following the rules as they understood them: They didn’t lie down on the benches, walk on the grassy areas, litter, or panhandle (something that was allowed in Jackson Square in New Orleans). They saw the park as a safe place because of the presence of police, guards, and close-circuit cameras, and they valued that safety. The women in the Casey et al. (2008) study also reported seeking out public spaces with these same safety features.

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Accessible Environments for Persons With Disabilities In recent years, we have been reminded that environments, particularly built environments, can be disabling because of their inaccessibility to many persons, including most people with mobility, hearing, and visual impairments. Ben Watson provides us with several examples of how the physical environment both curtailed and supported his activity at times, and he is now in a professional position to try to minimize the barriers people with bodily impairments experience in the world. The social model of disability emphasizes the barriers people with impairments face as they interact with the physical and social world, arguing that disability is a result of the relationship between the individual and the environment (Beckett & Campbell, 2015; Goering, 2015). In the social model, impairment is an aspect of the physical body and disability is restricted activity or social exclusion that comes from aspects of organization of the physical and social environments. In a conference of United Kingdom disability advocates in 1976, the relationship between impairment and disability was summarized this way: “Disability is something imposed on top of our impairments, by the way we are unnecessarily isolated and excluded from full participation in society” (The Union of the Physically Impaired Against Segregation and The Disability Alliance, 1976, p. 4). Disability advocates do not argue that medical and allied health professionals should not be concerned with the effects of physical impairments, but they do argue that such a medical approach is not sufficient to address the ways that the physical and social environments turn impairment into disability. (A note about language here: Early in the disability rights movement, people in the movement preferred the person- first language of “people with disabilities.” More recently, many in the movement have argued for the language of “disabled people,” arguing that it is the environment that disables and not that the disability is a part of their personhood. As with any other identity groups, we should always use the language preferred by the person.)

This way of thinking about disability was the impetus for development of the Disabled People’s International (2017) in 1981, a network of national organizations that promotes the rights of people with disabilities worldwide. In the United States, the social model of disability led to legislation at all levels of government during the 1970s and 1980s, most

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notably two pieces of federal legislation. The Rehabilitation Act of 1973 (Pub. L. No. 93-112) was the first federal act to recognize the need for civil rights protection for persons with disabilities. It required all organizations receiving federal assistance to have an affirmative action plan to ensure accessibility of employment to persons with disabilities. The Americans with Disabilities Act of 1990 (ADA) (Pub. L. No. 101- 336) extended the civil rights of persons with disabilities to the private sector. It seeks to end discrimination against persons with disabilities and promote their full participation in society. The social model of disability was also the driving force behind the United Nations Convention on the Rights of Persons with Disabilities that entered into force in May 2008 (United Nations Division for Social Policy and Development Disability, 2017).

Fifty million adults under the age of 65 in the United States and 2.5 million in Canada live with disabilities, in the community, usually in private households with their families (Coulombe, Jutas, Labbé, & Jutras, 2016). The United Nations Department of Economic and Social Affairs (2016) notes that 15% of the world’s population has some type of bodily impairment that can become disabling. They recommend the following elements of accessible environments: accessible housing and built infrastructures, accessible transportation, accessible public spaces and public services, accessible information and communication technologies, and full and active participation of persons with disabilities in the planning of inclusive and accessible natural and built environments. The five titles of the ADA seek to eliminate environmental barriers to the full participation of persons with disabilities. You will want to be aware of the legal rights of your clients with disabilities. Ben Watson has discovered that, in spite of the law, he still encounters many physical barriers to his full participation in society.

Title I addresses discrimination in the workplace. It requires reasonable accommodations, including architectural modification, for disabled workers. Title II requires that all public services, programs, and facilities, including public transportation, be accessible to persons with disabilities. Title III requires all public accommodations and services operated by private organizations to be accessible to persons with disabilities. It specifically lists 12 categories of accommodations: hotels and places

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of lodging; restaurants; movies and theaters; auditoriums and places of public gathering; stores and banks; health care service providers, hospitals, and pharmacies; terminals for public transportation; museums and libraries; parks and zoos; schools; senior centers and social service centers; and places of recreation. Title IV requires all intrastate and interstate phone companies to develop telecommunication relay services and devices for persons with speech or hearing impairments to allow them to communicate in a manner similar to that of persons without impairments. Title V covers technical guidelines for enforcing the ADA.

In response to this call for physical environments that meet the needs of disabled people, the design profession began to develop principles of universal design, which involves designing all products and built environments to be usable to the greatest extent possible by everyone, regardless of their age or impairments (Imrie, 2012). In addition, the design of places and products should be done in such a way so as not to draw attention to a person’s bodily conditions, to avoid creating a situation in which a person will face discrimination and stigmatization. To design universally, however, means that the designer must keep in mind a large variety of different individuals, not one particular type of user group —“individuals of different ages and with different physical, mental, and cognitive impairments” (Lid, 2014, p. 1345). For example, a public park may be made more accessible for Ben to travel through in his wheelchair without being accessible at all for someone with a visual impairment (Siu, 2013). Likewise, an urban intersection may be reengineered to allow Ben to travel through it safely in his wheelchair but still be quite unsafe for someone with a hearing impairment (Edwards & Harold, 2014). When designing a space for a particular person with a particular need or impairment, design professionals can consult with that particular person during the design process. However, when designing public spaces, it is important for design officials to get input from a great variety of people about the way they interact with the environment. And, indeed, people’s needs and bodily impairments change over time, and the use of universal design in the original design process can prevent environments from becoming disabling as the body changes over time.

Social workers need to keep in mind the high prevalence of bodily impairments among older persons, the fastest growing group in the United States. More accessible environments may be an important way to buffer

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the expected deleterious effects of a large elderly population. As the baby boomers age, they will benefit from the earlier activism of the disability community. Exhibit 7.7 lists some of the elements of environmental design that improves accessibility for persons with bodily impairments. It is important to remember, however, that this list is not exhaustive, and rapid developments in assistive technology are likely to alter current guidelines about what is optimal environmental design. For example, the minimum space requirements in the ADA’s guidelines for wheelchairs are already too tight for the new styles of motorized wheelchairs.

Photo 7.6 The kitchen in the Michael Ciravolo Jr. Wheelchair Suite, dedicated specifically by the Hotel Delmonico in New York City to accommodate people with disabilities.

Exhibit 7.7 ● Some Design Elements of Accessible Environments for Persons With Bodily Impairments

• Create some close-in parking spaces widened to 8 feet to accommodate unloading of wheelchairs (1 accessible space for every 25 spaces).

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• Create curb cuts or ramping for curbs, with 12 inches of slope for every inch of drop in the curb.

• Make ramps at least 3 feet wide to accommodate wheelchairs and provide a 5-by-5-foot square area at the top of ramps to entrances to allow space for door opening.

• Remove high-pile carpeting, low-density carpeting, and plush carpeting, at least in the path of travel. Put nonslip material on slippery floors.

• Avoid phone-in security systems in entrances (barrier for persons who are deaf).

• Make all doorways at least 32 inches wide (36 is better).

• Use automatic doors or doors that take no more than 5 pounds of force to open.

• Use door levers instead of doorknobs.

• Create aisles that are at least 3 feet wide (wider is better). Keep the path of travel clear.

• Connect different levels in buildings with ramps (for small level changes) or a wheelchair-accessible elevator.

• Place public phones no higher than 48 inches (35 to 42 is optimal). Place other things that need to be reached at this optimal height.

• Provide brightly lit foyers and areas with directories to assist persons with low vision. Use 3-inch-high lettering in directories.

• Install Braille signs about 5 feet off the ground.

• Provide portable tactile paving and Braille and audio guides in public parks to assist people with visual impairment.

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• Make restroom stalls at least 3 feet deep by 4 feet wide (5 feet by 5 feet is optimal).

• Install toilets that are 17 to 19 inches in height. Provide grab bars at toilets.

• Hang restroom sinks with no vanity underneath, so that persons in wheelchairs can pull up to them.

• Avoid low seats and provide arm supports and backrests on chairs.

• Apply nonslip finish to tubs and showers. Install grab bars in tubs and showers.

• Use both visual and audible emergency warning systems. Sources: Based on Brawley, 2006; Johnson, 1992; Siu, 2013.

Critical Thinking Questions 7.5

Which do you think are the healthiest type of communities in which to live: rural, small town, suburban, or urban? What do you think are the costs and benefits of living in each of these types of communities? How much thought have you given to what makes an accessible environment for people with the type of mobility disability that Ben Watson has? How easy would it be for Ben to visit your home, your favorite restaurant, or your classroom?

Implications for Social Work Practice This discussion of the relationship between human behavior and the physical environment suggests several practice principles.

Assess the physical environment of your social service setting. Do clients find it accessible, legible, and comfortable? Do they find that it provides adequate privacy and control? Does it provide optimal quality and intensity of sensory stimulation? If it is a residential setting, does it promote social interaction? Routinely assess the physical environments of clients, particularly

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those settings where problem behaviors occur. Check your evaluation against clients’ perceptions. If you have no opportunity to see these environments, have clients evaluate them for you. Provide space on the intake form for assessing the physical environments of clients. Know the physical environments of the organizations to which you refer clients. Assist referral agencies and clients in planning how to overcome any existing environmental barriers. Maximize opportunities for client input into design of their built environments. Be alert to the meanings that particular environments hold for clients. Recognize that people have attachments to places as well as to other people. When assisting clients to learn new skills, pay attention to the discontinuities between the setting where the skills are learned and the settings where they will be used. When planning group activities, ensure the best possible fit between the spatial needs of the activity and the physical environment where the activity will occur. Keep the benefits of the natural environment in mind when planning both prevention and remediation programs. When possible, help clients gain access to elements of the natural environment and, where appropriate, help them plan activities in the natural environment. Recognize any issues of environmental justice impacting the communities where you work. Assess the uses that clients make of information and communication technologies, considering both the benefits and the costs of their use of such technologies. Become familiar with new developments in assistive technologies for persons with physical impairments and with the resources for financing them. Become familiar with technology for adapting environments to make them more accessible.

Key Terms behavior settings 205 behavior settings theories 205 biophilia 208 built environment 212 control theories 200

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crowding 204 deep ecology 206 density 204 ecocritical theories 206 ecofeminism 206 ecotherapy 209 environmental justice 210 evidence-based design 216 natural environment 207 personal space 201 place attachment 219 place identity 220 primary territory 204 privacy 200 programs 205 public territory 204 secondary territory 204 staffing 205 stimulation theories 199 technology 213 territoriality 204

Active Learning 1. Take a walking tour of your neighborhood. Do you see any signs of

stimulus overload or restricted environmental stimulation in the physical environment? What signs do you see of people engaging in territorial behavior? Do you see any behavior settings in which specific programs are enacted? How well do people seem to be caring for the natural environment? Are there features of the natural environment that seem particularly appealing to you? Are there places in the neighborhood to which you have a strong attachment bond? Do you note any of the design features to improve accessibility for persons with disabilities noted in Exhibit 7.7? What effects do you think the physical environment of the neighborhood might have on children, adolescents, and elderly adults?

2. Sitting alone or with a small group of classmates, make a list of all the communication technology devices you make use of. Make another list of the uses you have made of these devices in the last 2 days. Think about or discuss your relationship to these devices: how attached you

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are to them, how big a part of your life they are, and how you feel when you don’t have access to them. How do you see these devices making your life better? What, if any, are their ill effects on your life? Finally, make a list of the benefits these devices provide to society. Make another list of the downside of these devices for society. What have you heard other people say about the benefits and downside of these technological devices?

3. Sitting alone or with a small group of classmates, imagine that Ben Watson is visiting your community for the weekend. You would like to take him out to dinner. Working alone or together, develop a list of questions that you will want to ask of restaurant managers about their accessibility for Ben to dine there. Now, each of you get out your cell phone and call one of your favorite restaurants and go through your list of questions. What did you learn?

Web Resources

Academy of Neuroscience for Architecture: www.anfarch.org

Site maintained by the Academy of Neuroscience for Architecture contains information about the academy and its projects, upcoming workshops on neuroscience and specific design environments, and links to neuroscience and architecture organizations.

American Association of People with Disabilities: www.aapd.com

Site maintained by the American Association of People with Disabilities, a national nonprofit cross-disability organization, contains information on benefits, information on disability rights, news, and links to other disability-related sites.

Center for Health Design: www.healthdesign.org

Site maintained by the Center for Health Design, a research and advocacy organization committed to using architectural design to transform health care settings into healing environments.

Environmental Justice: www.epa.gov/environmentaljustice

Site maintained by the U.S. Environmental Protection Agency contains basic information about different types of environmental hazards and information on environmental laws and regulations.

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http://www.anfarch.org

http://www.aapd.com

http://www.healthdesign.org

http://www.epa.gov/environmentaljustice

Job Accommodation Network: http://askjan.org

Site maintained by the Job Accommodation Network of the Office of Disability Employment Policy of the U.S. Department of Labor contains ADA statutes, regulations, guidelines, technical sheets, and other assistance documents.

National Alliance to End Homelessness: www.endhomelessness.org

Site maintained by the National Alliance to End Homelessness contains basic facts about homelessness; facts and policy issues related to homeless families, chronic homelessness, rural homelessness, homeless youth, homeless veterans, domestic violence, and health care; and suggested solutions for ending homelessness.

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http://askjan.org

http://www.endhomelessness.org

8 Cultures

Elizabeth D. Hutchison Linwood Cousins

Chapter Outline Learning Objectives Case Study 8.1: Rubina Living Across Cultures What Is Culture? Theories of Culture

Materialist Perspective Mentalist Perspective Other Theoretical Perspectives

Major Concepts in the Study of Culture Values Ideology Symbols Language Norms Subcultures and Countercultures Ideal Culture Versus Real Culture

Ethnocentrism and Cultural Relativism Culture and Power

Race Ethnicity Gender Sexuality Social Class Disability

Genes and Culture Digital Culture How Culture Changes Implications for Social Work Practice Key Terms Active Learning Web Resources

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Learning Objectives 8.1 Analyze one’s own emotional and cognitive reactions to a case study. 8.2 Outline the elements that make up a comprehensive definition of culture. 8.3 Compare three theoretical perspectives on culture (materialist, mentalist, and practice orientation). 8.4 Apply a number of major concepts in the study of culture to a case study. 8.5 Analyze how the approaches of ethnocentrism and cultural relativism would benefit or be harmful to social work practice. 8.6 Give examples of how culture and power intersect in the social categorizations of race, ethnicity, gender, sexuality, social class, and disability. 8.7 Summarize contemporary thinking about the interactions of genes and culture. 8.8 Analyze the benefits and costs of digital culture. 8.9 Identity the major mechanisms involved in cultural change. 8.10 Apply knowledge of human culture to recommend guidelines for social work engagement, assessment, intervention, and evaluation.

Case Study 8.1 Rubina Living Across Cultures Rubina is a 22-year-old Pakistani American female who was recommended to an outpatient mental health clinic by her primary care doctor due to possible depression and anxiety. On the referral the doctor noted that Rubina has chronic headaches, shortness of breath, and chest pains. The doctor has completed thorough physical assessments with bloodwork and believes that Rubina’s symptoms are likely psychosomatic.

At the intake appointment Rubina is very cooperative and open. She tells the social worker that she was born in the United States to parents from Pakistani origins. Her parents moved to the United States in their 20s, before she was born, for better economic opportunities. Rubina’s parents currently work in the restaurant business and have struggled financially as long as she can remember. Despite their financial struggles, her parents have always emphasized the importance of education and pushed Rubina and her siblings to excel in school. Rubina graduated high school at the top of her class and is currently studying business at an Ivy League school.

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Rubina tells the social worker that she is doing well at school and that most of the stress in her life comes from her parents. Rubina lives at home with her mother, father, and three younger siblings. She reports that although her parents have been in the United States for over 20 years they continue to live their day-to-day lives like “back home.” Rubina clarifies that Pakistan is not home for her—she has only been there a few times on vacation—but that her parents derive all their expectations, rules, and norms from that culture. Expectations that bother Rubina the most include her parents needing to know where she is at all times and that, as the eldest child in the family, she needs to take care of her siblings (by helping with homework every day and driving them around to extracurricular activities). It also really bothers her that her parents expect her to listen to them unconditionally, although she is in her last semester of college.

Values of respecting one’s elders, honoring one’s parents, and helping family members are very strong within the family, and Rubina feels extremely guilty anytime she tries to put her needs before her family’s. It’s during these times that Rubina’s unexplained body aches and pains seem to flare up the most. When Rubina tries to assert herself she is met with a lot of resistance and told she is trying to act “American.” This causes a lot of cognitive dissonance for Rubina, for she was born in the United States and as a result often feels American. On some days, however, when Rubina hears about hate crimes toward minorities in the news she reports feeling more “Brown” and that perhaps her mother is right that she is not a real American. Because Rubina doesn’t relate to the Pakistani culture much, she feels cultural dysphoria and often feels out of place wherever she goes.

While trying to navigate through cultural identity issues, Rubina tells the social worker that she recently started practicing Islam after joining her university’s Muslim Student Association (MSA). She really likes how culturally diverse the MSA is and has become friends with many second- generation immigrants from the Middle East, Africa, and Asia, like herself, as well as recent North, Central, and South American converts. Rubina feels that she can relate to her peers in the MSA about culture issues and young- adulthood issues in ways she can’t with her family. Attending MSA lectures and interacting with other Muslims has helped her explore religion in ways she had not before. Rubina feels that religion gives her a stronger sense of identity and makes her feel more grounded.

Rubina tells the social worker that her new interest in Islam was not warmly received at home, although her family identifies themselves as Muslim. When Rubina started to learn more about religion from sources outside her family, she came to realize that her parents misused religion to enforce their cultural values during her childhood. For example, if Rubina ever disagreed

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with her parents about an issue, even respectfully, her mother would tell her that Rubina was displeasing Allah (God). Rubina doesn’t know if her parents did this knowingly or out of ignorance but indicates she is resentful of her parents either way. Rubina has more recently become vocal at the dinner table about issues important to her, but her parents scoff at her ideas.

In the past two months Rubina began to experiment with the hijab (Islamic headscarf) for the first time, and this has further exacerbated conflict at home. Rubina says that when she wears her hijab she feels closer and more connected to God. Although Rubina’s parents are considered conservative by most standards, they told her to not wear the hijab because of the recent increase in anti-Muslim sentiment within their local community. Rubina feels that her parents’ views of the hijab only substantiate her claims that her parents pick and choose standards that are convenient for them.

Rubina appears to understand that difficult family dynamics are likely causing her physical ailments, but she tells the social worker she doesn’t know how to manage her stress in healthy ways. She is willing to try counseling and expresses some optimism that even if counseling doesn’t work, at least she will have someone to talk to who won’t judge her.

—Najwa Awad

What Is Culture? Rubina, like many of us, moves back and forth across several different cultures in her daily life. That is why the title of this chapter is “Cultures” and not “Culture.” The world has always contained a rich array of cultures, and history is largely a tale of the conflicts that occurred when different cultures encountered each other in the same space. However, in past generations, in what has been called “traditional culture,” it was not unusual for people to live their lives in relatively unchanging cultural enclaves with clear norms and values, with little encounter with people from other cultures with different norms and values. In many places in the world today, this type of cultural segregation is no longer the way that humans live. In the contemporary world, in many but not all places, we come into contact with a variety of cultures through daily activities but also through the media, travel, reading, migration, and a global economic system. The first author is immersed or has been immersed in many different cultures, including a broad U.S. culture, several different regional cultures, White racial culture, social work culture, rural culture, small-

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town culture, city culture, family culture, three different university cultures, many different classroom cultures, several different workplace cultures, religious culture, political culture, consumer culture, peer culture, gender culture, entertainment culture, social networking culture, and more. The case study indicates several cultures in which Rubina participates, including “American” culture, university culture, family culture based on “back home” Pakistani culture, the peer culture of the Muslim Student Association that includes much cultural diversity, and the current culture of anti-Muslim sentiment in the United States. As her social worker gets to know Rubina better, she will probably learn of other cultures in which Rubina participates, perhaps a social media culture and a culture of business students. What about you? In which cultures do you participate, and how do the different cultures shape your identity?

In the contemporary world, cultures interact with and influence each other. Almost all of us live at the intersection of several different cultures; sometimes these different cultures reinforce each other; sometimes they borrow from each other; and sometimes our cross-cultural experiences are fraught with the kind of conflicts that Rubina is experiencing. Human behavior must be understood in the context of multiple interacting cultures.

So what is culture? Contemporary social scientists suggest that culture is one of the most elusive social science terms to define. Researchers use many different definitions, reflecting different theories for understanding culture and focusing on different phenomena (Gardiner, 2018). More than 50 years ago, two anthropologists, Kroeber and Kluckhohn (1952), developed a list of 164 definitions of the term culture found in the social science literature. They divided these definitions into the eight categories presented in Exhibit 8.1.

Exhibit 8.1 ● Categories of Definitions of Culture Exhibit 8.1 ● Categories of Definitions of Culture

Topical: A list of topics to be considered in the study of culture, topics such as social structure, religion, economic system, habits, and so forth

Historical: Social heritage and tradition, passed down from one generation to the next

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Behavioral: Shared, learned human behavior, a way of life

Normative: Ideals, values, norms, or standards for living

Functional: The way people solve problems and adapt to their environments

Mental: Ideas, values, and habits

Structural: Patterned and interrelated ideas, symbols, and behavior

Symbolic: Arbitrarily assigned meanings that are shared Source: Adapted from Kroeber & Kluckhohn, 1952, pp. 40–79.

Anthropologists trace contemporary definitions of culture back to the definition offered by anthropologist E. B. Tylor in 1871: “that complex whole which includes knowledge, belief, art, morals, laws, customs and any other capabilities and habits acquired by man as a member of society” (p. 1). This definition of culture is a broad definition, and many of the definitions found in the anthropology, cultural psychology, cultural studies, and sociology literatures that came after Tylor’s time continued in this broad way of thinking about culture. For example, in 1969 sociologist Peter Berger provided an even broader definition, defining culture as “the totality of man’s products, both material and immaterial” (p. 6). Other scholars call for a narrower, more focused definition, but these scholars have a lot of variation in their thinking about what the narrower focus should be. Some focus on material culture, which includes physical objects, resources, and spaces that people use to define their culture. Examples include homes, places of religious worship, work spaces, tools, products, and technologies (see Tilley, Keane, Küchler, Rowlands, & Spyer, 2013). Other scholars focus on beliefs and values; some focus on norms and habits, and others focus on language, symbols, and meaning making (Inglis, 2016). Several disciplines are involved in the study of culture, and each discipline includes an array of definitions. There is no agreed-on definition of culture and probably never will be. Exhibit 8.2 provides some definitions of culture used in the contemporary disciplines of anthropology, cultural psychology, cultural studies, and sociology.

Exhibit 8.2 ● Definitions of Culture Used in Contemporary

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Anthropology, Cultural Psychology, Cultural Studies, and Sociology

Exhibit 8.2 ● Definitions of Culture Used in Contemporary Anthropology, Cultural Psychology, Cultural Studies, and Sociology

Author Discipline Definition

Ballantine, Roberts, & Korgen, 2018, p. 67

Sociology

The ideas and “things” passed on from one generation to the next in a society, including knowledge, beliefs, values, rules and laws, language, customs, symbols, and material products

Barker & Jane, 2016, p. 9

Cultural studies

The actual grounded terrain of practices, representations, languages, and customs of any specific society . . . the contradictory forms of common sense

Gardiner, 2018, p. 3

Cultural psychology

The cluster of learned and shared beliefs, values (achievement, individualism, collectivism, etc.), practices (rituals and ceremonies), behaviors (roles, customs, traditions, etc.), symbols (institutions, language, ideas, objects, artifacts, etc.), and attitudes (moral, political, religious, etc.) that are characteristic of a particular group of people and that are communicated from one generation to another

Guest, 2017, p. 35

Anthropology

A system of knowledge, beliefs, patterns of behavior, artifacts, and institutions that are created, learned, shared, and contested by a large group of people

Haviland, A society’s shared and socially

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Prins, Walrath, & McBride, 2017, p. 326

Anthropology

A society’s shared and socially transmitted ideas, values, and perceptions, which are used to make sense of experience and generate behavior and are reflected in that behavior

Ritzer, 2016, p. 54

Sociology

The ideas, values, practices, and material objects that allow a group of people, even an entire society, to carry out their collective lives in relative order and harmony

In this chapter, culture is defined as a system of knowledge, beliefs, values, language, symbols, patterns of behavior, material objects, and institutions that are created, learned, shared, and contested by a group of people. As you can see, this definition is very similar to the definition proposed by anthropologist Guest (see Exhibit 8.2), with some additions. This definition indicates that culture is “inside our heads” as thoughts, beliefs, perceptions, and emotions (Cousins, 2015). It is also in the social and material worlds with patterns of behavior, material objects, and the social institutions we create to manage social life. It is created over time, shaped by human interactions. It is learned through a process called enculturation. The hallmark of culture is that it is shared by a group of people, but what we like most about Guest’s definition is that it recognizes that culture is both shared and contested. This notion that culture is contested as well as shared is very important to social work. As Ritzer’s definition of culture (as seen in Exhibit 8.2) points out, shared culture allows both small and large groups to carry out their collective lives in relative order and harmony. And yet social workers recognize that order and harmony too often favor elite participants in a culture while at the same time harming or oppressing other participants. Besides the conflicts between cultures, intense internal struggles often erupt over beliefs, values, symbols, and behaviors. Consider Rubina’s story. She navigates the conflicts between “American” culture and “back home” Pakistani culture, as well as the conflicts between her religious culture and the dominant religious culture in the United States. But she also lives with an intense internal struggle about the nature of her family culture. Now, think back to Amira in Case Study 6.7 in Chapter 6. Amira, like Rubina, is a 22-year-old

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cultures, but her struggles are not identical to those of Rubina. This is an important reminder that we must avoid making assumptions about people based on their ethnicity or any other single identifier. We must allow people to tell their own stories of cultural conflict. Social workers are often called on to intervene in these internal struggles, whether they occur in a family, a small group, a community, an organization, or even a larger society.

Photo 8.1 Music is a cultural creation

©The Washington Post/Getty Images

Theories of Culture The study of culture can be divided into two main streams: the humanities approach and the social science approach (Griswold, 2013). In the humanities approach, and in common usage, culture is associated with the fine and performing arts and with “serious” literature. Traditionally, societies and groups were evaluated on the basis of their art and literature products. Some cultures and some cultural works were, and still are in common usage, considered better than other cultures and cultural works. It is not unusual to hear someone head off to the art museum or a symphony performance saying, “I am going to get some culture.” The social science

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performance saying, “I am going to get some culture.” The social science approach to culture began to be developed during the 19th century when the new disciplines of anthropology and sociology began to use the word culture in a different way than traditionally used in the humanities. In this new way of thinking, culture refers to a society’s total way of life. Social scientists say, “We are doing culture all the time” rather than “I am going to get some culture.” To begin to think about how we are all doing culture all the time, consider some of the cultural creations presented in Exhibit 8.3. Social scientists attempt to study cultures in terms of relativism instead of evaluation; one culture is not better than another, just different. They also think of culture as a force that stabilizes societies and allows them to persist over time.

Exhibit 8.3 ● Cultural Creations

As you might have guessed, we are using a social science approach to culture in this chapter and are not considering theories of culture found in the humanities. Over time, social scientists have developed almost as many theories of culture as definitions of culture. And books have been written on every social science theory of culture considered to be important to

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of culture presented by anthropologist Haviland and colleagues (2017): materialist perspectives, mentalist perspectives, and other perspectives. The intent is not to provide an exhaustive understanding of culture theory but to provide a window on some of the main themes in contemporary culture theory.

Before beginning that discussion, we call your attention to the discussion in Chapter 1 of this book about controversies surrounding assumptions undergirding social science theory, particularly the competing assumptions about whether human behavior is determined by forces beyond the control of the person (determinism) or people are free, proactive agents in the creation of their behavior (voluntarism). That controversy shows up in theorizing about culture in the form of questions about human agency in the creation, maintenance, and changing of cultures. Human agency refers to the capacity of individuals to act independently and to make their own free choices. Some theories of culture assume that humans have agency in creating, maintaining, and changing culture, and other theories assume little to no human agency in relation to culture.

Materialist Perspective The materialist perspective places primary emphasis on the role of the environment, technology, and economy in creating, maintaining, and changing culture. Ideas, values, beliefs, and cultural products are seen as adaptations to environmental, technological, and economic conditions. Still today, the best known theory in the materialist perspective is Marxism, which proposes that culture is driven by the economic organization of a society. Not only material things such as food, clothing, lodging, and communication technology but also consciousness—what we are aware of and how we think and feel about things—are cultural by- products of the economic system. For example, we might ask if Rubina’s parents’ views of the hijab are based, in some part, on their struggles in the economic system. In this perspective, cultural change is the result of growing conflict between economic classes. As noted in Chapter 2, neo- Marxist critical theory focuses on the culture industry that mass produces popular culture products such as movies, television shows, and social media, arguing that products of the culture industry manipulate humans into passivity (Scannell, 2007; Steinert, 2003). In the view of Marxism and critical theory, human agency is quite limited.

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Whereas Marxism focuses on the economic institution and neo-Marxist critical theory on the culture industry as the driving force of culture, cultural ecology focuses on the impact of the physical environment on culture. Cultural ecologists are interested in how humans adapt their cultures to the natural environment and how humans modify nature to suit their needs and desires. They are particularly interested in the relationship of the physical environment to the cultures of marginalized and vulnerable groups of people. They are also concerned about threatened landscapes, and this has led many cultural ecologists into environmental activism. As you can see, unlike Marxism and neo-Marxist critical theory, cultural ecology is interested in human agency and the human capacity to manipulate the physical environment in the development of culture (Antoinette & WinklerPrins, 2010).

Mentalist Perspective The mentalist perspective sees humans creating, maintaining, and changing culture on the basis of their beliefs, values, language, and symbolic representations. Culture is understood by understanding how participants think, feel, and speak. Interpretive anthropology views humans mostly as “symbolizing, conceptualizing, and meaning-seeking” creatures (Geertz, 1973, p. 5). Culture should be understood by peeling back layer upon layer of socially constructed meaning. In the case of Rubina, what does it mean to her to be Brown, and what does it mean to others? How did these meanings develop over time? Also, what does the hijab mean to Rubina, her parents, and the people she encounters on the street? How did these meanings develop over time? There is much room for human agency in this perspective. Culturalism emphasizes the day-to- day aspects of culture and the active, creative way that people participate in constructing shared meaning and shared meaningful practices. In this view, cultural meaning unfolds over time as people interact (Barker & Jane, 2016). This perspective puts strong emphasis on the role of human agency in constructing culture. Structuralism examines culture as a product of the human brain’s mental structure. More specifically, it proposes that the structure of human cognition leads us to conceptualize the world in terms of binary opposites (e.g., bad-good, black-white, day- night, cold-hot, female-male, life-death, us-them). It suggests that we understand what we are in large part by thinking about what we are not (Layton, 2006). There is limited room for human agency from this

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perspective. Semiotics is the study of meaning making through signs and symbols. These theoreticians and researchers study the way language is used as code for values and ideas, but they also study other types of signs and symbols, such as war memorials, Internet memes, food, and clothing items such as the hijab (Barker & Jane, 2016; Layton, 2006). They are interested in what can be expressed and who can express it, leaving some room for human agency but more room for some culture participants than for others.

Poststructuralism and postmodernism have developed as critiques of structuralism but also serve as critiques of Marxism and neo-Marxism. Poststructuralism rejects the idea of an underlying stable structure of culture, particularly the idea of meaning making through fixed binary opposites. For example, it is in agreement with those who propose gender as a nonbinary attribute. These theorists see meaning as unstable and in process; attributes like Black identity or femininity are not fixed attributes but descriptions in language that have come to count as truth. They are productions of culture that developed in particular times and places (Barker & Jane, 2016). Postmodernism, like poststructuralism, argues that truth and meaning are perspectival; the development of ideas, knowledge, symbols, and values take place from particular perspectives that come from living in particular times and places. There are always many possible conceptual schemes from which judgment of truth and value can be made. The human condition is fragmented, ambiguous, and uncertain (Barker & Jane, 2016). As we write this in June 2017, we are paying attention to discussions of “fake news” and “alternative facts.” These are postmodern ideas being presented by people who often argue that there are certainties and truth. Although poststructuralism and postmodernism seem to leave room for human agency, theorists in this tradition do not emphasize human agency.

Exhibit 8.4 ● Characteristics of Traditional, Modern, and Postmodern Culture

Characteristic TraditionalCulture Modern Culture Postmodern Culture

Positive

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Role of rationality

value for irrational aspects of life; religious traditions superior to reason

Supreme value of rationality; rational control of nature

Questions the limits of rationality

Status

Status based on bloodline; hierarchy as natural order; patriarchy

Status based on achievement; egalitarianism

Emphasis on difference, not power

Source of authority

Religious authority

Nation-state; science

Globalization; national authority breaks down

Stability and change

Stability and order valued; order based on religion

Progress valued Unpredictabilityand chaos

Unit of value Communalvalues Individualism

Diversity: multiplicity of perspectives and voices

Life structure Agrarian, subsistence agriculture

Industrialization, urbanization, capitalism, commodity fetishism, specialization of function

Electronic communications, simulation, mass consumption

It is important to note that many contemporary culture scholars suggest

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that three major types of cultures have been produced in recent centuries: traditional culture, modern culture, and postmodern culture (see Gotham, 2013; Griswold, 2013). Although the postmodernists do not see these different cultures as a historical development, traditional culture or premodern culture is the name generally given to preindustrial societies based on subsistence agriculture. Modern culture arose with the 18th- century Enlightenment and is characterized by rationality, industrialization, urbanization, and capitalism. Postmodern culture is the term many people use to describe contemporary societies driven by global communication technology, societies where people are exposed to media images that span place and time, allowing them to splice together cultural elements from these different times and places (Griswold, 2013). One of the earliest journals to be Internet based is titled Postmodern Culture and has become a leading electronic journal of interdisciplinary thought on contemporary cultures. Exhibit 8.4 presents the primary characteristics usually attributed to these three types of culture. Although these types of culture are often presented as a historical timeline, traits of all three types of culture can in fact be found in technology-driven capitalist societies today and often become the source of contemporary culture wars within societies. Furthermore, many nonindustrial and newly industrializing societies can be characterized as either traditional or modern cultures.

Other Theoretical Perspectives Some culture scholars (anthropologists, sociologists, psychologists, political scientists, economists, and social workers) have been particularly interested in finding a way of thinking about culture that allows for human agency while also recognizing the constraints that culture puts on it. They present a practice orientation (Bourdieu, 1977; Giddens, 1979; Ortner, 1989, 1996, 2006) that seeks to explain what people do as thinking, intentionally acting persons who face the impact of history and the constraints of structures embedded in society and culture. It asks how social systems shape, guide, and direct people’s values, beliefs, and behavior. But it also asks how people, as human actors or agents, perpetuate or change the cultures of social systems.

History, social structure, and human agency are key elements in a practice orientation. History is made by people, but it is made within the constraints of the social, economic, political, physical, and biological systems in which people are living. To understand human diversity, especially as it

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relates to oppression, exploitation, and subjugation, we must listen to the memories of both powerful and marginalized observers. We must listen to clients as much as to social workers.

Structure refers to the ordered forms and systems of human behavior existing in public life (e.g., capitalism, family, public education). We carry forth meanings, values, and beliefs through social, economic, and political practices in our everyday personal lives and the institutions in which we participate. Social structure and social institutions are the focus of Chapter 9 in this book. We reproduce structures when we assume the rightness of the values, beliefs, and meaning that undergird them and see no need to change them.

As suggested earlier, human agency recognizes people as capable of exercising their will to shape their lives. Thus, although racism and religious bias are structured into society, they are not so completely dominant over Rubina that she has no room for meaningful self-expression about issues such as with whom she associates and what she wears. Human agency is a major source of hope and motivation for social workers who encounter people, organizations, and systems that seem unable to break away from the constraints of history and culture. However, no individual or group is a fully free agent. All are constrained by biology and by external factors such as the climate, natural resources, and existing social institutions—although we may be able to modify some of these constraints through technology (Kurzweil, 2012). Examples of technologies that modify constraints of biology and nature are medicines, agricultural breakthroughs, climate-controlled homes, telecommunications, and transportation.

Critical Thinking Questions 8.1

When you think of your day-to-day life, do you think you live in a traditional, modern, or postmodern culture? Explain. What do you see as the benefits and costs of each of these types of cultures? How much human agency do you think you have to take charge of your own life? How much human agency do you think Rubina has? What factors make a difference in how much human agency people have?

Major Concepts in the Study of Culture

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As noted earlier, contemporary understandings of culture include numerous themes with different scholars focusing on different concepts. In this section, we consider some of the major concepts used in the study of culture across disciplines and theoretical perspectives. We have already taken a look at material culture, which includes physical objects, resources, and spaces that people use to define their culture. Other important concepts in the study of culture are values, ideology, symbols, language, norms, subculture, counterculture, and ideal culture versus real culture.

Values Cultures promote and nurture a core set of values, beliefs about what is important or unimportant, desirable or undesirable, and right or wrong. They reflect the basic ideals and shared cultural standards of a group or society. One of the most frequently noted ways to compare and contrast the values of different cultures at the societal level is to think in terms of individualist culture versus collectivist culture. In this view, an individualist culture is made up of people who are responsible to and for themselves and whose individual achievement is the overriding goal. The United States and western European countries are often used as examples of individualist societies, with the United States often considered to be the most individualistic society in the world. A collectivist culture is made up of people who consider the group to be most important, with an emphasis on traditions, cooperation, and a sharing of common goals. Societies that are typically noted to be collectivist cultures include most of Asia, Africa, and South America. Some researchers have noted that components of both individualist and collectivist values exist in most cultures, and even within individuals (Gardiner, 2018), but it is also probably true that most cultures tend to tilt one way or the other. We can see that Rubina’s parents value a collectivist approach, at least for the workings of their family, and Rubina, at least in this phase of her life, has been influenced by the individualist values of the wider U.S. culture.

Cultural values are not equally shared by all participants, and in any country in the world looking at a daily newspaper or reading comments on social media quickly demonstrates struggles over cultural values. For example, in the United States and around the world, there is a cultural debate about the proper prioritization of values of environmental protection versus economic growth. Often cultural life includes dualisms

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of competing values, two things that are both valued but in competition with each other—perhaps people value individualism and collectivism or environmental protection and economic growth. In the United States, we value both privacy and security, and since September 11, 2011, we have had lots of debates about the proper balance of these two values. Policies that were made to provide security—such as governmental surveillance of telephone and Internet communications—have been criticized for their invasion of privacy. Similarly, in social work we value both individual freedom and the common good. In individual practice situations, these two values are in competition when one person’s individual freedom is harmful to another individual or group of individuals, for example, parents’ right to parent as they choose versus the rights of a child to be protected from abusive or neglectful parenting. In the situation of competing values, we always have to consider how to balance them in specific situations.

Ideology Ideology is akin to values but is used to mean a set of shared beliefs that explains the social world and guides people’s actions, especially in relation to economic and political theory and policy. Here is an example. In his book American Nations: A History of the Eleven Rival Regional Cultures of North America, Colin Woodard (2011) argues that the United States has been a deeply divided country from the days the original colonies were settled by people from different regions of the British Isles, as well as from France, the Netherlands, and Spain. He proposes that this pattern of settlement resulted in 11 different regional cultures: “Some championed individualism, others utopian social reform. Some believed themselves guided by divine purpose, others championed freedom of conscience and inquiry. Some embraced an Anglo-Saxon Protestant identity, others ethnic and religious pluralism. Some valued equality and democratic participation, others deference to a traditional aristocratic order” (p. 2). Over time, some people migrated and new waves of immigration happened, but Woodard argues that strong traces of the 11 regional cultures persisted. The 11 cultures have formed shifting alliances from the Revolutionary War to the Civil War to the current time, always struggling to gain control of the ideology and institutions of the federal government.

Woodard proposes that since the Civil War, these 11 regional cultures have coalesced into two primary competing political ideologies: one side pushing for a large role for the federal government in securing social and

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economic justice at home and opposing military intervention abroad while the other side pushes for a small role for federal government in domestic policy and a large military presence abroad. Other issues get woven into these two ideologies from time to time, but their basic core has not changed since the Civil War. One issue woven into political ideologies in recent years is anti-immigrant and anti-Muslim sentiment. This is an ideology that causes pain to Rubina, her family, and her peers in the MSA. Woodard’s book presents incisive analysis of how attitudes toward issues such as poverty policy, racial injustice, and immigration have been shaped over time.

Symbols Cultures include complex systems of symbols, and much of human behavior involves symbols. A symbol, simply stated, is something that stands for something else. It can be verbal (language), an artefact (a flag), or nonverbal behavior (standing for the national anthem). We are often not aware that we are expressing ourselves symbolically, because “much symbolic communication is nonverbal, action-based, and unconscious” (Guest, 2017, p. 39). Let’s consider Rubina’s recent use of the hijab. She says it symbolizes her relationship with God, but for her parents it is a symbol of danger. In recent years, researchers in the United Kingdom, Canada, and the United States have studied the meaning of the hijab among Muslim women, and as you might guess they have found that it carries different meanings for different women. For example, Ann McGinty (2014) studied the meaning of the hijab among five Palestinian American Muslim women living in Milwaukee, Wisconsin. For some of the women, as for Rubina, wearing the hijab represents an internalization of their religious faith and their relationship with God. It serves as a reminder of their desire “to be good,” to live in accord with the tenets of their faith. To one woman, it is a part of a personal identity quest, a way to deal with her feelings of exclusion and a need to belong. To another woman, wearing the hijab is not a religious practice but a way to symbolize political solidarity and political protest against Islamophobia. Some women note a desire to be more visible to let other people know that “there are Muslims in Milwaukee” (McGinty, 2014, p. 694) and to diminish the stigma of being Muslim. These women see wearing the hijab as a form of activism and participate in community outreach while wearing the hijab to make the Muslim community more visible in the media in a

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positive way. One of the women chooses not to wear the hijab because she is highly critical of the local Muslim community’s pressure to wear it and feels that they stigmatize women who do not wear it. Rubina might find meaning in what Rafa reported to McGinty about a difference between herself and her parents. She was born in the United States, unlike her parents, and when talking about the difference that made in thinking about the hijab, she said that her parents do not see the United States as their country: “They always had the fear, while I feel like this is my place” (McGinty, 2014, p. 695). Perhaps this is an idea that Rubina’s social worker could explore with her.

Language One important aspect of symbolic culture is language, the system of words or signs that people use to express thoughts and feelings to each other. Language is found in three primary forms: spoken, written, and nonverbal. Human brains are wired at birth to learn any spoken language to which they are exposed, but as brain synapses are pruned over time to improve brain efficiency the capacity to learn new languages is diminished. Written language allows humans to store information and ideas and produce a cultural history; it also allows communication over wide distances. Nonverbal language consists of gestures; facial expressions; body postures; and vocal elements such as rate, volume, and intonation. One might imagine that even when Rubina does not challenge her parents’ expectations verbally, she might be communicating her dissatisfaction with a combination of facial expressions, body postures, and vocal elements. American Sign Language is an example of a complex language built entirely on gestures. It allows for people who are mute or hearing challenged to communicate in face-to-face interactions; text messaging technologies have also extended the ability for people who are mute or hearing challenged to communicate with the written language of their choice.

According to Ballantine and colleagues (2018), there are more than 7,100 spoken languages in the world, with 40% of the world’s population speaking one of the eight most common languages as their first language. The five most common first languages in the world are Chinese (1.2 billion speakers), Spanish (414 million speakers), English (335 million speakers), Hindi (260 million speakers), and Arabic (237 million speakers). English is the most common Internet language around the

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world. With so much variability in language in different places of the world, learning a new language becomes a major challenge for people migrating across national lines. This is especially challenging for people who migrate as adults; migrating adults are usually capable of thinking complexly but not able to communicate their complex thoughts in their new language. This can be very frustrating. It should be noted that a number of countries of the world have more than one official language, and people who live in countries in the European Union (EU) often learn several languages as they travel freely across the EU.

New words are added to a culture’s language as the culture evolves and new cultural products are developed. In February 2017, Merriam-Webster (2017b) announced that it had just added over 1,000 new words to its English online dictionary, “including terms from recent advances in science, borrowings from foreign languages, and words from tech, medicine, pop culture, sports, and everything in between” (para. 1). The new words include Seussian (suggestive of works of Dr. Seuss), conlang (an invented language), and face-palm (covering one’s face with embarrassment). Other new words relate to technological development: net neutrality, abandonware, botnet, binge-watch, and photobomb. Some are political terms: truther, SCOTUS, and FLOTUS. Still others involve combining words to provide new metaphors or imagery, such as train wreck, side-eye, walk back, and geek out. By the time you read this chapter, no doubt Merriam-Webster will have added more words, and you might want to check their website to see what the added words suggest about U.S. and world culture.

Norms Sociologists have been particularly interested in norms, the culturally defined rules of behavior that guide people in what they are to do or not to do. Many norms are informal whereas others have been formalized in laws. The expectation that we stay to the right on the metro elevator is an informal norm whereas the expectation that we drive below a certain speed limit is a norm that has been codified into law. Sociologists make a distinction between norms that are folkways and norms that are mores. Folkways are norms about desirable behaviors that are relatively unimportant and not strictly enforced. Speaking quietly in the university library or wearing the latest fashion may be expected behavior, but the expectations are not usually enforced. Mores, on the other hand, are

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considered more important norms and often hold moral significance in the culture. Being unfaithful in a committed relationship or using your smartphone to cheat on an exam are examples of mores, both of which will usually carry punishment if discovered. Often it is not clear whether particular behaviors are folkways or mores, and that may vary from setting to setting. For example, wearing the hijab might be considered a folkway in some Muslim groups and a more in other Muslim groups. Likewise, some people in the United States consider standing with hand over heart when the national anthem is played to be a folkway whereas other people consider it to be a more.

Norms are reinforced through sanctions, rewards (positive sanctions) for compliance and punishment (negative sanctions) for noncompliance. Sanctions can be informal or formal. They can range from a smile to reinforce compliance or a frown to challenge noncompliance, withheld allowances, fines for parking violations, failing grades or expulsion for plagiarism, or imprisonment or even the death penalty for murder. Families and societies struggle to identify the most effective sanctions for encouraging compliance with cultural norms. We know that Rubina’s parents expect her to always let them know where she is going and to follow their rules unconditionally. When she challenges these expectations, one way they try to punish her resistance is to accuse her of trying to act American, an accusation that is unsettling to her because it reinforces her confusion about her cultural identity. Another way they try to punish her is to tell her that she is displeasing Allah. Cultural norms are often derived from religion, but as Rubina is finding, not all members of a religious group draw the same norms from the religion.

Subcultures and Countercultures Within most cultures, there are subcultures that involve groups of people who accept much of the dominant culture but distinguish themselves by one or more culturally significant characteristics. For example, the Muslim Student Association (MSA) to which Rubina belongs is a subculture of the larger culture of the university that she attends. The MSA members probably share many of the values and norms of the larger university culture but are distinguished by their adherence to the religious tenets of Islam and their desire to build a Muslim religious community on campus. No doubt, Rubina’s university has many other subcultures, such as other religious subcultures, a subculture of environmental activists, racial and

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ethnic subcultures, subcultures formed around particular music genres, a theater subculture, subcultures of different athletic activities, perhaps a deaf subculture, and many more. In the United States, social class groups often form subcultures; the super wealthy have networks, exclusive clubs, and a culture of opulence that differs a great deal from the cultures of the middle and lower classes. A give-and-take exists among subcultures and between subcultures and the larger culture, with subcultures contributing to and influencing each other and the larger culture. When conflict with the larger culture becomes serious, a subculture can become a counterculture.

A counterculture not only differs in significant ways from the dominant culture but also rejects the norms and values of the larger culture. It may openly act in opposition to the dominant culture, but there are several ways to do this. Like the Old Order of Amish of Pennsylvania and Ohio, who reject the dominant U.S. culture definition of success, countercultures may withdraw and establish their own cultural conclaves with their own rules. Another way to act in opposition to dominant culture is to engage in violent sabotage of it. For example, the Ku Klux Klan and other White supremacist groups reject the larger societal principles of democratic pluralism and may engage in violent behavior against it. In the past, they engaged in lynchings, but today they are more likely to engage in a variety of types of intimidation, including hanging nooses in prominent and symbolic places or belligerently challenging an immigrant’s right to live in the United States. Computer hackers are another contemporary example of a counterculture. Some hackers are simply having fun developing technical skills, but others are engaged in hacking for the purpose of subverting authority, destroying the Internet, and even influencing national elections. Of course, assertive countercultures are not always a negative force, and some assertive countercultures challenge the unfair treatment of groups who are marginalized and denied power in society. If Rubina’s university were to develop a strong anti-Muslim culture or policies that were repressive to Muslim students, it is possible that the MSA would transition from subculture to counterculture.

Ideal Culture Versus Real Culture Arlene Skolnick (1997) wrote that “Americans have still not come to terms with the gap between the way we think our families ought to be and the complex, often messy realities of our lives” (p. 86). We could substitute

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the word culture for families and have a statement that reflects some of the tensions in cultural life. Sociologists make a distinction between ideal culture, which consists of the values and practices that are considered desirable, and real culture, which is what people actually think and do. For example, a major U.S. value is democracy, but average voter participation in the United States from 1950 to 2012 was 48.3%, compared to 92.5% in Italy and 89.5% in Iceland (Ballantine et al., 2018). Another important U.S. value is equal opportunity to quality education, and yet, in reality, the inequalities in our educational institutions are important drivers of growing social and economic inequalities.

Critical Thinking Questions 8.2

Which cultures are you a part of? What are three important values and three important norms of each of these cultures? Are there any conflicts in values and norms across the different cultures in which you participate? Explain. If you were to be Rubina’s social worker, what value and norm conflicts might come up in your work with her?

Ethnocentrism and Cultural Relativism As globalization intensifies, the world’s people are more and more likely to encounter the diversity of global cultures. How we respond to these cross-cultural experiences may well determine the survival of planet Earth. Culture is learned over time from people we care about, and most people tend to think their culture is the best. Ethnocentrism is the belief that one’s own cultural way of life is normal, natural, and even superior to other cultural ways of life; other cultures are judged by the standards of one’s own culture. Most societies instill some degree of ethnocentrism in their members as a way to hold the culture together. Belief in one’s own culture provides a sense of pride and identity and promotes loyalty, unity, and conformity. Ethnocentrism can also be a barrier to cross-cultural understanding and lead to misunderstandings between people. It can encourage hostility, racism, war, and even genocide. Rubina worries about the anti-Muslim ethnocentrism in the United States and is concerned about what she reads about hate crimes against Muslims and Brown people in general.

Social scientists have challenged the strong human tendency toward

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ethnocentrism by suggesting an approach of cultural relativism. Cultural relativism calls for suspending judgment of other people’s cultural values and practices in order to understand them in their own cultural context through the eyes of their own members, avoiding judging one culture by the standards of another culture. Cultural relativism does not require that we accept or agree with all beliefs and practices of a particular cultural group, but it allows us to try to understand beliefs and practices in the social and cultural contexts in which they developed and are maintained. It is a very important approach for social workers to learn to incorporate in practice at every system level. It requires us to approach our social work practice with cultural humility, recognizing that culture is an important part of human behavior, that people live within many different cultures, and that we will never understand other cultures as well as the people who live within them. It also requires that we be self-reflective about our own cultural experiences and interested in and open to how other people understand their own cultural identities. Whatever we may think of Muslim women wearing a hijab, we would want to approach Rubina by trying to understand what it means to her in her particular social and cultural context. One way to be helpful to Rubina in her current emotional struggles would be to open communications to help her and her parents to put each other in cultural context. Rubina could learn more about what her parents’ life was like in Pakistan, why they decided to immigrate to the United States, and how they have tried to adapt to a very different culture than the one they left. Her parents could learn more about what it is like to grow up with one culture at home and another in her life outside the family.

For the past decade, neuroscientists have been studying the neural basis of prejudice (attitudes and emotional responses to the members of a social group) and stereotyping (generalized characteristics ascribed to a social group) (see Amodio, 2014; Cozolino, 2014). They have found that both prejudice and stereotyping are complex cognitive processes that are supported by a network of neural structures, but different networks are involved in these two cognitive processes. The amygdala appears to be the main brain structure involved in prejudice. The amygdala is the center for rapid appraisal of stimuli and mobilization of response to threat. It receives direct information from all sensory organs, allowing it to respond very rapidly to perceived social threat. The amygdala is so fast that it responds in advance of a conscious awareness of danger, and prejudice is mostly an unconscious process known as implicit bias. Perceived threat triggers a

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biochemical cascade of fight-or-flight response. Research indicates that the amygdala is conditioned to respond with fear to members of out-groups (groups to which we do not belong), especially if there is little or no history of interaction with those out-groups or if a person’s prior history has resulted in seeing difference as threatening. Research also indicates that the amygdala can become conditioned to perceive threat in situations in which a person is engaged in interaction with members of out-groups and worries about appearing prejudiced in the eyes of others (Amodio, 2014). This perceived threat can inhibit motivation to become involved with groups of people who are different from us. Other neural structures that have been identified to play a role in prejudice include the orbital frontal cortex, insula, striatum, and medial prefrontal cortex. The neural structures found to be involved in stereotyping include the temporal lobe, medial prefrontal cortex, and lateral prefrontal cortex.

Neuroscientist Robert Sapolsky (2017) cites research that finds that our brains are especially sensitive to skin color, but there is tremendous variation in the strength of the reaction. The essence of this research is that fear conditioning occurs much faster for other-race faces than for same- race faces. People tend to judge neutral other-race faces as being angrier than neutral same-race faces. In addition, people tend to remember same- race faces better than other-race faces and to show more empathy for same-race than other-race faces when shown videos of people being poked with needles. People who show more implicit racial bias on implicit bias tests are more likely to show more amygdala activation when encountering other-race people.

Cozolino (2014) suggests that prejudice is an expression of social phobia, and indeed, xenophobia is a term used to describe fear and hatred of strangers or foreigners or of anything that is strange or foreign. Although researchers have had some success in reducing behavioral and physiological expressions of implicit bias in the laboratory, implicit bias is very difficult to change in a cultural milieu that constantly reinforces the bias. For example, it is very difficult to extinguish racial bias if the culture constantly presents racial prejudice and stereotypes. It is difficult to extinguish anti-Muslim sentiment if it is constantly expressed in the media, the family, or the political institution. Neuroscience research suggests that the best interventions for reducing prejudice include increasing people’s awareness of the human tendency for implicit bias, helping them to identify cues that a threat response is occurring in their cross-cultural

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interactions, and helping them to prepare preplanned ways of dealing with situations where implicit bias is aroused (for example, a plan such as “I will slow down and respond more carefully”). The idea of slowing down is important because the amygdala responds about a half second ahead of the conscious processes of attention and awareness that can put the brakes on amygdala activation and avoid what is often called an “amygdala hijack,” a quick reaction that has negative consequences (Soclof, 2015). Over time, activities to get cognitive control over prejudiced and stereotypical attitudes and behavior can become habitual. As social workers, we must engage in an ongoing process of recognizing and examining our implicit biases, because they can seriously inhibit our effectiveness. We can also help clients recognize their own implicit biases and find ways to minimize them.

Culture and Power For several decades now, culture scholars have been interested in how the dynamics of power are embedded in culture (Griswold, 2013; Guest, 2017). Power can be thought of as the ability to act in a chosen way and to direct or influence the behavior of others. As suggested earlier, although we often think of culture as composed of similar people who equally share norms and values, in reality people in a given culture are usually diverse and their relationships are complicated by power dynamics within the culture. Some people are able to participate more fully in culture than other people. Some people are drawn into the center of the culture and granted resources and privileges. Other people are ignored or marginalized in the granting of resources and privileges. Some are even annihilated. The power arrangements of a culture are supported by cultural values, ideologies, and norms. Culture defines what is “legitimate, proper, and normal . . . an all-but-unconscious understanding of how things are and should be” (Griswold, 2013, p. 165). Culturally instilled knowledge and attitudes lead people to accept some power arrangements and reject others.

Cultural understanding of who should be powerful and who should be powerless has deep historical roots. And history itself is usually told from the perspective of the people who have the power to construct it. In recent years, there has been an ongoing struggle in the United States over content in high school history textbooks. Some school board members have accused the textbooks of liberal bias whereas others have accused the

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textbooks of conservative bias. In 2014, the Texas State Board of Education accused history textbooks and the accompanying online resources of being “anti-American” because they included “negative aspects” of U.S. history—aspects such as treatment of Native Americans and Japanese internment camps (Speed, 2015). They specifically criticized textbooks that did not pay enough attention to the achievements of President Ronald Reagan, gave too little credit to the importance of Moses on the thinking of U.S. founders, were not sufficiently laudatory of the free market economic system, and were too sympathetic to Islam (Associated Press, 2014). Texas is such a large state that textbooks written for it will influence content in textbooks used across the country.

Sometimes coercion or physical force is used to ensure compliance with cultural norms. Most often, however, coercion or force is not necessary. Instead, cultural power is embedded in the media, schools, and religion to influence the understanding of what is natural, normal, and even possible. This creates a cultural condition called hegemony, the ability of a dominant group to obtain consent and agreement to cultural values and norms without the use or threat of force. With this hegemony of values and norms, some thoughts and actions become unthinkable. People discipline their own behavior to be in accord with what is considered normal, even when this runs counter to their own personal interests.

Cultures create social institutions to promote and maintain their core values. Chapter 9 examines how power is created and maintained in major social institutions in the United States and globally. In addition, in every culture, social identity groups get caught up in the dynamics of cultural power. Those dynamics vary somewhat from culture to culture, but some of the dynamics are almost universal. In this section, we take a look at how several social identities are embedded in cultural dynamics of power, including race, ethnicity, gender, sexuality, social class, and disability.

Race Rubina says that when she hears about hate crimes toward minorities, she feels “Brown.” What does being Brown mean to her, and why does she associate it with hate crimes toward minorities? Her reaction is tied up in the concept of race, a category that has been used for centuries to divide the human population and to stratify it into superior and inferior groups. Race is a system of classification that uses certain physical characteristics

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to divide the human population into supposedly discrete groups. Contemporary social scientists agree that race is a flawed cultural classification system. Although the classification, historically, was presumed to rest on genetic differences between groups, contemporary studies of genetics reveal no biologically distinct human groups. And, indeed, they find that there is more genetic variation within racial groups than between racial groups (Healey & Stepnick, 2017). Although other physical features have sometimes been associated with racial categories, skin color is the prominent physical attribute used to distinguish race. And yet humans come in many hues that cannot be divided into discrete groups based on color. Over time, racial categorizing has used a complex mix of skin color and national origin. In regular interactions, humans use visible cues to make judgements about what they perceive to be another person’s racial classification.

Racial categorizing happens all over the world, but it takes on different meanings in different places. Social scientists trace the origins of contemporary racial classification to the 1400s when people of western Europe began to travel to Africa, Asia, and eventually North and South America. As they traveled to, conquered, and colonized new lands, they became more attentive to the physical differences they encountered, especially differences in skin color (Healey & Stepnick, 2017). From the beginning, the European understanding of race was linked to ideas about inferior (conquered) and superior (conquering). The western European conquerors/colonizers were of light hue, and although they encountered much variation in skin color hue, they thought of race in binary terms of White (conqueror, superior) and not White (conquered, inferior).

Although it takes different forms around the world, racialization— assigning racial character to groups of people—has continued to be a prominent method of classification in the postcolonial world. Unrelated people are lumped together based on skin color and other attributes, in the context of social, economic, and political systems of inequality left in the wake of colonization. As workers migrate within and between countries, new forms of racialization occur, but the White/not White binary way of thinking about race continues to prevail in the United States and Europe (Guest, 2017).

The U.S. racial system developed in the context of conquest and seizure of land of an Indigenous people (not White), enslaved people from Africa

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(not White), and importation of indentured servants from Europe (White). An ideology of White supremacy prevailed, a belief that non-Whites were biologically different, intellectually inferior, and less than human in a spiritual sense (see Smedley, 2011, for a thorough discussion of the history of race in North America). White supremacy was more than ideology in the early history of the United States, however; it was also formalized in the political system. Anthropologist Pem Buck (2001) documents some of the ways that White economic elites formalized White privilege in early 1700s Virginia, and their motivation for doing so. The elites were confronted with a situation in which poor landless Whites were beginning to join with African slaves against the European economic elites. To combat this, the elites introduced a set of legal privileges that were reserved for Whites, such as the right to own a gun, livestock, and land; the right to obtain freedom at the end of indenture; the right to discipline Blacks; and eventually the right to vote. The intent of these legal privileges was to drive a wedge between the European and African laborers who had much in common.

The rule of hypodescent has been key to maintaining boundaries between the races in the United States since the time of slavery. Hypodescent is the tradition of assigning children of mixed-race unions to the subordinate group. This is sometimes called the “one drop of blood rule,” meaning that having any ancestor of a subordinate group (e.g., Black) classifies you as belonging to that race. The hypodescent rule was enacted into laws in many U.S. states and even backed by the U.S. Supreme Court as late as 1982 (Guest, 2017). It is no longer enforced by law but is still widely applied in U.S. culture. A notable contemporary example is the case of Barack Obama, son of a White woman and Black man from Kenya, raised by White grandparents, and considered to be the first Black president of the United States.

Long-established patterns of unequal treatment based on race persisted after the legal end of slavery. Jim Crow segregation laws legally enforced boundaries between Whites and Blacks in the South—in housing; education; property ownership; voting rights; and public services such as bathrooms, water fountains, and public transportation. Although much has changed since these earlier days, the basic outline of Black inequality and White dominance has persisted, even in the face of resistance, protest, and political activism. Perhaps no area of race relations is more explosive than the relationship between the Black community and the criminal justice

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system. In numerous studies, Blacks have reported being treated less fairly and respectfully in their contacts with the police than Whites (see Epp, Maynard-Moody, & Haider-Market, 2014). One research team of linguists recently used footage of body-worn cameras during routine traffic stops to investigate that complaint. They found that officers speak with consistently less respect when speaking with Black community members during routine traffic stops than when speaking with White community members (Voigt et al., 2017).

As groups other than western Europeans began to immigrate to the United States—groups from Asia and from eastern and southern Europe—new questions were raised about who was White and who was not. Nativists fought to preserve the racial purity of the nation’s Anglo-Saxon heritage, and immigration laws were used to this end. As they first entered the United States, groups as diverse as Chinese, Irish, Italians, Greeks, and eastern Europeans were considered non-White. In this way, racial classification began to include nationality as well as skin color. A 1790 U.S. law limited the right to naturalization (citizenship) to Whites only (Orleck, n.d.). Religion was important also, and nativists considered both Catholics and Jews to be non-White. As the immigration stream to the United States became more diverse, racial categories continued to be created and contested. When collecting information on race, the U.S. Census Bureau is required to adhere to the 1997 Office of Management and Budget (OMB) standards on race and ethnicity as presented in Exhibit 8.5. For the first time in 2000, individuals were presented with the option to self-identify with more than one race. As you can see, given this classification system, Rubina’s family, with Pakistani roots, would be classified as Asian. The OMB acknowledges that this classification of race is not scientific.

Exhibit 8.5 ● Racial Categories and Descriptions Used by the U.S. Census Bureau

Category Description

White A person having origins in any of the original peoplesof Europe, the Middle East, or North Africa

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Black or African American

A person having origins in any of the Black racial groups of Africa

American Indian or Alaska Native

A person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment

Asian

A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, Japan, Korea, Malaysia, Pakistan, the Philippines, Thailand, and Vietnam

Native Hawaiian or Other Pacific Islander

A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands

Source: U.S. Census Bureau, 2017a.

One question that has arisen in recent years is where people from the Middle East fit. Before September 11, 2011, they were not considered a separate race in the United States, and under current law, as reported in Exhibit 8.5, they are considered White. In October 2016, the OMB proposed that “Middle Eastern and North African” be added as a new racial category (Helmy, 2016). In some news reports, this was called a new race category, and in other news reports, it was called a new ethnic category. And, indeed, the OMB classification system muddies the use of the terms race and ethnicity, as we will see in the discussion of ethnicity in the next section. Just as sometimes happened with groups from Central and South America in the past, people of Middle Eastern heritage are now sometimes thought of as neither Black nor White, but Brown. And Brown is a way that Rubina—along with other people with South Asian heritage —sometimes thinks of herself as she sorts out her cultural identity in a world where White supremacist ideology is still strong.

Racism is the belief that race accounts for differences in human character or ability and that a particular race is superior to others, justifying access to

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power, privilege, resources, and opportunities on the basis of race. It may be expressed as either individual or institutional. Individual racism is expressed through personal prejudiced beliefs and discriminatory actions based on race. Institutional racism, also called structural racism, includes the structuring of racial inequality into social institutions, policies, and systems. Police officers interacting with Black community members with less respect than that afforded to White community members is an example of institutional racism. The perpetuation of racial inequality rests on a long-standing racial ideology that one race (White) is superior to others.

It is important to note that Whiteness is also stratified along class lines, and not all people of European descent benefit equally from White privilege. Poor Whites are the target of hateful stereotypes, promulgated by more affluent Whites, and are often cut off from educational and work opportunities. In particular, many have been hurt by economic globalization, whereas affluent Whites have benefited. Their resentment has helped to fuel populist nationalist political movements in the United States and Europe. Woodard (2011) argues that elite Whites try to avoid having less affluent Whites protest their lower status by keeping them afraid of non-Whites.

Ethnicity Rubina tells the social worker that she recently started practicing Islam while navigating through cultural identity issues. When speaking of cultural identity issues, she seems to be talking about what is commonly understood as ethnicity. In an essay titled “Who Am I? Who Are My People,” Kirk and Okazawa-Rey (2013) note some questions often pondered by people struggling with ethnic identity, including “Who am I? Who do I want to be? . . . Where/what/who are my ‘home’ and ‘community’?” Ethnicity is a word we hear a lot (e.g., ethnic food, ethnic music, ethnic community, ethnic conflict), and it can be used to emphasize different aspects of social life. Ethnicity is a sense of cultural, historical, and sometimes ancestral connection to a group of people that is considered to be distinct from people outside the group. In different times and places, ethnicity may include a common history and ancestors; association with a particular geographic territory; a shared language; a shared religion; a sense of shared physical characteristics; and shared cultural practices such as food, clothing, music, and architecture. Rubina is currently finding

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as food, clothing, music, and architecture. Rubina is currently finding religion to be helpful in navigating through cultural identity issues. The U.S. Office of Management and Budget focuses on a combination of language and national origin as the distinguishing traits of ethnicity. It considers ethnicity to be a separate identity from race and provides two ethnic categories: “Hispanic or Latino” and “Not Hispanic or Latino” (U.S. Census Bureau, 2017b). Hispanic refers to coming from a country where Spanish is spoken, and Latino refers to a person with national origins in Mexico, Central America, or South America. As with race, the OMB acknowledges that this is not a scientific way to categorize ethnicity. It seems that our official ways of defining race and ethnicity are quite muddled at the moment.

Ethnic identity is that part of personal identity that derives from one’s sense of being a part of an ethnic group. Ethnicity is a more pressing issue in day-to-day life for some people than for others. Research indicates that in the United States people from ethnic minority and immigrant backgrounds are more likely to have a strong ethnic identity than are European American people or people who are from the third generation of an immigrant family (Tsai & Fuligni, 2012). (Note: Rubina’s parents are considered first-generation immigrants; Rubina, who was born in the United States of immigrant parents, is considered second generation; and any children Rubina might have would be considered third generation.) Many European Americans tend to see their ethnicity as the default position and think that it is only “others” who have ethnicity. Much of the research on ethnic identity has examined how ethnic identity develops in people from ethnic minorities, looking at how they navigate between the host culture and ethnic culture, focusing on a split between “mainstream identity” and “ethnic identity.” Some researchers have argued in recent years that this binary way of thinking about ethnic identity is too simplistic for the world we live in today. For example, van de Vijver and colleagues (van de Vijver, Blommaert, & Gkoumasi, 2015) suggest that many societies today have transitioned from being sites of diversity to become sites of superdiversity, experiencing a “diversification of diversity,” noting that “people from more places now migrate to more places” (p. 37). In large cities in Europe and the Americas, many people now live in neighborhoods that include a majority of people from the host country along with immigrants from many different countries. Social identities are becoming more complex. And, indeed, many families of the world have become multiethnic. In recent years, the political conversation in western

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democratic, Western values are compatible with Islam. In a study of a highly diverse neighborhood in Antwerp, Belgium, one research team found that strong Muslim ethnic identity and Belgian identity were not at all incompatible and typically developed hand in hand (van de Vijver et al., 2015).

So how do societies deal with diversity, let alone superdiversity, of ethnic cultures? The United States has a complicated history of dealing with people of different national origins, religions, skin colors, and ethnic identities. And issues related to cultural diversity continue to be controversial. From the earliest days, the United States was ethnically diverse, with the mix that resulted from immigration from various regions in Europe, forced migration of Africans, and conquest of Indigenous people. With new waves of immigration, the path to incorporation into U.S. society typically followed color lines. In societies around the world, the approach to managing ethnic diversity can be divided into two opposing attitudes: assimilation versus multiculturalism (Ritzer, 2016). In the process of assimilation, minority groups and new immigrants are expected to adopt the patterns and norms of the mainstream culture and cease to exist as a separate group. In the process of multiculturalism, minority groups and new immigrants and their children enculturate to the mainstream culture while also retaining their ethnic culture. Both mainstream identities and ethnic identities are maintained. Multiculturalism is also called cultural pluralism. There are long-standing tensions in the United States about which model of managing ethnic diversity will be dominant, assimilation or multiculturalism.

Ethnic identity can be a source of belonging and can also be a source of great conflict within a society. In the 20th and 21st centuries, we have seen many instances of high-profile ethnic conflict around the world, such as the Turks and Armenians in Turkey, Nazi Germans and Jews in Germany, Tutsi and Hutu in Rwanda and Burundi, Arabs and ethnic Africans in Darfur, and the conflict among various ethnic groups after the breakup in Yugoslavia. Sometimes religion is a major part of the ethnic conflict. For example, in Pakistan where Rubina’s parents grew up, ethnic conflict has included struggles over religion (Sunni versus Shia), language (Pashto, Sindi, Balochi, Punjabi, Urdu, and Siraiki), territory, and caste (Majeed, 2013). It would be helpful for Rubina and her social worker to familiarize themselves with some of the themes of these struggles and to begin to understand where Rubina’s parents fit in these systems of ethnic conflict.

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It is always helpful for family members to put each other in this kind of historical and cultural context.

Ethnic cleansing is the term used to describe efforts of one ethnic or religious group to expel or destroy another group in a particular geographic area. We have seen ethnic cleansing in the examples of ethnic conflict noted in the last paragraph, but examples can also be found in the history of the United States. Indian removal was the name given to a U.S. 19th-century policy to forcibly remove Native Americans from their ancestral homelands in the eastern parts of the country to lands west of the Mississippi River. During World War II, Japanese American families living on the West Coast were forced to leave their homes and relocate to internment camps. Like other countries, the United States has also used its immigration policies to exclude some ethnic groups. For example, the Chinese Exclusion Act was passed in 1882 and was not repealed until 1943, suspending the immigration of Chinese laborers. In 1888, the Scott Act extended this exclusion to disallow long-term legal Chinese American residents to reenter the United States after a visit to China. As I write this in June 2017, there is much political controversy in the United States about whether, and if so, how, to restrict immigration of people from many predominantly Muslim countries.

Critical Thinking Questions 8.3

As you think about Rubina’s story, what implicit biases do you think people might have about her in the classroom, on the street or at the shopping mall, and at home? What are your reactions to the racial categories used by the U.S. Census Bureau? What do you think of the proposal to add a racial category of “Middle Eastern and North African” to census data? How important are race and ethnicity in your own life? Explain.

Gender Anthropologists consider gender to be a central element in every facet of human cultures (Guest, 2017). Sociologists consider gender to be a master status for many people—a social position more important than other social positions—because of its centrality to a person’s identity (Ritzer, 2016). Sociologist Judith Lorber (2016) proposes that gender is one of the major ways that human cultures organize their day-to-day lives. And yet gender

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ways that human cultures organize their day-to-day lives. And yet gender is a highly contested concept in contemporary times.

Sex and gender are terms that are often used interchangeably, and their distinctions are often confused. As noted in Chapter 3, sex is a biological idea. It is typically thought of as a binary designation—female or male— based on chromosomes, gonads, genitalia, and hormones. At birth, individuals are usually proclaimed either male or female based on genitalia. Gender is a cultural creation, composed of the expectations about behaviors, attitudes, and personalities that each culture assigns to people of different sexes.

When a woman is pregnant these days, one of the first questions she is asked is “Do you know the sex?” It’s as if we can’t begin to think about a new human baby unless we know the sex. The question is asked with an assumption of a binary system of male and female. And once the sex is known, gendered assumptions are made about femininity or masculinity, assumptions that will guide social interactions in the family and beyond. But the evidence is clear that neither sex nor gender is so distinctly binary.

Some babies are born intersex, with bodies that are not clearly either female or male. Although we don’t have reliable data about the number of intersex people in the world’s population, a commonly reported statistic suggests that intersex genital variation occurs about once in 1,500 to 2,000 births (Davis & Preves, 2017). At the high end of world estimates, intersex happens at about the same rate as red hair (United Nations Human Rights, 2017). Sex wasn’t always thought of as binary nor has it always been assigned based on genitals. For example, in 1876 pathologist Theodore Klebs classified anatomical sex into five categories based on gonads (ovaries, testes, or a mix of ovarian and testicular tissue). Recently hormonal levels have been used to assign female sex by the International Olympic Committee (IOC) and the International Association of Athletics Federation (IAAF). They are looking for higher than “normal” levels of androgen in females that would indicate that one is “not female,” acknowledging that hormonal levels are on a continuum in both females and males. Even chromosomes are not always a clear way to assign gender; some people have XY chromosomes but have an outward appearance of being female, having both breasts and a vagina (Davis & Preves, 2017). In some cases, intersex traits are obvious at birth, but in other situations, they are not obvious until puberty (United Nations Human

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babies to have them fit the genital binary and sometimes used hormonal treatments as well. Intersex advocates have pushed to abolish such surgeries at birth to allow intersex individuals to make their own decisions about such surgeries when they have the capacity to do so. In 2015, Malta was the first country to pass a law to prohibit surgery and treatment of sex characteristics of minors without informed consent (United Nations Human Rights, 2017).

Western understanding of gender has been based on the assumption that gender flows automatically from genitalia and reproductive organs—and that strong, clear gender differences exist, based on sex. It is grounded in an exaggerated understanding of biological differences, and it carries biological differences into spheres where biology is totally irrelevant. A set of stereotypes have been socially constructed for femininity and masculinity, and different behavioral norms have been established for females and males. As anthropologist Guest (2017) suggests, “Gender is taught, learned, performed, and policed” (p. 275). There is nothing biological about which clothes people should wear—who should wear dresses, who should wear pants, or who should wear high heels—and, indeed, the norms for clothing vary across place and time. No biological differences would indicate that women can’t drive, vote, work outside the home, fight in wars, or hold political office, and yet these norms have at different times and in different places been written into laws and carefully policed. Gender expectations about who can play particular sports, write poems, nurture children, or do math likewise are not based on biology. Margot Shetterly’s 2016 book Hidden Figures, which was made into a movie, tells the story of African American women who used their mathematics skills to help advance the space race in the United States. The book challenges both gender and racial stereotypes and demonstrates the sad reality that stories that counter these stereotypes don’t often get told. Cultural ideology can be so strong that gender expectations can be seen as natural and normal. Gender must be examined, however, as it intersects with race, social class, and sexuality, because different stereotypes have developed for different groups of males and females.

Exhibit 8.6 ● Gender Identity Labels and Definitions Exhibit 8.6 ● Gender Identity Labels and Definitions

Term Definition

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Agender A person who does not think they align with any gender, or feels a lack of gender

Bigender A person who identifies as two genders

Cisgender A person whose gender assigned at birth alignswith their gender identity

Gender fluid A person who fits or uses many labels for theirgender identity

Gender nonconforming

A person who does not observe society’s rules about dress and activities for a person based on their sex

Genderqueer A person who has identities outside of the male— female gender binary but may identify as a combination of both or neither

Nonbinary A person who does not identify with male orfemale

Nonlabeling A person who does not describe their genderidentity with any particular label

Pangender A person who identifies as all genders

Questioning A person who is unsure of their current genderidentity

Third gender A person who categorizes themselves as neither man nor woman; a social category in societies that recognize three or more genders

Transgender An umbrella term used for people whose sex assigned at birth does not align with their gender identity

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Two-spirit Umbrella term used by some Indigenous North Americans to label “gender-variant” people in their communities

Undecided A person who has not aligned gender identity witha label Source: Based on Oswalt, Evans, & Drott, 2016, Table 1, p. 504.

Transgender is a term used to identify people who have gender identity (internal sense of gender) and gender expression (external expression of gender) that is different from their assigned sex. It is also used as an umbrella term to identify all people who are gender nonconforming, including people who are gender fluid, identifying sometimes as male and sometimes as female, as well as people who do not identify with either of the two culturally dominant genders. There is no single trans path, and Exhibit 8.6 presents some common definitions of terms used by transgender people to describe their gender orientation. The list should not be thought of as exhaustive because we are living in a fluid time when people are renegotiating the labels they use to describe themselves. People who are transgender may or may not locate themselves in culturally established gender categories. They may or may not wish to use such medical treatments as hormone therapy or sex reassignment surgery for biological transition. Sometimes a distinction is made between transgender (gender as a cultural construction) and transsexual (based on biological sex and used to describe someone who has undergone biological transition). Trans man refers to someone who was assigned to the female gender at birth but who identifies as a male. Trans woman refers to someone who was assigned to the male gender at birth but who identifies as a female.

The general awareness of trans people has increased in recent years in the United States and other countries. In 2016, about 30% of U.S. adults reported knowing someone who is transgender, compared to 17% in 2014 (Halloran, 2015; Pew Research Center, 2016). Older adults are less likely than younger adults to say they know someone who is transgender. Although attitudes toward people who are transgender are improving, there is evidence from several databases that transgender people in the United States are physically and sexually assaulted at high rates both by people known to them and by strangers (Stotzer, 2009). These data remind us that many people lash out when confronted with any suggestion that gender is

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not binary, but cross-cultural research indicates that gender is not so rigidly defined as binary in all cultures. Many Native North American cultures have had traditions of gender diversity, including roles for two- spirit individuals who are socially defined as neither man nor woman but a combination of the two. In mountain villages in Afghanistan where male children are needed for family prestige, young girls are sometimes presented as boys, with the “appropriate” clothes, haircuts, and behaviors common to boys. At puberty, they are “changed” into girls (Nordberg, 2014).

Gender is not just a system of classification; it is also a system of stratification. It has been used to give dominance to men and a subordinate status to women. It is supported by misogyny, a cultural belief that “men are better, stronger, more rational, more capable, and more authoritative than women” (Kurian, 2011, para. 1). It can be manifested in numerous ways, including gender discrimination, belittling of women, harassment of women, violence against women, and sexual objectification of women. There are global differences, however, in the ways that societies deal with gender and create gender disparities and inequalities. For example, some Swedes have argued for gender-neutral pronouns as a way of promoting gender equality. Swedish preschools and elementary schools have begun to use the gender-neutral pronoun hen, and this word was recently added to the official dictionary (Noack, 2015).

Since 2006, the World Economic Forum (2016) has presented an annual global gender gap report that quantifies the magnitude of gender-based disparities around the world and tracks their progress over time. Measurement of the gender gap is based on study of four areas of social life: economic participation and opportunity, educational attainment, health and survival, and political empowerment. In 2016, of the 144 countries studied, 68 countries increased their overall gender equality and 74 experienced a decrease in gender equality. This indicates that there is no clear trend toward universal improvement in the status of women. The best improvements in gender equality were in health and survival and in education, with lower improvement in economic participation and much lower improvement in political empowerment.

The scores are presented as female-to-male ratios. A score of 1 represents perfect gender equality, which no country has achieved, and the closer the score is to 1 the greater the gender equality. Exhibit 8.7 reports the scores

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for the 10 countries with the most gender equality and the 10 countries with the least gender equality in 2016. Of the 144 countries, the United States was ranked 45th in gender equality overall, down from 20th in 2014. It was 26th in gender equality in terms of economic participation and opportunity, 1st in educational attainment, 62nd in health and survival, and 73rd in political empowerment. These findings suggest that the strong educational attainment of women in the United States does not translate to improved status in other spheres of life. We should also note that Pakistan is next to the bottom in the world in terms of gender equality. You probably are familiar with the riveting story of Malala Yousafzai who was shot for going to school in Pakistan. And yet Rubina’s family has always encouraged Rubina to excel in school here in the United States. Perhaps her social worker could encourage her to explore with her parents what their experiences were with girls and schooling in Pakistan and how they came to put such high value on the education of their children, including their female children, here in the United States.

Exhibit 8.7 ● Ten Countries With the Most and Least Gender Equality

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Source: World Economic Forum, 2016.

Sexuality Sexuality is both a physiological process and a cultural construction. Physiologically, it involves a range of desires and behaviors related to erotic physical contact. Culturally, it involves debates about which kinds of physical desires and behaviors are moral, appropriate, and natural. In this chapter, we focus on those cultural debates and how they relate to power. All societies have cultural rules to regulate sexual relations—rules

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about the why, how, when, where, and with whom of sexuality, about who is allowed to do what with whom. People in all societies are enculturated to channel sexual desires into a limited number of acceptable sexual behaviors. Cultural norms regarding sexuality vary across time and place, and social scientists agree that, at least in Western cultures, cultural norms of sexuality are currently in flux.

There are cultural debates about the “when” of sexuality, but the biggest cultural debates about sexuality have centered on the “why” and “with whom” questions. In terms of “when,” all cultures have values and norms about the appropriate age for the sexual debut. There is growing international agreement that children should not be engaged in sexual interaction other than exploration of their own bodies, but child brides are still common in many parts of the world. Research in the United States indicates that child brides are at higher risk of intimate partner violence and are often unable to negotiate safe sex (McFarlane, Nava, Gilroy, & Maddoux, 2016). There is less agreement about sexuality during adolescence than about childhood sexuality, as seen in the debate about how much of the U.S. sex education curriculum should focus on abstinence.

The biggest “why” debate is whether procreation or pleasure is the purpose of sexuality. Anthropologists agree that in the social organization of early humans, sexual activity was basically oriented toward reproduction. They also agree, however, that sexuality began to lose its exclusive reproductive meaning early in human evolution. Religion has been a major force in the debate about the purpose of sexuality. Revolutions in reproductive technology have spurred new religious controversies about sexuality for pleasure. There are divisions within each of the three Abrahamic religious traditions—Christianity, Islam, and Judaism—on this question. In Christianity, the Catholic leadership has condemned sexual intercourse that occurs without the possible “natural” outcome of conception. Natural family planning but not use of artificial contraceptives is considered acceptable. Some Protestant groups share the Catholic view, but many Protestant denominations favor the use of contraceptives, with some arguing that sexual pleasure facilitates interpersonal bonding and that contraceptives are needed to prevent overpopulation (Benagiano & Mori, 2009). There are similar divisions on the issue of contraception within both Islam and Judaism. The use of contraception does not appear to be a major ethical issue in Hinduism, Sikhism, and Buddhism.

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Cultures have had a lot to say about with whom it is appropriate and moral to have sexual relations, but the answers have not been the same across time and place. Here are some examples. Cultures have varied over time about the acceptability of having sexual relations with anyone to whom you are not married. About 15% of countries today have rules requiring that sexual involvement only happens in marriage (Haviland et al., 2017), but many countries have very lax standards about this issue. Adultery has been criminalized in many societies, and some states in the United States continue to have laws against adultery. In the United States and many other countries, it is illegal to have sexual relations with a child, although the age of consent varies from country to country, and even state to state in the United States. There are incest taboos in all cultures, prohibiting sexual relations among certain close relatives, but the definition of close varies. During European colonization, White men were allowed to have sexual relations with non-White women, but sex was vehemently prohibited between White women and non-White men (Stoler, 2010). In the United States, antimiscegenation state laws were passed in the 18th century, outlawing marriage between members of different races and often including the criminalization of cohabitation and sex between Whites and non-Whites. These laws were ruled unconstitutional in the 1967 Loving v. Virginia Supreme Court ruling. In 1949, South Africa passed the Prohibition of Mixed Marriages Act that prohibited sexual relationships between White people and people of other race groups, a law that was not repealed until 1985 (Beningfield, 2006). Sodomy laws have existed for hundreds of years, originating from religious prohibitions against nonprocreative sexual acts. Sodomy has been defined in different ways, narrowly to prohibit anal sex between two men, but more broadly to include any sexual penetration other than vaginal intercourse, including oral and anal sex. Sodomy laws were declared unconstitutional in the United States in 2003 in the Lawrence v. Texas case, but sodomy remains technically illegal in the military, and some lawmakers continue to try to reban sodomy (Criminal Defense Lawyer, 2017). Sodomy laws are still operative in some places in the world and are even punishable by death.

In the dominant Western model, sexuality is binary: heterosexuality and homosexuality. But this binary approach is a relatively recent invention, typically traced to the late 19th century, and some societies of the world still lack terms to distinguish sexuality this way (Haviland et al., 2017). Recently, in Western cultures, the heterosexual–homosexual binary has been supplemented with a bisexual category and sometimes an asexual

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category. Sexology research indicates that human sexuality does not fit so neatly into a binary system. Researchers have found diversity, flexibility, and fluidity along a continuum of sexual desire and sexual behavior. Recent research has found that, in the United States, people under 30 years of age are more likely than others to identify as neither heterosexual nor gay/lesbian: 29% for this age group, compared to 24% in the 30–44 age group, and 8% in the 45–60 age group (Oswalt et al., 2016). The Klein Sexual Orientation Grid (KSOG) (Klein, Sepekoff, & Wolf, 1985) studies eight components of sexual orientation (sexual attraction, sexual behavior, sexual fantasies, emotional preference, social preference, lifestyle preference, sexual identity, and political identity) using a scale of 1 (heterosexual only) to 7 (gay/lesbian only) and checking for three time periods (past, present, and ideal). As researchers are recognizing that sexual orientation is more complex than once thought, people are developing new terms to describe their sexual desires and behaviors. Social workers should avoid making assumptions about how people think about and enact their sexuality.

And what is the intersection of sexuality and power? Let’s begin with the changing status of what has come to be called the LGBTQ community. The legal rights of this community have changed substantially in the United States and other Western countries since the first edition of this book was published in 1999. Although there has been a recent wave of acceptance for same-gender couples in many Western countries, they are still a very vulnerable group in many parts of the world. In 2016, same- gender sex was illegal in 65 countries and punished by death in 10 countries; same-gender marriage was legal in 22 countries (Cameron & Berkowitz, 2016). The United States has some of the most advanced LGBTQ rights in the world, but civil protections for this group still vary from jurisdiction to jurisdiction. As noted earlier, sodomy was decriminalized nationwide in 2003. A June 26, 2015, Supreme Court ruling, Obergefell v. Hodges, recognized the marriages of same-gender couples nationwide. As this chapter is written in June 2017, however, fewer than half of U.S. states offer protection against discrimination based on sexual orientation and gender identity. In many states, employers may fire or refuse to hire a person based on sexual orientation or gender identity, and LGBTQ people have no protection against discrimination in public accommodations or housing. LGBTQ youth continue to encounter harassment and bullying in school, and LGBTQ youth and adults are frequent victims of violent hate crimes (Southern Poverty Law Center,

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2017).

Sexual assault, a sexual act in which a person is coerced or physically forced to engage against their will, is a clear example of sexuality interacting with power. It is difficult to measure, largely because it often goes unreported. RAINN (Rape, Abuse & Incest National Network) is the largest anti–sexual violence organization in the United States. They estimate that sexual violence has fallen by more than half since 1993; even so, it is estimated that someone in the United States is sexually assaulted every 98 seconds. It is estimated that each year 80,600 inmates are sexually assaulted; 60,000 children are victims of substantiated sexual abuse; 321,500 people 12 and older are sexually assaulted; and 18,900 members of the military experience unwanted sexual contact. Ninety percent of sexual assault victims are female and 10% are male (RAINN, 2017). Data suggest that 1 in 5 women and 1 in 16 men are sexually assaulted while in college. In 8 out of 10 cases of sexual assault the victim knew the person who assaulted them (National Sexual Violence Resource Center, 2015). Rape culture is a term that has been used to describe the cultural norms that develop in some settings that allow rape and sexual assault to be “excused, legitimized and viewed as inevitable” (Dodge, 2016, p. 67). Alexa Dodge (2016) writes about how new social media are used to extend rape culture when photographic images of acts of sexual violence are disseminated online.

Sex trafficking, also called commercial sexual exploitation, refers to the sexual exploitation of human bodies for the social, political, economic, and/or sexual benefits of others. Victims of sex trafficking are often brutalized with physical, emotional, and sexual violence. Worldwide, it is estimated that 4.5 million people are victims of sex trafficking each year, and in the United States, the best estimate is that hundreds of thousands of domestic born children are at risk of being sex trafficked each year. Godoy, Sadwick, and Baca (2016) suggest that cultural expectations, norms, and values that support the sexual objectification of women, children, and adolescents contribute to sex trafficking. In the United States, women, children, members of the LGBTQ community, persons with mental and physical disabilities, Indigenous persons, and migrants are the people most vulnerable to sex trafficking. There is evidence, however, that sexually exploited boys and young men are less likely to be identified than sexually exploited girls and women (Godoy et al., 2016).

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Social Class Social class is a system of power based on wealth, income, and social position that produces unequal access to society’s resources. Inequality exists in every contemporary culture, but it is organized in different ways in different places. That raises two questions: (1) Is inequality a natural part of human culture? (2) Is inequality based on culture or social structure? In this chapter, we consider briefly the relationship of social class to culture, and Chapter 9 focuses more completely on how inequality is created and maintained in major societal institutions.

Let’s take a look first at what anthropologists suggest about the history of the cultural production of social class. They report that until the development of agriculture about 10,000 years ago, human economic and social structure was organized around hunting and gathering, also known as food foraging. There are still some hunting and gathering societies in the world today. It is thought that these societies were and are egalitarian in nature (called egalitarian societies), sharing resources to ensure the success of the group. Food foraging societies are highly mobile, especially when on food-getting expeditions. Therefore, it makes little sense in these societies to accumulate luxuries or surplus goods, and this lack of accumulation serves to limit status differentials (Haviland et al., 2017).

Anthropologists also identify some societies as ranked societies, where wealth is not unequal, but the society is stratified based on prestige and social position. The positions of prestige—positions such as chief—are hereditary for the most part. People in prestigious positions usually do not accumulate great wealth; instead they typically distribute any accumulated societal wealth to the group members, often through gift-giving rituals. The potlatch ceremony celebrated by the Kwakiutl of the Pacific Northwest is an example of these gift-giving rituals. In this ceremony, the chief holds an elaborate feast and gives guests all his personal possessions. The more bountiful the gift giving, the more prestige the chief gains in the community (Guest, 2017).

Anthropologists characterize social class in the United States and many other countries today as a system of social status based on conspicuous consumption and the accumulation of surplus (Haviland et al., 2017). Some people gain status by giving away their accumulated surplus, as in the ranked societies, but many people prefer to gain prestige by simply

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accumulating as many luxuries as they can. In the contemporary world, social class is created by the dual mechanisms of market exchange and inheritance. Market exchange involves the buying and selling of goods and services with prices that are determined for the most part by rules of supply and demand. The greater the demand and/or the lower the supply, the higher the prices. In the global capitalist economy, people who live in technologically wired parts of the world buy and sell anything and everything without having face-to-face contact. This certainly changes the culture of exchange.

The study of the intersection of culture and social class has most often focused on people living in poverty. On March 3, 2014, under the leadership of Representative Paul Ryan, the U.S. House of Representatives Committee on the Budget submitted a report titled The War on Poverty: 50 Years. In a section titled “The Causes of Poverty,” the report identified three causes: family, work, and education. Living in a single-parent household was proposed to be the single most important determinant of poverty, followed by the disinclination to work and the lack of desire or capacity to acquire the education needed for independent living as an adult. The report echoed the culture-of-poverty model for understanding poverty presented by Oscar Lewis (1959, 1966) and a report on the Negro family presented by Daniel Patrick Moynihan (1965). Both Lewis and Moynihan presented poverty as a cultural phenomenon created by pathology, the personal failings of individuals, families, and communities, rather than by structural economic arrangements. Lewis argued that sustained poverty produces a set of cultural beliefs, values, and behaviors that perpetuates the culture of poverty over time, even if economic conditions improve. Researchers have not found support for this proposition, however, finding instead that beliefs and behaviors change with changing economic opportunities (Small, Harding, & Lamont, 2010). The culture-of-poverty approach has been recycled in U.S. federal government policy over and over and showed up again in the 2014 budget report that argued that governmental programs to assist poor families had made the problem worse by fostering dependency on the government (see Cousins, 2013).

The culture-of-poverty approach was originally intended to call attention to the way of life developed by poor people to cope with the difficult circumstances of their lives at the bottom of the social class structure. Lewis was an anthropologist who proposed the culture of poverty based on

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study of Mexican and Puerto Rican families, but the concept was soon racialized to refer primarily to African American families. It has seldom been used to describe the situation of poor White families. It has been twisted to suggest that Black schools and Black communities remain poor because of the beliefs, values, morals, and traditions of Black families. Cousins (2015) points out just a few of the factors that get left out of this type of argument: racism and racial discrimination, redlining mortgage lending policies that denied loans to Black families or forced them to buy only in Black neighborhoods, employment discrimination that kept Black people working in low-paying jobs despite qualifications for better-paying ones, and refusal to admit qualified Black applicants to major colleges and universities. Cousins is suggesting that to understand poverty we must look not just to the culture of poverty but to the social, economic, and political culture that produces class advantage for some and class disadvantage for others.

Some contemporary anthropologists argue that it is appropriate to study social class and social inequality as cultural phenomena, but the focus should be on the top of the social class structure, not the bottom. They are particularly interested in studying cultures that value conspicuous consumption and accumulation of luxury. Gusterson (1997) refers to this as “studying up,” studying the culture of the powerful as well as the powerless. He notes that it is not easy to study the powerful because they have gates, guards, and security devices, and, consequently, remaining invisible is a part of their privilege. Anthropologist Karen Ho (2009) solved that problem by studying Wall Street banking while working in the business herself in the 1990s. She notes that this period of record corporate profits and soaring stock prices was also a period of rapid downsizing, layoffs, and dismantling of the governmental social safety net. She learned that when corporations lay off workers, stock prices go up as do the profits of the investment banks. She documents a relentless search for unending profits and for governmental deregulation of the financial services industry, all of which contributed to the severe recession of 2009. Since the recession, several books have explored the lives of corporate elites who helped to produce that crisis. In Fools Gold, Tett (2010) tells a story of how a revolution in banking methods coupled with Wall Street greed escalated wildly out of control and caused a financial meltdown. Lewis’s The Big Short (2010) tells the story of the financial crisis through the eyes of managers of three small hedge funds and a bond salesman at Deutsche Bank, four men who saw the vulnerability of the subprime mortgage

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industry and made a bundle by betting on the housing market’s collapse. Fraudulent and predatory practices in banking and corruption among governmental regulators were combined with a culture that condoned exploitation of people up and down the economic ladder, especially among those who were most economically vulnerable. The recession resulted in 3.6 million jobs being lost and 4 million home foreclosures, including a large number of Black and Latino victims of fraudulent, predatory mortgages (Greenbaum, 2016). The people who caused the recession have mostly been rewarded rather than punished, which suggests a need to study government elites as well as corporate elites.

To understand social class in any country, it is necessary to understand the political culture of the country. For example, we know that there is less inequality, less difference in the economic conditions between the top and bottom social classes, in the Nordic countries than in other countries, including the United States. There is much evidence that people in the Nordic countries are relatively egalitarian in their outlook and put a high value on government involvement to reduce economic inequality. There is high support for redistribution of resources to reduce inequality through tax policies and generous social programs (Chan, Birkelund, Aas, & Wiborg, 2010). The United States, in comparison, has the highest rate of inequality of any wealthy country. Individual initiative and responsibility are highly valued, and government involvement in the capitalist system for the purpose of redistribution of resources is expected to be kept to a minimum. These different political cultures related to the role of government in the economic system make for very different social class systems.

Disability We may think that physical, emotional, or cognitive disabilities are purely biological or psychological, but the experience of disability is strongly shaped by the cultural context. Disability is a universal phenomenon, and sooner or later most people will have some experience with disability in their lives, but that is not always acknowledged as cultures create beliefs and norms about disability. Cultures differ greatly regarding which specific conditions are recognized as a disability, the way the causes of disability are understood, the positions people with disabilities hold in society, and norms and laws regarding the rights of people with disabilities (Meyer, 2010). Disability is a vast category and may include people whose

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impairments are as varied as hearing, vision, cognitive, learning, mobility, or psychiatric. At least three cultural models of disability have been presented in recent history: the traditional model, the medical model, and the social model. In the traditional model, people with impairments are seen as unfortunate, different, blemished, and maybe even nonhuman, and isolation or segregation is a common solution. In the medical model, people with impairments have medical conditions, and the solution is to fix them medically so that they may adapt better to the environment. In the social model, impairment is not considered as significant as the disability that is constructed by physical structures, social attitudes, and cultural mores. The environment disables, and the solution is to change the physical and/or social environment (Peters, 2014).

What disabilities mean to persons possessing them as well as to those with whom they come in contact is influenced by cultural beliefs and norms. Those meanings also play out in social institutions that determine the distribution of resources and generate social and economic inequality. Historically, disability has been used to justify processes of dominance over and exclusion of people with disabilities. The notion of normality was used to categorize people with disabilities as “not normal,” or somehow not legitimate (Baynton, 2016). Think about how this categorization might lead President Franklin Delano Roosevelt to avoid being seen in his wheelchair in public. The idea that people with disabilities are not normal has led to harsh, even violent treatment of them at various points in time. Babies with physical disabilities have been killed, and disabled children have been abandoned to live on the streets. Adults with disabilities have been placed in jails or asylums. By the 18th century, people with disabilities were often called freaks and monsters and were presented in “freak shows” at carnivals. In the early 19th century, people with developmental disabilities were targeted by the eugenics movement, and people with some types of disabilities were terminated in Nazi Germany. Some disability rights activists argue that the current use of genetic testing and selective abortion is a perpetuation of eugenics. A philosophy of “rehabilitation” came into vogue in the United States and other countries when large numbers of veterans returned from World War II with disabilities (Castañeda, Hopkins, & Peters, 2013).

In the 1960s and 1970s, a social movement among people with disabilities and their allies began to emerge in a number of countries, leading to policies such as the Americans with Disabilities Act (ADA) of 1990,

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which asserted disability rights not previously recognized. Much has been accomplished in the activist movement for dignity and independence for people with disabilities, but much is left to do. For example, in the United States, people with disabilities are 3 times as likely as the general population to be victims of serious violence. Their rate for victimization by sexual assault is nearly 4 times that of the general population (Ballantine et al., 2018). As this book goes to press, the U.S. Congress is trying to roll back protections for people with disabilities outlined in the ADA.

Here is another example of what is left to do. In an earlier section, we looked at questions related to sexuality, including questions about who is allowed to do what with whom. In all the recent attention to the rights for people with disabilities, little attention has been paid to the constraints on and possibilities for sexual desire and sexual behavior among people with disabilities. Anthropologists Don Kulick and Jens Rydstrom (2015) explored how state power intersects with sexuality for people with disabilities living in group homes in Denmark and Sweden. These two countries are both liberal welfare states with similar cultural histories; they are both considered to be sexually progressive and have been at the forefront of disability rights. However, they take very different approaches to the sexuality of people with severe disabilities. In Sweden, like most countries of the world, the sexual lives of people with severe disabilities are denied and repressed. The staff in group homes are trained to discourage any signs of sexual desire. In contrast, Denmark supports the rights of people with severe disabilities to express their sexuality. Group homes for people with disabilities are supported by a network of advocates, sexual advisors, social workers, medical professionals, counselors, and educators who are committed to recognizing and facilitating the sexual desires of people with disabilities. Sexual advisors undergo an 18-month training course and work under an elaborate set of national guidelines. People with severe disabilities are supported to engage in such sexual activities as masturbation, having sex with a partner, or purchasing sexual services from a sex worker. Kulick and Rydstrom consider this to be a social justice issue that extends the rights of people with disabilities.

Critical Thinking Questions 8.4

What do you think about the changing ideas about the binary nature of gender and sexuality? What examples have you seen of this cultural

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change? How important are gender and sexuality labels in your own life? Explain. How important has social class been in your own life in the past 2 days? Explain. What role does ability and disability play in your life? What factors can make a difference in how important gender, sexuality, social class, and disability are in people’s lives?

Genes and Culture These days, the common answer to the old question of whether it is nature or nurture that drives human behavior goes like this: “Human characteristics are the product of gene-culture coevolution,” an evolutionary process involving the interaction of genes and culture over long periods of time (Gintis, 2011, p. 878). Scholars across such diverse disciplines as anthropology, biology, economics, genetics, and psychology agree that humans have two inheritance systems—genetic inheritance and cultural inheritance—occupying the same physical body. The two systems cannot always be treated independently (O’Brien & Laland, 2012; Richerson, Boyd, & Henrich, 2010). Although there are still disagreements about which came first in human history, biological change or cultural change (Fisher & Ridley, 2013), there is general agreement that human history involves extensive gene–culture coevolution.

In his 2002 book The Dawn of Human Culture, Richard Klein proposed that human culture emerged about 200,000 years ago when a single genetic change gave humans the capacity to adapt to a remarkable range of natural and social environments. Fisher and Ridley (2013) argue that it is quite possible that cultural innovation produced the genetic change, noting that there is historical evidence of culture-driven gene evolution. They provide three examples. First, they argue that gene mutations that allowed humans to remain lactase-persistent into adulthood, meaning that, unlike other species, they continue to have the enzyme to digest the lactose in milk after weaning, did not trigger dairy farming. Rather, the genetic mutation occurred in response to dairy consumption. Second, they argue that the higher alcohol tolerance of Europeans in comparison to Asians was the consequence of greater alcohol consumption in Europe. Third, the invention of fire and cooking 2 million years ago altered the human gut size; again, genetic change followed cultural innovation. Fisher and Ridley (2013) argue that the smallest, most trivial new cultural habit can lead to genetic changes that sharpen the habit, whether it is related to creativity, technological skill, or intensified empathy. Economist Gintis (2011)

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provides an example. He suggests that as humans developed cultures that involved living near other humans, they began to develop the abilities for cooperating and empathic communication. This led to genetic changes that encoded the capacity for cooperation and empathy into the human genome and sharpened the capacity.

Gene-culture coevolutionary theory (GCT) is a branch of theoretical population genetics that explores how cultural and genetic processes interact over evolutionary time (Laland, Odling-Smee, & Myles, 2010; O’Brien & Laland, 2012). It is generally agreed that cultural innovations tend to spread more quickly than genetic mutations, creating novel cultural environments that may stimulate genetic change. Culture usually accelerates human evolution, but sometimes culture can slow down the evolutionary process. GCT argues that the interactions of genes and culture offer a faster and stronger mode of human evolution than either could produce by itself. GCT scholars propose that cultural evolution happens by some of the same types of mechanisms as occur in genetic evolution (mutation, disffusion, and drift), but some critics of GCT challenge this analogy, arguing that culture is ill-defined and overlapping whereas the gene is well-defined and discrete. Proponents of GCT argue that this is an outdated view of the gene, noting that it is now known that genes are overlapping, movable, and nested, with the same fluidity as culture. You may recall this newer approach to understanding the gene as presented in Chapter 3, The Biological Person. The human genome provides a large brain, capable of adapting and innovating, always entangled with ongoing genetic evolution.

Digital Culture Development of new technologies is a major way that cultures innovate. Throughout human history, key shifts in information and communication technologies have changed the way people relate to each other and the world around them. Today many of us live in a digital world of electronic technology, a world where everything is computerized. Lindgren (2017) divides the history of digital culture into four stages, characterized by the introduction and diffusion of four technologies:

1. Widespread diffusion of the use of personal computers among ordinary people

2. Introduction of the Internet to a wide, global population

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3. Evolution of web 2.0 technology, user-created content, and social media networking

4. Introduction of portable devices—laptops, tablets, mobile phones— with ever-present access to wireless networks

The technological development of the course of these four stages happened rapidly. Not all people have the same access to the new technologies, however, and the digital divide is discussed in Chapter 9, Social Structure and Social Institutions.

Mobile phones have changed our day-to-day lives in many ways. Now we live in a mobile world as well as a digital world. We have one device that fits into a pocket, some pockets anyway, on which we can do many things: talk, text, listen to music, take photos, post the photos on various platforms, make video calls, access the World Wide Web, get directions, find a restaurant or other business, play games, watch videos, and much more. This means we can communicate with each other without having to be in a fixed physical place. New questions have come up about the cultural norms for privacy and intimacy and about how to protect the security of our communications. The Internet allows cross-cultural communication, but it is still used in different ways in different cultures.

Today, online and offline are mingled, and we are often in two or more places at once. Many people are now online all the time, looking up information and communicating with other people on several platforms. We take phone calls at any time and place in front of small or large groups of eavesdroppers and onlookers. We are still negotiating what the new cultural norms will be for doing this, but it is small wonder that texting has become a preferred way to communicate for many, because it is silent and unobtrusive. It avoids the problems of eavesdroppers and onlookers. Mobile phones allow us to coordinate activities with great efficiency, and we often wonder how we coordinated our social lives without them.

Our mobile devices are a great boon for staying connected to others and have great potential for building a strong sense of community. They also allow us to form subcultures that are very cut off from other subcultures, and we can end up living in a bubble of folks with similar beliefs and norms. After the 2016 national elections in the United States, social analysts began to discuss how social media is contributing to subcultures that are becoming increasingly polarized and distrustful of each other (see Mihailidis & Viotty, 2017). Social media is used to spread rumors and

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misinformation, which we have come to call fake news. Bots and algorithms dominate online search for information and may lead us into echo chambers where we only hear what confirms our biases.

Here is an example from the 2016 national elections in the United States. Just after the election, Edgar Welch, a 28-year-old from North Carolina, drove to Washington, DC, carrying a rifle and handgun. He entered Comet Ping Pong Pizzeria, a pizza place I often frequented when I lived around the corner from it, with the purpose of freeing children being held in the restaurant as part of a sex operation run by Hillary Clinton and aides. He found no children there and was arrested. What became known as Pizzagate started as rumors among a large online group, and the story was expanded and spread to Facebook, Twitter, Instagram, and YouTube during the final weeks of the campaign period. It was not until the mainstream media began to investigate the story that people not included in the subculture where the story originated became aware of it. This incident and many others are leading social critics to suggest that we are using our digital devices to become more and more polarized, not just in the United States but around the world. The technology is a result of cultural innovation, but it no doubt is also shaping the culture.

How Culture Changes Culture generally works to maintain stability, but environmental, demographic, economic, technological, political, and other changes challenge cultures to adapt. Sometimes cultural change is quite voluntary with people welcoming new ideas, tools, and methods. Often, however, cultural change is forced on people by outsiders. In recent times, some cultures have been changing faster than others, and in those cultures the pace of cultural change seems to have intensified. Anthropologists ask the question whether recent developments in information and communication technology are causing as monumental a cultural revolution as the industrial revolution. Among those who have the power to drive and direct cultural change in their own favor, change is seen as progress, but change is not usually seen as progress by people who do not benefit from it. Globalization is a good example. For those who have the power to manipulate global markets to amass great wealth, globalization is seen as progress, but, increasingly, globalization is seen as the enemy to people who have lost ground as profits are maximized at the expense of

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workplace safety, worker compensation, and environmental conservation.

Anthropologists identify innovation, diffusion, and cultural loss as some of the most important mechanisms of cultural change (Haviland et al., 2017). Innovation is any new idea, tool, or method. A primary innovation is the creation, invention, or chance discovery of an entirely new idea, tool, or method. A secondary innovation is a new application or modification of an existing idea, tool, or method. Force of habit tends to block ready acceptance of the new and unfamiliar, but cultural beliefs may encourage some innovations more than others. Religious ideology can be a major force against cultural innovation, as happened when Galileo was tried for heresy for declaring that the Earth revolves around the sun, an idea that ran counter to Roman Catholic dogma at the time.

Ideas, tools, and methods also spread from one culture to another, a process of cultural change known as diffusion. The rapid spread of information and communication technologies is a recent example of the diffusion of cultural tools. Anthropologists suggest that cultural borrowing accounts for a very large part of any culture’s content (Haviland et al., 2017). But cultures are selective about what they borrow, and they use new cultural ideas, tools, and methods in a way consistent with other features of the local culture.

Sometimes acceptance of a new innovation results in cultural loss, when an existing idea, tool, or method is abandoned. Plant and animal extinctions as a result of human action on the natural environment is one example of cultural loss. Loss of knowledge of nature in highly urbanized cultures is another example. A third example is the loss of spoken languages. Anthony Woodbury (2017) reports that 5,000 to 6,000 languages (others say more) are spoken in the world today, but it is projected that a century from now, the number may fall to the hundreds, as more and more communities that were once self-sufficient are pressured to integrate with more powerful cultures.

In multicultural societies, cultural change can be understood in terms of four processes: assimilation, accommodation, acculturation, and bicultural socialization. These terms are used to describe the minority individual’s or group’s response to the dominant culture and may have implications for clients’ well-being.

Assimilation is the process in which the cultural uniqueness of the

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minority is abandoned and its members try to blend invisibly into the dominant cultures. Historically, an assimilation ideology that asserts the ideal of Anglo conformity has prevailed in the United States. Immigration laws were based on beliefs about which groups of immigrants could most easily assimilate. Many minorities, especially first-generation immigrants, often resist giving up parts of their ethnic identity in order to protect their sense of meaning and purpose in life. Rubina will face assimilation pressure to forgo wearing the hijab, but she seems prepared to resist that pressure. Accommodation is the process of partial or selective cultural change. Nondominant groups follow the norms, rules, and standards of the dominant culture only in specific circumstances and contexts. This process is more common than assimilation in the multicultural, multiethnic society of the United States. Rubina follows the university rules and shares most of the norms of the dominant U.S. culture, but she will not remove her hijab, and her family does not live by many U.S. cultural standards at home. Acculturation is a mutual sharing of culture. It involves cultural modification of an individual, group, or people by adapting to or borrowing traits from another culture, a merging of cultures as a result of prolonged contact. Cultural groups remain distinct, but certain elements of culture change, and they exchange and blend preferences in foods, music, dance, clothing, and the like. Bicultural socialization involves a nonmajority group or its members mastering both the dominant culture and their own. It is necessary for people like Rubina who are the children of first-generation immigrants. Rubina seems to have mastered both cultures well enough to move back and forth between school and home during childhood and adolescence, but in her current life stage, she struggles to resolve the conflict between the culture of her parents and the culture of her peers regarding young-adult independence. The struggle has been so great that it is now affecting her health. Depending on how large the differences are between two cultures, bicultural people may see their bicultural identities as incompatible or as relatively conflict-free (Repke & Benet-Martinez, 2017).

Social workers who conduct multidimensional cultural analyses should seek to understand the processes by which culture is being maintained, adapted, and changed in the lives of the individuals, families, groups, and communities with whom they work. We must also be alert to the fact that

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the process of cultural change is not always voluntary. We must pay attention to the political, social, and economic practices that undergird institutional norms and values. If these processes are harmful and oppressive for some people, we have a professional obligation, through our code of ethics, to facilitate change. And we have a role to play in helping families like Rubina’s to negotiate cultural conflicts within the family.

Critical Thinking Questions 8.5

How do you see genes and culture interacting in the production of your own behavior? What do you see as the benefits of digital culture to your own life? What are the benefits for society? What are the harms of digital culture in your own life? What are the harms for society? What one cultural change would you most like to see? What do you see as the forces that might support that cultural change? What do you see as the forces that would oppose such a cultural change?

Implications for Social Work Practice As a social worker, you will want to recognize the powerful role that culture plays in the lives of the individuals, families, small groups, organizations, communities, and social movements with which you come in contact. Here are a few principles to guide your social work assessment and intervention.

Engage in an ongoing process of identifying and examining your own implicit biases and the impact they have on your professional activities. Recognize the multiple interacting cultures involved in the stories you hear. Pay attention to material culture in the communities in which you work. Assist individuals, groups, organizations, communities, and social movements to exercise human agency in the ongoing creation, maintenance, and change of the cultures in which they participate. Recognize how culture has been created, maintained, and changed over time in the families, small groups, organizations, communities, and social movements with which you work. Assist client systems to examine cultural values, ideology, symbols,

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language, and norms—and any conflicts about those—involved in their situations. Recognize how power and culture interact to create privilege and disadvantage for client systems, particularly as they relate to major identities such as race, ethnicity, gender, sexuality, social class, and disability. Support individuals and collectivities who resist cultural marginalization, recognizing their strengths, creativity, and hope as well as their pain. Advocate for social work interventions and policy practices that improve the life chances for identity groups who have been marginalized by cultural ideology and norms. Be mindful of how digital culture affects your social work practice and the client systems with which you work. Work to ensure that nondominant groups have a significant say in how cultural change proceeds.

Key Terms accommodation 257 acculturation 257 assimilation 245 bicultural socialization 257 counterculture 239 cultural humility 240 cultural relativism 240 culture 232 enculturation 232 ethnic identity 245 ethnicity 244 ethnocentrism 240 gender 246 hegemony 242 human agency 234 ideology 237 language 238 material culture 231 materialist perspective 234 mentalist perspective 234

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multiculturalism 245 norm 239 practice orientation 236 race 242 racism 244 subculture 239 symbol 237 values 236 xenophobia 241

Active Learning 1. Compare the cultural experiences that Rubina is having as a young

adult with your own young-adult experiences, considering the following themes: cultural values, cultural ideology, cultural symbols, language, cultural norms, subcultures, and countercultures. Now imagine that you and Rubina change places for a day. How do you think you might react to the values, symbols, and norms of Rubina’s life situation? How do you think she might react to the values, symbols, and norms of your life situation?

2. Consider where you fit in the social categories related to race, ethnicity, gender, sexuality, social class, and disability. For each category, consider whether you carry cultural privilege or cultural disadvantage. Sociologists describe master identities as those that are most important for our sense of self. Of the social categories of race, ethnicity, gender, sexuality, social class, and disability, would you consider your identity in any of these social categories to be your master identity? If so, which one or ones, and for what reasons? If not, is there another social category that would constitute a master identity for you?

3. Think about a cultural change that you have seen in your lifetime. Perhaps it is a technological innovation, a fashion change, a change in political culture, a change in the cultural attitudes about gender and sexuality, or some other type of cultural change. What do you think were the forces behind the cultural change? How has that cultural change affected your own life? What are the advantages and disadvantages of that cultural change for society as a whole? For your family? For you personally?

Web Resources

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Critical Multicultural Pavilion: www.edchange.org/multicultural

Site maintained by Paul C. Gorski contains resources, research, awareness activities, and links to multicultural topics.

Diversity Toolkit: www.ucalgary.ca/dtoolkit/

Site maintained by Darren Lund at the Werklund School of Education at the University of Calgary contains a glossary and bibliography for issues of diversity and social justice.

International Journal of Multicultural Education: http://ijme- journal.org/index.php/ijme

An open-access e-journal committed to promoting educational equity, cross-cultural understanding, and global awareness in all levels of education.

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http://www.edchange.org/multicultural

http://www.ucalgary.ca/dtoolkit/

http://ijme-journal.org/index.php/ijme

9 Social Structure and Social Institutions Global and National

Elizabeth D. Hutchison

Chapter Outline Learning Objectives Case Study 9.1: Leticia Renteria’s Struggle to Make It in the United States Patterns of Social Life Contemporary Trends in Global and U.S. Social Institutions

Theories of Social Inequality Classical Sociological Theories of Social Inequality The Contemporary Debate Structural Determinism Versus Human Agency

Implications for Social Work Practice Key Terms Active Learning Web Resources

Learning Objectives 9.1 Analyze one’s own emotional and cognitive reactions to a case study. 9.2 Give examples of how social structure and social institutions give order and stability to social life.

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9.3 Recognize national and global trends in eight major social institutions (government and political, economic, education, health care, social welfare, religious, mass media, and family and kinship). 9.4 Analyze different theories of social inequality, including both classical and contemporary. 9.5 Apply knowledge of social structure and social institutions to recommend guidelines for social work engagement, assessment, intervention, and evaluation.

Case Study 9.1 Leticia Renteria’s Struggle to Make It in the United States Leticia Renteria is a 30-year-old woman who, along with her husband Marcos Vargas, is parent to three young children. She lives in the Coachella Valley of California, which is a dichotomous region hosting both extreme wealth and extreme poverty. Leticia, unfortunately, fits into the latter category. Born in the border town of Mexicali, Baja California, Mexico, Leticia grew up poor, in proximity to the United States and surrounded by American culture. As a youth, she enjoyed a renewable visitor visa, which allowed her to travel back and forth across the border to visit an aunt and several cousins (some of whom were born in the United States), who lived not far away in the Imperial and Coachella valleys of California. Leticia’s experiences in the United States gave her even more understanding of the differences in opportunities between the United States and Mexico and made her yearn for those available in the United States, especially as she grew to working age. Work in Mexicali mostly consisted of very long hours at the extremely laborious maquiladoras (U.S. factories producing products for export in a free trade zone) or in various other low-paying informal occupations, such as selling raspados on street corners. Mexico’s minimum wage remained at less than US$5.00 per day, and actual average wages for industries in which she was qualified to work with her high school– equivalent degree only rose slightly to US$8.00 to US$10.00 per day. With prices in the border region growing steadily to match U.S. prices in some areas, these wage rates simply became unfeasible for Leticia, and she soon made one of the most difficult decisions of her life: At age 19, she entered the United States legally on her visitor visa and decided to stay past her permissible time of visit—she thusly became an undocumented immigrant.

Leticia moved outside of the heavier border patrol enforcement zone, a zone within 60 miles of the border, to the nearby Coachella Valley, where she was able to stay with a relative for a low amount of rent. At age 20, she met

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Marcos. The two married within a year. Marcos is a lawful permanent resident of the United States, having adjusted status many years ago after immigrating without papers from Mexico. Marcos works year-round in a landscaping company that provides services to the lush golf courses and country clubs of the affluent part of the Coachella Valley; Leticia toils in seasonal positions in produce packing houses and landscaping crews, those positions beginning and ending based on seasonal need. In between her periods of employment, Leticia is without income altogether due to her inability to qualify for unemployment benefits because of her immigration status.

Despite their employment challenges, Leticia and Marcos were able to get together enough money to buy a used mobile home in a nearby settlement, where they pay rent for the space upon which their home sits. Leticia has mixed feelings about their home ownership—although she is excited to accomplish this version of the “American dream,” she is frustrated and disappointed by the conditions of their mobile home park. The park is located in a rural area, several miles outside of the nearest city, and is not connected to water and wastewater services offered by the local municipal water district. The park’s owner pipes water to the spaces from a well independently dug on the site, and the water coming from the well has recently been tested and reveals impermissibly high levels of arsenic contamination. The lack of wastewater services means that all of the homes are relying on septic systems, which unfortunately frequently fill or clog up, resulting in overflow, stench, and other problems. Moreover, not far down the street sits an illegal dump, which was created by the landowner “under the radar” without the knowledge of enforcement authorities and which now causes an unbearable stench and sometimes smoke in Leticia’s settlement. To make matters worse, when Leticia is not working and Marcos has the family’s only car at his work, she is stuck at home, given that the nearest public transportation stop is more than 5 miles away and the nearest grocery stores, services, and recreation are more than 10 miles away.

Over the years, Leticia and Marcos had three children together, who are now 4, 5, and 7 years old. Leticia does her best to find childcare for the children with neighbors and acquaintances during the times she is able to work and continues working at night to complete the cooking, cleaning, and other tasks that Marcos and others expect her to do as a woman. All three of the children suffer from varying degrees of asthma, which Leticia believes is related to the dusty nature of their desert mobile home park, as well as the fumes and smoke that frequently come from the nearby dump. However, the community clinic where Leticia takes the children to be treated does not keep any data related to these kinds of causes and does not connect patients’ health indicators to any environmental factors, so Leticia is left to rely on her own

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suspicions. The children receive medical care in the clinic, thanks to the state insurance program, because they are citizens of the United States. Leticia cannot qualify for any such assistance, given that she remains undocumented. Leticia and Marcos hope that their children will succeed in school, but they are not really sure how the system works, and they are really intimidated by the English-speaking teachers and big buildings and campuses, so they have mostly thus far refrained from getting involved with their children’s school. Leticia tries her best to access some of the few other resources in the area for her children to help them supplement their education and get their minds off other stressors. The children particularly enjoy spending time at the new Boys and Girls Club in the nearby town of Mecca when the family has the time and transportation to get there.

Despite her marriage to a lawful permanent resident, Leticia has not yet applied for legal immigration status because she and Marcos cannot afford the immigration and attorney fees, which would cost more than $6,000. Even with their hard work, Leticia and Marcos remain at the minimum wage rate of $10.50 per hour and are only bringing home a little more than $20,000 per year. This is far from enough to support their family of five and to cover the $50 to $100 per month they try to send to family back in Mexico. Leticia does not apply for food stamps or other cash assistance for her children (though they do qualify, because they are U.S. citizens) because she has heard that children who receive government benefits are the first ones sent to war when they turn 18 and that the children have to pay back all the benefits they received when they become adults. She just wishes that someday there will be an increase in the minimum wage, so that she and Marcos could make ends meet on their own. From everything Leticia hears on television, though, a lot of companies and politicians really don’t want to see that happen. She figures that nothing ever happens unless powerful people want it to happen, so she thinks her minimum wage will never change.

Leticia finds her low wage rate doubly unjust because of all the things she has to tolerate in her workplace. As is common in landscaping and agricultural jobs, Leticia frequently encounters supervisors and coworkers who make unwelcome sexual comments to her and who sometimes even touch her in uncomfortable ways. Though these interactions would constitute illegal sexual harassment, Leticia, like most other women, never complains, for fear of losing her job, fear of immigration enforcement, and even fear of stigma among acquaintances as well as consequences in her own relationship with Marcos if he were to find out.

Early one morning, Leticia was detained by immigration authorities on her way to work, after having been originally stopped by a sheriff’s deputy for a supposed violation related to a frame around her license plate. In

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immigration detention, she is offered the right to stay in detention and present her deportation defenses to a judge—which could take months—or the option to leave the country immediately by signing a voluntary departure. Leticia has heard horror stories about deported mothers whose children get placed into the state foster care system and lose connection with their families. She tries to reach a local nun who helps in the community, to see if she can get any advice. However, even the nun isn’t sure what to do or where to turn. So, even though Leticia knew that she could apply for status through her husband, she was scared to wait out the multimonth process and decided to leave by voluntary departure. She returned to the United States with her cousins by car with no papers only a few days later, simply telling the immigration officers at the border that she was a U.S. citizen just like her cousins. What Leticia wouldn’t realize until much later, when she and Marcos finally went to apply for her status, is that her voluntary departure followed by her quick illegal return and misrepresentation of citizenship probably disqualified her for any legal immigration status until she spends years outside of the United States as a penalty.

—Megan Beaman Jacinto

Patterns of Social Life As you read this story, you were probably aware of both the people and the environments involved. A number of people are involved in the story, and you may be observing how they are interacting with each other and what each contributes to the current situation. Although you do not want to lose sight of the personal dimensions of Leticia Renteria’s story, in this chapter consider the broad patterns of social life that she and her family have encountered and continue to encounter. Notice the connections between the personal troubles of this family and broader social conditions.

A good way to begin to think about broad patterns of social life is to imagine that you and 100 other people have made a space journey to a new planet that has recently, thanks to technological breakthroughs, become inhabitable by humans. You are committed to beginning a new society on this new frontier. How will you work together to be successful in this endeavor? What will you need to do to ensure your survival? Now imagine that your society of 100 has grown to include more than 7 billion people, spread across six continents, with news and ideas being carried around the globe instantly through multiple media outlets, billions of dollars moving across continents electronically, and products being manufactured and

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services being provided by a dispersed global labor force. How would you suggest that people work together to ensure the survival of this global society? One way to think about Leticia Renteria’s story is to think of it as a globalization story. In Chapter 1, we defined globalization as a process by which the world’s people are becoming more interconnected economically, politically, environmentally, and culturally.

Sociologists and anthropologists have given much thought to how people work together to try to ensure the survival of a society. They have identified two concepts—social structure and social institutions—as central to understanding those endeavors. Social structure and social institutions are among the more abstract concepts used by sociologists. In the broadest sense, social structure is another term for society, or simply an acknowledgment that social life is patterned, not random. It provides the framework within which individual behavior is played out in daily life. Social structure is a set of interrelated social institutions developed by human beings to provide stability to society and order to individual lives. Recently, immigration laws in the government and political institution is one attempt to bring stability and order to life.

Our understanding of social institutions is complicated by the casual, everyday use of the term institution to cover a variety of meanings. In this book, however, we use the definition of social institution as a stable, organized, patterned set of roles, statuses, groups, and organizations that provides a basis for behavior in particular areas of social life (Ballantine et al., 2018; Newman, 2017). To provide stability, social institutions organize rights and duties into statuses and roles and the expected behaviors that accompany them. A status is a specific social position; a role is the usual behaviors of persons occupying particular statuses. Sociologists have identified a set of interrelated social institutions—such as family, religion, government, economy, and education—with each institution organizing social relations in a particular sector of social life. We see evidence of each of these institutions in the lives of Leticia Renteria and her family.

Sociological treatment of social structure and social institutions emphasizes the ways in which they persist and contribute to social stability. But often they persist despite unintended consequences and evidence that they are ineffective. In addition, although social institutions are relatively stable, they also change—whether by accident, by evolution, or by design (McMichael, 2017; Scott, 2014). Social institutions persist

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only when they are carried forward by actors and only when they are actively monitored.

W. Richard Scott (2014) suggests three types of processes that contribute to the stability of social institutions: regulatory processes, normative processes, and cultural-cognitive processes. Different types of processes are at work in different social institutions. Regulatory processes involve rules, monitoring, and enforcement through rewards and punishment. Normative processes involve values and norms about how things should be done. Cultural-cognitive processes involve beliefs about the world and how to behave in it.

Eight interrelated social institutions are discussed in this chapter: the government and political institution, economic institution, educational institution, health care institution, social welfare institution, religious institution, mass media institution, and family and kinship institution. We can see how important each of these institutions is in the current lives of Leticia Renteria and her family. Exhibit 9.1 presents these social institutions and the major functions they perform for society.

Contemporary Trends in Global and U.s. Social Institutions As suggested, social institutions are relatively stable, but they also change. They are created and modified over time as people interact in various social configurations. They have undergone great changes over time, yet they often seem so resistant to change. Usually the pace of institutional change is slow, but there are also times of transition when the pace of institutional change is quite rapid, for example, the period at the beginning of the industrial revolution. Contemporary futurists suggest that we have entered a time when the pace of technological change will continue to accelerate rapidly, and we might expect that continued rapid technological change will produce change, sometimes rapid change, in most if not all major social institutions (Kurzweil, 2012). As the contributing authors and I have worked on this, the sixth edition of this book, we have often been amazed at how quickly knowledge of human behavior becomes outdated in the contemporary era.

Writing about global social structure and social institutions at the

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beginning of the 21st century, Anthony Giddens (2000), a British social scientist, suggested that the recent pace and scope of change has produced a “runaway world.” Some social scientists suggest that the pace and scope of change in the past few decades has produced several crises for global as well as U.S. social institutions, for example, an inequality crisis, a financial volatility crisis, an energy crisis, a climate crisis, and a security crisis. They propose that these combined crises are leading to a quest for new ways of organizing the global social structure and that we may now be at a turning point transitioning to yet unclear new ways of organizing social life (see McMichael, 2017). I cannot predict future trends in social structure and social institutions, but I believe it is important for social workers to think about their work in the context of contemporary trends and to imagine the possibilities for how they might help to shape future trends in such a way that they bend toward social, economic, and environmental justice.

Exhibit 9.1 ● Key Social Institutions and the Functions They Perform

Social Institution Functions Performed

Government and political institution

Making and enforcing societal rules

Resolving internal and external conflicts

Mobilizing collective resources to meet societal goals

Economic institution Regulating production, distribution, andconsumption of goods and services

Educational institution

Passing along formal knowledge from one generation to the next

Socializing individuals

Health care institution Promoting the general health

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Social welfare institution

Allocating goods, services, and opportunities

Enhancing social functioning of individuals

Contributing to the social health of the society

Religious institution

Answering questions about the meaning and purpose of life

Socializing individuals

Maintaining social control

Providing mutual support

Mass media institution

Managing the flow of information, images, and ideas

Family and kinship institution

Regulating procreation

Conducting initial socialization

Providing economic, emotional, and physical care of its members

It is increasingly difficult to understand the changes in our own society without recognizing the global context of those changes. Globalization is affecting all aspects of social life around the world. Indeed, the process of globalization has been stimulating changes in the major social institutions for several decades, but in a pronounced way for the past few decades. The discussion that follows positions trends in U.S. social institutions within a global context. Doing so illuminates how U.S. society is both different from and the same as other societies, and it aids critical thinking about the question of why we do things the way we do. International scholar Philip McMichael (2017) suggests that the long arc of human history is “now bending toward recognition of the importance of cultural diversity and biodiversity for human and planetary sustainability” (p. xiii).

Perhaps the most important and troubling trend in contemporary life is the

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continued extremely high level of social inequality, both between nations and within nation-states. Although globalization has brought some improvements in literacy, health, and living standards for many, we pay particular attention to trends in social inequality because the profession of social work has historically made a commitment to persons and groups that are disadvantaged in the distribution of institutional resources. To carry out this commitment, we must have a way of understanding social inequality and its influence on human behavior. Throughout this chapter, I demonstrate how social inequality is created and maintained in eight major interrelated social institutions. But first we take a closer look at inequality globally and in the United States.

There are many debates about whether globalization is leading to increased or decreased global inequality, and the answer depends on how the question is asked. McMichael (2017) argues that although a global middle class has emerged in some previously low-income countries such as Brazil, Russia, India, China, and South Africa, global inequality is deepening when China and India, which together account for one third of the world’s population and are growing in wealth, are removed from the calculations. He reports that 80% of the world’s population lives in countries where income differentials are widening. On the other hand, the United Nations Development Programme (UNDP, 2016) reports that, in recent years, a large number of developing countries have been transformed into dynamic major economies. It notes, however, that economic growth does not automatically translate into reduced inequality. Its most recent report (UNDP, 2016) indicates that the top 1% of the global wealth distribution holds 46% of the world’s wealth. The richest one fifth of the world’s people consume 86% of the world’s good and services, compared to the poorest one fifth who consume 1.3% of the world’s goods and services. The 25 richest Americans have a combined income nearly as great as the combined income of 2 billion of the world’s poorest people (Sernau, 2017). Although different data sources report different numbers, there is agreement that we are talking about comparatively huge disparities in the contemporary world.

Not all regions of the world have shared equally in the benefits of globalization, and high levels of inequality exist in regions of the world experiencing recent economic growth. During a time of massive income growth worldwide, average incomes fell in most of sub-Saharan Africa, and much of that region is now further behind the rest of the world than in

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1990. The area is rich in natural resources, but the wealth is concentrated in a few families. Twenty years ago, 93% of poor people lived in low- income countries; now 75% of the world’s poorest people live in middle- income countries (McMichael, 2017). So, although available data show a slight average decline in global inequality, they also indicate that income inequality is growing between the poorest 10% and the richest 10% of the world’s people. In all the regions of the world, some groups are more deprived than other groups in income and other resources. These groups include women and girls, ethnic minorities, Indigenous peoples, people with disabilities, and migrants (UNDP, 2016).

Although most of the global inequality is due to inequality between countries, as you see from this discussion, the gap within nations is also staggering. Let’s look at income inequality in the United States. In the period from 1947 to 1973, income inequality in the United States declined slightly. Since 1974, however, income inequality has grown substantially. The most commonly used measure of income inequality is the Gini index, which measures the extent to which the distribution of income within a country deviates from a perfectly equal distribution. Gini index scores range from 0 (perfect equality) to 100 (perfect inequality). As Exhibit 9.2 shows, the Gini index in the United States grew from 39.4 in 1970 to 48.1 in 2016. Emmanuel Saez (2012) reports that the incomes of the top 1% of earners in the United States captured more than half of the overall economic growth in the country in the period from 1993 to 2010. Looking at wealth instead of income, Ritzer (2016) reports that 80% of the wealth gained in the United States from 1983 to 2009 went to the wealthiest 5% of the population, whereas the poorest 60% saw a 7.5% decline in wealth.

The United States has the highest level of inequality of all the wealthy industrialized nations (Sernau, 2017). Exhibit 9.3 shows the income inequality ranking of 18 advanced industrialized countries from 2010 to 2015, based on the Gini index, moving from the country with the least inequality at the bottom (Finland, Gini index of 21.5) to the country with the greatest inequality at the top (United States, Gini index of 47.7). The 18 countries presented in Exhibit 9.3 are used throughout this chapter to make comparisons between the United States and other wealthy countries. I call these countries the comparison countries. Of course, the United States does not have more inequality than all countries in the world. In a general sense, highly industrialized, high-income countries have much lower levels of inequality than nonindustrial or newly industrializing

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countries. The rate of inequality is much lower in the United States than in many low- to middle-income countries. Overall, the highest rates of inequality can be found in some African and Latin American countries, but the rate of inequality is not consistent within these regions.

Exhibit 9.2 ● Gini Index of Inequality in the United States, 1970– 2016

Leticia Renteria came to the United States to escape brutal poverty in Mexico. In recent years, Mexico has developed trade agreements with a number of other countries and has moved from being the world’s 26th largest economy to being the 8th largest. Most of Mexico’s recent industrial growth has been in the maquiladoras, and real wages in Mexico have declined by about 20% in this period of growth. A large percentage of workers, about 40% of Mexico’s workforce, are poorly paid and have few employment options (Sernau, 2017). Nearly half of Mexican families live in poverty, a rate that has not changed since the early 1980s (McMichael, 2017). Although Leticia Renteria and Marcos Vargas are struggling for economic survival in the United States, they do not wish to return to Mexico.

Exhibit 9.3 ● Ranking of Social Inequality in 18 Advanced Industrial Countries From 2010 to 2015

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Source: Based on Central Intelligence Agency, 2016.

Some social analysts argue that social inequality is the price of economic growth and suggest that the poorest families in the United States enjoy a much higher standard of living than poor families in other countries (Hederman & Rector, 1999). But a comparison of the United States with other advanced industrialized countries suggests that societal health is best maintained when economic growth is balanced with attention to social equality. A growing international research literature suggests that high levels of inequality are bad for the social health of a nation. Let’s look at three social indicators for the 18 industrialized countries in Exhibit 9.3: childhood mortality (probability of dying before age 5), life expectancy, and secondary school enrollment. In 1960, the United States had a lower childhood mortality rate than 10 of the comparison countries listed in Exhibit 9.3. In 2016, the United States had the highest childhood mortality rate of the 18 countries, more than 3 times that of the country with the lowest childhood mortality rate, Finland (World Bank, 2017a). Likewise, all the comparison countries have longer life expectancies than the United States does (Central Intelligence Agency, 2017b). The United States does better in terms of educational equality; looking at the 25- to 54-year-old age group, the United States has higher secondary education completion rates than 13 of the comparison countries (Organisation for Economic Co- operation and Development [OECD], 2016a). These data suggest that education does not reduce economic inequality as much as sometimes

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suggested.

There is growing support for the idea that economic inequality is associated with a number of social ills, including low social cohesion, distrust, violence, poor health, and economic stagnation (see Fairbrother & Martin, 2013; Payne, 2017; Stiglitz, 2012; Van de Werfhorst & Salverda, 2012). The evidence of a correlation between economic inequality and a variety of social ills is strong, but because most of the research is cross- sectional we must be cautious about concluding that economic inequality is the cause of the other social ills. Researchers are currently taking a hard look at that issue (see van de Werfhorst & Salverda, 2012).

Poverty is one measure of social inequality, but there are different approaches to measuring poverty across the world. The available evidence indicates that before industrialization only a small elite enjoyed living conditions that would not, today, be described as extreme poverty. Roser and Ortiz-Ospina (2018) argue that the reduction of extreme poverty in the past 2 centuries is “one of the most remarkable achievements of humankind” (para. 5). They report that 44% of the world population lived in extreme poverty in 1981, dropping to 11% in 2013. They indicate that this achievement is due in large part to the improvements of living conditions in China. The countries in sub-Saharan Africa have lagged behind in such improvements, and the largest numbers of people living in extreme poverty live in Africa. Poverty around the world is particularly high among children, and in low- and middle-income countries more than 20% of children under the age of 10 live with less than the 1.90 international dollars (int.-$) per day set by the World Bank as the line for extreme poverty. Because of exceptionally high income inequality, a fraction of people in high-income countries continue to live in extreme poverty, most notably true in the United States. The World Bank has set a goal to eliminate extreme poverty in the world by 2030, but Roser and Ortiz-Ospina (2018) argue that eliminating extreme poverty is not possible without decreasing economic inequality.

Poverty rates in the United States demonstrate that social inequality is related to race and ethnicity, age, gender, family structure, educational attainment, and disability (Semega, Fontenot, & Kollar, 2017). The overall poverty rate in 2016 was 12.7%, almost the same rate that existed in 2007 before a steep rise related to the economic recession. Although the majority of people living below the poverty level are White, and people of

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color can be found in all income groups, Blacks and Hispanics are about 2.5 times as likely as Whites to be poor. The poverty rate in 2016 was 22.0% for Blacks, 19.4% for Hispanics, 10.1% for Asians, and 8.8% for non-Hispanic Whites. The good news is that the differential between Whites and groups of color has decreased in recent years. The bad news is that the differential remains quite large.

The poverty rate was 12.3% among the native-born population in 2016 and 15.1% among the foreign-born population. Foreign-born noncitizens have a higher poverty rate (19.5%) than foreign-born naturalized citizens (10.0%) (Semega et al., 2017). Indeed, foreign-born naturalized citizens have a lower poverty rate than native-born citizens. You can see from Leticia Renteria’s story how lack of citizenship makes people particularly vulnerable in the labor market.

Over the past 50 years, vulnerability to poverty has shifted from older adults to children. From 1959 to 2016, the percentage of the U.S. population 65 years and older living in poverty decreased from about 35% to about 9.3% (DeNavas-Walt, Proctor, & Hill Lee, 2006, 2013; Semega et al., 2017). The proportion of the population younger than age 18 living in poverty showed a smaller decrease in this same period, from about 27.0% to 18.0%. Since 1974, the poverty rate for persons younger than 18 has been higher than for those 65 and older. In 2016, children under the age of 18 represented 23.0% of the total population and 32.6% of the people living in poverty.

Women are more likely than men to be poor in the United States as well as globally. In the United States, women’s poverty rate (14.0%) is higher than men’s (11.3%). Single-parent, mother-only families are more likely to live in poverty (26.6%) than two-parent families (5.1%) or single-parent father- only families (13.1%) (Semega et al., 2017).

The poverty rate also varies by educational attainment. In 2016, 24.8% of people aged 25 and over without a high school diploma lived in poverty, compared to 13.3% with a high school diploma and no college, 9.4% with some college but no degree, and 4.5% with at least a bachelor’s degree (Semega et al., 2017).

The poverty rate for adults with a disability is more than twice the poverty rate for adults without a disability. In 2016, the poverty rate for people aged 18 to 64 with a disability was 26.8%, compared with 10.3% for adults

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of the same age without a disability (Semega et al., 2017). Among the 18- to 64-year-old population, people with a disability represented 7.8% of all people and 18.1% of people living in poverty.

We turn now to analysis of trends in eight major social institutions, both globally and in the United States. We look for the good news in these trends, but we also pay close attention to how social inequality and social conflict are created or maintained in each institution.

Critical Thinking Questions 9.1

Do you agree with Anthony Giddens that we now live in a “runaway world”? Explain your answer. Do you agree with social scientists who suggest that recent developments in social institutions have produced an inequality crisis, financial volatility crisis, energy crisis, climate crisis, and security crisis? What evidence have you seen in your own life of the presence or absence of these crises? What evidence do you see in the case of Leticia Renteria and her family?

Trends in the Government and Political Institution Leticia Renteria lives in fear of agents of the government, particularly immigration agents. For the most part, she sees the government as a coercive force rather than a supportive one in her life. She believes that only powerful people can influence government actions. The government and political institution is responsible for how decisions get made and enforced for society. It is expected to resolve both internal and external conflicts and mobilize collective resources to meet societal goals.

Political systems around the world vary widely, from authoritarian to democratic. Authoritarian systems may have a hereditary monarchy or a dictator who seized power; sometimes democratically elected leaders become dictators. Leaders in democratic systems are elected by their citizens and are accountable to them; they must govern in the context of written documents (Ballantine et al., 2018). Evidence suggests that the government institution is in transition globally, including in the United States. There is much complexity in global trends in government and politics, but the following historical factors are supremely important for

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beginning to understand current complexities.

1. Colonialism. The contemporary global political landscape must be understood in the historical context of colonialism (Kurtz, 2016; McMichael, 2017). Eight European countries (Belgium, Britain, France, Germany, Italy, the Netherlands, Portugal, and Spain) and Japan were involved over several centuries in setting up colonial empires, which allowed them to strengthen their own economies by exploiting the raw materials and labors of the colonized countries. Colonial governments took power away from local governance and prevented the localities from establishing stable political systems. Most of these empires came to a rather abrupt end after World War II, but they left a disorganized political legacy in their wake in much of Africa, Central and South America, and parts of Asia and the Middle East. After the colonized countries established their independence, the United States and other Western powers advanced a new institutional framework that called for free trade and transformation of the formerly colonized countries into democracies. This new institutional framework, sometimes referred to as neocolonialism, is promoted by such international organizations as the World Bank, the International Monetary Fund (IMF), and the World Trade Organization (WTO). These organizations, which are led by the United States and western Europe, regulate relations between countries, and this role carries much power over political and economic institutions (Loomis, 2013). The United States and western Europe also played a major role in coercing former colonies to organize into nation-states and imposed national boundaries that were inconsistent with age-old ethnic divisions. This has resulted in ongoing ethnic clashes throughout the former colonies (McMichael, 2017).

2. International power struggles. Across time, groups have tried to assert their will over other groups, and the struggle for power over people, ideas, and natural resources is very much a part of the contemporary geopolitical scene. Sometimes nations or transnational organizations use the hard power of military force. Other times, they use the soft power of persuasion and inducement. Two bloody world wars in the 20th century left Europe weakened and wary of war as a viable solution to conflicts between nations. With the European states weakened after World War II, the United States and the Soviet Union emerged as competing superpowers. These two superpowers became competing spheres of influence, each trying to promote its political

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and economic interests around the world in a struggle known as the Cold War. The collapse of the Soviet Union in 1989 produced political instability in the former Soviet Union, and that region is no longer considered a superpower. In the meantime, after World War II, the nations of Europe began a process of unification, a process that has not always been smooth but has produced the European Union (EU). China and India are now emerging as major powers in the world. During the Cold War, the United States made extensive use of the soft power of foreign aid to encourage loyalty to its political (democracy) and economic (free market capitalism) visions. In the contemporary era, powerful countries are using foreign aid to ensure access to scarce natural resources. For example, in 2006, China made a $1.4 billion deal to develop new oil fields in Angola, which became the biggest supplier of oil to China. In this deal, China agreed to rebuild Angola’s railway and bridges, roads, irrigation systems, hospitals, and schools (Brautigam, 2009). Overall, there has been a downward trajectory of international aid, and the United States lags behind most European countries with respect to the amount of its gross national product (GNP) that goes to nonmilitary international aid, far behind the northern European countries (Karger & Stoesz, 2018).

3. Economic globalization. Changes in the government institution are intertwined with changes in the economic institution, and these changes taken together are playing a large role in global inequality. Beginning in the 1970s, economic globalization started to present serious challenges to nationally based democracies. For a number of centuries, political and economic life had been organized into nation- states with bureaucracies for maintaining order and mobilizing resources to meet societal needs. Starting in the 1970s, however, new information and transportation technologies made possible the development of transnational corporations (TNCs), which carry on production and distribution activities in many nations. These corporations cross national lines to take advantage of cheap labor pools, lax environmental regulations, beneficial tax laws, and new consumer markets. It is hard for any nation-state to monitor or get control over TNCs, and no international government exists (Sernau, 2017). Under these circumstances, around 1970, governments began to retrench in their efforts to monitor and control the economic institution. A neoliberal philosophy that governments should keep their hands off the economic institution took hold, perhaps nowhere

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more than in the United States. McMichael (2017) argues that the neoliberal philosophy seriously limits the ability of a political and government institution to focus on the common good.

4. Transnational centers of power. Although no international government exists, the United States played a leadership role in the development of several transnational political and economic organizations and policies at the end of World War II. The United Nations (UN) was developed to ensure international peace and security. The World Bank was developed to promote reconstruction in war-torn nations but has, in recent years, taken on a concern for poverty. The World Bank president is appointed by the U.S. president. The International Monetary Fund (IMF) was developed to promote international monetary cooperation and a fair balance of trade. The managing director of the IMF is appointed by the United Kingdom, France, and Germany. The General Agreement on Tariffs and Trade (GATT) was designed to provide an international forum for developing freer trade across national boundaries; the World Trade Organization (WTO) was developed under GATT in 1995 to regulate the global economy according to principles of free trade. More recently, the United States, Canada, and Mexico signed the North American Free Trade Agreement (NAFTA) in 1994. European nations joined together as the EU, adopting a common currency, a set of common legal and economic structures, and other joint endeavors. Similar organizations are in various stages of development in Latin America, Asia, and Africa. The World Bank, IMF, and WTO, all governed by unelected officials, have become very powerful in dictating how nation-states should govern. For example, when making loans, the World Bank requires that borrowing nations follow the principles of neoliberalism, including reducing their social welfare programs, privatizing their public services, and becoming more open to imports. In 2000, the WTO developed a General Agreement on Trade in Services (GATS) that compels governments to provide unlimited market access to foreign service providers. Among other things, GATS imposes severe constraints on national governments’ ability to protect the environment. The IMF has enforced these principles, sometimes overriding decisions made at the national level. The deliberations of the WTO are secret; members can lodge complaints, but the decision of the WTO’s dispute settlement program is binding unless every member of the WTO votes to reverse it. There is much evidence that the decisions of the World Bank, IMF,

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and WTO have been more favorable to some nations than others (McMichael, 2017). A wave of nationalism, best exemplified by Britain’s vote to leave the European Union and the election of U.S. president Donald Trump in 2016, is a recent response to the bureaucracies of globalization.

Photos 9.1A & 9.1B State, local, and federal governments are social institutions responsible for making and enforcing societal rules. Here we see the U.S. Federal Reserve building and the Capitol in Sacramento, California.

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Growing faith across the world in the wisdom and efficiency of the economic institution led many nation-states to withdraw from direct control of activities they had hitherto controlled. They do this in several ways. The government sells enterprises that produce goods or deliver services to the private sector. Another approach is for the government to retain ultimate control over a program but contract with private organizations for some activities. The United States makes heavy use of contracting in many governmental sectors. And, finally, governments sometimes give up their claims to the right to regulate particular activities they have previously regulated but not controlled. It is widely noted that deregulation of financial institutions over several decades in the United States and Europe was a primary factor in the 2008 financial crisis (Jeffers, 2013).

Economic globalization combined with war and political strife has produced mass cross-national migration. Most of this migration has occurred within regions; for example, most refugees fleeing Syria originally flee to neighboring countries Turkey, Lebanon, Jordan, and Iraq (Migration Policy Centre, 2016). But there is also a trend of migration from low-wage to high-wage countries (Newman, 2017). This has led to considerable political attention to immigration issues around the globe. In the United States and Europe, immigration issues are the source of intense political debate. As we think about the trials of Leticia Renteria and her family, we are reminded of this increased attention to immigration issues. Some observers (Teeple, 2000) have suggested that nation-states compensate for their inability to control the business processes that cross their borders by heightening their attempts to control the human movement across their borders. By controlling borders, a nation-state can get some control of the flow of labor across national boundaries.

In the United States, three issues are creating concern in the government and political institution: a sharply divided electorate, the role of money in the political process, and voter turnout. Concerning a sharply divided electorate, recent elections and attempts at legislation have been more acrimonious than at any time in recent history. There have always been sharp divisions about what kind of country the United States should be, but these tensions have been exacerbated in recent times. Concerning money in the political process, a Supreme Court decision and subsequent federal court of appeal ruling in 2010 resulted in wealthy individuals, corporations, and unions having the right to make unlimited political

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expenditures as long as the contributions are independent of specific candidates or political parties. Exhibit 9.4 shows the votes cast in the most recent national election (as of 2017) as a percentage of the voting-age population. The United States is third from the bottom of comparison countries in terms of voter participation, with a voter turnout of 55.7% compared to 87.0% in Belgium, the country with the highest turnout rate (Desilver, 2017). Most comparison countries have seen a decline in voter turnout in recent years. In the United States, there is much controversy about recently passed state voter ID laws, which conservatives say are needed to prevent voter fraud and liberals say are intended to suppress the vote of minorities of color.

Exhibit 9.4 ● Votes Cast in Most Recent National Election (as of 2017) as Percentage of the Voting-Age Population

Source: Desilver, 2017.

The future of the neoliberal philosophy is not clear. For a number of decades, it served wealthy nations and wealthy individuals well. However, the 2008 global economic crisis called its principles into question and began to chip away at its primary premise that the market has its own wisdom and should not be interfered with. The wisdom of deregulation is getting another review. For some time now, poor nations and social justice advocates have engaged in growing resistance to the neoliberal philosophy

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and its implementation by the World Bank, IMF, and WTO. There has been much concern about the unfair advantage given to wealthy nations and the exploitation of labor and natural resources in poor nations. There is also much concern about the damage done to the environment caused by placing the chase for wealth above any other value and by the World Bank’s emphasis on energy and export agriculture rather than on social investments such as education, health services, housing, and water and sanitation systems. However, there is also much resolve by rich and powerful individuals and societies to hold on to neoliberal principles.

What happens in the government and political institution has enormous impact on the life chances of every group in society. For example, two important political issues play a large role in the level of inequality in a society: tax policy and minimum wage policy. European governments tax their wealthier citizens at a much higher rate than the United States does and set higher minimum wages. These actions of the government impact what social workers can and cannot do to promote individual and collective well-being. Social workers cannot afford to ignore processes and trends in the political arena. In the United States, social workers must be attuned to the important role money plays in providing access to government and politics, to continuing underrepresentation of women and people of color among elected officials, and to existing and proposed barriers to access to the electoral process. They must also be aware of the possibilities of what can be accomplished by collective action.

Trends in the Economic Institution As you read the story of Leticia Renteria and her family, their economic struggles seem paramount, and yet, both Leticia and Marcos are employed and working hard to provide for their family. The economic institution has primary responsibility for regulating the production, distribution, and consumption of goods and services. In a capitalistic market economy, such as the one in the United States and many parts of the world, what one is able to consume depends on how much one is paid for selling goods and services in the economic marketplace. Most people, if they are not independently wealthy, exchange labor for wages, which they then use for consumption. The nature of the economy has been ever changing since premodern times, but the rate of change has accelerated wildly since the beginning of the industrial revolution, particularly in recent decades under neoliberalism and economic globalization.

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Economic life can be organized in many ways, and a great variety of ways have been used over time. In recent times, different approaches to organizing the economic institution around the world fall on a continuum with market capitalism at one end and a centralized or planned economy at the other end. In market capitalism, the economy operates by voluntary exchange in a free market and is not planned or controlled by a central authority. The goods and services produced by human labor are exchanged in the market and not produced for consumption by the laborer. The means of production are privately owned by one group, and another group, the workers hired through a labor market, own little besides their capacity to work. No governmental interference is thought to be needed because “the invisible hand of the market” will ensure fair production and distribution, including fair profit for some and not for others. Investment is privately controlled. In a centralized or planned economy, the government plans and controls production and distribution of goods and services. The means of production are collectively rather than privately owned, and the terms of labor are regulated by the government rather than by the market. In such economies, there is deep distrust of the exploitation of labor thought to occur in a market run by a financial elite in pursuit of their own self- interests (Ballantine et al., 2018; Ritzer, 2016).

In reality, no country in the world today practices either pure market capitalism or a pure planned (centralized) economy. The U.S. economy is thought to be a special case of capitalism in the world today, coming the closest to pure market capitalism. And yet there are a number of ways in which national and state governments in the United States interfere with market-based production and distribution of goods and services, including labor regulations, public education, public libraries, social security legislation, Medicare, and Medicaid. A number of countries have mixed economies where the good of the whole society is considered paramount, and private profit is less important than in pure capitalism. In these countries, collective planning is engaged in an attempt to balance societal needs with individual economic freedom. Northern European countries are the best examples of mixed economies. The former Soviet Union was once considered to be the best example of a planned economy, but since its fall in 1991, the region no longer holds that distinction. China is often thought to be the current best example of a pure planned economy today but, in fact, is becoming a dominant capitalist force while holding on to its highly centralized government (McMichael, 2017). There is much agreement that economic globalization is pushing all countries toward some embrace of

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market capitalism.

Before further discussion, some clarity is needed about what we mean by economic globalization. The primary ingredients are a global production system, a global labor force, and global consumers organized through a global market. Much of what we wear, eat, and use has global origins, involving commodity chains located in a number of countries. If you look around your room, you will see many examples of economic globalization, but much of the global process will be invisible to you. Two examples, taken from the work of Philip McMichael (2017), demonstrate some of the complexity of current globalization. First, let’s look at the U.S.-based athletic shoe industry. The design and marketing of the shoes are typically done at headquarters in the United States by workers earning relatively high wages. The materials are produced, dyed, cut, stitched, and assembled and then packed and transported in work sites in South Korea, Taiwan, China, Indonesia, and the Philippines, primarily by women earning low wages. The shoes are sold globally but disproportionately to consumers in wealthy advanced industrialized countries.

A second example involves the food we eat. In wealthy countries, we have become accustomed to having our favorite fruits and vegetables available year-round. We can have this because of the global food market. During the winter months, if we live in the United States, we can get grapes, apples, pears, apricots, cherries, peaches, and avocados from Chile and tomatoes, broccoli, bell peppers, cucumbers, and cantaloupe from Mexico. If we live in Japan, we might get pineapples and asparagus from Thailand; and if we live in Europe, we can buy strawberries, mangoes, and chilies grown in Kenya as well as organic fruits and vegetables from China. What do you know about the labor conditions under which the food on your table was produced? As Philip McMichael (2017) suggests, it is now “virtually impossible for consumers to recognize the impact of their consumption on people and environments elsewhere” (p. 20).

The global economy is driven by corporate desire for the bigger profits that come from cheap raw materials and cheap labor and by consumer desire for cheap and novel products. Corporations are constantly seeking cheaper labor sites to stay competitive. Much of the global economy is controlled by TNCs. TNCs have become very powerful over the past several decades; in fact, UN data indicate that TNCs account for two thirds of world trade and hold most product patents (cited in McMichael, 2017).

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Most TNCs are headquartered in France, Germany, Japan, the United Kingdom, or the United States.

Photo 9.2 Walmart is a growing symbol of economic globalization.

Proponents of economic globalization argue that in time it will bring modernity and prosperity to all regions of the world. Critics argue that it is just an unsustainable pyramid scheme that must end because prosperity of victors is always paid for by the losses of latecomers or because the physical environment can no longer sustain the economic activities (Sernau, 2017). This is a good place to point out that not all peoples of the world put a high value on consumerism and chasing economic growth, values that are central to globalization. Unfortunately, however, policies of the World Bank, IMF, and WTO have made it impossible to make a living on subsistence farms and small-craft enterprises. A number of globalization scholars argue that economic globalization as we have known it is not sustainable because of the social disruption and environmental degradation it has wrought and that we may be seeing the beginning of a transition to a different form of capitalism that puts greater

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emphasis on sustainability (see McMichael, 2017). The future of globalization is not certain, but several trends can be identified at its current stage of development.

1. Regional disparities. Rich nations have been getting richer, a few nations have made impressive gains, most poor nations have made few gains, and the poorest nations have lost ground. Consumers in high-income countries benefit from the cheap labor of workers in newly industrializing countries. Current regional disparities must be put into historical context. Globalization gained speed just as European colonialism collapsed, at the end of World War II. Formerly colonized countries began the global era in a compromised position created by colonial exploitation. The newly created World Bank made large loans to the former colonies to improve their infrastructures, and much of the money was used to import technology from wealthy industrialized countries. In the 1980s, a combination of factors, including recession in the United States and other wealthy Western nations, produced a debt crisis in many previously colonized countries. They began taking out new loans to pay for previous loans. The World Bank and IMF imposed austerity measures, which resulted in social service cuts, as a condition for restructuring the loans. Some countries have not been able to recover from the debt crisis, especially those facing a massive AIDS crisis. More recently, low-income countries were severely affected by the 2008 global economic crisis, which originated in the financial systems of the wealthy countries of the world. Poor countries entered the recession in already weak fiscal positions, and there have been several negative impacts of the recession on their fragile economies: a decline of foreign aid, restricted access to credit, lost trade, and loss of remittances from family members who have migrated to wealthy countries (McMichael, 2017). Sub-Saharan Africa has been the global region most vulnerable to these economic losses, but low-income countries in eastern Europe, Asia and the Pacific, and Latin America have also been at risk.

2. Labor force bifurcation. As globalization progressed, wage labor began to bifurcate, or divide into two branches. One branch is the core of relatively stable, skilled, well-paid labor. The other branch is the periphery of periodic or seasonal (often referred to as casual) low- wage labor. In the new global division of labor, the upper tier of jobs is found disproportionately in the wealthy advanced industrialized

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countries, and the lower tier of jobs is found disproportionately in the previously colonized countries. Recently, bifurcation of labor has occurred all over the world, in advanced industrial societies as well as in poor, newly industrializing societies (McMichael, 2017). Work in the core is usually full time and comes with nonwage compensation such as sick leave, health insurance, and retirement benefits. Work in the periphery is usually part time and/or temporary, with many working on a contract basis, and it provides few if any nonwage benefits. Use of such casual, irregular low-wage labor provides employers with a lot of flexibility as they try to stay competitive. Workers in the periphery often work very long hours in crowded and unsafe workplaces, and, if they are women like Leticia Renteria, they may cope with sexual harassment on the job. Women have been reported to compose 70% to 90% of the temporary workers in advanced industrial societies, but recently many jobs historically performed by middle-class men are being filled by contract workers who do not receive the nonwage benefits once associated with these jobs (McMichael, 2017). In the United States, the period of labor force bifurcation has been accompanied by a precipitous increase in CEO salaries and stagnation in wages of other workers. The CEO-to- worker compensation ratio was 20:1 in 1965, peaked at 376:1 in 2000, and was 303:1 in 2014 (Mishel & Davis, 2015). This is a much higher CEO-to-worker compensation ratio in the United States than in most other countries. In Switzerland, the country with the second largest ratio, chief executives, on average, make 148 times what the average worker makes. The ratio is 29:1 in Poland, 36:1 in Austria, 48:1 in Denmark, and 58:1 in Norway (Ferdman, 2014). This is an important contributor to growing inequality in the United States.

3. Outsourcing. Outsourcing relocates the production of goods and services from one place to another as a strategy to reduce costs. Today, when we think of globalization, we tend to think first of outsourcing, like the outsourcing of the production of athletic shoes noted earlier. Industrial products are manufactured and assembled in export zones of poor countries with low wages and few or nonexistent labor and environmental protections and then shipped to wealthier consumers around the world (Sernau, 2017). Information and communication technologies allow corporations to coordinate these outsourcing projects. Under neoliberalism, governments as well as corporations have been outsourcing service contracts. Again, information and communication technologies have allowed the

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outsourcing of such activities as call centers, graphic design, computer programming, and accounting. In an interesting twist to the outsourcing trend, as wages have risen in India, India began to outsource some of the work outsourced there to other countries such as the Philippines, Thailand, Poland, China, and Mexico (McMichael, 2017).

4. Displacement. Automation and outsourcing of work sheds stable jobs. At the beginning of the 21st century, it is estimated that 1 billion workers, or one third of the world’s labor force, mostly in the Global South, were either unemployed or underemployed (Davis, 2006). Peasants in the Global South were pushed from their subsistence farms as corporate and governmental organizations pressed for monoculture, or the growing of one crop for export purposes, on agricultural land. They were pulled to low-wage, insecure work in urban export zones. As corporations and governments sought more flexibility in hiring the workforce, more workers in the Global North, particularly in the United States, became involuntary part-time workers, or casual laborers working on a contract basis with no job benefits or job security (Ritzer, 2016). In both wealthy and poor nations, people have increasingly worked “off the books” as servants to the wealthy. It is estimated that 50% of the workers in the Global South work in the shadow, also called underground, economy of illegal or undeclared work (McMichael, 2017).

5. Labor exportation. Migration for the purpose of finding work is not a new phenomenon, but it has become an important part of economic globalization. As many formerly colonized countries struggled to repay debt incurred during the 1980s, exporting workers became a way for countries to gain access to foreign currency. First, labor migrants in the Global South moved to other areas within their region, from the farms to the cities. When cities became overburdened, laborers began to migrate to northern regions. In 2013, the World Bank estimated that nearly 1 billion people, one in every seven in the world, had migrated either internally or across international borders to seek better opportunities. It further reports that remittance flows to developing countries more than quadrupled from 2000 to 2012. It suggests that labor migration and remittances from the migrants to folks back home offer a vital lifeline for many countries. For example, Indonesian villages use remittances to finance schools, roads, and housing (McMichael, 2017). Although they are struggling financially, Leticia Renteria and Marcos Vargas are committed to

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sending remittances back home to Mexico because they are well aware of the extreme poverty in which many of their relatives live. A majority of labor migrants are women and children, and both women and children are vulnerable to human trafficking. Human trafficking, or the trade in humans, has received increasing global attention in the past decade (World Health Organization, 2012). Labor-related trafficking occurs in a wide range of labor sectors, including domestic servitude, hospitality services, agriculture, fishing, manufacturing, mining, and construction. Women and children may also be forced to serve as wives. Trafficking, then, is a form of modern-day slavery. Although it is difficult to find reliable data on the extent of trafficking, Polaris (2018), an organization that runs a national human trafficking hotline, estimates that the number of victims in the United States reaches into the hundreds of thousands annually.

6. Limited protection by organized labor. Since the beginning of industrial capitalism, labor unions have been the force behind governmental protection of workers’ rights, fighting successfully for such protections as workplace safety, a minimum wage, a reduced workweek, and pensions. Economic globalization has seriously weakened the bargaining power of nationally based labor unions, because companies can always threaten to take their business somewhere else. In the United States, the rate of union membership, or the percentage of all workers who are union members, decreased from 20.1% in 1983 to 10.7% in 2016 (Desilver, 2015; U.S. Bureau of Labor Statistics, 2017a). However, labor unions are still strong in some countries. Exhibit 9.5 shows data on the rate of union membership in selected countries in 2015. You might notice that the five countries with the highest rate of union membership are among the six countries with the lowest rates of inequality. In the United States, the union membership rate of public-sector workers (ranging from 27.5% to nearly 42%) is more than 5 times that of private-sector workers (6.6%) (Desilver, 2015). The two groups with the highest unionization rates in the United States are protective service occupations (police officers, firefighters, and security guards) and education, training, and library occupations. Both groups have unionization rates of 35.3% (Desilver, 2015). Long (2013) compared the wages of union workers with the wages of nonunion workers during the period of 2001 to 2011 and found that union wage levels have been consistently higher than nonunion wages. In 2011, union workers had an average wage of $23.02 per hour compared to $19.51

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per hour for nonunion workers.

Exhibit 9.5 ● Proportion of Employees in Unions (%) in Selected Countries in 2015

Sources: Government of Canada, 2016; U.S. Bureau of Labor Statistics, 2017a; Worker-Participation.EU, 2016.

Social workers who participate in policy development must be informed about the serious challenges to job security in the contemporary era. They are also called on to deal with many of the social problems arising out of these changes in the economic institution—problems such as displaced workers, inadequate resources for family caregiving, domestic violence, substance abuse, depression, and anxiety.

Critical Thinking Questions 9.2

What have you heard about the benefits of economic globalization? What have you heard about harms from economic globalization? What do you make of the controversy about whether economic globalization is a good or bad thing? How is economic globalization affecting the government institution? How is economic globalization affecting Leticia Renteria and her family?

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Trends in the Educational Institution Leticia Renteria and Marcos Vargas know that education is important for their children, but they are not sure how to help their children succeed at school. Traditionally, the primary purpose of the educational institution has been to pass along formal knowledge from one generation to the next —a function that was largely performed by the family, with some help from the religious institution, until the 19th century. Formal education, schooling that includes a predetermined curriculum, has expanded dramatically around the world in the past several decades, and yet there are parts of the world where formal education is minimal.

In 2015, several international organizations worked together to organize the World Education Forum 2015 in Incheon, Republic of Korea. The participants adopted the Incheon Declaration for Education 2030, which presents a vison for world education for the next 15 years. The goal is to “ensure inclusive and equitable quality education and promote lifelong learning opportunities for all” (UNESCO, 2015). Guidelines for meeting this goal include the following:

1. Ensure that all girls and boys complete free, equitable, and quality primary and secondary education.

2. Ensure that all girls and boys have access to quality early childhood development, care, and preprimary education so that they are ready for primary school education.

3. Ensure equal access for all women and men to affordable and quality technical, vocational, and tertiary education, including university.

4. Substantially increase the number of youth and adults who have relevant skills, including technical and vocational skills, for employment, decent jobs, and entrepreneurship.

5. Eliminate gender disparities in education and ensure equal access to all levels of education and vocation training for the vulnerable, including persons with disabilities, Indigenous peoples, and children in vulnerable situations.

6. Ensure that all youth and a substantial proportion of adults, both men and women, achieve literacy and numeracy.

7. Ensure that all learners acquire the knowledge and skills needed to promote sustainable development.

The last guideline related to sustainable development is a new guideline

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not previously included in goals for international education, consistent with growing international concern about the global climate crisis.

In an era of a knowledge-based global economy, there continue to be large global gaps in opportunities for education, as reflected in UNESCO’s 2016 Global Education Monitoring Report. There is much evidence of long-term benefits of quality early childhood education, but in low- and middle- income countries, 3- and 4-year-old children in the richest households are almost 6 times as likely as the poorest children to attend early childhood education. Almost 30% of the children from the poorest households in low-income countries have never been to school. Gender parity in education has been achieved at the global level, but not in all countries. In sub-Saharan Africa, there is growing gender parity among the richest 20%, but among the poorest 20%, only 83 females per 100 males completed primary education, and this ratio drops to 40 females per 100 males in upper secondary school. From 2005 to 2014, 15% of global adults lacked functional literacy skills, and 63% of these were women. Lack of access to primary school education in low-income countries was worsened by conditions the World Bank set on debt refinancing in the late 1980s, which mandated reductions in education expenditures. The result was reduced educational levels in Asia, Latin America, and Africa and a widening gap in average years of education between rich and poor countries (McMichael, 2017).

Nations around the world structure their educational systems in different ways, and we have heard a lot in this era of intensified global competition about how educational outcomes in the United States stack up against those in other high-income countries. U.S. educational historian Diane Ravitch (2013) sums up much of what I have heard from the mass media:

In the early years of the twenty-first century, a bipartisan consensus arose about education policy in the United States. Right and left, Democrats and Republicans, the leading members of our political class and our media elite seemed to agree: Public education is broken. Our students are not learning enough. Public schools are bad and getting worse. We are being beaten by other nations with higher test scores. Our abysmal public schools threaten not only the performance of our economy but our national security, our very survival as a nation. This crisis is so profound that half measures and tweaks will not suffice.

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Schools must be closed and large numbers of teachers fired. Anyone who doubts this is unaware of the dimensions of the crisis or has a vested interest in defending the status quo. (p. 3)

Ravitch (2010) provides some context for this contemporary concern about the U.S. educational institution. Her historical research taught her that in almost every decade of the 20th century, critics loudly proclaimed that the public education system was in crisis. The nature of the proposed crisis shifted over time: Sometimes the schools were considered too academic and not sufficiently tied to the needs of the industrial economy, and other times the schools were attacked for their lack of academic rigor. Most recently, the proposed crisis in the educational institution has focused on the achievement gap between children of different racial and ethnic groups, but contemporary criticisms also emphasize the poor performance of U.S. students on international tests. Just as the nature of the proposed crisis has shifted over time, so has the nature of the proposed solutions, with each generation of policymakers assuming they have found the “silver bullet” to “fix” the educational institution.

Exhibit 9.6 ● Comparison of PISA Scores for 15-Year-Old U.S. Students With Students From Other Wealthy Countries Exhibit 9.6 ● Comparison of PISA Scores for 15-Year-Old U.S.

Students With Students From Other Wealthy Countries

Literacy Area

Scores of U.S. Students Compared With Students From Other Wealthy Countries

Mathematics

• The average score for U.S. students was 470, compared with an average score of 490 for all students tested.

• 6% of U.S. students scored at the proficiency level (highest level), compared with 11% of all students tested.

• The U.S. average score was higher than 28 education systems, lower than 36 education systems, and about the same as 5 education systems.

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Science

• The average score for U.S. students was 497, compared with an average score of 501 for all students tested.

• 9% of U.S. students scored at the proficiency level, compared with 8% of all students tested.

• The U.S. average score was higher than 39 education systems, lower than 18 education systems, and about the same as 12 education systems.

Reading

• The average score for U.S. students was 497, compared with an average score of 493 for all students tested.

• 10% of U.S. students scored at the proficiency level, compared with 8% of all students tested.

• The average score for U.S. students was higher than 42 education systems, lower than 14 education systems, and about the same as 13 education systems.

Source: Based on Kastberg, Chan, Murray, & Gonzales, 2016.

The story told by the mass media is often one of decline in the educational institution. For example, a 2010 Newsweek story indicated that “once upon a time, American students tested better than any other students in the world. Now, ranked against European schoolchildren, America does about as well as Lithuania, behind at least 10 other nations” (Thomas, Wingert, Conant, & Register, 2010, p. 24). Let’s take a closer look at that story of decline. As I write this, I am looking at the most recent performance (2015) of U.S. 15-year-old students on testing by the Program for International Student Assessment (PISA). The results for the three literacy areas—math, science, and reading—are summarized in Exhibit 9.6, along with a comparison of U.S. student scores with scores of students from other high-income countries. Overall, 14 education systems had higher average scores than the United States did in all three literacy areas. The average scores of U.S. students were about the same as the average for all students in science and reading but below the average in mathematics. The U.S. average scores in science and reading in 2015 were about the same as in previous assessment years, but the average scores in mathematics were

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12 points lower than in 2012 and 18 points lower than in 2009 (Kastberg, Chan, Murray, & Gonzales, 2016). So it is, indeed, true that U.S. students are not the top-ranked students in international testing. But is this a sign of decline of the U.S. educational institution? Long-term data suggest not. In fact, there has not been a time when U.S. students were first on international tests. When the first international tests were administered in the mid-1960s, U.S. students ranked at or the near the bottom of all students tested. In the 1970s, 1980s, and 1990s, U.S. students typically scored in the bottom quartile or near the international average (Ravitch, 2010). The story told by these data is that U.S. students do not stand out on international tests but are not faring worse over time, nor are they faring much better after the past 16 years of ongoing national policy experiments. National test scores tell a different story, a story of constant improvement over time. U.S. fourth and eighth grade students have made significant, even remarkable, gains in national reading and mathematics test scores since 1978 (Ravitch, 2013; Rothstein, 2011).

But what of the recent concern about the achievement gap between White and minority students of color, more specifically Black and Hispanic students? This is a more complicated question. There is, no doubt, a very substantial gap between the educational achievement of the White and Black populations in the United States, a gap that is as old as the nation, and there is strong evidence of a White–Hispanic gap as well. Paul Barton and Richard Coley (2010) of the Educational Testing Service examined the White–Black gap in educational achievement from the beginning of the 20th century to 2010. They found a large reduction in the gap in the 1970s and 1980s, when Black students made greater gains than White students. They also found that improvement in reducing the gap stagnated in the 1990s, and progress has continued to slow since that time. The gap remains large. Ravitch (2013) provides evidence that Black and Hispanic students have continued to make impressive gains since 1990, but White students have been making gains as well, slowing the pace of reduction in the gap. For example, in 1990, 83% of Black fourth graders and 67% of Hispanic fourth graders scored “below basic” in mathematics; in 2011 the percentages dropped to 34% for Black fourth graders and 28% for Hispanic fourth graders. The improvements in reading scores were not as dramatic but impressive nonetheless. The Black–White academic achievement gap is now smaller than the achievement gap between the poorest and most affluent students in the United States (Reardon, 2011). The income achievement gap has been growing for the past 50 years and

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continues to increase. Carnoy and Rothstein (2013) argue that given the high rate of inequality in the United States, it is impressive that the average scores of U.S. students on international tests are as high as they are because there is clear evidence that around the world children from low- income families do not perform as well academically as children from middle- and high-income families.

This analysis suggests that the U.S. educational institution needs some improvement, but it does not suggest an institution in a crisis of steep decline as the architects of recent policy experiments have often suggested. Since the beginning of the 21st century, two national policy experiments have created instability in the U.S. educational institution: the 2001 No Child Left Behind (NCLB) legislation passed during the George W. Bush administration and the Race to the Top policy direction of the Obama administration. The stated goals of both policies were to raise academic achievement for all students, out of concern that U.S. students are falling behind those in other wealthy nations, and to close the achievement gaps that divide low-income students and students of color from their peers. Both NCLB and Race to the Top greatly expanded the role of the federal government in the educational institution, but they also favored the neoliberal principles of privatization and market competition. Even though both policies had wide support across the political spectrum, the data do not support the success of these two policy initiatives. There is increasing international evidence that the achievement gap is highly correlated with economic inequality, and school policy has limited impact. Students begin their journey through the public school system with an already existing achievement gap. Changes in the governmental and economic institutions would be the most effective way to close that gap. There is clear evidence that the most effective educational changes for reducing the achievement gap are quality early childhood education and smaller class size (Ravitch, 2010; Schweinhart, Barnett, & Belfield, 2005). Testing alone has not proven to raise student scores (Ravitch, 2013), and reliance on test-based teacher and school accountability has led to score inflation and cheating in some school systems. When schools have been closed and replaced by new charter schools, the charter schools have not performed better than the closed schools (Gleason et al., 2010). Betsy DeVos, secretary of education in the Trump administration, has moved toward greater privatization of the nation’s public school system, with greater emphasis on charter schools.

Diane Ravitch (2010) reminds us that the U.S. educational institution has

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contended with three major policy changes in the government and political institution since 1960. First, legally sanctioned racial segregation of schools came to an end. Unfortunately, the legal rulings that ended it were followed by the flight of Whites and middle-class Blacks from some urban schools, leaving behind school districts struggling with racial isolation and concentrated poverty. Second, court rulings and legislation required public schools to serve students with disabilities. This change in policy direction was long overdue but also expensive and challenging for the schools. Third, changes in federal immigration policy brought millions of non- English-speaking students into the public schools. In addition, the educational institution has needed to adjust to changes in the family institution (to be discussed shortly), growing societal inequality, and ever- changing information and communication technology. In recent years, teachers and school administrators have had to live with persistent attacks from politicians and the mass media. Another recent trend is the entry of for-profit colleges and universities at the tertiary educational level.

Around the world, citizens and leaders are concerned about whether their educational institution is responding well to globalization and the rapid pace of change in other institutions (Ballantine et al., 2018). Certainly, there is a need for improvement in the U.S. educational institution, and it makes sense to look for ideas from the countries that have successful educational institutions based on two criteria: First, their students score well on international testing, and second, their students’ socioeconomic status does not have a large impact on learning outcomes. Evidence suggests that the best educational outcomes occur in countries where there are universal early childhood education programs; where the teachers are well-trained, experienced, well-paid, highly respected, and given professional autonomy; where the curriculum is broad-based and rigorous; and where there are resources to address the needs of students in every school (Ravitch, 2013; Ripley, 2013; Tucker, 2011).

Leticia Renteria and Marcos Vargas value education for their children but are intimidated by the schools their children attend. The children are often aware of their parents’ lack of comfort in interacting with the school. Social workers can help schools and parents become more comfortable with each other. Social workers should also become active partners in efforts at educational reform, particularly those that equalize educational opportunities, but to be effective in these efforts, we need to be informed about trends in the educational institution. By the time you read this, the

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public conversation about the educational institution and ways to improve it may have shifted again. We must carefully evaluate whether what we see and hear in the mass media about circumstances in the educational institution are supported by available evidence.

Photos 9.3A & 9.3B The contrast between these two classrooms— one in a well-resourced suburban school in the United States and the other on a footpath in Ahmedabad, India—demonstrates global inequality in resources for education.

Trends in the Health Care Institution Health is an important issue for Leticia Renteria and her family. Leticia is concerned that environmental hazards are the cause of her children’s asthma. She is happy that the children are able to receive health care at the community clinic and hopes to stay healthy herself because she does not qualify for health care assistance. Health is important to this family, but health is also important to a society. Child development, adult well-being, and family stability are all affected by health. The health care institution is the primary one for promoting the general health of a society. At one time, health care was addressed primarily in the home, by families. Today, in wealthy countries, health care is a major social institution, and health care organizations are major employers (Ballantine et al., 2018).

Unfortunately, there is much disparity in the global health care institution, both between and within countries (Organisation for Economic

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Cooperation and Development [OECD], 2017; World Health Organization, 2017b). Global inequalities in child and adult mortality are large and growing. They are highly influenced by factors in the economic institution and the health care institution but also by factors in the educational institution and the family institution. In 2016, globally, nearly half of all deaths of children under the age of 5 were attributable to undernutrition. Although more children of the world survive their 5th birthday than ever before, 5.6 million children younger than age 5 died in 2016, about 15,000 per day. Children in sub-Saharan Africa are more than 15 times more likely to die than children in high-income countries (World Health Organization, 2017c).

In poor countries, basic health prevention and treatment services have been slowly improving, but serious gaps remain. In 2015, 71% of the global population had access to safe drinking water on their premises, and 89% were within a round trip of 30 minutes to collect water (World Health Organization, 2017d). One in three people of the world are without sanitation facilities, including 946 million people who defecate in the open. Access to adequate water and sanitation are vital to the prevention and care of 17 neglected tropical diseases (World Health Organization, 2017e). The World Health Organization (2017e) identifies 17 tropical diseases referred to as “neglected” because they have not received the attention of pharmaceutical companies in the past. The people affected by these diseases typically are the poorest in the world and live in remote, rural areas; urban slums; or conflict zones. The diseases are caused by unsafe water, poor housing conditions, and poor sanitation. You may be as shocked as I am that Leticia Renteria and her family, living in the United States, have neither safe drinking water nor adequate sanitation.

Within-country health disparities are very prominent in the United States, where deep inequalities are related to socioeconomic status, race, and ethnicity, and poverty is seen as the driving force behind the growing health disparities (Centers for Disease Control and Prevention [CDC], 2013). Research consistently finds that life expectancy increases as personal income increases (Burtless, 2012). The infant mortality rate for non-Hispanic Blacks is more than double the rate for non-Hispanic Whites, and the rates are higher in the South and Midwest than in other parts of the country. Non-Hispanic Black adults are 50% more likely than other adults to die of heart disease or stroke before age 75. Compared with Asian and non-Hispanic White adults, the prevalence of diabetes is higher

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among Hispanic and non-Hispanic Black adults, as well as among adults of mixed races. The prevalence is also higher among adults with lower incomes (CDC, 2013). It is clear that race and social class critically impact health disparities in the United States. Even at the higher ends of education, there are large health gaps between African Americans and Whites (Williams, Mohammed, Leavell, & Collins, 2010).

Although much of the health disparities in the United States are related to factors in other social institutions, aspects of the health care institution play a large role. The United States is the only one of the comparison countries used in this chapter without universal health coverage (OECD, 2017). The uninsured rate in the United States dropped considerably after the passage of the Affordable Care Act in 2010, from a high of 18.2% of the nonelderly population in 2010 to 10.3% in 2016 (Kaiser Family Foundation, 2017b). News reports suggest that the uninsured rate increased to 12.2% in 2017 (Bryan, 2018). Most uninsured people are in low-income families and have at least one employed family member. Adults are more likely to be uninsured than children, and people of color are more likely to be uninsured than non-Hispanic Whites (Kaiser Family Foundation, 2017b).

Ballantine and colleagues (2018) suggest that the United States has both the best and the worst health care system among wealthy countries. It is one of the best in the world in terms of quality of care, trained practitioners, facilities, and medical technology. But it is the worst in terms of costs, inefficiency, equality of access, and fragmentation and competing interests. As demonstrated in Exhibit 9.7, the United States spends a much greater percentage of its GDP on health care than any of the other wealthy countries covered in this chapter, but this expenditure does not pay off in terms of the most often used measure of the health of a nation, life expectancy.

Exhibit 9.7 ● Health Spending as Percentage of GDP (2014) and Average Life Expectancy at Birth (2015) in Select Countries Exhibit 9.7 ● Health Spending as Percentage of GDP (2014) and

Average Life Expectancy at Birth (2015) in Select Countries

Country Percentage of GrossDomestic Product Spent Average Life Expectancy at Birth

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United States 17.1% 79

Sweden 11.9% 83

Switzerland 11.7% 83

France 11.5% 83

Germany 11.3% 81

Netherlands 10.9% 82

Denmark 10.8% 81

Belgium 10.6% 81

Canada 10.4% 82

Japan 10.2% 84

Norway 9.7% 82

Finland 9.7% 81

Australia 9.4% 82

Austria 9.4% 82

Italy 9.2% 83

United Kingdom 9.1% 82

Spain 9.0% 83

Ireland 7.8%s 82

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Source: World Bank, 2017b, 2017c.

The reasons why the health care institution is so costly in the United States are quite complex, but two contributing factors are discussed here. First, compared with the health care systems in other countries, the U.S. approach to financing health care is extremely complex, and the administrative cost of this complex system is greater than in the more streamlined universal systems in other industrialized countries (Reinhardt, Hussey, & Anderson, 2004). Second, the health care institution is influenced by culture. Health care in the United States reflects the aggressive, can-do spirit of the mainstream culture (Gardiner, 2018). For example, compared with European physicians, U.S. physicians recommend more routine examinations and perform many more bypass surgeries and angioplasties than European doctors. These are both examples of a more aggressive approach to treatment that could be attributed to a reimbursement system that rewards such aggressiveness as much as to a cultural bias toward aggressive treatment (Reinhardt, Hussey, & Anderson, 2002).

Societies around the world struggle with health care costs and quality, access to care, and medical technology (OECD, 2017; Rapoport, Jacobs, & Jonsson, 2009). Most governments in Europe made a decision in the late 1800s and early 1900s to support health care as a human right and put some form of national health care system into place. It appears that they were operating out of a belief that maintaining a healthy population is necessary to maintain a strong society (Ballantine et al., 2018). In the United States, health care has not been viewed as a human right, historically, and the health care system developed with less direction and made piecemeal policies over time. Medical research has been a major strength in the U.S. health care system, but the two biggest challenges in the past 3 decades have been lack of universal access to care and continuously escalating costs. Access to health care was improved with the passage of Medicare and Medicaid in the 1960s, but large numbers continue to have no health care insurance. Several attempts were made to develop federal legislation to address these problems for a number of decades, but these efforts failed because politicians had conflicting philosophical positions on the role of government in health care delivery and because of considerable opposition from private insurance companies, physicians, and pharmaceutical companies.

After a year-long contentious debate, the U.S. Congress passed the Patient

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Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, and both bills were signed into law in March 2010 and are now generally known as the Affordable Care Act. The health insurance reforms were to roll out over several years. Here were some of the key pieces of the legislation (Cockerham, 2012; U.S. Department of Health and Human Services, 2017):

Young adults can stay on their parents’ health insurance policies until age 26. People with Medicare can get key preventive services for free and receive a 50% discount on drugs in the “donut hole.” An additional 32 million people were to be covered by health insurance by 2014, and it was projected that 95% of people in the United States will be covered by the end of 2018. Medicaid coverage was expanded for the poor, extending coverage to people with incomes of up to 133% of the federal poverty line. Almost all people were required to have health insurance (individual mandate) or be fined. Employers with more than 50 employees were required to provide health insurance for their employees or be fined. Health insurance companies are unable to reject applicants because they have preexisting conditions, charge excessive rates, or cancel policies after policyholders become sick.

As this book is being prepared for production, the future of this health care reform is uncertain. Several states challenged the legality of the law, and the challenges went to the U.S. Supreme Court in 2012. The Supreme Court upheld the individual mandate provision but ruled that states could refuse to participate in the Medicaid expansion piece of the legislation. In 2017, 33 states and the District of Columbia participated in Medicaid expansion (Families USA, 2018). Republican senators and representatives continue to challenge the health care reforms, and the House of Representatives has voted to repeal the law so many times I have lost count. Individual states were encouraged to create their own health care exchanges to assist the uninsured in getting enrolled in insurance plans, but by 2018, only 23 states and the District of Columbia had their own state- based marketplace rather than relying on the federally facilitated marketplace (Kaiser Family Foundation, 2018). The rollout of the federal government exchange in October 2013 had massive technical problems that were mostly worked out by early December 2013. Early in the

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formulation of the policy, a public insurance option, whose intent was to keep prices down by competing with private insurance, was dropped from the plan. It was hoped that Medicaid expansion would lower the costs for many people, but the Supreme Court made that piece optional. The hopes for cost containment rest to a great extent on the willingness of currently uninsured healthy young adults to become insured and join the risk pools of insurance companies. This is key to lowering the overall costs of insurance. The tax bill passed by Congress in 2017 eliminated the penalty for not having insurance coverage, thereby killing the individual mandate of the ACA (Luhby, 2017). We continue to be a deeply divided country about the appropriate role for government in the health care institution. Stay tuned.

Like many other families, the family of Leticia Renteria may need social work assistance to navigate the very complex, quite fragmented health care system if the children’s health problems worsen. Social workers need to be particularly sensitive to the situation of some immigrant families who try to integrate traditional healing traditions with Global North, technology- oriented medical practices.

Critical Thinking Questions 9.3

As this chapter was being written, there were many conflicting stories in the mass media about the performance of both the educational institution and the health care institution in the United States. How is what you have seen in the mass media about these social institutions in the past month similar to and different from what is reported in this chapter? How do you understand the strengths and limitations of these two social institutions in the United States, as compared with their counterparts in other wealthy countries? Why are these social institutions so controversial in the United States?

Trends in the Social Welfare Institution People in the community where Leticia Renteria and her family live are very excited about the new Boys and Girls Club in the nearby town. However, Leticia has heard many stories that make her fear the U.S. social welfare institution. Although food stamps and cash assistance programs might help bring some economic stability to the family, Leticia fears that receiving such assistance would make her children vulnerable to

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oppressive governmental intervention later in life. Her decision to voluntarily depart when she was faced with immigration detention was driven by fears about her children being placed in the state foster care system. Social workers working in such situations must have a good understanding of the special stressors of undocumented immigrants. We can play an important role in such communities to counter misinformation about social welfare services, such as some of what Leticia has heard. As social workers, we are well aware of the network of social welfare agencies and programs that could help such families; we are also aware of the gaps in the contemporary social welfare institution.

The social welfare institution is concerned with the fair allocation of goods, services, and opportunities to enhance social functioning of individuals and contribute to the social health of the society. The social welfare institution also engages in social control, in programs such as child and adult protective services. The social welfare institution developed in all industrialized countries in the 19th and 20th centuries as these nations tried to cope with the alienation and disruption caused by social inequalities of industrial market capitalism (Teeple, 2000). It was an expression of altruism toward the people who did not fare well in this economic arrangement, but it also was an expression of concern that the inequalities inherent in the system could destabilize a society and undermine its social health.

The social welfare institution, like any other social institution, reflects the culture of the society. Social welfare scholars often call attention to the cultural attitudes toward social welfare in the United States compared with European countries (Karger & Stoesz, 2018). The U.S. social welfare institution has, historically, put primary emphasis on promoting independence and preventing dependence. In contrast, the European social welfare states have put more emphasis on promoting social inclusion and using the social welfare institution as an investment to protect the health of the society, which they refer to as social protection (European Commission: Employment, Social Affairs & Inclusion, 2017; Sernau, 2017). Exhibit 9.8 demonstrates that public expenditure on social welfare (including old age, survivors, disability, health, family, unemployment, housing, and other policies), as a percentage of GDP, varies among affluent societies. It also demonstrates that public expenditures on social welfare increased in most affluent societies from 1990 to 2016. Almost all of the listed countries made a substantial increase in the percentage of

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GDP spent on social welfare after the 2008 financial crisis.

Exhibit 9.8 ● Public Social Expenditures on Social Welfare as a Percentage of GDP in 1990 and 2016

Exhibit 9.8 ● Public Social Expenditures on Social Welfare as a Percentage of GDP in 1990 and

2016

Country 1990 2016

France 24.3% 31.5%

Finland 23.3% 30.8%

Belgium 24.4% 29.0%

Italy 20.6% 28.9%

Denmark 22.0% 28.7%

Austria 23.2% 27.7%

Sweden 27.2% 27.1%

Germany 15.7% 25.3%

Norway 21.4% 25.1%

Spain 21.6% 24.6%

Japan 19.2% 23.1%

Netherlands 18.2% 22.0%

United Kingdom 15.2% 21.5%

Switzerland 12.1% 19.7%

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United States 13.2% 19.3%

Australia 13.1% 19.1%

Canada 17.6% 17.2%

Ireland 16.8% 15.2% Source: OECD, 2016b.

Four things are important to remember when interpreting this trend. First, countries suffered a decline in GDP during and in the aftermath of the 2008 financial crisis, as always occurs at such times (Papell & Prodan, 2012). Second, in the midst of economic decline, many countries stepped up their social welfare expenditures in some areas to cushion the blow of the crisis and stimulate the economy. Third, in the immediate aftermath of the financial crisis, governments around the world were being encouraged to engage in austerity measures, including trimming back the social welfare institution. Fourth, even though public expenditures for social welfare had been growing as a portion of GDP, it is important to note that as wealthy societies have higher proportions of late-life adults, expenditures on old-age benefits are increasing at a much faster rate than those in other social welfare sectors. In many affluent countries, government expenditures for children and families have been falling, and child poverty rates have been growing whereas poverty rates for older adults have not (UNICEF, 2012). Given what we are learning about the long-term negative health consequences of early deprivation, cost cutting in programs serving children and their families in order to fund programs for older adults could pose serious challenges for the social welfare institution in the future. For all wealthy nations, the social welfare needs of an aging society pose a serious challenge for the social welfare institution going forward.

Social welfare policy is driven by political and economic philosophies. The United States is a diverse society, and there is much competition of ideas about what constitutes the public good and what type of social welfare institution is needed, if at all. Although the philosophical differences are more complex than this, we can divide them into conservative and liberal views of social welfare. Conservatives believe that the public good is best served when the federal government has a minimal

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role in social welfare. They believe that to the extent that social welfare programs are needed, they should be run by a combination of state and local governments and the private sector. They believe that income inequality and some level of unemployment are good for society, and any attempt by the government to stabilize the economy is harmful. Liberals believe that the government institution, particularly the federal government, should be the primary force in the social welfare institution because it is the institution most capable of promoting social justice, thereby promoting the public good. In their view, social justice is incompatible with high levels of inequality and unemployment, and the government has a role to play in minimizing the harms of market capitalism (for a fuller discussion, see Karger & Stoesz, 2018).

Social welfare policy in the United States, as in any society, varies with who holds political power at any given time and has shifted over time. From the 1930s to the 1970s, beginning with the presidency of Franklin Delano Roosevelt, the general policy direction was for the federal government to play a strong role in the social welfare institution. The Social Security Act of 1935 began a process of government protections that was expanded during the 1960s and 1970s, with the passage of Medicare, Medicaid, the Food Stamp Program, and Head Start, among other programs (Marx, 2012). In the late 1970s, the traditional liberal belief in a federally based social welfare system began to lose favor. The new liberals (neoliberals) began to assume some of the conservative philosophy, which led to a diminishing sense of public responsibility and an increasing emphasis on individual responsibility for the social well- being of the nation. Neoliberal philosophy, under the democratic administration of Bill Clinton in the 1990s, led to welfare reform that greatly curtailed supports to poor children and their families. Since the 1980s, the conservative philosophy has been in ascendancy with ongoing attempts to privatize social security (unsuccessful to date) and to otherwise limit the role of the federal government in the social welfare system. (At the same time, however, cultural conservatives have called for an increased role for the federal government in issues such as contraception, abortion, and school prayer.) With a huge federal debt caused by tax cuts, two wars, and a financial crisis, it does not appear that a liberal philosophy of social welfare will regain prominence in the near future.

The data cited in Exhibit 9.8 indicate that 14 of the 17 wealthy countries used as comparison in this chapter devote a greater percentage of their

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GDP to public social welfare expenditures than the United States. We must be careful in interpreting the data, however. Given ambivalence about government and a strong belief in the market, the United States has developed a mixed social welfare system made up of federal, state, and local governmental programs; private nonprofit social welfare organizations; and a growing number of private for-profit organizations. It is hard to compare this system with the European model in terms of expenditures, but it is safe to say that the welfare institution in the United States is more fragmented than the European model, and its family support policies, such as family leave, family allowances, and early childhood education and care, are much less comprehensive. Indeed, the European countries are not alone in providing more generous public support to families than is offered in the United States. Parental leave policies are a good example. In the United States, parents are offered 12 weeks of unpaid leave under the Family and Medical Leave Act, which exempts companies with fewer than 50 paid employees. All other wealthy countries used as comparison in this chapter as well as many low- and middle- income countries provide paid parental leave. For example, Estonia offers more than a year and a half of paid leave to new parents. A number of other countries—Austria, Bulgaria, Czech Republic, Hungary, Japan, Latvia, Lithuania, Norway, and Slovaka—offer over a year’s worth of leave. Although most countries offer more leave for mothers than for fathers, at least 31 countries provide some leave for fathers. In most countries with paid family leave, a social security–type system is used to fund the paid leave. Many countries reimburse about 100% of average earnings, but some only pay a portion of the missed earnings. Although the United States does not have a national paid leave policy, a few states and some corporations provide paid leave (Livingston, 2016).

How should we evaluate the performance of the social welfare institution? It is not a simple matter to consider how a given society’s social welfare system is doing with allocating goods, services, and opportunities to enhance social functioning of individuals and contribute to the social health of the society. Let’s take a look at two approaches that have been taken to that question.

Annually, the United Nations prepares the Human Development Index (HDI) to rank the social health of nations. HDI rankings are based on a composite of three variables: life expectancy, educational attainment, and income. On this index, the United States has consistently scored in the top

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five countries of the world, based on its high GDP; however, in 2016, the United States had the sixth highest score on the HDI index. As noted earlier, the United States has the lowest life expectancy of the comparison nations. It scores relatively high on educational attainment in terms of number of years of education completed, but student performance on international test scores is not stellar. When the HDI is adjusted for level of societal inequality, the U.S. position in the HDI index falls by 10 places (United Nations Development Programme, 2016).

UNICEF (2012) suggests that child poverty, a measure not included in the HDI, is the best single measure for making international comparisons of the social health of nations. UNICEF proposes that because children are the future of a society, nations pay a large future price for child poverty, in terms of reduced educational achievement, reduced skills, lost productivity, increased unemployment, lower levels of health, increased welfare dependence, increased costs in the criminal justice system, and loss of social cohesion. There is, indeed, growing evidence that childhood poverty is related to most of these social conditions.

According to UNICEF’s 2012 report on child poverty, the United States had the highest rate of child poverty of any of the comparison countries reported in the chapter, using a definition of relative poverty as living in a household with disposable income, when adjusted for family size, of less than 50% of the national median. Four of the countries used for comparison in this chapter—Finland, the Netherlands, Norway, and Denmark—had child poverty rates less than 7%. Six others—Sweden, Austria, Switzerland, Ireland, Germany, and France—had rates from 7% to 10%. A third group of five countries—Belgium, Australia, the United Kingdom, Canada, and Japan—had rates from 10% to 15%. Two other countries—Italy and Spain—had rates from 15% to 20%. The child poverty rate for the United States was 25.5%. UNICEF (2012) also studies the impact of social policy on child poverty rates by considering the child poverty rate before and after taxes and benefits programs. It concludes that social policy makes a considerable difference in the relative child poverty rate. For example, its data indicate that Canada and the United States begin with the same level of relative child poverty (just over 25%), but after taxes and social benefits are calculated, the rate in Canada is about half the rate of the United States. Social policy had the biggest impact on relative child poverty in Ireland, which had a more than 40% rate of relative child poverty before taxes and social benefits but a rate less than 10% after taxes

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and benefits. It is clear that the social health of a society is affected by decisions made in a number of social institutions, including the government and political institution, the economic institution, the educational institution, the health care institution, and the social welfare institution, as well as the family and kinship institution discussed later.

Some welfare scholars suggest a social welfare institution in transition (Karger & Stoesz, 2018). Across the Global North, countries pursued liberal social policies after World War II. As a result of the competition inherent in economic globalization, Western industrial nations have been cutting or slowing the growth of their social welfare programs since the 1970s. At the same time, demand for social services has increased as workers have tried to cope with the insecurities in the global labor market. Retrenchment of the social welfare institution in combination with increased concentration of income and wealth has produced political unrest across Europe and the United States and spurred rage across the political spectrum. In the United States, this rage produced both the conservative Tea Party and the liberal Occupy Movement at the beginning of the 2nd decade of the 21st century. The future of the social welfare institution is uncertain.

Leticia Renteria seems to think of the social welfare institution only as a coercive institution, one that tries to control behavior rather than provide compassionate support. Indeed, the social welfare institution in the United States has always played a social control function as well as a social reform function (Hutchison, 1987). In recent times, it has moved toward greater attention to social control than to social reform (Hutchison & Charlesworth, 2000; Teeple, 2000). Social workers cannot be active participants in moving that balance back to social reform unless they clearly understand trends in the interrelated social institutions discussed in this chapter.

Trends in the Religious Institution Although the Catholic Church was a very important part of the life of Leticia Renteria back in Mexico, she and Marcos do not regularly attend church. However, when Leticia was frantic at being detained by immigration officials, one person she thought might be able to help her was a nun in her community. The religious institution is the primary one for addressing spiritual and ethical issues. It also serves important

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socialization, social control, and mutual support functions. Sociologists study three components of the institution: a belief system, religious rituals, and an organizational structure that provides networks of support as well as roles and statuses (Roberts & Yamane, 2016).

Although there is a long history of conflict and adaptation as the major world religions confronted each other in the same political and geographic areas, globalization has urgently increased the need for religious communities to find ways to coexist globally as well as locally. A religious belief system helps people to feel secure, and exposure to different belief systems can be unsettling and sometimes perceived as a threat to the integrity of one’s own beliefs and identity. Today, however, it is almost impossible for believers in one religious tradition to be isolated from other religious traditions. We are increasingly exposed to the beliefs, rituals, and organizations of diverse religious groups, and this is not a trend that is likely to be reversed. There are few choices about how to cope with this trend. We can attempt to impose one belief system on the world and commit genocide if that doesn’t work. Or we can attempt to find a unified ethical code that is consistent with all religious traditions and respectfully agree to disagree if that doesn’t work, giving legal protections to all groups. In the past, both choices have been put into practice at one time or another.

We have been living in a time of much religious strife. Serbian Orthodox Christians engaged in ethnic cleansing of Muslims in the former Yugoslavia. Catholics and Protestants waged a long and often violent battle in Northern Ireland. The Ku Klux Klan in the United States used religious arguments to vilify and sometimes persecute Jews, African Americans, and other groups. Terrorists have killed and injured thousands in the name of Islam. The United States has called on the name of God, and the language of good and evil, to justify the war on terror and the invasion of Afghanistan and Iraq. Hindus and Muslims kill each other in India. The Druk Buddhists in Bhutan murdered and drove out the Nepali Hindus in order to unite the country under one culture, religion, and language. When religious differences are woven with other forms of struggle, such as social class, ethnic, or political struggle, the conflict is likely to be particularly intense (Kurtz, 2016).

On the other hand, there are also historical and current stories of peaceful coexistence of religious groups. In 1893, representatives of a wide range of

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religions were brought together to create the Parliament of the World’s Religions. The second meeting of the parliament did not convene until a century later, in 1993 (Kurtz, 2016). It met again in 1999, 2004, 2009, and 2015. Another parliament is planned for November 2018. The mission of the parliament is to “cultivate harmony among the world’s religious and spiritual communities and foster their engagement with the world and its guiding institutions in order to achieve a just, peaceful and sustainable world” (Parliament of the World’s Religions, 2018). The theme for the 2018 meeting of the parliament is “The Promise of Inclusion, the Power of Love: Pursuing Global Understanding, Reconciliation, and Change.” Among the issues discussed and debated at the 2015 parliament were climate change, bigotry and hatred, rampant violence, preventable wars, abuses of human rights, unchecked income inequality, reparation and preservation of Indigenous rights, and gender equity.

It is not surprising that both violence and nonviolence have been used in the name of religion. The texts of all the major world religions include what Kurtz and Kurtz (2016) call both a “warrior motif” and a “pacifist motif” (pp. 294–295). All major religions justify violence on occasion, a sacred duty to fight against evil, but no religion justifies terrorism. All religions also prohibit harming others and call for loving one’s enemies. In the contemporary era, Islam is sometimes characterized as a violent religion, but Christianity was seen as the most violent world religion during the Crusades and the Inquisition. All the major world religions have proven capable of perpetrating violence in the name of religion, and all have demonstrated compassion and tolerance.

It is good to get a sense of the global religious landscape. Consider a group of 10 people that represent the distribution of world religions. Three will be Christian, two will be Muslim, two will be unaffiliated or atheists, one will be Hindu, one will be Buddhist or from another East Asian religion, and the remaining one will represent every other religion of the world (Kurtz, 2016). This landscape includes two Eastern religions (Hinduism and Buddhism) and three Western religions (Judaism, Christianity, and Islam). The Western religions are monotheistic, believing that there is only one God, whereas the Eastern religions are either polytheistic, believing in multiple Gods (e.g., Hinduism, some forms of Buddhism) or not believing in a deity (e.g., some forms of Buddhism). Eastern religions are less insistent on the primacy of their “truth” than the Western religions and are more likely to embrace nonviolence. Eastern religions have also tended to

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be less centrally organized than the Western religions.

Each of the major world religions has changed over time and place and become more diverse. Lester Kurtz (2016) suggests that we should speak of all the major world religions in the plural: Hinduisms, Buddhisms, Judaisms, Christianities, and Islams. He also argues that some of the most violent contests occur within these religious traditions and not between them, as experienced by the Christian Catholics and Protestants in Northern Ireland and the Muslim Sunnis and Shias in some Muslim majority countries.

Each of the major world religions, but especially the Western religions, has an internal struggle, sometimes called a culture war, between a branch of traditionalists and a branch of modernists (Kurtz, 2016). Traditionalists believe that moral obligations are rigid, given, and absolute. Modernists believe that moral commitment is conditional and fluid. These two branches often engage in a struggle for the heart and soul of the religious tradition, sometimes using violence to press their case.

Although many religious peoples around the world fear that modernism and postmodernism are destroying religion, there is clear evidence that the religious institution is quite resilient. Public opinion polls consistently report that religion is important in the lives of a great majority of people in the United States (77% in 2016), and yet a great majority of people also believe that religion is losing its influence (75% in 2016) (Gallup News, 2017). International data indicate that people in the United States have much higher weekly attendance at religious services than Europeans; they spend more time in private devotions and more money on religious activities than residents of other advanced industrialized countries. In 2016, about 55% of the U.S. population were church or synagogue members, compared with about 10% in 1776 (Gallup, 2017; Kurtz, 2016). As suggested in Chapter 6, diversity is the hallmark of the religious institution in the United States today, with about 1,500 to 2,000 religious groups represented, about half of them Christian (Kurtz, 2016; Parrillo, 2009). Indeed, the United States might be the most religiously diverse country in the world today.

Christianity remains dominant within the United States, but there are intense culture wars between traditionalists and modernists, with the conflict centering on such issues as the definition of family, the role of women, the beginning and end of life, same-sex relationships, prayer in

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school, and theories of the creation of the world. Both traditionalists and modernists base their arguments on their understanding of biblical texts, but each tends to see the other as immoral. Some examples will help to clarify the competing moral precepts regarding some of these questions. Traditionalists see the push for women’s rights as destructive to the traditional family and motherhood. Modernists see women’s rights as necessary in a just society. Likewise, traditionalists see the gay rights movement as a particularly vicious attack on the traditional family, and modernists see it as a struggle for dignity. Traditionalists argue that school prayer is essential to help students develop a moral code, and modernists argue that it is an intrusion on religious freedom and tolerance. The culture wars are intense because both groups wish for dominance in the political institution.

On the global scale, Kurtz (2016) suggests that each of the world’s major religions has something to offer to the effort to find a way for religious groups to peacefully coexist:

Hinduism: The idea that there are many paths to the same summit Buddhism: The idea that the way to escape suffering is to treat all creatures with compassion Judaism: The idea that we should be a light for others Christianity: The idea of loving one’s enemies Islam: The call for intensity of commitment

Given the clear evidence of the central importance of religion in the lives of billions of people in the world, social workers must become comfortable in assessing the role of religion and spirituality in the lives of their client systems at the individual, family, and community levels. We should not assume that all persons of a religious group hold the same beliefs regarding social issues. But we must be aware of religious beliefs—both our own and those of clients—when working with controversial social issues.

Trends in the Mass Media Institution As she does her household chores, Leticia Renteria often watches television, but she has considered taking a break from TV. More often than not, she feels devalued, frightened, and dismayed by what she sees and hears about such political issues as the minimum wage and immigration

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policy. On the other hand, watching Telemundo (a U.S. network that broadcasts in Spanish with closed captions in both English and Spanish) helps her stay in touch with her Latino heritage and make connections between the English and Spanish languages. Leticia uses social media on her smartphone to stay aware of local immigration enforcement actions and to keep up with what is happening in Mexicali.

The mass media institution is the primary institution for managing the flow of information, images, and ideas among all members of society. Mass media serves an entertainment role for society, but it also influences how we understand ourselves and the world. Mass media technology is the engine of globalization, giving people worldwide immediate access to other cultures and other markets. Rapid advances in electronic communication technology since the 1950s have resulted in widespread access to multiple forms of mass communication—“old media” such as newspapers, magazines, books, radio, television, and film and “new media” such as the Internet, digital television and radio, ever more elaborate multifunctional smartphones, and video games. Electronic media now allow two-way as well as one-way communication, and they can store and manipulate vast amounts of information. The mass media is thoroughly embedded in our daily lives and a larger focus of our leisure time than any other social institution (Hanson, 2017).

Photos 9.4A & 9.4B Mass media technology is the engine of globalization, and people around the world are saturated with images from multiple media forms. In Photo 9.4a, people walk in front of a real estate advertisement board written in six languages. Photo 9.4b shows keyword panels displayed at the Lima Convention Centre (Lima, Peru).

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Hodkinson (2017) suggests that when considering trends in the mass media institution, four elements of media should be considered: media technologies, media content, media industry, and media users (see Exhibit 9.9). There are important trends in each of these elements.

Trends in media technologies.

When the United States was founded, there was only one form of mass media: print. For much of the latter half of the 20th century, U.S. households had access to three television channels, but now there are hundreds of cable and satellite channels (Hanson, 2017). Growth of digital and Internet technology has transformed mass media. New media products have been coming at a very fast clip, giving us new mobile devices (for example, smartphones, tablets, game consoles, e-readers) and new Internet-based outlets (for example, Hulu, Netflix, iTunes, YouTube, Facebook, Twitter, Instagram, Snapchat, Whatsapp). Smartphones and tablets are bringing together several functions, serving as a telephone, a camera, a personal music player, a portable games machine, a video player, a diary, a data search machine, and lots more. All of this can be accomplished wherever we can access Wi-Fi or a high-speed cellular data network. A majority of older adults in the United States are using social media to get news, and a majority of young adults primarily use online streaming to watch television (Bialik & Matsa, 2017).

Trends in media content.

Increasingly, digital media allow individuals to choose and control the content to which they are exposed (Graber & Dunaway, 2018). This means that many of us live in “bubbles” of like-minded people receiving information about the world from the same sources while remaining totally unaware of what content people in other bubbles are receiving from different sources. Concern has arisen about how this is leading to increasing political and cultural fragmentation and polarization. Concern has also arisen about the accuracy (or inaccuracy) of information that spreads rapidly across social media. In 2017, cries of “fake news” were rampant across the political spectrum in the United States. A 2018 Pew Research Center survey in 39 countries found that people around the world

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overwhelmingly report a desire for unbiased coverage about political issues. In many countries, however, they found intense political differences in the views of the accuracy of the media, with the largest political gap occurring in the United States (Mitchell, Simmons, Matsa, & Silver, 2018). A shadow industry has arisen for developers of untrue news stories, and automated social media accounts are being programmed to spread misinformation. Many people see this as a major threat to contemporary societies.

Exhibit 9.9 ● Four Elements of the Mass Media Institution

Source: Based on Hodkinson, 2017, Figure 6, p. 9.

Trends in the media industry.

It is not accurate to speak of a single media industry. Instead there are distinct sectors of media, such as publishing, advertising, television, music, and social media. However, these sectors are becoming blurry as media sectors merge, with the same owners owning print news, book publishing, and film and other entertainment business. Contemporary media markets are overwhelmingly dominated by a small number of powerful, often transnational, companies. There have been many mergers, but mergers have not always been successful, and splits have occurred. For example, after a number of mergers Rupert Murdoch’s News Corporation, an international news and entertainment conglomerate, split into News Corp. (newspapers, information services, and book publishing) and 21st Century Fox (cable, broadcast, film, pay television, and satellite). Each of these entities remains vast in breadth and global reach (Hanson, 2017). In the United States, there is a tradition of private ownership of media industries, but in some parts of the world, media companies are publicly owned. Media companies are increasingly targeting a global market to sell products. For example, Viacom International Media Networks reports that

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it includes many of the world’s most popular multimedia brands seen globally in 700 million households in more than 160 countries and 37 languages (Viacom, 2018). Some critics suggest that the global reach of media companies based in North America and Europe, particularly in the United States, is a form of cultural imperialism through which U.S. cultural values are spread around the world (Croteau & Hoynes, 2014).

Trends in media users.

In the early days of the Internet, users formed an audience to read or watch content online. Certainly, we still use the Internet in this way, but now we can also have conversations and create content to share with others (Hodkinson, 2017). Here are some examples: writing a review of a product on Amazon, updating our Facebook page or downloading material to share with our friends, creating a video for YouTube, posting photos on Instagram, posting a blog entry, or sending a tweet. In 2012, three quarters of the world’s inhabitants had access to a mobile phone (World Bank, 2012). In 2017, 51.7% of the world’s population had access to the Internet, including 88.1% of people living in North America and 80.7% of Europeans. Only 31.2% of people living in Africa had Internet access, however (Internet World Stats, 2017a). English and Chinese are the two most used languages on the Internet (Internet World Stats, 2017b). Going forward, the digital divide will play an important role in systems of inequality between and within countries. One survey found that, in 2017, the average time spent with major media per day in the United States was 238 minutes on television, 197 minutes on mobile devices, 123 minutes online on desktop or laptop, 86 minutes on radio, 33 minutes on other connected devices, and 24 minutes on print media (The Statistics Portal, 2018). That is a lot of time spent with mass media.

In totalitarian societies, such as North Korea, the flow of information, images, and ideas is controlled by the government. In the United States, we have a long tradition of freedom of the press—a belief that the media must be free to serve as a public watchdog. Traditionally, the emphasis has been on the watchdog role in relation to the government and political institution—in other words, a press that is not controlled by the government. In the current era of media mergers and acquisitions, concerns have centered on media censorship by the economic institution. Critics suggest that powerful multinational media corporations censor the coverage of news to protect their economic or political interests.

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Organizations that analyze freedom of the press report that after 2 decades of improvement around the world, there was a decline in press freedom in recent years, and in 2017 only 13% of the world’s population has a free press where coverage of political news is strong, journalist safety is guaranteed, state intrusion in the media is minimal, and the press is not subject to legal or economic pressures (Freedom House, 2017). Organizations that analyze freedom of the press rated the United States as 43rd in freedom of the press in 2017, down from 32nd in 2013 and 21st in 2009. The highest marks went to the northern European countries (Freedom House, 2017; Reporters Without Borders, 2017).

In recent years, there is considerable concern about how the media abuses citizen privacy. There is concern about how social networking sites like Facebook violate users’ privacy. There is concern about how commercial sites engage in information gathering, profiling, and data mining on “free” online platforms in order to market their products (Croteau & Hoynes, 2014). There is concern about how media companies hack phones to gather information for news stories. There is also concern about the possibility that media companies might be cooperating with government surveillance of individuals.

Mass media critics suggest that control of the media by political and economic elites results in control of cultural meanings to benefit elites and silence dissident views. The mass media in the United States has historically been controlled by White, middle- and upper-class men, who have presented their worldviews. Mass media owners are interested in attracting affluent consumers and choose content with this aim in mind (Croteau & Hoynes, 2014). Women, people of color, low-income people, sexual minorities, and people with disabilities are underrepresented in media presentations, and when they are represented, the images are often unflattering. There has been some improvement in this situation in the past 2 decades, but there is still a long way to go. Historically, nondominant groups have developed alternative media to compensate for their absence or poor treatment in the dominant media. That is still the case today and is becoming a much easier task with the new Internet-based media (Wilson, Gutiérrez, & Chao, 2013).

Leticia Renteria is well aware of the negative images of immigrants that are often seen in the mass media in the United States. Social workers should be aware of how national and local media represent nondominant

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groups in their communities and collaborate with others to develop fairer representations.

Trends in the Family and Kinship Institution You would probably agree that family and kinship relationships are a very important part of the unfolding story of Leticia Renteria and her family. Extended family members provided Leticia with a place to live and other types of support when she moved to the United States. Her cousins helped her return to the United States after she made a voluntary departure to avoid deportation. Her husband and children are the focus of her life. Family and kinship is the most basic social institution, and in simple societies it fulfills many of the functions assigned to other social institutions in complex societies. Although the functions of family and kinship have been the subject of some controversy in the contemporary era, most societies generally agree that the family and kinship institution is primarily responsible for the regulation of procreation; for the initial socialization of new members of society; and for the economic, emotional, and physical care of its members.

As the primary unit of every society, families are altered as the result of social change, and globalization is changing family life in some extraordinary ways around the world (Karraker, 2013). There are increasingly diverse ways of being a family around the globe, and there seems to be an exception for almost every family trend identified. However, we can identify three global trends in family life.

1. Modified extended family form. Historically, the extended family has been more important in Latin America, Asia, and Africa than in Europe and North America. Globalization appears to be leading to some convergence toward a modified extended family, a family system in which family members are highly involved with each other but maintain separate dwellings (Leeder, 2004). This is the current family form for Leticia Renteria’s family, where family members maintain households across national lines, making them one of the growing numbers of transnational families. Within this general pattern are many variations. In wealthy advanced industrialized societies, governmental programs augment the care of dependent family members, but such programs are not typically available in nonindustrial or newly industrializing societies. Marriages continue to

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be arranged by elders in many parts of the world, particularly in African and Asian societies, but they are based on love matches in Western societies. Monogamy, or marriage to one person at a time, is the norm in Western societies, but polygamy, or marriage to multiple partners, is still followed in some parts of the world. Increasingly, families are formed based on commitments that do not involve legal marriage (McGoldrick, Garcia-Preto, & Carter, 2016; Walsh, 2012a).

2. Mass migration. Migration for a better life is not new; indeed, it is the history of the United States. From 1810 to 1921, 34 million people emigrated from Europe to the United States (McMichael, 2017). With economic globalization, many rural peasants in nonindustrialized and newly industrializing countries have been displaced by large agricultural corporations, many headquartered in the United States; some move to the cities in their own countries, and others immigrate to countries with greater economic opportunities. Many migrate because their labor became obsolete in a constantly reorganizing global market. Still others migrate to escape war or political persecution. By one account, 75% of refugees and displaced persons are women and children (McMichael, 2017). Often families are separated, with some members migrating and others staying behind, sometimes to migrate at a later stage. Migrants seek to earn money for families back home, and it is estimated that 100 million people globally depend on the remittances from family members who have migrated (McMichael, 2017). In affluent societies, such as the United States, some industries welcome the cheap labor of undocumented immigrants, and wealthy households welcome the access to cheap household servants. Yet ongoing backlash and political fear campaigns have developed against immigrants from low-income nations. Anti-immigrant sentiment has been particularly strong in the United States and Europe in recent years (Ross, 2015). U.S. president Donald Trump ran on an anti-immigrant platform in 2016.

3. Feminization of wage labor. In many parts of the world, women are increasingly involved in wage labor, in newly industrializing as well as highly industrialized societies (Karraker, 2013). For example, women make up 80% of the labor force in the export processing zones of Taiwan, the Philippines, Sri Lanka, Mexico, and Malaysia. In these export zones, women typically work longer hours at lower wages than men (McMichael, 2017). In the United States, families in which both parents work outside the home have become the norm. And yet there is a global gender wage gap. In 2015, the annual pay

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for women globally equaled the amount men were earning 10 years earlier (World Economic Forum, 2015). In the United States, the wage gap has been narrowing. In 2016, women earned 79% of what men earned, up from about 65% in 1980 (Joint Economic Committee United States Congress, 2016). The gender pay gap grows with age; in 2016, White women ages 18 to 24 were paid 88% of what White men of the same age were paid. Some research indicates, however, that recent cohorts of women have fallen further behind their same- age male peers as they aged (Pew Research Social & Demographic Trends, 2013). African American (60%) and Latino (55%) women have a much larger pay gap with White men (Joint Economic Committee United States Congress, 2016).

Three other trends are more characteristic of the United States and other late-industrial societies than of the preindustrial and newly industrializing societies but are occurring, nevertheless, in societies around the world.

1. A rise in divorce rates. The divorce rate in the United States peaked in 1981 and has been declining gradually since then but remains considerably higher than the 1960 rate. The United States has one of the highest divorce rates in the Global North countries (Ballantine et al., 2018).

2. Declining fertility. The overall birthrate in the United States declined to a record low in 2015 (Child Trends, 2016). Livingston (2018) suggests that this record low is primarily a result of a decline in birthrates among women younger than 30, and this decline is in part due to the Great Recession that began in 2007–2008. When there is an economic downturn, people tend to postpone childbearing.

3. Increasing number of lone-parent families. In 2014, over one third (35%) of children in the United States lived with only one parent, up from 11% in 1970 (Kids Count Data Center, 2017; Shore & Shore, 2009). Northern European countries also have high rates of lone- parent households (for example, 25% in the United Kingdom and 21.7% in Denmark and Germany), but lone-parent families are less common in southern Europe—less than 5% in Greece and Spain, 6% in Portugal, and 7% in Italy (U.S. Census Bureau, 2012). As noted earlier, lone-parent families are more likely to be poor than two- parent families.

Two other long-term trends in family relationships are likely to continue:

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greater valuing of autonomy and self-direction in children, as opposed to obedience and conformity, and equalization of power between men and women. These trends have been found to be almost universal, but they are more problematic in some societies than in others (Adams & Trost, 2005). Not all people agree that these trends are good, and some point to them as causes of the weakening of the family. Other people see these trends as providing possibilities for stabilizing the family in a time of great change in all major social institutions.

Social service programs serving families, children, and older adults need to be responsive to these changing trends. The confluence of declining family size, increasing numbers of single parents, increasing numbers of women in the paid labor force, and an aging population calls for a reexamination, in particular, of our assumptions about family caregiving for dependent persons. Social workers should lead the way in discussions about social policies that can strengthen families and alleviate family stressors. We must pay particular attention to the needs of immigrant families like the family of Leticia Renteria. These issues receive greater attention in Chapter 10.

Critical Thinking Questions 9.4

What would life be like without the mass media? How would you find out about national and global events? Where would you get your ideas about social welfare, religion, and family? How would your daily life be different? What are some recent media images you have observed about the social welfare and family and kinship institutions? About immigration?

Theories of Social Inequality Throughout this chapter, we have presented information on how social inequality is created and maintained in eight interrelated major social institutions. Social class is the term generally used by sociologists to describe contemporary structures of inequality. Perhaps no question regarding the human condition has generated more intense and complex controversies and conflicts than the related issues of inequality and distributive justice. Unequal distribution of resources is probably as old as the human species and certainly has existed in all complex societies. Long

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before the discipline of sociology arose, thoughtful people constructed explanations and justifications for these inequalities (Lenski, 1966; Sernau, 2017). Although social class has been an important topic for sociology, by no means do sociologists agree about the role it plays in human behavior.

The contributing authors and I have presented inequality as a problem, but as you have probably noted, not everyone agrees with this view. Gerhard Lenski (1966) did a careful study of how societies over time have answered the question of whether inequality is a good or bad thing. He divided the way societies have responded to this question into a conservative thesis and a radical antithesis. In the conservative thesis, inequality is the natural, divine order, and no efforts should be made to alter it. In the radical antithesis, equality is the natural, divine order; inequality is based on abuse of privilege and should be minimized.

Classical Sociological Theories of Social Inequality When social inequality is considered to be the natural order and divinely ordained, there is no need to search further for explanations of inequality. But as this traditional assumption gave way to a belief that human beings are born equal, persistent social inequalities required explanation and justification. Explanation of inequality and its relationship to human behavior became central to the emerging social and political sciences. Two classical theorists, Karl Marx (1818–1883) and Max Weber (1864–1920), have had lasting impact on the sociological analysis of social inequality.

Karl Marx was both a social theorist and a committed revolutionary. He was interested in explaining the social inequalities of industrial capitalism, but his interests went beyond explanation of inequality to promotion of a more just and equitable society. Marx (1887/1967) emphasized the economic determinants of social class relationships and proposed that class lines are drawn according to roles in the capitalist production system. Although he did not propose a strict, two-class system, he suggested a social class division based on a dichotomy of owners and controllers of production (bourgeoisie), on the one hand, and workers who must sell their labor to owners (proletariat), on the other. Marx saw the relationship between the classes to be based on exploitation and domination by the owners and controllers of production and on alienation among the workers.

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He saw social class as a central variable in human behavior and a central force in human history and believed that class consciousness—not only the awareness of one’s social class but also hostility toward other classes—is what motivates people to transform society.

In contrast to Marx, who was a revolutionary, Weber argued for a value- free social science. Weber differed from Marx in other ways as well. Marx saw a class division based on production roles (owners of production and workers); Max Weber (1947) saw a class division based on “life chances” in the marketplace. Life chances reflect the distribution of power within a community, including power in the economic realm, power in the social realm, and power in the legal realm. Power in the economic realm is social class. Power is the social realm is prestige. Power in the legal realm is political power. Instead of Marx’s dichotomous class system, Weber proposed that life chances fall on a continuum and that the great variability found along the continuum reflects the multiple sources of power. He suggested that social class is an important variable in human behavior but not, as Marx believed, the primary variable.

This difference in perspective on the causal importance of social class reflects the theorists’ disagreement about the inevitability of class consciousness or class action. Marx saw class consciousness and communal action related to class as inevitable. Weber saw social class as a possible, but not inevitable, source of identity and communal action.

The Contemporary Debate Attempts to determine the cause of persistent social inequalities have led to debate among sociologists who embrace functional theories and sociologists who embrace conflict theories. Functional theories of social stratification present structural inequality (social classes) as necessary for society. According to this view, unequal rewards for different types of work guarantee that the most talented persons will work hard and produce technological innovation to benefit the whole society. Conflict theorists (see Chapter 2 for more discussion of conflict theories), on the other hand, emphasize the role of power, domination, and coercion in the maintenance of inequality. According to this view, persons with superior wealth and income also hold superior social and political power and use that power to protect their privileged positions.

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Sociological functionalism was dominant in U.S. sociology during the 1940s and 1950s, but it faded in importance after that. However, functionalism was the root for modernization theory, which attempted, in the 1960s, to explain on the global level why some countries are poor and others are rich (Rostow, 1990). These theorists suggested that poverty is caused by traditional attitudes and technology—by the failure to modernize. The conflict perspective counterargument to modernization theory was dependency theory, which argued that poor societies are created by worldwide industrial capitalism, which exploits natural resources and labor (Frank, 1967). These theorists emphasized the tremendous power of foreign multinational corporations to coerce national governments in poor nations. They called attention to colonial imperialism as the historical context of contemporary global inequalities.

The recent debate has been between neoliberalism and the world systems perspective. Neoliberalism is based in classic economics and argues that free trade and free markets, with limited government interference, will result in a fair distribution of resources. As suggested earlier, this philosophy has been dominant across the world for the past few decades but is currently being challenged on several fronts. Economists at the World Bank and IMF have been strong voices in favor of neoliberalism, which informed the ideals of their structural adjustment program for dealing with the debts of impoverished nations. Structural adjustment called for poor countries to “clean house” by reducing government spending and bureaucracy and increasing exportation and entrepreneurship. To counter this view, the world systems perspective suggests that inequality is created and maintained by economic globalization (Wallerstein, 1974, 1980, 1989). Under this perspective, the world is divided into three sectors: a core sector that dominates the capitalist world economy and exploits the world’s resources, a peripheral sector that provides raw material to the core and is heavily exploited by it, and a semiperipheral sector that is somewhat independent but very vulnerable to the financial fluctuations of the core states. The core currently includes the United States, western Europe, and Japan; the periphery includes much of Africa, South Asia, and Latin America; and the semiperiphery includes such places as Spain, Portugal, Brazil, Mexico, Venezuela, and oil-producing countries in the Middle East (Leeder, 2004; McMichael, 2017). According to the world systems perspective, the hegemony of the core sector is reinforced by neocolonial practices of such transnational institutions as the World Bank, the IMF, and the WTO.

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Structural Determinism Versus Human Agency Will knowledge of my social class position help you to predict my attitudes and behaviors? That question has become a controversial one for contemporary social science. Social scientists who see human behavior as highly determined by one’s position in the social class structure (structural determinism) are challenged by social scientists who emphasize the capacity of humans to create their own realities and who give central roles to human actors, not social structures (human agency).

Macro-oriented sociologists have taken Émile Durkheim’s lead in arguing that human action is a by-product of social institutions external to human consciousness. Micro-oriented sociologists have taken Max Weber’s lead in the counterargument that humans are proactive agents who construct meaning in interaction with others. In a position more consistent with the multidimensional framework of this book, Anthony Giddens (1979) has proposed structuration theory, a theory of the relationship between human agency and social structure. Giddens notes that social practices repeat themselves in patterned ways over time and in space, structured by the rules and resources embedded in social institutions. Although acknowledging the constraints that rules and resources place on human action, he also notes that human agents have the ability to make a difference in the social world. Human actions produce social structure, and at all times human action is serving either to perpetuate or to transform social structure. You may recognize that this is very similar to the practice orientation to culture presented in Chapter 8. Some critics have suggested that Giddens is too optimistic about how much agency humans have, but Giddens acknowledges that those with the most power have a disproportionate opportunity to reinforce institutional arrangements that perpetuate their positions of power.

Structuration theory is a good framework for social workers. It calls our attention to power arrangements that constrain the behaviors of some actors more than others in a way that perpetuates social injustice. But it also calls our attention to the possibilities for human action to transform social institutions. Mary Ellen Kondrat (1999) suggests that structuration theory poses two questions that, when raised, provide critical consciousness, a necessary ingredient for progressive change agents. Critical consciousness can be defined as an ongoing process of reflection and knowledge seeking about mechanisms and outcomes of social,

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political, and economic oppression that requires taking personal and collective action toward fairness and social justice. The first question raised by Kondrat is, “How aware are we of the ways in which social institutions and social structure condition our behaviors?” The second question is, “How aware are we of the ways in which our day-to-day activities over time perpetuate or transform social structure?” Just as individual agency is essential for individual change, collective agency is essential for changing social institutions. That is the central point of the final chapter in this book, the chapter on social movements.

Critical Thinking Questions 9.5

Which social institutions have the greatest impact on your day-to-day life? What are some ways that your day-to-day activities perpetuate the existing social structure? What are some ways that your day-to-day activities have the potential to change social structure?

Implications for Social Work Practice The trends in social institutions and social structure discussed in this chapter suggest several principles for social work practice. These practice principles have the greatest relevance for social work planning and administration, but some are relevant for direct social work practice as well.

Develop adequate information retrieval skills to keep abreast of trends in the interrelated social institutions and the impact of these trends on human interdependence and dependence. Monitor the impact of public policies on poverty and inequality. Learn to use political processes to promote social policies and social services that contribute to the well-being of individuals and communities. Be particularly aware of the impact of trends in the economic institution on client resources and functioning. Collaborate with other social workers and human service providers to advocate for greater equality of opportunity in the educational institution. Work to ensure that the voices of poor and other oppressed people are included in ongoing public dialogue about health care reform.

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Consider the extent to which contemporary social welfare programs, especially those with which you are personally involved, are responsive to recent changes in the other major social institutions. Take the lead in public discourse about the fit between the current social welfare institution and trends in the other major social institutions. Be aware of the role religious organizations play in social service delivery and the role religion plays in the lives of clients. Collaborate with other social workers and human service providers to influence media coverage of vulnerable populations and patterns of social inequality. Review social service programs serving children, older adults, and other dependent persons to ensure they are responsive to changes in the family and kinship institution as well as the economic institution.

Key Terms bifurcate 275 colonialism 269 conservative thesis 294 critical consciousness 296 economic institution 273 educational institution 277 family and kinship institution 292 Gini index 266 government and political institution 269 health care institution 282 mass media institution 290 neocolonialism 269 neoliberal philosophy 270 outsourcing 275 radical antithesis 294 religious institution 288 role 264 social class 294 social institution 264 social structure 264 social welfare institution 285 status 264

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transnational corporation (TNC) 270

Active Learning 1. In the case study at the beginning of the chapter, Leticia Renteria is

eager to legalize her immigrant status to ensure that she can stay in the United States rather than return to her native Mexico. One way to begin to understand her motivation to stay in the United States is to do a comparative analysis of social indicators in the two countries. To do this, you can make use of some of the many web resources that contain statistics on global well-being, including the following:

www.census.gov. Official site of the U.S. Census Bureau. Search for International Data Base (IDB) and click for the database. You can select specific countries and years and get key summary information about the social health of the countries. www.unicef.org. Official site of the United Nations Children’s Fund. Search for Country Statistics and click on “Read more about this topic.” You can select a specific country and access data on the status of children in that country. www.undp.org. Site of the United Nations Development Programme. Search for Publications and scroll down until you see the latest Human Development Report. Click on the latest Human Development Report, and you will get country-by-country information on the Human Development Index and the latest report on efforts to meet development goals. Use these three resources, or other relevant resources, to prepare a statistical overview of the social health of the United States and Mexico. What are the areas of similarity? Main areas of difference? What indicators seem to be the most important in understanding Leticia Renteria’s motivation to stay in the United States? (Note: these three organizations may change the organization of their webpages from time to time, but be persistent, using the search process, to find these data.)

2. We have looked at the conservative thesis and the radical antithesis in an ongoing debate about the role of inequality in social life. Talk to at least five people about this issue, including at least one member of your family and at least one friend. Ask each person the following questions:

Is inequality a good thing for a society? If not, why not? If so, in what way, and good for whom? If we accept inequality as inevitable, how much is necessary? Should society try to maximize or minimize the amount of inequality?

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http://www.census.gov

http://www.unicef.org

http://www.undp.org

On what criteria should we measure inequality? If we seek equality, is it equality of opportunity or of outcomes?

What kinds of positions did people take? How did they support their arguments? Did you find more support for the conservative thesis or the radical antithesis in the responses you heard?

Web Resources

Center for Responsive Politics: www.opensecrets.org

Site maintained by the nonpartisan Center for Responsive Politics contains information on major organizational and individual contributors, the money collected and spent by major political candidates, and political news and issues.

The Civil Rights Project: https://civilrightsproject.ucla.edu

Site presented by the Civil Rights Project, which was founded at Harvard University in 1996 and in 2007 moved to UCLA, presents data that track racial achievement gaps in the United States.

Pew Research Center: Internet & Technology: www.pewinternet.org

Site presented by the Pew Research Center’s Internet Project presents reports on the impact of the Internet on families, communities, work and home, daily life, education, health care, and civic and political life.

United Nations Children’s Fund: www.unicef.org

Site contains cross-national information on the well-being of children.

U.S. Census Bureau: www.census.gov

Official site of the U.S. Census Bureau contains statistics on a wide variety of topics, including race and ethnicity, gender, education, birthrates, disabilities, and many other topics.

World Bank: www.worldbank.org

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http://www.opensecrets.org

https://civilrightsproject.ucla.edu

http://www.pewinternet.org

http://www.unicef.org

http://www.census.gov

Official site of the World Bank contains research and publications and open country-by-country data on such topics as poverty and inequality.

World Health Organization (WHO): www.who.int

Site contains information on the health and the health care institutions of countries around the world.

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http://www.worldbank.org

http://www.who.int

10 Families

Elizabeth D. Hutchison

Chapter Outline Learning Objectives Case Study 10.1: The Sharpe Family’s Deployment Adjustments Family Defined The Family in Historical Perspective Theoretical Perspectives for Understanding Families

Family Systems Perspective Exchange and Choice Perspective on Families Symbolic Interaction Perspective on Families Feminist Perspective on Families Life Course Developmental Perspective on Families Family Stress, Coping, and Resilience Perspective

Diversity in Family Life Diversity in Family Structures

Nuclear Families Extended Families Cohabiting Opposite-Sex Couples Couples With No Children Lone-Parent Families Stepfamilies Same-Sex Partner Families Military Families

Economic and Cultural Diversity Economic Diversity Cultural Diversity Immigrant Families

Challenges to Family Life Family Violence Divorce and Relationship Dissolution Substance Abuse

Implications for Social Work Practice Key Terms

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Active Learning Web Resources

Learning Objectives 10.1 Analyze one’s own emotional and cognitive reactions to a case study. 10.2 Analyze the merits of different approaches to defining family. 10.3 Compare six theoretical perspectives for understanding families (family systems, exchange and choice; symbolic interaction; feminist; life course developmental; and family stress, coping, and resilience). 10.4 Identify several types of diversity in family life that might be encountered by social workers. 10.5 Analyze three types of challenges to family life (family violence, divorce and relationship dissolution, and substance abuse). 10.6 Apply knowledge of family theories, family diversity, and family challenges to recommend guidelines for social work engagement, assessment, intervention, and evaluation.

Case Study 10.1 The Sharpe Family’s Deployment Adjustments Bobby Sharpe’s U.S. Army National Guard unit was deployed to Iraq in 2004 and to Afghanistan in 2010. Bobby suffered a relatively minor physical injury in Iraq and still has occasional nightmares about his tour in Afghanistan. He feels lucky, however, that he and his family have not suffered some of the traumatic postwar aftermath he has seen in the families of some members of his Guard unit.

Bobby is a 44-year-old African American man who lives in a small southwestern town. He has been married to Vivian for 21 years, and they have a 20-year-old daughter, Marcie, and an 11-year-old son, Caleb, who has cerebral palsy. Back when Bobby finished high school, he served in the army for 4 years. He received some good training, enjoyed making friends with people from diverse backgrounds, and had two tours overseas but never served in a war zone. After 4 years, he was eager to return home to be near his close-knit family. Soon after returning home, he ran into Vivian, who had grown up in his neighborhood, and they were soon spending a lot of time together. A year later, they were married, and a year after that, Marcie was

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born.

Bobby wasn’t sure what work he could do after he left the army, but a few months after he returned home, he got in touch with a high school friend who was working as a heating and air conditioning technician. On his friend’s recommendation, Bobby was hired where his friend worked and quickly learned the technical aspects of the heating and air conditioning business. When Marcie was born, Vivian cared for her at home and cared for her sister’s small children while her sister, a single mother, worked. When Bobby’s father had an automobile accident and had to miss work for 6 months, Bobby and Vivian provided some financial aid to Bobby’s mother and younger siblings while his father was out of work. Finances were tight, and Bobby and Vivian were afraid they would not be able to keep up the mortgage on their house, which was a source of great pride to them. Bobby decided to join the army National Guard to bring in some extra money. He also looked forward to the type of camaraderie he had experienced in the army. He went to drills one weekend per month and took time off from work for a 2-week training each year. His unit was mobilized on two occasions to assist with floods in the state. The extra money helped to stabilize the family economics, and he enjoyed the friendships he developed, even though only one other person in his unit was from his small town. When Marcie entered public school, Vivian took a job in the cafeteria at her school, which allowed Bobby and Vivian to start a college fund for Marcie.

Bobby grew up in a close-knit family that included his mother and father and three younger sisters, as well as a maternal grandmother who lived with them. Several aunts, uncles, and cousins lived nearby. Both parents were hardworking people, and they created a happy home. Bobby’s grandmother provided childcare when the children were small and helped to keep the household running smoothly.

Vivian grew up a few blocks from Bobby. Her father died in Vietnam a few months before she was born, and her mother moved her two daughters back to the town where she had grown up. She struggled to raise her two daughters while working two jobs, with some help from her mother, who lived in town but also worked two jobs. Vivian was lucky that another neighborhood couple became her godparents and played an active role in her life. This couple was never able to have children of their own, and they enjoyed including Vivian in their lives. She continues to consider them family.

During Bobby’s deployment to Iraq, Vivian and Marcie were able to get along fine, with the love and support of Bobby’s family; Vivian’s mother, sister, and godparents; and Bobby’s boss. They missed Bobby and worried

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about him, but Marcie was very good about picking up more responsibilities to help Vivian with the chores usually performed by Bobby. When the furnace broke, Bobby’s boss was generous about doing the repair. One of Bobby’s sisters helped Vivian juggle taking Marcie to her afterschool activities and picking her up. Bobby was injured by shrapnel in his last week in Iraq and spent 2 weeks in the hospital in the nearest city when he returned home. The family and friends network took care of Marcie while Vivian juggled trips to the hospital with her work schedule.

But things were more complicated when Bobby was deployed to Afghanistan. Bobby’s beloved grandmother had had a stroke 2 years before this deployment, and his mother and father were working opposite shifts at the local nursing home so that someone was always home to care for her. Bobby’s aunts, uncles, and cousins were taking turns providing a few hours of care so that his mom and dad could get a break and run errands. One of Bobby’s sisters had stayed in the city after she completed college and had a busy life there. Another sister, a single mother of a 2-year-old daughter, was serving in the army in Iraq when Bobby left for Afghanistan. Her daughter was living with Bobby and Vivian while she was deployed. Bobby and Vivian’s son Caleb is the joy of the family, but he requires extra care. While Bobby was deployed, Vivian’s mother moved in with Vivian and cared for Caleb and the 2-year-old niece during the day while Vivian worked and then turned their care over to Vivian so that she could do a 6-hour shift caring for an older woman with dementia. To help stabilize the family finances, Vivian accepted the offer to take a supervisory position in the school department’s lunch program. She was excited about the new responsibilities, but the demands of the new job were often too much during a time of great family upheaval. Vivian was especially concerned about monitoring Marcie’s afterschool activities now that she was approaching adolescence, but her godparents were a great help with that, just as they had been for Vivian during her adolescent years. The women’s group at the family’s church provided emotional support as well as occasional meals and transportation for Marcie. Marcie and Caleb missed their dad, and Marcie worried a lot about his safety, especially during the weeks when they did not know his whereabouts.

Bobby returned from Afghanistan with no physical injuries, but his best friend from the Guard lost a leg to a roadside bomb. When Bobby came home, Vivian, Marcie, and Caleb were thrilled and were eager to pick up life where they left off. Bobby wanted to spend a lot of time by himself, however, and Vivian realized that he was having trouble sleeping, sometimes had nightmares, and was easily startled by loud noises. She did some research on the Internet and decided that she needed to give Bobby time to readjust. She did her best to help Marcie and Caleb understand this also. She

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was pleased, but also worried, when Bobby began to go for long walks and to spend time with a new puppy. After 4 months, Bobby was able to talk about the guilt he felt about surviving when other Guard members had died. He gradually began to be more like his old self and was happy to get back to work. He still makes time to spend with his friend who lost a leg in Afghanistan. His grandmother died 6 months after he returned from Afghanistan, and he and the rest of the family still miss her.

Now, the Sharpe family is in a new phase, with Marcie away at state university on a track scholarship. Bobby and Vivian are so proud of her decision to study for a career in occupational therapy, a decision that was influenced by the family’s experiences with Caleb. Marcie found the transition to university to be a big challenge. She struggled to manage her time between track practices and meets, academic assignments, and her desire to travel home as often as she could. She missed her mom, dad, and brother and being able to join the extended family at weekly church services. She was also challenged by the diversity in the student body and found herself beginning to question some of the assumptions she had held about the meaning of such issues as family, gender expression, race, and war. By her sophomore year, she had figured out some time management strategies and become more comfortable with the diversity in the student body. Bobby, Vivian, and Caleb created a new family ritual of attending some of her track meets and bringing some of her favorite family dishes to share with friends after the meet.

Family Defined We know that families are one of the key institutions in almost every society, past and present. Perhaps no other relationships contribute as much to our identity and have such pervasive influence on all dimensions of our lives as our family relationships. Families address personal needs, but they also contribute to the public welfare by caring for each other and developing responsible members of society (Newman, 2017).

Families in every culture address similar societal needs, but there are many variations in family structure, family customs, and power arrangements. Around the globe, families are expected to provide economic security, emotional support, and a place in society for each family member; they also fulfil the critical social roles of bearing, providing for, and socializing children and youth (Karraker, 2013). Families respond to these challenges in different ways, due in no small part to different cultures and different

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political and economic circumstances. Family situations and their access to resources differ as a function of their socioeconomic location. As suggested in Chapter 9, social, cultural, and economic globalization is changing families in the United States and around the world (Gardiner, 2018).

So what is a family? We were all born into some sort of family and may have created a similar or different sort of family. Take a break from reading and think about who is family to you. Who is in your family, and what functions does your family perform for you? We hear a lot of talk about family and family values, but family means different things to different people. Even family scholars struggle to define how family is different from other social groups. White, Klein, and Martin (2015) suggest that family differs from other social groups in degree only. They propose that nonfamily groups such as friend networks and coworkers often have some of the same properties as families but usually to a lesser degree; families tend to last substantially longer than other social groups and to be intergenerational in nature.

The family literature includes many definitions of family, but the many definitions center on three ways to form a family: biologically, legally, or socially. Biologically, family refers to people related by blood and genetically bound to each other, however distantly. Examples of biological family relationships include parents, children, aunts, uncles, second cousins, grandparents, and great-grandparents. Families are created legally by marriage, adoption, or formalized fostering. There are many ways that families can be created socially, by social interaction, when there is no biological or legal relationship. Sometimes neighbors, godparents, or longtime friends are considered family. These have been called “fictive kin,” but I prefer to refer to them as chosen family. Vivian Sharpe clearly thinks of her godparents as family, and they have come to be family for Marcie as well. Family is increasingly being created by cohabiting romantic partners of either opposite sexes or the same sex. Family may also be created by informal fostering.

The U.S. Census Bureau has used essentially the same definition of family since 1930. The 2010 version of the definition is “A family consists of a householder and one or more other people living in the same household who are related to the householder by birth, marriage or adoption” (Pemberton, 2015, para. 2). This definition includes families formed

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biologically and legally, as long as they are living in the same household, but not those formed socially without legal sanction. How does this definition fit for the way you think about who is in your family? How does it fit for Bobby and Vivian Sharpe’s family? It would certainly include Bobby, Vivian, Marcie, and Caleb during many years. It also could embrace Vivian’s mother when she lived in the household during Bobby’s deployment to Afghanistan. Did it still include Bobby while he was deployed and not living in the household? Does it include Marcie while she is away at university? It is clear that they and other family members think so. But what about Bobby’s 2-year-old niece? Was she family in the time she spent in the household? And what about the extended family members who do not reside in the household with Bobby and Vivian? Who do you think Bobby, Vivian, Marcie, and Caleb consider to be family? How would they define family?

Exhibit 10.1 ● Four Approaches to Defining Family Exhibit 10.1 ● Four Approaches to Defining Family

Family as structure

Family based on formal legal relationships among members

Family as household Family as a residential unit

Family roles

Family as members interacting and communicating in the context of social roles such as husband and wife, mother and father, son and daughter, brother and sister

Family as interaction Family as active creators of a common culture

Source: Based on Ciabattari, 2017.

Family scholars have attempted to develop more inclusive definitions of family, definitions that include social as well as biological and legal relationships, definitions that would embrace more forms of families. Family sociologist Teresa Ciabattari (2017) suggests the four approaches to defining family summarized in Exhibit 10.1. Although controversies remain, there is evidence that people in many countries, including the United States, are becoming more inclusive as they think about who counts as family (see Powell, Bolzendahl, Geist, & Steelman, 2015). One research

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team studied the definition of family used by students in teacher education programs in the Czech Republic (Havigerová, Haviger, & Truhlářová, 2013). They asked respondents to explain the term family to someone unfamiliar with the term and found that the respondents used seven categories of terms in their definitions. In descending order according to frequency of response, the categories of terms used were being together, emotions, social roles, care, economics, responsibilities, and leisure.

For the purposes of our discussion, I use a definition of family proposed by Baxter and Braithwaite (2006): Family is “a social group of two or more persons, characterized by ongoing interdependence with long-term commitments that stem from blood, law, or affection” (p. 2). Increasingly, we exercise the freedom to use the word family to describe the social group with whom we have emotional closeness (a social definition). However, our freedom to define our own families is limited. We must interact with organizations that have their own definitions of family and sometimes have the power to impose those definitions on us. Local, state, and federal governments have definitions of family and have the power to enforce those definitions when providing goods, services, and legal sanctions. Examples include legal standards about who can marry, who has the right to custody, who inherits from whom, who can benefit from filing joint tax returns, who receives survivor benefits, who can visit hospital intensive care units, and who can make medical decisions for another person. In 2017, the issue of who counts as “close” family members was raised in challenges to the Trump administration refugee ban (Barnes, 2017). At question was whether grandparents count as close family members. In the United States and many other countries, the most contentious and public struggle over the tension between legal definitions and social definitions of family involve families formed by same-sex couples, a topic covered later in the chapter. As social workers, we should be most interested in whom a person considers to be family, because that is where social resources can be tapped, but we must also be alert to situations where legal definitions do not recognize a given form of family and how enforcement of those definitions impinges on the lives of particular individuals and families. This is an area that calls for social work activism.

In the United States, monogamy, or partnering with one spouse at a time, is the legal way to start a biological family. But anthropologists estimate that 80% to 85% of the world’s societies prefer some type of polygamy, or

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having more than one spouse at a time (Haviland et al., 2017). Polygamy can take the form of either polygyny (one man and multiple wives) or polyandry (one woman and multiple husbands). Polyandry is much less common than polygyny, however. Polygyny is found on every continent but is most common in Islamic countries, African countries, and parts of Asia (Gardiner, 2018). All societies allow monogamy, and, indeed, most people of the world cannot afford to support multiple spouses.

There are cultural variations in the process of mate selection. In most societies, mate selection is governed by both exogamy and endogamy rules. Exogamy rules require that mates must be chosen from outside the group. Most societies have either formal or informal rules prohibiting mating with specified family members, often referred to as the “incest taboo,” but there are differences across cultures about which family members are prohibited. In the United States, 25 states prohibit marriage of first cousins, but 6 states allow it under some circumstances where the couple cannot reproduce, and North Carolina allows first-cousin marriage but prohibits double-cousin marriage (such as a sister and brother marrying cousins who are brother and sister) (LegalMatch, 2014). There are also some informal exogamy taboos against mating with people within other groups, such as in the same university dorm (dormcest) and with people in the workplace (workcest) (Newman, 2017). Endogamy rules, on the other hand, require that mates should be selected from within the group on characteristics such as religion, race and ethnicity, and social class. Bobby and Vivian were honoring these rules when they chose each other, but endogamy rules are loosening in many places.

In the United States and other Western societies, mate selection is a culmination of romantic love, and it is often assumed that there is one true love in the world for each one of us. In many Eastern societies, marriages are arranged, and it is generally assumed that there are several possible mates with whom one can establish a successful long-term relationship. It is also assumed that parents will make wiser decisions than young people would make for themselves. In countries like Japan, however, love marriages are beginning to replace arranged marriages (Gardiner, 2018).

The Family in Historical Perspective I often hear people lament the demise of the family. Maybe you hear this as well. To understand whether there is reality in this lament, it is

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necessary to place the contemporary family in a historical context. This is a daunting task, however. For one thing, the family has never been a monolithic institution. The structure and functions of families always varied according to race, ethnicity, religion, sexual orientation, social class, and so on. Most of what has been written about the family historically was written from the perspective of dominant members of society. It is only since the 1960s, when the discipline of social history began to describe the lives of women and other marginalized groups, that we have a more complete understanding of the variety of ways families have adapted to the challenges they’ve faced in their lives. When people in the United States talk about the “golden age of the traditional family,” they are typically talking about one particular group of families: White, middle- class, heterosexual, two-parent families living in the 1950s. Social historians argue that the rosy picture usually painted about this group is really something that never existed. It is important to remember that a great diversity of family structures and functions has existed in the United States and around the world over time.

For another thing, in the United States, because we are a very young country, we tend to have a very short view of history. A longer-term tracing of the history of families worldwide would be the subject of multiple books. So, for the longer-term global view, I simply note two important themes. First, it seems clear that families have adapted both their structures and their functions over time to cope with the changing nature of societies, as hunting and gathering societies gave way to horticultural societies, which gave way to agrarian societies, which gave way to industrial societies, and industrial societies are giving way to postindustrial societies focused on information, services, and technology. Second, a global understanding of the family in contemporary times must take account of the effects of colonialism. As the United States and European countries exploited local people in colonized countries, family life was directly impacted in both the colonizing and colonized countries. Most recently, families have been separated as some members relocate to find work, sometimes relocating from rural areas to cities within their own country and other times moving to wealthier countries where work is more plentiful.

Any discussion of the history of the family in the United States should begin with the Native peoples who predated the White settlers from Europe. The Native peoples included more than 2,000 cultures and

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societies, each with its own set of family customs and lifestyles (Leeder, 2004). There were some similarities across these societies, however. As with other societies, social life was organized around the family. Affection was lavished on children, who were never spanked or beaten. Children were instructed and disciplined by numerous caregivers in the extended family. There was a clear gender division of labor, with women growing crops and caring for the home and property and men hunting, fishing, and waging war. In many Native societies, however, women were afforded a great deal of respect and power (Dunbar-Ortiz, 2014). Beginning in the 19th century, all Native Americans in the United States were required to leave their ancestral homelands and move to reservations in the western part of the country.

The White settlers established small, privately owned agricultural enterprises, and families performed many of the functions that have since been turned over to other institutions such as hospitals, schools, and social welfare agencies. Households were large, and all household members worked to ensure the economic survival of the household. Men planted crops, tended livestock, and sometimes worked at a trade. Women tended the gardens, worked in the fields, cared for smaller animals, put away food for the winter, and sewed and laundered the clothes. Children worked from a young age, and some families sent the children to be servants in other households. The male was considered the head of the household and owned the labor of all household members. During most of this period, the majority of African American families lived and worked as slaves on large plantations in the South. All family members, including children, worked.

David Fischer’s (1989) historical analysis found regional differences in the organization of family life among the White settlers. From 1629 to 1775, four major waves of English-speaking immigrants settled in what became the United States of America. Each wave of immigrants came from a different part of what is now the United Kingdom and brought their own family customs with them. Family customs differed along several dimensions, including gender power arrangements, child-rearing practices, appropriate marriage partners, and nuclear versus extended family. Different attitudes about social inequality were also transmitted through the family. Fischer argues that in spite of later waves of immigration and much interregional mobility these regional differences in family customs have endured to some degree.

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During the industrial revolution, the economy of the United States and other newly industrializing nations shifted from the family-based economy of small, privately owned farms to a wage-based economic system of large-scale industrial manufacturing. Families became smaller, and they began to spread apart as the young adults left the farms and moved to cities to find jobs. In the early 20th century, millions of African Americans left the agricultural South and migrated to the industrial North. The functions of the family changed to accommodate the changes in the economic system. In the upper and middle classes, men went out to work and women ran the household, but less advantaged women engaged in paid labor as well as family labor. By 1900, one fifth of U.S. women worked outside the home, and many children worked in mines, mills, and factories (Newman, 2017). The great majority of African American women engaged in paid labor, often serving as domestic servants in White households where they were forced to leave their own families and live in the employer’s home. Women in other poor families took in piecework so they could earn a wage while also staying in the home. Poorer families also took in boarders to assist the family financially, something that also happened in the earlier agrarian period. Rather than the center of work, the family home became a place to retreat from economic activities, and the primary role of the family was to provide emotional support to its members.

The idea that work and home are separate spheres—with men in charge of the work sphere and women in charge of the home sphere—took hold during the industrial period. In reality, most families could not afford to have only one worker in that era. Ciabattari (2017) suggests that the ideal of separate spheres of work and home, though never a reality for many families, continues to drive the organization of the U.S. labor market and governmental family policies today, which are based on the assumption that workers do not have family responsibilities. The Family and Medical Leave Act (FMLA) of 1993 requires employers with more than 50 employees to provide up to 12 weeks of unpaid sick leave per year for the birth or adoption of a child or to care for a sick child, parent, or spouse, excluding temporary and part-time workers. It covers both male and female workers. With the exemptions, over 40% of private-sector employees are not eligible for FMLA leave, with the probability of being eligible increasing with level of education (Jorgensen & Applebaum, 2014). Compare this with the way that most other countries have responded to the increasing numbers of dual-earner families. One research project found that of 173 countries studied, 168 guarantee paid leave to

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women for childbirth and maternity, 98 countries guarantee at least 14 weeks of paid leave, and 66 guarantee paid paternity leave (Heymann, Earle, & Hayes, 2007). This issue is addressed more comprehensively in Chapter 9 of this book. Earle, Mokomane, and Heymann (2011) studied the most competitive economies across the globe and found all of them except the United States provide paid leave for mothers. They conclude that providing paid family leave does not interfere with economic competitiveness.

The family changes that occurred during the industrial era created the conditions for contemporary trends in family life. Large families so beneficial to agricultural life were replaced by small families and low fertility rates. The romantic dyad became the central component of the family, and expectations for intimacy and personal fulfilment increased. Failure to meet such high expectations no doubt played a role in the rising divorce rate and perhaps contributed to the rise in cohabitation. Ciabattari (2017) argues that the redefinition of marriage from a utilitarian relationship to a relationship based on mutual attraction, intimacy, and personal happiness paved the way for recognition of same-sex couples. She also suggests that the economic instability that accompanied the economic transition from an industrial economy to an information/service/technology economy led to a decline in men’s wages and to more women entering the labor market. This change in turn has contributed to more egalitarian relationships. The industrial revolution led to the rise of an independent life stage in which young people often live alone, frequently at some distance from parents. Consequently, young adults have had more choice about partners and have made less traditional choices than in the past. Family members are now often scattered across state and national lines, but the new technologies allow for continued connection. Recently, work and family time is once again comingled in many families, as the new technologies allow more work from home. Unfortunately, this often means that the workday is expanded.

There is general agreement that the most pronounced change in family life in the United States in the past 50 years is the change in gender roles. By 1960, one third of all workers were women (Gibbs, 2009), but employers typically paid women less than men performing the same job. In addition, women were often treated in a demeaning manner at work. Females were about half as likely as males to go to college, and less than 10% of students playing high school sports were girls (Gibbs, 2009). When women needed

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surgery or other medical treatment, they often had to secure the signed consent of husbands or fathers. In many settings, they were not allowed to wear pants in public. (For a comprehensive review of the changes in gender roles in the United States since 1960, see Collins, 2009.) By 2016, women made up 39% of the labor force worldwide and 46% of the labor force in the United States (World Bank, 2017d). In 2013, 57.2% of U.S. women ages 25 to 64 were in the labor force compared to 69.7% of men; this includes 74.8% of women with children ages 6 to 17 and 64.7% of women with children under the age of 6. Unmarried mothers have higher rates of labor force participation than married mothers, 75.4% compared with 68.1%. Women working full time earned 82% of what men earned in 2013, up from 62% in 1979 (U.S. Bureau of Labor Statistics, 2014). In Bobby’s family, as in many African American families, women have always been in the paid labor force, often working more than one job. Black women have had higher rates of employment than White women since the Reconstruction period. For example, in 1920, the rate of employment of married Black women was 5 times the rate of employment among married White women. Some of this was based on the economic structure, but even middle- and upper-middle-class Black women had high rates of employment (Ciabattari, 2017). Landry (2000) argues that middle- class Black women “pioneered an egalitarian ideology of the family” (p. 5).

Along with this revolution in the labor force, there has been both change and persistent inequality in gender roles related to housework and childcare. From 1965 to 2010, women reduced the time they spent on housework, from 30 to 16 hours per week. During the same period men doubled the time they spent on housework, from 5 to 10 hours per week (Bianchi, Sayer, Milkie, & Robinson, 2012). As women’s participation in the labor force has increased, a surprising thing has happened about the amount of time parents spend on childcare activities. In 1965, mothers averaged 10.5 hours of childcare per week; in 2010, they averaged 13.7 hours per week, a 40% increase. During this same period, fathers also increased the amount of time they spent on childcare, from 2.6 hours per week to 7.2 hours per week (Bianchi et al., 2012). Family sociologists suggest that parenting expectations have intensified in the past few decades (Ciabattari, 2017).

Not all people in the United States agree that the changes in gender roles are a good trend. Certainly, around the world, many societies have not

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embraced these changes, even though economic globalization has depended on the cheap labor of women in poor societies working long hours in low-wage jobs (McMichael, 2017).

Critical Thinking Questions 10.1

Where have you gotten your ideas about what it means to be family? Have those ideas changed over time? If so, what influenced those changes? What beliefs do you have about appropriate gender relationships, child-rearing practices, and appropriate marriage partners? How might those beliefs affect your ability to work with different types of families and families facing different types of challenges?

Theoretical Perspectives for Understanding Families With an understanding of societal trends affecting families as background, you can use a number of theoretical “lenses” to understand family functioning and avenues for positive change. This section introduces six of these theoretical perspectives: the family systems perspective; the exchange and choice perspective; the symbolic interaction perspective; the feminist perspective; the life course developmental perspective; and the family stress, coping, and resilience perspective.

Family Systems Perspective Perhaps the theoretical perspective on the family most used by social workers is the family systems perspective, which focuses on the family as a social system. As you might imagine, this approach requires a focus on relationships within the family and relationships between the family and other social systems, rather than on individual family members. Persons are not thought of as individuals but as parts of overall patterns of roles and interactions (Smith & Hamon, 2017). All parts of the family system are interconnected. Family members both affect and are affected by other family members; when change occurs for one, all are affected. Certainly, we can see that Bobby’s and his sister’s deployments and their grandmother’s stroke affected the entire extended kinship system. From

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the family systems perspective, families develop boundaries that delineate who is in the family at any given time. In the Sharpe family, the boundaries have shifted over time to cope with stressors of various kinds. Among members, families develop organizational structures and roles for accomplishing tasks, commonly shared beliefs and rules, and verbal and nonverbal communication patterns (White et al., 2015). Like all systems, families have subsystems, such as a parental subsystem, sibling subsystem, or parent–child subsystem. Some family systems theories focus on the relationships within the family system whereas others focus on the ecosystem in which the family lives and the relationships between the family system and other social systems.

Family systems theorists who focus on the relationships within the family often use a mix of psychodynamic and social systems perspectives. Theorists who approach family situations from this perspective assume that current personal and interpersonal problems are the result of unresolved problems in the family of origin, the family into which we were born and/or in which we were raised (Allen & Henderson, 2017). They suggest that these unresolved problems continue to be acted out in our current intimate relationships. Patterns of family relationships are passed on from generation to generation, and intergenerational relationship problems must be resolved to improve current problems. Some social workers who employ this approach draw heavily on Murray Bowen’s (1978) concept of differentiation of self. Bowen suggested two aspects of differentiation of self in the family system (Walsh, 2014):

1. Differentiation between thinking and feeling. Family members must learn to own and recognize their feelings. But they must also learn to think about and plan their lives rather than reacting emotionally at times that call for clear thinking. It is assumed that many family problems are based on family members’ emotional reactivity to each other. This aspect of differentiation is very similar to Daniel Goleman’s concept of emotional intelligence, which is discussed in Chapter 4.

2. Differentiation between the self and other members of the family. While recognizing their interdependence with other family members, individuals should follow their own beliefs rather than make decisions based on reactivity to the cues of others or the need to win approval. They should do this, however, without attacking others or defending themselves. A clear sense of self allows them to achieve

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some independence while staying connected to other family members. This aspect of differentiation is similar to Howard Gardner’s concept of interpersonal intelligence, also discussed in Chapter 4.

The concept of differentiation has been criticized for its Anglo American emphasis on individualism versus collectivism. To some, it pathologizes the value of connectedness that prevails in some cultures. There is some merit to this criticism if the theory is misused to interpret a strong sense of familial responsibility as seen in the Sharpe family, and many ethnic minority families, to be a sign of lack of differentiation. A strong separate self is not a value in many cultures, and maturity is understood as the ability to live in respectful relation to others, appreciating human interdependence. In this matter, as with all others, it is important to practice with a desire to understand the cultural context of family life.

Exhibit 10.2 ● Sharpe Family Genogram

If you use a family systems perspective that focuses on relationships within the family for thinking about the Sharpe family, you might want to do a multigenerational genogram, or a visual representation of a family’s composition and structure (see Exhibit 10.2), to get a picture of the multigenerational family’s patterns of relationships. (Females are indicated by circles, males by squares; lines indicate marriages and births.) The Sharpe genogram helps you to visualize the extended family relationships in Bobby Sharpe’s family and Vivian’s more limited extended family system in her family of origin. It may lead you to think about whether Bobby’s deployments stirred unresolved grief about the loss of her father for Vivian and the loss of her husband for Vivian’s mother.

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Family systems theorists who focus on the relationships of the family with other social systems take an ecological perspective. They are interested in how the family system is interdependent with the physical and social environments. For example, the multilevel family practice model (Vosler, 1996) widens the social worker’s theoretical framework to include the larger systems in which the family system is embedded—including the neighborhood, local community, state, nation, and current global socioeconomic system. Thus, the multilevel model is broadly focused, acknowledging the economic, political, and cultural factors that affect resources available to the family and how family members view their current situation and future challenges. This model recognizes, as suggested in Chapter 9, that the family institution is interrelated with other social institutions—religious, political, economic, educational, social welfare, health care, and mass media. Among other things, this perspective would call our attention to how the Sharpe family is affected by terrorism and war, a global economic meltdown, and health and social welfare policies related to elder care and children with disabilities. They are also influenced by mass media coverage of race issues.

A family ecomap can be used to assess the way the Sharpe family is connected to larger social systems. The family ecomap uses circles, lines, and arrows to show family relationships and the strength and directional flow of energy and resources to and from the family (Hartman & Laird, 1983; see also Vosler, 1996). Ecomaps help the social worker and the family to identify external sources of stress, conflict, and social support. Exhibit 10.3 is an example of an ecomap for the Sharpe family during Bobby’s deployment to Afghanistan. It shows that Bobby and Vivian’s nuclear family has both external stressors and external resources.

Exchange and Choice Perspective on Families The common theme in the exchange and choice perspective on families is that family relationships are based on the exchange of resources valued by the participants—that family members act to maximize those outcomes they most value. Four assumptions of this perspective are the following (Smith & Hamon, 2017):

Humans act out of self-interest. Humans make choices about relationships. Humans are rational in their choices.

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Social relationships are characterized by interdependence and reciprocity.

Thibaut and Kelley were early exchange theorists who were interested in relationship stability and satisfaction and in how people evaluate the rewards and costs of their relationships. They proposed the concepts of comparison level and comparison level alternative (Kelley & Thibaut, 1978; Thibaut & Kelley, 1959). Comparison level, a standard for evaluating the rewards and costs of a given relationship, is based on what the evaluator expects from the relationship. The stable relationship is one in which all parties think that they are getting what they expect from the relationship. This theory recognizes that different people have different expectations for relationships. Comparison level alternative is the lowest level of outcomes a person will accept in a relationship in light of alternative relationship opportunities.

Rusbult (1980, 1983) proposed an investment model of social exchange that considers the level of commitment in relationships. In this model, commitment is based on feelings of psychological attachments and an intention to persist with the relationship in good times and bad. Rusbult suggested three conditions that enhance commitment:

There is a high level of satisfaction with the relationship based on feeling that needs and expectations are being met by the relationship. Alternative relationships are perceived to be unavailable or unattractive. There is a history of investing resources in the relationship and of receiving resources from the relationship.

Johnson and colleagues (Johnson, Caughlin, & Huston, 1999) furthered the exploration of relationship commitment by identifying three dimensions of commitment: personal, moral, and structural. Personal commitment is a personal desire to stay in a relationship. Moral commitment refers to values and morals that obligate one to stay in a relationship. Structural commitment focuses on the constraints against leaving a relationship, including the quality or lack of alternatives, the costs associated with ending the relationship, and the amount of investment in the relationship.

Exhibit 10.3 ● Sharpe Family Ecomap During Bobby’s Deployment to Afghanistan

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Let’s think of Vivian and Bobby Sharpe. It seems clear that they both have a commitment to the relationship and that they have persisted in the relationship in good times and bad. They both have invested time, effort, and identity in the relationship and have created and received such resources from the relationship as extended family members, children, shared memories, a house and other possessions, and mutual friends. They seem to have both a personal desire to stay in the relationship and a moral commitment to the relationship. They both also have a strong commitment to their two extended families.

The exchange and choice perspective has been used to study how people make choices about romantic partnerships (Schvaneveldt & Hubler, 2012). It has also been used to study whether couples stay together or separate. One research team found that women with higher education and greater earnings were more likely to stay married than women with lesser education and earnings when their relationships were nonviolent. However, in abusive marriages, women with higher education and earnings were more likely to get divorced (Kraeger, Felson, Warner, & Wenger, 2013). Researchers have also used the exchange and choice perspective to study different attitudes of women and men about the sexual exchange (Basow & Minieri, 2011).

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The exchange and choice perspective has been a major perspective in the field of aging for studying caregiving in intergenerational exchanges. Many societies assume that parents will be “repaid” for the resources they invested in bearing and rearing children when they are old and need care. A study in Norway, England, Germany, Spain, and Israel found that older adults who were able to reciprocate in exchange relationships with their adult children reported greater life satisfaction, but the highest level of satisfaction was reported by older adults who gave more to their adult children than they received (Lowenstein, Katz, & Gur-Yish, 2007). Another research team found that adult children, especially sons, were more likely to provide both instrumental and emotional support to their older adult parents if their parents had provided childcare for the grandchildren at an earlier time (Guerts, Poortman, & van Tilburg, 2012). Another study found that frail older persons in assisted living used types of deference, such as pleasantness, cooperation, and gratitude, to gain reciprocity in their relationships with family and staff (Beel-Bates, Ingersoll-Dayton, & Nelson, 2007). And, finally, one study found that sibling relationships are damaged when siblings perceive a lack of balance in sibling contributions to the care of aging parents (Whiteman, McHale, & Soli, 2011).

As noted in Chapter 2, the exchange and choice perspective has been criticized for its assumption that all human behavior is based on self- interest and for ignoring altruistic behavior. Some suggest that it assumes a separate rather than a connected self, even though interdependence has been a theme of exchange and choice theorists. These are valid criticisms, but a number of versions of the perspective propose that values, norms, and expectations are included in the evaluation of the benefits and rewards of interpersonal exchanges. The inclusion of moral commitment in relationships can account for altruistic exchanges.

Symbolic Interaction Perspective on Families Symbolic interaction theory has been one of the most influential theories in family studies (Allen & Henderson, 2017; Smith & Hamon, 2017). In the simplest terms, the symbolic interaction perspective on families understands family life as a system of meaning created through interaction. There are several streams of symbolic interaction theory with each focusing on particular themes of social life. In this chapter, I focus on four concepts that are particularly salient to family life: meaning, symbols,

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rituals, and roles.

Symbolic interaction theory proposes that human behavior is based on the meanings that people hold about objects and the social world. It further proposes that meanings come from social interaction and are based on interpretation of those interactions. Family studies scholars are interested in the meaning that particular types of behavior have for family members and in how families make meaning as they interpret cultural codes and beliefs. They are particularly interested in what family means to family members and how that meaning is influenced by cultural norms and expectations. For example, for the Sharpe family, family is a tight four- generational unit that is committed to stay together and support each other in good times and bad. It also is a unit that can incorporate members not connected by birth or marriage, members such as Vivian’s godparents. When Marcie arrived at university where she was not embedded in the family in day-to-day interactions, she began to understand that not all of her peers held the same meaning of family, and she confronted the question of what she wanted family to mean in her future life if she did not return to her hometown where her extended family interacted on a regular basis.

Cultures and families use complex systems of symbols to build cohesion and manage conflict. As noted in Chapter 8, a symbol is something that stands for something else. It can be language (shared family name), an object (a favorite family Christmas ornament), or nonverbal behavior (cooking from a family recipe carried down through the generations). Often, family members are not aware that they are engaging in symbolic behavior. One research team (Suter, Daas, & Bergen, 2008) investigated how lesbian couples negotiate a family identity through the use of symbols and rituals. They interviewed mothers of 16 two-parent lesbian families who had conceived their children through donor insemination. They found that the great majority of the couples in their sample used two types of symbols to develop a family identity. Most of the couples chose to use a hyphenated last name for the mothers and the children, to signify to the world that they are family. One mother reported continuing with her unhyphenated last name to remind her parents who were unsupportive of her partner relationship that she was their daughter and therefore her children were their grandchildren—in hopes of encouraging them to behave like grandparents to her children. All but one of the couples reported choosing sperm donors who had physical characteristics similar

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to the nonbiological mother, explaining that “looking related” symbolized familyhood.

A ritual is a set of actions or words performed regularly. They occur in the daily lives of families and are used to mark annual events. Imber-Black (2012) identifies five ways that family rituals are used:

1. They are used to shape and express family relationships. The use of bedtime rituals for children is one example.

2. They are used to mark transitions in family relationships and roles, such as high school graduation parties.

3. They are used for healing; the best example is the funeral ritual. 4. They are used to demonstrate what a family believes in. Two

examples are going to church together and marching in protest demonstrations as a family.

5. They are used to celebrate at times such as marriages, birthdays, and holidays.

The Sharpe family has developed a new family ritual of bringing Marcie’s favorite family dishes to share with her friends after track meets.

Role is a central concept in at least one stream of symbolic interaction theory. Roles are “the expected behaviors, rights, obligations, responsibilities, and privileges assigned to a social status [position]” (Ballantine et al., 2018, p. 128). In families, social statuses may include father, mother, grandparent, son, daughter, and so on. Roles are the expectations of how individuals should enact their social statuses. There are several ways to think about role expectation. There are the expectations that the larger society has for how family roles should be enacted, there are expectations within a given family of how roles should be enacted, and the individual occupying a particular role has his or her own expectations about how the role should be enacted. Role expectations may be clear or blurred. As noted earlier, gender roles have been changing for some time, becoming more blurred over time.

Role conflict is another important theme among symbolic interaction theorists who focus on roles. A common type of role conflict occurs when a person is expected to play two incompatible roles. In the recent past, the family literature has been filled with research about the role conflict that women face as they try to simultaneously perform mother and work- related roles (see Brown & Sumner, 2013; Meuleman, Kraaykamp, &

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Verbakel, 2017). Less research has focused on how men navigate role conflicts involved in family and work-related roles. Vivian Sharpe experienced such role conflict when she assumed a supervisory position while Bobby was on his second deployment. Marcie Sharpe faces such role conflict as a student athlete who must complete academic work in a timely manner, attend practices and perform at track meets, and try to get home to be a part of family events. Such role conflict leads to role strain.

Perhaps the most studied family roles are family gender roles. As noted in Chapter 8, gender is a socially created concept that consists of expectations a culture has for how men and women behave. Gender has historically organized family life in several ways (Knudson-Martin, 2012):

How decisions are made, whose interests take priority, and whose understanding of the world prevails How emotions should be expressed Which skills should be developed in females and males

As noted earlier, gender roles have been changing and yet remain a source of inequality, both in the world and in families. That idea receives further attention in the discussion of the feminist perspective on families. In the Sharpe family, gender roles have historically been more balanced than in many other families. Symbolic interaction theory would suggest that this family draws its expectations of gender roles from the wider society but is highly influenced by the meaning their African American culture has made of gender historically, which has been much more egalitarian than the view held by the wider society.

Feminist Perspective on Families As with other theoretical perspectives on the family, there are many variations of the feminist perspective, which has evolved over time. The perspective discussed here can be thought of as one stream of the larger conflict perspective. Unlike the family systems perspective, the feminist perspective on families proposes that families should not be studied as whole systems, with the lens on the family level, because such attention results in failure to attend to patterns of dominance, subjugation, and oppression in families (Chibucos & Leite, 2005). As suggested in Chapter 2, the focus of the feminist perspective is on how patterns of dominance in major social institutions are tied to gender, with women devalued and

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oppressed. When applied to the family, the feminist perspective proposes that gender is the primary characteristic on which power is distributed and misused in the family (Allen, Lloyd, & Few, 2009). Although the Sharpe family, like many African American families, has relatively egalitarian approaches to enacting gender roles, they live in a world that gives men more power than women and are influenced by that bias. Men and women are both involved in nurturing care, but women are considered the primary caregivers. Bobby and Vivian have nieces and nephews whose fathers have taken no responsibility for their children, leaving the mothers to take full responsibility for their economic and emotional well-being.

The feminist perspective makes a distinction between sex and gender: Sex is biologically determined, but gender is socially constructed and learned from the culture. The feminist perspective questions how society came to assign male and female characteristics; seeks understanding of women’s and children’s perspectives on family life; analyzes how family practices create advantages for some family members and disadvantages for others; and raises questions about caregiving responsibilities in families (Wood, 2006). It argues that a diversity of family forms should be recognized and that the strengths and weaknesses of each form should be thoughtfully considered. It calls attention to the family as a site of both love and trauma (Allen et al., 2009). Although gender is the starting point of the feminist perspective, most feminist theories focus on disadvantage based on other characteristics as well, including race, ethnicity, social class, sexuality, age, religion, nationality, and ability status. For example, womanist feminism, developed by women of color, calls attention to how Black women have had very different experiences from White women related to work, given their history of being both economic providers and caregivers for their own as well as other people’s children (Collins, 1990).

The intersectionality feminist theory is consistent with the multidimensional approach proposed in this book. Feminists of color introduced the concept of intersectionality to challenge the idea that gender is a monolithic category (Collins, 2000). They suggested that no single category is sufficient to understand social oppression, and categories such as gender, race, and class intersect to produce different experiences for women of various races and classes. Bobby Sharpe’s sister could probably embrace this version of feminist theory, based on the observation that her e-mails from Iraq often included musings about what she was learning about how different her life experiences and life chances have

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been from other women in her unit—White women, other African American women, and Asian and Latino women. She has also been shocked at the level of sexual harassment and sexual violence she has found in the military.

Intersectionality theory has also been used to look at other intersections in women’s lives—for example, those related to sexuality, religion, disability, age, and nationality. From this perspective, a person may experience oppression based on gender or some other attribute but also experience privilege based on a different attribute. Some people may experience oppression related to several social categories. Intersectionality theory is being expanded to study transnational contexts, considering the consequences of colonialism and capitalism for women (Allen et al., 2009). Intersectionality theory would call attention to the ways that Bobby Sharpe and members of his family have experienced oppression related to race. But it would also suggest that Bobby has been able to build a middle- class life that has given him some class privilege compared with poorer African American families. He also carries male privilege, heterosexual privilege, age privilege, and Christian privilege.

Life Course Developmental Perspective on Families The life course developmental perspective on families expands the concept of family system to look at families over time (McGoldrick et al., 2016). Families are seen as multigenerational systems moving through time, composed of people who have a shared history and a shared future. Relationships in families go through transitions as they move along the life course; boundaries shift, rules change, and roles are constantly redefined. The family moving through time is influenced by cultural factors and by the historical era in which they live. The life course perspective recognizes that different members of the family are born in different historical eras and experience particular family life events at different ages. This is what they refer to as cohort effects, with a cohort defined as a group of persons who were born during the same time period and who experience particular social changes within a given culture in the same sequence and at the same age. For example, when Bobby was deployed to Iraq and Afghanistan, he and Vivian were young adults with family and work obligations. Bobby and Vivian’s parents were in late middle adulthood with memories of the

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Vietnam War, even traumatic memories for Vivian’s mother. Marcie was in middle childhood, a period in which she was expected to be focused on school achievement and had the cognitive capacity to understand the dangers of war. Caleb was in early childhood during Bobby’s second deployment and was old enough to miss his dad and be aware of the climate in the family as members adapted structure and roles to compensate for Bobby’s absence. The members of this one family experienced the wars in Iraq and Afghanistan in different ways given their different positions in the life course.

The life course developmental perspective on families proposes that transition points, when the family faces a transition in family life stage or in family composition, are particularly stressful for families. Such transition points are especially stressful to those with a family or cultural history of trauma or disruption. McGoldrick et al. (2016) recognize that contemporary families are undergoing changes and have many forms, but they delineate seven stages that many U.S. families seem to pass through: leaving home; emerging young adults; joining of families through marriage/union; families with young children; families with adolescents; launching children and moving on at midlife; families in late middle age; and families nearing the end of life. Each of these stages involves normative changes and challenging tasks, both for individual family members and for the family system as a whole. In this view, change is inevitable in families, and transitions offer opportunities for positive adaptation and growth. The identified life stages may not fit many of the families in today’s society, however, including divorced and remarried families and families without children.

From the life course developmental perspective, we can see that Bobby and Vivian’s nuclear family was becoming a family with an adolescent and needed to open the family boundaries to allow for Marcie’s growing relationships with peers during Bobby’s deployment to Afghanistan. At the same time, they were a family with young children and needed to focus inward to ensure adequate care for two young children, including one with special care needs. This was happening as the family coped with the stressful transitions of Bobby’s deployment and Vivian’s new work responsibilities. The life course developmental perspective would alert us to the possibility that the family could struggle under the pressure of these stressful transitions. Recently, the family has needed to make some adjustments as Marcie left the family home to attend university. No doubt,

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Bobby, Vivian, and Caleb missed her greatly, and she had adjustments to make to take more responsibility for managing her time and for living in a more multicultural environment.

Family Stress, Coping, and Resilience Perspective You read about theories of individual stress and coping and the risk and resilience framework in Chapter 5, and the research in these areas is incorporated into the family stress, coping, and resilience perspective. The primary interest of the family stress, coping, and resilience perspective is the entire family unit (Price, Price, & McKenry, 2010). One theoretical foundation of this perspective is the ABC-X model of family stress and coping, based on Rueben Hill’s (1949, 1958) classic research on war- induced separation and reunion. It theorizes that to understand whether an event (A) in the family system becomes a crisis (X), we also need to understand both the family’s resources (B) and the family’s definitions (C) of the event. The main idea is that the impact of stressors on the family (the X factor) is influenced by other factors, most notably the internal and external resources available and the meaning the family makes of the situation. With some updating, this theory continues to be the basis for examining family stress and coping (see Allen & Henderson, 2017).

The ABC-X model describes a family transition process following a stressful event. A period of disequilibrium is followed by three possible outcomes: (1) recovery to the family’s previous level of functioning; (2) maladaptation, or permanent deterioration in the family’s functioning; or (3) bonadaptation, or improvement in the family’s functioning over and above the previous level. Thus, under certain circumstances, a stressor event can actually be beneficial, if the family’s coping process strengthens the family in the long term.

A more complex, double ABC-X model incorporates the concept of stress pileup (McCubbin & Patterson, 1983). Over time, a series of crises may deplete the family’s resources and expose the family to increasing risk of very negative outcomes (such as divorce, violence, or removal of children from the home). In this view, the balance of stressors and resources is an important consideration. Where there are significant numbers of stressors, positive outcomes depend on a significant level of resources being available to family members and the family as a whole. A family timeline, or chronology depicting key dates and events in the family’s life (Satir,

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1983; Vosler, 1996), can be particularly helpful in identifying times in the family’s life when events have piled up. Family timelines can be used to identify the resources that have been tapped successfully in the past, as well as resource needs in the present. Exhibit 10.4 presents a family timeline for the Sharpe family. It suggests a pileup of stressors for the family in the period before, during, and after Bobby’s deployment to Afghanistan; consequently, they needed a significant number of resources to allow for continued healthy individual and family functioning.

Two types of stressors are delineated in the ABC-X model (McCubbin & Figley, 1983). Normative stressors are the typical family life cycle transitions, such as the birth of a first child or the first child leaving home. Nonnormative stressors are potentially catastrophic events, such as natural disasters, medical trauma, drug abuse, unemployment, and family violence. These nonnormative events can quickly drain the family’s resources and may leave family members feeling overwhelmed and exhausted. Lower-level but persistent stress—such as chronic illness or chronic poverty—can also create stress pileup, resulting in instability within the family system and a sense of being out of control on the part of family members.

The family resilience perspective extends the family stress and coping perspective by seeking to identify and strengthen processes that allow families to bear up under and rebound from distressing life experiences. From this perspective, distressed families are seen as challenged, not damaged, and they have the potential for repair and growth (Walsh, 2016). In her book Strengthening Family Resilience, Froma Walsh (2016) draws on existing research on risk and resilience to present a family resilience model for intervention and prevention. She defines resilience as “the capacity to rebound from adversity strengthened and more resourceful” (p. 4). She describes this as “bouncing forward,” rather than bouncing back. She assumes that all families face adversity, but resilient families “struggle well” and experience “both suffering and courage” (p. 6). She cautions social workers to avoid the tendency to pathologize the families they encounter in the midst of transitional distress, assessing families, instead, in the context of the situations they face and looking for family strengths.

Walsh (2012c, 2016) has taken the research on risk and resilience and organized the findings into a conceptual framework for targeting interventions to strengthen core processes of family resilience, whatever

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form the family takes. She organizes this framework into three dimensions: family belief systems, organizational patterns, and communication processes. Each dimension is summarized here.

Family belief systems. How families view problems and possibilities is crucial to how they cope with challenges. Resilient families make meaning of adversity by viewing it as a shared challenge. They find a way to hold on to a shared confidence that they can overcome the challenge. They act on this shared hope by taking initiative and persevering. They draw on a spiritual value system to see their situation as meaningful and to imagine future possibilities. Organizational patterns. Resilient families have organizational patterns that serve as shock absorbers. They maintain flexibility in family structure and are able to make changes in roles and rules to respond to the demands of the moment, but in the midst of change, they hold on to some rituals and routines to provide stability and continuity. Strong family leaders provide nurturance and protection to children and other vulnerable family members, but they also leave some room to negotiate rules and roles, based on the situation at hand, and exercise leadership with warmth. Resilient families provide mutual support and commitment while honoring individual differences. They are able to mobilize extended kin and community resources.

Exhibit 10.4 ● Sharpe Family Timeline

Communication processes. Good communication is vital to family resilience. Resilient families send clear, consistent, and genuine messages. They share a wide range of feelings and show mutual

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empathy and tolerance for differences. They can use humor to lighten threatening situations. They also engage in collaborative problem solving, identifying problems and possible solutions, sharing decision making, and taking concrete steps.

Froma Walsh (2012b) cautions that

the concept of family resilience should not be misapplied to blame families that are unable to rise above harsh conditions, by simply labeling them as not resilient. Just as individuals need supportive relationships to thrive, families need supportive institutional policies, structures, and programs in workplace, health care, and other larger systems. (p. 412)

The Bobby Sharpe nuclear family has weathered a number of challenges along the way: health problems, war zone deployments for Bobby and his sister, the birth of a baby with special care needs, intense elder care needs, and the launching of the firstborn child. According to Froma Walsh’s model of family resilience, they are a resilient family. They view each adversity as a shared challenge for the extended kinship network, and they move forward with confidence that they can overcome each challenge. They take the initiative to devise plans for handling difficult situations, and they draw on a deeply held faith that makes meaning of their challenges. In terms of organizational patterns, they are flexible in the assignment of roles and resourceful in mobilizing extended care resources. They have made more use of family than community resources, but Vivian was grateful for the support of their church during Bobby’s deployment to Afghanistan. They communicate well, for the most part, often using humor to lighten stressful situations. Perhaps Vivian, her sister, and her mother could benefit from more open communication about the struggles they had after Vivian’s father was killed in Vietnam. They have never been able to talk about this, and it may well play a role in Vivian’s sister’s clinical depression and her mother’s pervasive sadness.

Critical Thinking Questions 10.2

Which one of the preceding theoretical perspectives on families do you find most useful for thinking about the multigenerational Sharpe

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family? Which perspective do you think offers the least insight into this family? Which of the perspectives do you find most useful for thinking about your own family? The least useful? Explain your answers.

Diversity in Family Life One question that must be asked about each of the theoretical perspectives on families is how well it applies to different types of families. As suggested earlier, diversity has always existed in the structures and functions of families, but that diversity is clearly increasing, and the reality today is that a great deal of diversity exists among families, both in the United States and globally. There is diversity in family structures, as well as economic and cultural diversity.

Diversity in Family Structures It is difficult, if not impossible, to catalog all the types of family structures represented in the world’s families. The following discussion is not meant to be exhaustive but rather to provide an overview of some relatively common structures that social workers might encounter.

Nuclear Families

There is a worldwide trend toward the nuclear family structure as societies become more industrialized and more people live in urban areas where smaller families are more practical (Ballantine et al., 2018). The nuclear family is an adaptation to industrialization and urbanization and has been the most common family form in the United States throughout most of its history. Consequently, we would expect nuclear family to be easy to define. Actually, the anthropology and family literatures present different definitions of this family structure. Some definitions specify that the nuclear family is composed of mother, father, and children (Guest, 2017). Others specify that a nuclear family is composed of at least one parent and one child (Haviland et al., 2017). The latter definition would include a broader brush of families, including lone-parent families and same-sex partners with children. But for the purpose of this discussion, we define the nuclear family as composed of two parents and their biological, adopted, or fostered offspring, because we think it is important to distinguish this

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idealized family structure from other family structures. Although the nuclear family has been presented as the ideal model throughout U.S. history, it has always been an ideal that was difficult to accomplish (Hareven, 2000). Families in colonial days and later were often marked by unplanned pregnancies and untimely death. Early parental death led to remarriage and stepfamilies and to children being placed with extended family or in foster care or orphanages. Nonkin boarders were brought in to provide income and companionship.

In 2012, according to the U.S. Census Bureau (Vespa, Lewis, & Kreider, 2013), 20% of households in the United States were married couples with children, down from 40% in 1970. We don’t know a lot about the functioning of nuclear families because they are not often studied, except to compare other types of families with them. For example, children in lone-parent families are often compared with children in two-parent families, with the finding that children benefit from the resources— material and social—that come with two parents (see Shore & Shore, 2009). Recent U.S. Census data indicate that adults in married-couple families are older, more likely to be college educated, more likely to own their own homes, and more likely to have higher incomes than lone-parent families (Vespa et al., 2013). Both government (through marriage initiative programs) and religious groups are actively involved in trying to promote more two-parent families. Some social scientists see risk in nuclear families as compared with extended families, suggesting that the family can easily become too isolated with too much pressure put on the spousal relationship to fill each other’s needs (Walsh, 2012b).

Photo 10.1 The birth of a first child is a major transition for a family system, calling for new roles and the management of new tasks.

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The often idealized nuclear family has a father in the labor force and a stay-at-home mother. That type of nuclear family peaked in the 1950s but was already beginning to decline by 1960. In 2016, 61.1% of married couples with children younger than age 18 had two parents in the labor force (U.S. Bureau of Labor Statistics, 2017b). Having two parents in the labor force puts married couples at an economic advantage over single parents but also raises concerns about who will provide childcare and other domestic labor.

Nuclear families may include adopted and foster children (as may lone- parent families, same-sex partner families, and stepfamilies). The American Academy of Child and Adolescent Psychiatry (2015) estimates that 120,000 children are adopted each year in the United States. Recent data indicate that 25% of adopted children in the United States are international adoptions, 38% are private domestic adoptions, and 37% are foster care adoptions (Statistic Brain, 2017). On average, adoption is a highly successful solution to providing permanent family relationships to children whose biological parents are unavailable. Adoptive families face the same challenges as other families, but they also face some additional

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ones. Every adopted child has two families, and disclosure about and navigation of this complexity must be addressed. The adoptive family must also develop a coherent story about how they came to be family and cope with issues of loss, grief, and attachment (Rampage et al., 2012).

Families who foster are a unique family structure providing temporary, safe, and stable homes to children who have been maltreated or otherwise under the legal care of the state. In September 2015, 427,910 children were in state-sponsored foster care in the United States. About 30% of these children were in kinship foster home placements, being cared for by relatives (Children’s Bureau, 2017). An unknown number of children were also being informally fostered, most often by relatives. The temporary nature of fostering presents its own special challenges for both the child and the family, and foster parents are typically called on to manage difficult behaviors of children with a history of trauma. In addition, they parent under the oversight of child welfare agencies (Julien-Chinn, Cotter, Piel, Geiger, & Leitz, 2017).

Extended Families

An extended family is one in which two or more adult generations share households and family tasks. This is a common pattern in agricultural societies around the world. In the United States, this pattern exists in some rural families, as well as in some ethnic groups, particularly among Mexican Americans and some Asian American groups. This is financially practical, and it also allows family groups to practice their ethnic traditions (Ballantine et al., 2018). However, there are some downsides to the extended family. Sometimes family members exploit the labor of other family members. In other cases, the emotional and economic obligations to the extended family may come at the expense of individual development (Leeder, 2004).

In recent years, there has been great debate about the appropriate role for extended family in the care of children orphaned by AIDS in southern Africa (see Mathambo & Gibbs, 2009). In the United States, although parental substance abuse is not a new challenge for child welfare agencies, the current opioid epidemic is straining child welfare budgets. In 1999, parental substance abuse was the reason for removal of children from the home in 15.8% of the cases. This percentage had doubled by 2014, with 31.8% of children removed from the home being removed because of

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parental substance abuse (National Conference of State Legislatures, 2017). About one third of children placed in foster care because of parental substance abuse are placed with relatives (Generations United, 2016). Where resources are scarce, both support and misery are shared.

Some family scholars suggest it is more appropriate to speak of the contemporary family in the United States and many other nations as a modified extended family than a nuclear family (Knodel, Kespichayawattana, Saengtienchai, & Wiwatwanich, 2010). Members of the extended family network may not reside together, but they are involved with each other in ongoing emotional and economic action. They stay connected. This is clearly the pattern in the Sharpe family, and as I write about their “extended family,” that is the way I am thinking about extended family. This is also the pattern in the current migrations across national lines. Family members are often separated across thousands of miles, but money is shared and the new technologies allow ongoing communication. Often immigrant groups travel together in kin networks and live very close to each other when not living together. The extended kin network is a source of support in times of crisis. For example, children may be transferred from one nuclear family to another within the extended kin network as need arises, as happened when Bobby and Vivian cared for their niece while her mother was deployed to a war zone. The extended kin system also influences values and behaviors. Extended family ties are usually stronger in Asian and Pacific Islander Americans, Native Americans, African Americans, and Latino Americans than among middle-class White Americans (Ho, Rasheed, & Rasheed, 2004).

Cohabiting Opposite-Sex Couples

Cohabiting is living together in a romantic relationship without marriage. This method of forming a romantic partnership has been on the increase in the United States and other Western societies since 1960. Haviland et al. (2017) report that the number of cohabiting unmarried opposite-sex couples in the United States increased from 439,000 in 1960 to 8.3 million in 2015. Cohabitation is now recognized as a family form by family scholars. Sociologists Patrick Heuveline and Jeffrey Timberlake (2004) examined data from almost 70,000 women from 17 nations to learn how nonmarital cohabitation in the United States compares with that in 16 other late-industrialized nations. They examined the percentage of women in each of the nations estimated to experience at least one cohabiting

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relationship before the age of 45 and found a very large cross-nation range, from 4.4% in Poland to 83.6% in France. Spain and Italy were at the low end, with less than 15% of women in each country reporting cohabitation. The United States fell in the middle of the range, with about 50% of women estimated to ever cohabit before age 45, and more recent data indicate that, although the numbers are rising, the United States continues to rank in the middle globally in terms of cohabitation (OECD Family Database, 2016). Heuveline and Timberlake (2004) suggest that the cross- national differences in rates of cohabitation are influenced by a number of sociocultural factors, including religion, the economy, partnership laws and benefits, and availability of affordable housing. Besides differences in rates of cohabitation, they also found different types of cohabiting relationships occurring in different nations. For example, cohabitation can be a prelude to marriage or an alternative to marriage.

Heuveline and Timberlake (2004) found that cohabiting relationships are less stable in the United States than in other countries. More recent research also found that cohabiting unions in the United States are very short-lived, averaging a couple of years in length before ending in either separation or, less often, marriage (Brown, Manning, & Payne, 2017). Analyzing U.S. data from 2006 to 2010, Copen, Daniels, and Mosher (2013) found that first cohabitations lasted longest for foreign-born Hispanic women (33 months) and shortest for White women (19 months).

The global increase in cohabitation is related to the increasing age at marriage. In the United States and other Western industrialized countries, cohabitation is most frequent among young adults ages 20 to 34 (OECD Family Database, 2016). Recent analyses indicate that roughly three quarters of U.S. young adults have cohabited at some point, and the majority of recently married couples had cohabited before marriage (Manning & Sykes, 2015). Data indicate, however, that older adults are the fastest-growing group of U.S. cohabitors as the baby boomers age (Vespa, 2012).

Demographic data indicate that women with less than a high school education were more likely than women with a bachelor’s degree or higher to cohabitate as a first union in the period 2006–2010 (Copen et al., 2013). One analysis indicates that the demographics of cohabitors are changing, with cohabitors being increasingly likely to be Black or Hispanic, to have grown up without both parents or without a religious affiliation, and to

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have had children before they began the cohabitation union (Vespa, 2014). However, the data also indicate that the share of cohabitors with plans to marry has been declining over time in all groups and that attitudes about having and raising children in cohabiting unions have shifted over time. In one analysis, 74% of women aged 15 to 44 thought it was okay to have and raise children in cohabiting unions, with little difference across educational attainment, age, or race/ethnicity (Sykes, 2015). Researchers have noted the rise in serial cohabitation, defined as two or more cohabiting relationships over time, particularly among emerging adults (Vespa, 2014). The researchers suggest that serial cohabitation is a new intensive form of dating among some emerging adults and an alternative to marriage among some older never-married women (Lichter, Turner, & Sassler, 2010). The evidence suggests that some serial cohabitors would prefer to be married whereas others are opposed to marriage.

Qualitative research with a U.S. sample of cohabiting young adults identified three primary motives for cohabiting: wanting to spend more time together, wanting to share financial burdens, and wanting to test compatibility (Huang, Smock, Manning, & Bergstrom-Lynch, 2011; Vespa, 2014). There were gender differences in the perceived disadvantages of cohabitation. Women saw cohabitation as involving less commitment and less societal legitimacy than marriage, whereas men noted the loss of freedom involved in cohabitation. Both men and women reported that the benefits of cohabitation outweigh the disadvantages.

For several decades, marriage and family researchers have been interested in the relative benefits and costs of cohabitation in relation to marriage, generally finding a marriage advantage for both individual well-being and relationship satisfaction. During the 1980s and 1990s, an extensive body of research found that premarital cohabitation increased the likelihood of divorce. More recent research indicates that as cohabitation became more widespread, this connection between premarital cohabitation and divorce disappeared (Manning & Cohen, 2012). One research team recently studied the question of relationship quality by examining relationship happiness among four groups: married couples who married without previous cohabitation (direct marriage), married couples who had previously cohabited, cohabiting couples with plans to marry, and cohabiting couples with no plans to marry (Brown et al., 2017). They found that women who went directly to marriage without prior cohabitation (direct marriage) reported higher levels of relationship

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satisfaction than any other group, but men who married directly did not share that advantage in relationship satisfaction. There was no difference in relationship satisfaction between men who cohabited premaritally and cohabiting men who plan to marry, but cohabiting women with plans to marry had less relationship satisfaction than married women who cohabited premaritally. The lowest levels of relationship satisfaction were found in cohabiting men and women with no plans to marry. Although there were some gender differences in the advantages of marrying without prior cohabitation, no overall gender gap was found in relationship happiness. The researchers point out that direct marriage is increasingly uncommon, and most married couples fall in a middle ground as either married with prior cohabitation or cohabiting with plans to marry.

Another research team examined the way that individual, not relationship, well-being is associated with cohabitation and marriage (Musick & Bumpass, 2012). They used several measures of individual well-being including global happiness, depressive symptoms, global health, and self- esteem. Social ties were also measured, including quality of relationships with parents, contact with parents, and time with friends. They summarized their overall findings in this way: “We found the similarities between marriage and cohabitation to be more striking than the differences” (p. 12). They found that entering any union, whether by marriage or cohabitation, improved psychological well-being and reduced the level of contact with parents and friends. They found no differences in individual well-being between those who married directly and those who cohabited premaritally. Those who were married fared better in health, but cohabitors measured higher in happiness and self-esteem. However, the researchers found that psychological well-being diminished over time in both the married and cohabiting groups.

Couples With No Children

Over the past 4 decades, the United States and other wealthy nations have seen an increase in the proportion of married couples who are childless. Of note, relatively high rates of childlessness were experienced in these same societies from 1890 to 1920, followed by the lowest recorded prevalence of childlessness during the 1950s and early 1960s (Abma & Martinez, 2006; Kohli & Albertini, 2009). Thus, the current high rates of childlessness are a return to a trend started in the late 19th century. Couples may be temporarily or permanently childless. Permanently

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childless couples may be voluntarily or involuntarily childless. Although childlessness is a growing type of family structure, there is very little research on childless couples; most of the research that has been done focuses on childless women, with little or no attention to childless men (fertility of men is much harder to study) or to the childless couple system. Research on infertility has been more inclusive of men. The research also often does not distinguish between married and unmarried women.

The most comprehensive study of childless women in the United States to date was conducted by Joyce Abma and Gladys Martinez (2006) at the National Center for Health Statistics. Their study examined three types of childlessness: temporarily childless, voluntarily childless, and involuntarily childless. They studied both married and unmarried women and did not make distinctions between these two groups. They found that from 1976 to 2002, the percentage of women aged 35 to 39 who were childless increased from 11% to 20%, and the percentage of women aged 40 to 44 who were childless increased from 10% to 18%. The voluntarily childless was the largest group of childless women in 2002, making up 42% of all childless women; 30% were temporarily childless, and 28% were involuntarily childless. As might be expected, given declining fertility between the ages of 35 and 44, women who were temporarily childless were more likely to be in the younger cohort, ages 35 to 39, and women who were involuntarily childless were more likely to be in the older group, ages 40 to 44.

All three groups of childless women were found to have more egalitarian views on family relationships than the women who were parents. There were some differences in the profiles of these three groups of childless women, however. Consistent with earlier research, the voluntarily childless women, compared with parenting women and other childless women, were disproportionately White, tended to be employed full time, had the highest incomes, and were more likely to be nonreligious. However, from 1995 to 2002, the percentage of Black women among the voluntarily childless increased to where it was equivalent to their share of the total population of women ages 35 to 44. From 1976 to 2002, Hispanic women were consistently underrepresented among the voluntarily childless.

One finding from the Abma and Martinez (2006) study is that there was a slight downturn in the percentage of women who were voluntarily

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childless and a slight upturn in the percentage who were involuntarily childless from 1995 to 2002. They speculate that this change is probably related to the trend toward later marriage and childbearing, resulting in some couples discovering that they had fertility problems when they decided to become parents. Infertility can be caused by problems in the reproductive system of the man, the woman, or both. It is a global problem, but in countries with low resources it is most likely to be caused by sexually transmitted diseases, unsafe abortions, and home deliveries in unhygienic circumstances. Although there are many assistive technologies for dealing with fertility problems, these are inaccessible to most women in low-resource countries. In many countries of the world, childlessness is highly stigmatized, as well as an economic disadvantage where children are economic providers (Ombelet, 2014). One recent study of Australian childless women found that they reported high levels of stigmatization and exclusion from certain social and civic domains of life (Turnbull, Graham, & Taket, 2016). Research in Germany indicates that the social networks of midlife parents and childless couples differ, with midlife childless women having many fewer mothers in their networks and mothers having many fewer childless women in their networks (Wagner, Wrzus, Neyer, & Lang, 2015). These differences were not found between fathers and childless men.

Research on the emotional impact of infertility indicates that it is a major source of stress. Infertility has been consistently associated with lower scores in quality of life, affecting mental health, physical vitality, and social functioning (Gana & Jakubowska, 2016). Contradictory findings have been reported, however, on the impact of infertility stress on marital satisfaction. Some researchers have found that couples experiencing infertility report normal levels of marital satisfaction. Other researchers have found that infertility is associated with lower levels of marital satisfaction. Still other researchers report that infertility brings partners closer. Gana and Jakubowska (2016) found that infertility impacted both emotional well-being and marital satisfaction but had a stronger impact on emotional distress than on marital satisfaction. The stressors related to infertility may go on over a long period of time. Treatments can be very costly and are often unsuccessful.

Little is known about the lives of childless couples. In one attempt to understand the life trajectories of childless adults, an entire issue of the journal Ageing & Society was devoted to research on childless older adults.

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One researcher (Wenger, 2009) found that by the time they reached old age, childless people in rural Wales had made adaptations to their childless situation and developed closer relationships with kin and friends. This is the way Vivian Sharpe’s godparents have adjusted to involuntary childlessness, and they draw great pleasure from being a part of the lively extended kin network in which Vivian and Bobby are embedded. On average, however, childless older adults in Wales entered residential care at younger ages than older adults who had children.

Lone-Parent Families

Lone-parent families are composed of one parent and at least one child residing in the same household. They are headed by either a divorced, a widowed, or an unmarried parent. In recent decades, the prevalence of lone-parent families has dramatically increased in all income groups in the United States and other late-industrial societies but nowhere more than in the United States (U.S. Census Bureau, 2012). In 2014, over one third (35%) of children in the United States lived with only one parent, up from 11% in 1970 (Kids Count Data Center, 2017; Shore & Shore, 2009). This compares with less than 5% in Greece and Spain, 6% in Portugal, and 7% in Italy (U.S. Census Bureau, 2012). Around the world, lone mothers are the great majority of parents in lone-parent families, but households headed by lone fathers are on the rise, with a ninefold increase in the United States since 1960 (from 14% of all lone-parent families in 1960 to 24% in 2011) (Livingston, 2013). Lone fathers are more likely than lone mothers to be living with a cohabiting partner (41% versus 16%), are less likely to live at or below the poverty line (24% versus 43%), and are somewhat less educated, older, and more likely to be White (Livingston, 2013).

In the United States, 67% of Black or African American children, 53% of American Indian children, 42% of children of two or more races, 42% of Hispanic or Latino children, 25% of non-Hispanic White children, and 17% of Asian and Pacific Islander children lived with one parent in 2014 (Kids Count Data Center, 2017). It is important to exercise caution with these statistics, however. Sometimes families who get counted as lone- parent families reside with other family members and/or may have the support of a romantic partner, as demonstrated by data about lone-father families.

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It is difficult to generalize about lone-parent families because of the different pathways taken to creating a lone-parent family and the diverse circumstances in which they live. Some lone parents have always been single, and others are separated, divorced, or windowed. Some are co- parenting, and others are not. Some are financially secure, and others are impoverished. Some have extensive support from robust support networks, and others are relatively isolated. Some have chosen to parent alone, using processes such as adoption, donor insemination, or surrogacy. The status of lone-parent families often changes over time as the lone parent moves in and out of relationships.

Lone parents around the world have some common challenges: They are playing the dual roles of nurturer and income provider, often with no partner assistance. On average, they work longer hours, have more economic problems, and have less emotional support than married parents. If they became lone parents after divorce, they and their children must cope with loss and grief, may have to relocate, and face decline in their standard of living (Anderson, 2012). Lone-parent families headed by mothers are especially vulnerable to economic insecurity and poverty, and the most common form of single parenthood (about 75%) involves low- income minority mothers (Ventura, 2009).

For decades, research has found that single mothers have greater psychological distress than married mothers and engage in less effective parenting. A preponderance of research has also found that children in lone-parent families are more likely than children in married families to have more behavioral and emotional problems, poor school readiness, lower school academic achievement, and higher school dropout. In adulthood, they have been found to engage in more risky health behaviors and to be involved in unstable relationships (see Nicholson, D’Esposito, Lucas, & Westrupp, 2014, for a review of this research). In a longitudinal study of Australian children, Nicholson and colleagues (Nicholson et al., 2014) found that the weekly household income of single mothers was one quarter to one third that of couple mothers, and the rates of poverty were much greater in the lone-parent families (40% versus 6%). Lone mothers reported much greater psychological distress and were found to have less effective approaches to parenting. They reported exposure to adverse environmental circumstances at 3 times the rates of couple mothers. The researchers found, however, that when they controlled for socioeconomic and neighborhood factors, there were no differences in parenting practices

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between lone and couple mothers, and the differences in psychological distress were greatly reduced. Other studies suggest that poverty is a bigger factor than single parenthood in the differences in child outcomes and parental functioning (Edin & Kissane, 2010). Ruth Sidel (2006) interviewed 50 women from a variety of racial, ethnic, religious, and social classes who had been single mothers at some point in their life. She describes their lives in moving detail and suggests that they are “unsung heroes” who seek to raise their children and make ends meet in the face of immense challenges. Her in-depth interviews tell a story that goes beyond the typical quantitative research about lone-parent families.

Photo 10.2 Family time can happen in many ways.

©iStock/ bernardbodo

Cross-national differences in government policies result in different circumstances for single mothers and their children, however. Some countries provide universal child allowances, paid maternity leave, and free childcare. Children of single mothers have higher rates of poverty than children from two-parent families around the world, but the poverty rates among children of single parents are much lower in countries that provide such supports. In 2005, the poverty rate (based on 55% of median income) for single-mother families in the United States was 51%, compared with 8% in Denmark (Casey & Maldonado, 2012). This is a very large range and primarily reflects differences in child and family policies in the two countries. Three other countries had poverty rates of over 40% for single- mother families: Canada, Germany, and Ireland. At the other end of the continuum, three other countries had poverty rates of less than 15% for single-mother families: Norway, Finland, and Sweden.

In the United States, social policy has focused on two priorities to improve

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the living situation of children in lone-parent families, as well as to decrease public expenditures on these families: improved child support payment by the nonresidential parent and marriage of the lone parent. The first of these priorities is to step up the enforcement of child support payment by the nonresidential parent. Research indicates that if nonresidential parents pay the child support required, the economic situation of residential children does indeed improve, although not to the level they would experience if both parents resided together. However, for impoverished families, the payment of child support is not sufficient to bring them out of poverty (Huang & Han, 2012).

The second policy direction proposed in the United States in recent years is to encourage marriage of the lone parent. Some policy analysts conclude that this would, indeed, improve the economic situation of children currently being raised in lone-parent families (see Rector, Johnson, & Fagan, 2008). Others conclude that although this might be a good solution for some lone-parent families, male unemployment and marginal employment present serious barriers to marriage for many low-income couples (Edin & Reed, 2005; Gibson-Davis, Edin, & McLanahan, 2005). These latter researchers have found that men and women in impoverished neighborhoods often value marriage highly but do not see themselves as economically stable enough to have a viable marriage. Impoverished lone mothers have reported that they do not have a pool of attractive marriage partners who are economically stable, not addicted to drugs and alcohol, not involved with the criminal justice system, and able to be loving and kind parents to their children (Edin, Kefalas, & Reed, 2004).

Stepfamilies

Stepfamilies have always been a relatively common family form in the United States, but they have changed over time. In colonial days, stepfamilies were typically the result of one parent dying and the other parent remarrying. Today, most stepfamilies are formed after biological parents divorce or dissolve their relationship and go on to form new romantic partnerships. Stepfamilies are those with two adults and children, where one adult is not the biological parent. We don’t have good current data on the number of stepfamilies in the United States, but it is estimated that one in four marriages (26%) include stepchildren (Stykes & Guzzo, 2015). However, some data suggest that in the current era, stepfamilies are more likely to be cohabiting than married (Pasley & Garneau, 2012).

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Another indication of the prevalence of stepfamilies comes from a Pew Research Center (2011) report that found that 4 in 10 U.S. adults report having a step relative, with 30% reporting a step or half sibling, 18% reporting a living stepparent, and 13% reporting a stepchild. Among the survey respondents under the age of 30, 52% reported having step relatives.

Stepfamilies can be of several types. The most common is the stepfather family in which the mother has children from a previous relationship in the household. Another type is the stepmother family in which the father has children from a previous relationship in the household. Some stepfamilies have children from both partners’ prior relationships living in the household. Any of these family forms can become more complex when children are born to the new partnership. Stepfamilies are also formed by same-sex partners where one or both partners have children from prior relationships living in the household. Although not counted by the U.S. Census Bureau as living in stepfamilies, many children reside with a single mother and make visits to the biological father and his new wife.

Stepfamilies are complex family structures. They involve complicated networks of relationships that include biological parents; stepparents; perhaps siblings and stepsiblings; and multiple sets of grandparents, aunts, uncles, and cousins. Children in stepfamilies may move back and forth between two homes and maintain connections with the nonresident parent. There are a number of subsystems in the stepfamily, including the new couple, the parent–child, the stepparent–stepchild, the child–nonresidential parent, the biological parents, the parent–stepparent–nonresidential parent, and sometimes the sibling or stepsibling subsystem. The parent–child subsystem is a more long-standing form than the new couple subsystem.

The new stepfamily must negotiate rules, roles, rituals, and customs. Things as simple as foods served in the household, bedtimes, chores, and methods of discipline may become points of tension. This works best when the issues and expectations are made explicit. It is quite common for loyalty conflicts to arise involving several subsystems, with family members feeling torn and caught between people they love (Pasley & Garneau, 2012). The biological parent often feels torn between loyalty to the child(ren) and love for the new spouse or partner. Children may aggravate this situation by testing the biological parent’s loyalty to them. Children may feel a conflict between their loyalty to the nonresidential

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parent and the need to form a relationship with the stepparent. Children can easily get triangulated into conflict between the parent and stepparent, between the residential parent and the nonresidential parent, or between the stepparent and the nonresidential parent. Events such as Parent Night at school can become a knotty situation. The more children in the stepfamily situation, the more complicated the negotiations can become.

Stepfamilies work best when all parties involved recognize that stepfamilies are a different system form from nuclear families, a more complex form, where attachments cannot be assumed (Miran-Khan, 2017). It appears that many stepfamilies navigate the complex system with some success. The Pew Research Center (2011) report indicated that 70% of adults with at least one step relative report being very satisfied with their family life, compared to 78% of adults with no step relatives. Research indicates, however, that children in stepfamilies generally have lower well- being than children in two-biological-parent households, with little or no advantage over children in single-parent households (King, Boyd, & Thorsen, 2015). Research also indicates that a sense of family belonging is associated with child well-being. King and colleagues (2015) found that for adolescents living in stepfamilies, the perceived quality of relationship with both the biological parent and the stepparent was the factor most strongly associated with the feeling of family belonging. The perceived quality of relationship with the biological parent was even more strongly related to a sense of belonging than the perceived quality of relationship with the stepparent. Van Der Pas, Tilburg, and Silverstein (2013) reviewed the research on later-life stepfamilies and reported that issues of filial expectations are prominent in this literature, especially in relation to caregiving. For example, older men in stepfamilies have been found to have greater rates of institutionalization than older men from traditionally married families.

Same-Sex Partner Families

There is evidence that long-term relationships, even marriage, between same-sex partners were relatively common in premodern Europe (Boswell, 1994), but same-sex marriage is a new phenomenon in modern times (Patterson, Riskind, & Tornello, 2014). No other transformations in family lives around the world are as rapid as the changes in same-sex families. In the 1990s, same-sex marriages were not legally recognized anywhere in the world. In 1989, Denmark was the first country to give legal rights to

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same-sex couples but did not allow them to marry. In 2001, the Netherlands became the first country to allow same-sex marriage, and by August 2017, 25 countries allowed same-sex marriage (Pew Research Center Religion & Public Life Project, 2017b). Around the world, same- sex couples may legally marry but not adopt children in some places; they can adopt but not marry in other places. In some countries, same-sex sexual behavior is illegal, and it is punishable by death in a few countries (Bearak & Cameron, 2016; Patterson et al., 2014). In the United States, a 5-4 Supreme Court ruling in June 2015 made same-sex marriage legal in every state, ruling that marriage is a fundamental right and any ban on marriage equality is unconstitutional. However, efforts at the state level to restrict the civil rights of LGBTQ people have gained steam since 2013 when the Supreme Court first ruled in favor of some marriage rights for same-sex couples. In June 2017, the Washington Post reported that since 2013, state legislatures have introduced 348 bills that restrict LGBTQ rights in some way (Mason, Williams, & Elliott, 2017). Given the current state of debate about same-sex marriage and other LGBTQ civil rights, it is quite likely there will be other actions by nations and states by the time you read this.

As we review the research literature on same-sex couples, it is important to keep the previous context in mind. The preponderance of research about same-sex partner families was done in a time when such partnerships were not legally recognized. As we think about research reports, if the data are available, we should consider when the sample participants were born, where they were born, and their cultural group memberships. Even in the United States, same-sex families face different risks and protections depending on such factors, and we should not assume that successful coping in one cultural niche can be generalized to other subcultures (Green, 2012). Another thing to remember as we review the available research is that researchers who used large survey samples, including U.S. Census Bureau data, have had to interpret same-sex family relationships based on answers to standardized questions, and that interpretation is not always straightforward and is open to reinterpretation. Here is an important example. The U.S. Census Bureau retracted its 2010 estimates of the number of same-sex couple households after critical review of its interpretation of answers on the two questions it had used to determine same-sex families. It initially reported 901,997 same-sex households in the United States, but upon reinterpretation reduced that number to 646,464, a reduction of 28%. An even more dramatic drop in same-sex married

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couples was reported, from 349,377 to 131,729, or a reduction of 62% (Cheng & Powell, 2015). Given the small numbers of same-sex families represented in large data sets, even a small amount of miscoding can lead to very different results. Research on same-sex families has focused on two issues: the relationship between same-sex partners and the well-being of children in same-sex families.

Most of the research on same-sex couple relationships compares them to opposite-sex couple relationships. Overall, this research finds that same- sex partnerships share many characteristics with opposite-sex partnerships. In general, the same set of factors predict the quality of partner relationships: commitment to the relationship, perceived benefits of being in the relationship, good communication, good problem solving and conflict resolution, closeness with flexibility, and good support from outside the relationship (Green, 2012). One consistent finding of difference between same-sex couples and opposite-sex couples is that same-sex couples are more likely to avoid traditional gender role divisions that create power imbalances. Same-sex couples are not perfectly equal, but they tend to be more equal in the division of household labor and parenting activities than opposite-sex couples (Gotta et al., 2011). Some researchers have found that same-sex partners report about the same frequency of arguments as heterosexual couples (Peplau & Fingerhut, 2007), but others have found that same-sex couples report less conflict than heterosexual couples, more relationship satisfaction, and better conflict resolution (Balsam, Beauchaine, Rothblum, & Solomon, 2008). There is evidence that both same-sex and opposite-sex partners tend to disagree about similar topics, such as sex, money, and household tasks (Kurdek, 2006). Some studies find that members of same-sex partnerships are more likely than married opposite-sex couples to separate when they are unhappy, but the one longitudinal study that has followed the first same-sex partners to take advantage of Vermont’s civil union laws found that same-sex couples in civil unions are less likely to separate than same- sex couples not in legally recognized unions (Balsam et al., 2008). Gay male couples have reported much higher rates of nonmonogamous sexual behavior than lesbian and opposite-sex couples, but both same-sex and opposite-sex couples reported greater commitment to monogamy in 2000 than in 1975 (Gotta et al., 2011). Lesbian couples report lower frequency of sex than gay male or opposite-sex couples (Gotta et al., 2011).

Many lesbians and gay men became parents in earlier heterosexual

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relationships, before coming out as gay or lesbian. Increasingly, lesbians and gay men are also becoming parents in the context of their same-sex partner relationships, with the assistance of reproductive technology or by adoption (Green, 2012). The best available research indicates that more than 111,000 same-sex couples are raising an estimated 170,000 biological, step, or adopted children in the United States. Same-sex couples are 4 times as likely to adopt as heterosexual couples and 6 times as likely to raise foster children. Half of children younger than 18 living with same-sex couples are non-White, and indeed, same-sex couples of color are more likely than White same-sex couples to be raising children. The median household income of same-sex couples with children is lower than the median for opposite-sex couples with children, probably because the preponderance of these couples are lesbian (Gates, 2013). Lesbian couples may choose artificial insemination, and gay male couples may choose to use a surrogate mother; each method results in the child sharing a bloodline with one partner but not the other. There is very little research on gay men who become fathers via surrogacy, but one study found that these fathers reported greater closeness with their families of origin after becoming fathers and also reported heightened self-esteem (Bergman, Rubio, Green, & Padrón, 2010). Other research has found that when lesbian couples use artificial insemination, the biological mother is likely to be the primary childcare provider and to have a somewhat closer relationship with the child (Bos, van Balen, & van den Boom, 2007).

Considerable research attention has been given to the question of how children fare in families of same-sex partners. The American Sociological Association reviewed those studies based on U.S. families and prepared an amicus brief for the Supreme Court’s deliberations about same-sex marriage. Manning and colleagues (Manning, Fettro, & Lamidi, 2014) published the results of that review. They concluded that “there is a clear consensus in the social science literature indicating that American children living within same-sex parent households fare just as well as those children residing within different-sex households over a wide array of well-being measures: academic performance, cognitive development, social development, psychological health, early sexual activity, and substance abuse” (p. 485). This analysis was based on the review of over 40 studies published since 2002. Most of this research is based on convenience or snowball samples. These types of samples may result in a selective group of participants who represent the most high-functioning same-sex families. Data from large nationally representative samples are

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generally preferred in research, but those samples often include too few same-sex families for dependable statistical analysis and typically determine the sex of the parents on interpretations of existing questions. There is some controversy about the available research because the handful of researchers using data from large nationally representative samples have found that children from same-sex families do not fare as well as adults as children from opposite-sex families on some measures. The most often cited of these studies is work by Regnerus (2012). Other researchers have reviewed the Regnerus research and found fault with several aspects of the statistical analysis, particularly with the interpretations Regnerus made of two research questions to determine which families had same-sex parents. Cheng and Powell (2015) replicated the Regnerus study, had different interpretations of those research questions as they related to the identification of same-sex parents, and found almost no differences between adults who were raised in same-sex families and those raised in opposite-sex families. This finding is remarkable given the fact that the available research is based on same-sex families who lived in times of great hostility toward their family form; this is especially true of those studies that focused on adults who were raised in same-sex families (versus children currently living in them). Research by Prickett and colleagues (Prickett, Martin-Storey, & Crosnoe, 2015) may provide a partial explanation of these consistent findings of well-being among children raised in same-sex families. Using a nationally representative survey of time use conducted by the U.S. Census Bureau, they found that same-sex parents are involved, on average, 1 hour more each day in child-focused time than opposite-sex parents (3.5 hours versus 2.5 hours). We are living in a time of great change in social attitudes about and legal standards for same-sex families. Research must be put in the context of the time in which the data were collected.

Military Families

Military families may have any of the family structures already discussed. They are included in this discussion of diversity of family structures, however, because of some special challenges they face in times of deployment to war zones. In the United States, military members may serve in either the active-duty or reserve components of the military. Active-duty members serve in the U.S. Army, Navy, Marine Corps, or Air Force. Reservists serve either in the Army National Guard or Air National Guard. Compared with other recent conflicts, deployments to Afghanistan

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and Iraq were more frequent and lengthier, usually lasting 12 to 15 months (Gil-Rivas, Kilmer, Larson, & Armstrong, 2017).

About half (51.4%) of military service members are married, and about two fifths (42.1%) have children, with reservist members more likely than active-duty members to be married and have children (Office of the Deputy Assistant Secretary of Defense, 2014). The circumstances of reservist families are different in some ways from those of active-duty families. Active-duty military families typically live on or near military installations where the active-duty member receives daily military training. Reservist families live and work in a civilian community and receive military training one weekend per month (Hall, 2016).

Research indicates that active-duty families usually cope well with temporary separations during peacetime (Flake, Davis, Johnson, & Middleton, 2009; Meadows et al., 2017). Active-duty military spouses are accustomed to managing as single parents for periods of time and then readjusting to operating in their predeployment family structure again when the deployment ends. Reservists and their families, on the other hand, are accustomed to occasional brief deployments to respond to state, local, and even national emergencies. They are not as prepared to deploy quickly for long periods of time and must deal with the break in civilian employment, as well as prepare the family for the coming separation. Consequently, active-duty families and reservist families face both similar and different challenges.

Spouses of both active-duty soldiers and reservists have reported loneliness, loss of emotional support, role overload, and worry about the safety and well-being of the deployed spouse (Padden & Agazio, 2013). Parents who are spouses or partners of soldiers deployed to war zones report higher levels of stress than the national average for parents, and research indicates an increase in child maltreatment rates by civilian spouses while their military service members are deployed to war zones (McCarthy et al., 2015). Communication with the military member in the war zone is spotty at best, as the deployed soldier is in and out of the range of adequate communications systems, but research indicates that regular communication during deployment is associated with better family relationships postdeployment (Meadows et al., 2017; Wadsworth & Southwell, 2011). During his deployment to Iraq, Bobby Sharpe was able to have only infrequent contact with his family, but he was able to have

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fairly regular contact by e-mail and Skype much of the time he was in Afghanistan. Both the family members at home and the deployed family member may try to avoid alarming each other about what is happening in their worlds, and together they must gauge how involved the deployed family member can be in making decisions about what is happening at home. Bobby Sharpe did not know his furnace was broken until he returned home from his first deployment, because Vivian did not want to bother him with that kind of family problem. She also avoided telling him that she was overwhelmed with the demands of work and family while he was in Afghanistan.

As the end of the deployment draws near, family members report that they begin to worry about what to expect when the soldier returns, in terms of possible war wounds or personality or behavior changes (Gil-Rivas et al., 2017; Meadows et al., 2017). Marcie Sharpe had heard scary stories of parents coming home with completely changed personalities. She worried a lot about this during Bobby’s second deployment. Although it is often a joyous time, the military member’s return home can be very stressful for families. Family members have to readjust to one another and realign family roles. Three out of four military families report that the first 3 months after coming home can be the most stressful period of the deployment process (Flake et al., 2009; Meadows et al., 2017). Soldiers have to reacclimate to life away from the war zone and renegotiate roles, responsibilities, and boundaries with family members who had made adjustments in their absence (Gil-Rivas et al., 2017). This readjustment is particularly difficult when there have been physical or mental injuries, such as traumatic brain injury or post-traumatic stress disorder (Gil-Rivas et al., 2017; Meadows et al., 2017). Families tend to stabilize over time, but many families have needed to prepare for another deployment that can come in as quickly as 1 year.

Photo 10.3 This father and son share a moment of joy during a welcome home ceremony when the Arkansas National Guard’s 39th Infantry Brigade Combat Team returns from deployment to Iraq.

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Children of both active-duty and reservist families involved in the Iraq and Afghanistan wars have been found to be at increased risk for a range of problems in psychosocial functioning. In the time just before a parent’s deployment, children may become withdrawn or engage in regressive behavior. Early in the deployment, they may be overwhelmed, sad, and anxious and have more somatic (physical) symptoms, but these symptoms usually diminish once children adjust to the deployment. They are usually excited and relieved when the military service member parent comes home but may experience conflict about the readjustments being made at home (Flake et al., 2009). One study of children of deployed National Guard members found that they reported missing their deployed parent as the biggest difficulty of the deployment. Their biggest worry was that their deployed parent would be injured or killed. The biggest change in their lives involved increased responsibility at home, more chores, and more responsibility for younger siblings. They reported concern about trying to avoid upsetting the parent at home. The children also described some positive aspects of deployment. Some reported being proud of what their deployed parents were doing for the country, although this pride was tempered when they heard talk from television, classmates, and other

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sources suggesting that the war is bad. Some children also reported pride in themselves for their ability to be more responsible while the deployed parent was away (Houston et al., 2009).

There is one important difference in the experiences of active-duty and reservist families. A large portion of active-duty military families continues to live in or near military installations during the family member’s deployment. This allows them to have ongoing support from other military families as well as from military programs. Reservist families, on the other hand, are scattered across all 50 states and the U.S. territories, many of them living in rural communities. This is especially the case for National Guard members because the National Guard has a strong tradition in rural communities, where it serves as a point of pride as well as a supplement to the low wages often found in these communities (Martin & Sherman, 2010). Sometimes a National Guard family is the only one in their area experiencing deployment at a given time. This is problematic because of the lack of access to other families facing similar experiences. Children of deployed reservists have reported that a chance to talk to other children with a deployed parent would be a big help (Houston et al., 2009). Likewise, the returning reservist service member may be isolated from other returning soldiers, as well as from some of the medical and psychiatric resources available in and near military installations.

U.S. military service members have been involved in military combat in Afghanistan since 2001 and in Iraq since 2003, with changing intensity and focus over time. It is hard to say what the outcome of these wars will be, but it is clear that the military families involved, both active-duty and reservist families, will continue to experience multiple challenges in the aftermath of the wars. According to a large-scale study sponsored by the RAND Corporation, many service members from the wars in Iraq and Afghanistan underwent prolonged periods of combat stress (Tanielian & Jaycox, 2008). In the aftermath of the trauma, many service members and veterans are experiencing horrific combat injuries; others are experiencing substance abuse, PTSD, relationship problems, and work problems (Wadsworth & Southwell, 2011). Social workers in all practice settings should be alert to possibilities for engaging these families in supportive services.

Critical Thinking Questions 10.3

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Which, if any, of the family structures discussed did you grow up in? What do you see as the major strength of this type of family structure? The major challenge? Which, if any, of these family structures are you living in now? If this is different from the type of family structure you grew up in, what do you consider to be its major strength and major challenge?

Economic and Cultural Diversity Family structure is influenced by economic and cultural patterns, as well as immigration status. As you read the following sections on economic diversity, cultural diversity, and immigrant families, think about how your family structure is affected by the family’s position in the economic structure; cultural heritage; and experience with immigration, if at all.

Economic Diversity

Economic inequality exists in all societies, historical and contemporary, but the number of social classes and the amount of inequality vary from society to society. As indicated in Chapter 9, the United States has less inequality than some nations of the world, but it has more inequality than any other advanced industrialized nation. And, unfortunately, since 1970, the gap between the richest and poorest U.S. citizens has been growing. The question to be addressed here is what impact do economic resources have on family life? How do family economic circumstances affect parental relationships, parent–child relationships, and child development? A large volume of research has found that individual physical and mental health, marital relationships, parent–child relationships, and child outcomes decline as economic stress increases. Two theoretical models have been proposed to explain the connection between economic resources and individual and family functioning: the family economic stress model and the family investment model.

The family economic stress model is based on Glen Elder’s (1974) research on the impact of the Great Depression on parents and children. This research found that severe economic hardship disrupted family functioning in ways that negatively affected marital quality, parenting quality, and child outcomes. In the family economic stress model based on this research, economic hardship leads to economic pressure, which leads to parent distress, which leads to disrupted family relationships,

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which leads to child and adolescent adjustment problems (see Exhibit 10.5; Conger & Conger, 2008).

Exhibit 10.5 ● Family Economic Stress Model

Source: Conger & Conger, 2008, Figure 5.1, p. 67.

There is a great deal of research to support the family economic stress model. Economic stress, such as unemployment, low income, and high debt, has been found to have negative effects on the physical and mental health of parents (Kahn & Pearlin, 2006; Mckee-Ryan, Song, Wanberg, & Kinicki, 2005). Research has also found that psychological distress about economic pressures takes its toll on marital quality (Gudmunson, Beutler, Israelsen, McCoy, & Hill, 2007). Couple disagreements and fighting increase with financial strain. Parental psychological distress and marital conflict have been found to affect parenting practices, leading to less parental warmth and more inconsistent, punitive, and controlling discipline (Mistry, Lowe, Renner, & Chien, 2008; Waanders, Mendez, & Downer, 2007). One recent test of the family economic stress model, using prospective longitudinal data, found that economic hardship led to

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economic pressure, and economic pressure was associated with parental emotional distress and couple conflict. Parental emotional distress and couple conflict were associated with harsh parenting and behavior problems in children (Neppl, Senia, & Donnellan, 2015). Another test of the model found that among Latino immigrant families, parents who reported greater financial stress also reported higher levels of depressive symptoms, which were associated with lower parent-reported levels of monitoring and supporting the children’s academic activities (Gilbert, Brown, & Mistry, 2017).

Family economic hardship has been found to be associated with a number of child outcomes. Children in families experiencing economic hardship tend to have higher levels of depression and anxiety (Gutman, McLoyd, & Tokoyawa, 2005). They also have been found to demonstrate more aggressive and antisocial behaviors (Solantaus, Leinonen, & Punamaki, 2004). Economic disadvantage is associated with lower self-esteem and self-efficacy in children (Shek, 2003) and poorer school performance (Gutman et al., 2005). Adolescents who report worrying about the family’s finances also report more somatic complaints, such as stomachaches, headaches, and loss of appetite (Wadsworth & Santiago, 2008).

Whereas the family economic stress model focuses on the impact of economic stress on family life, the family investment model presents a different explanation for the connection between economic status and child and family functioning. This model focuses on investments that parents with economic resources are able to make in the development of their children (Conger & Donnellan, 2007; Martin et al., 2010). Families with abundant economic resources are able to make more learning materials available in the home; spend more time engaged in intellectually stimulating activities, such as visiting museums and traveling; secure education in enriched educational environments; secure outside assistance such as tutoring and specialized training; provide a higher standard of living in such areas as housing, clothing, nutrition, transportation, and medical care; and reside in a safe, clean, attractive, and roomy environment. They also are able to open doors to social networks that provide educational and career opportunities. This seems to go without saying, but there is empirical support for the proposal that family income affects the types of investments parents make in their children (Bradley & Corwyn, 2002), and this investment has been demonstrated to be positively associated with child cognitive development (Linver, Brooks-Gunn, &

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Kohen, 2002; Sohr-Preston et al., 2013; Vasilyeva, Dearing, Ivanova, Shen, & Kardanova, 2018).

Some researchers have been interested in how helpful these two theoretical models of the connection between economic resources and individual and family functioning are for understanding families from different cultural groups. One research group found support for the family investment model in European American families but not in African American, Hispanic, and Asian American families. They had mixed findings for the family economic stress model, with support for the model among European American, African American, and Spanish-speaking Hispanics, but little or no support for the model among Asian American families and English- speaking Hispanics (Iruka, LaForett, & Odom, 2012). Another research team tested to see which of the two models provides better explanations for conduct problems among economically distressed African American adolescents. They found that the family processes identified by the family economic stress model—parental emotional distress, caregiver conflict, and parenting practices—provided a more correct model than the family investment model for understanding how economic hardship is associated with increased conduct problems in this population (Simons et al., 2016).

Cultural Diversity

The world over, we are living in a time when people are moving about from society to society and increasing the level of cultural diversity in small towns, suburbs, and cities. As suggested earlier, there has always been cultural diversity in the United States, but with the new waves of immigration in recent years, the United States has become a microcosm of the whole world in terms of the complex mix of ethnic heritages and religions. Across cultural groups, families differ in how they define family; in how they organize family life; and in their customs, traditions, and communication patterns (McGoldrick & Ashton, 2012). They differ in how much importance is placed on individual freedom versus family harmony, in expectations about help-seeking behavior, in the valuing of egalitarianism versus hierarchy, and in norms about emotional expressiveness (Campos & Kim, 2017). Social workers face a daunting challenge in responding sensitively and appropriately to each and every family they encounter.

In the past, many of the clinical models for family practice were based on

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work with primarily middle-class and often two-biological-parent European American families. Working from these models often led to thinking of racial and ethnic minority families as deviant or deficient. One of the most dramatic examples of the damage this way of thinking can do is Anne Fadiman’s (1998) story about the experience of a Hmong family with the health care and child protective systems in California. (If you haven’t read this book yet, I suggest you put it on your to-do list during your next break between terms.) In recent years, however, there has been a concerted call for social workers and other professionals to practice in a culturally sensitive manner that moves from culturally aware to culturally competent practice (Sue, Rasheed, & Rasheed, 2016). I prefer to talk in terms of culturally sensitive practice, because I doubt that we can ever be truly competent in a culture other than the one in which we were raised, and certainly not in the multiple cultures we are likely to encounter in our work over time. In light of the great diversity in contemporary life, the goal should be to remain curious and open-minded, taking a stance of “informed not knowing” (Dean, 2001).

Photo 10.4 It is important for social workers to understand ethnic differences in family beliefs, rules, communication patterns, and organizational norms.

©Maria Moratti/Contigo/Getty Images

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As suggested in Chapter 8, cultures both endure and change. It is important to recognize some of the ways that family cultures differ as they are transmitted intergenerationally, and it is also important to recognize the ways that family cultures evolve as they come into contact with other cultures. In addition, we must recognize that many families are made up of members of more than one cultural background, and children in these families often get pushed by the outside world to identify with only one cultural identity (McGoldrick & Ashton, 2012). To help us think about both cultural stability and change, I present two recent reports here, one that focuses on cultural difference and the other that focuses on cultural adaptation. First, let’s look at an example of how family cultures can differ.

Campos and Kim (2017) analyze major themes in research findings about the cultural contexts of European American, East Asian, and Latino families. Research regarding North American people of European Protestant heritage indicates, on average, a highly individualistic group that values opportunities to voluntarily form and terminate family and other relationships. Importance is attached to self-disclosure and authentic emotional expression as facilitators of relationship development. Both East Asian and Latino cultures are more collectivist than European American culture, but they are also quite different in their collectivism. Campos and Kim (2017) describe the East Asian cultural context as harmony collectivism. The potential for mismanaging existing relationships is a threat to harmony, and interpersonal conflicts are to be avoided. Highly aroused emotions, even positive ones, are to be prevented because they can disrupt relationships. Relationship closeness is expressed through such instrumental assistance as offering practical advice. Support is freely accepted, but seeking support is considered disruptive to relationships. In contrast, Campos and Kim describe the Latino cultural context as convivial collectivism. A cultural value of familism supports strong interdependent relationships built and maintained through frequent positive emotional expression, frequent interaction, and politeness that honors the dignity of each person. Support is freely sought and freely given. This is only a small sampling of the cultural contexts of families living in the United States.

Another line of research examines how families in the United States adapt culture when their culture of heritage is in the minority. In this tradition, Kim and Hou (2016) report that researchers are now proposing a

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tridimensional model of cultural transmission in families that are in the cultural minority in the United States. Their research indicates that Chinese American parents in the United States socialize their children to Chinese culture, to mainstream American culture, and to a hybrid Chinese American culture. The hybrid Chinese American culture is forged as families live in subcultures with other Chinese American families and develop their own version of culture that is a mix of Chinese and mainstream American. The researchers further found that intergenerational transmission occurs primarily through the mother. These researchers suggest that family culture may be even more complex than this tridimensional model indicates and that for many families, we should think in terms of a multidimensional model.

I do not present a cookbook approach to working with family cultural differences but rather a process by which we can develop cultural awareness about the family groups with which we work. The first step, as suggested earlier, is to develop an intense understanding of the limitations of our own cultural perspective and a healthy respect for the integrity of all cultures. Starting from this position, we can set out to become as well informed as possible about the cultural groups represented by the families we serve. One thing social workers are particularly good at, when we are at our best, is putting people and situations into context. We will want to use that strength to learn as much as possible about the context of the culturally variant families we encounter. There are a number of ways to learn about specific cultural groups: through library and Internet research, history books, biographies and autobiographies of group members, films and documentaries about the group, conversations with friends or colleagues who are members of the group, attendance at cultural festivals, and asking your clients what you need to know to be helpful to them.

Even though we want to learn as much as we can about the cultural group, we must realize that there are many variations within all cultural groups. When I need to avoid stereotypical application of knowledge about a cultural group, it helps me to think about how many variations there are within my own cultural group and how well or poorly generalizations about my group apply to me. It is also helpful to hear different stories from members of the group, through books, videos, or personal conversations. It is particularly important to remember that there are social class differences among all cultural groups. You will want to consider whether the African American woman you are working with is middle class or working class

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and know something about her experiences with oppression. You will want to keep in mind that more than 500 distinct First Nations (or Native American) peoples exist within the United States, and they differ in language, religion, social structure, and many other aspects of culture (Weaver, 2011). You will want to know how a specific nation coped with attempts to eradicate their cultural practices. You will want to note whether the Latino immigrant family came from a rural or urban environment and what level of education they received in their home country; you will also want to note their country of origin and whether they are of documented or undocumented status. When working with an Asian or Pacific Island family, you will want to know not only the country of origin (out of 60 represented in the United States) but also the social class and education level of the family, religious beliefs, and when the family first immigrated to the United States. You will want to note how integrated the family from North Africa or the Middle East is into U.S. mainstream culture, as well as how traditional they are in religious and cultural beliefs. These are only a few examples of how you will need to individualize families while also putting them into cultural context.

Immigrant Families

The United States is built on successive waves of immigration and is currently the world’s leader as a destination for immigrants. In 2015, approximately 43.3 million immigrants were living within the United States, making up 13.5% of the U.S. population. Immigrants and their U.S.-born children number about 84.3 million people and constitute about 27% of the U.S. population (Zong & Batalova, 2017). Immigrants are foreign-born people who plan to settle permanently in the United States. They may be economic migrants seeking better jobs and pay, family migrants who come to join family members already here, or refugees involuntarily fleeing political violence or extreme environmental distress. Current immigrants to the United States are more diverse than earlier immigrants in terms of country of origin, language, religion, and socioeconomic status. The places from which immigrants come have changed over time, influenced by immigration policies. For example, 1965 amendments to the Immigration and Nationality Act of 1952 created a “family reunification” category and gave preference to immigrants who had family members already in the United States. The 1986 Refugee Assistance Extension Act made it easier for families facing political persecution and extreme environments in their home countries to enter the

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United States. The Immigration Act of 1990 shifted policy away from family reunification to individuals with specific education and credentials and to wealthy individuals who could invest in the U.S. economy (Bush, Bohon, & Kim, 2010). Immigration policy has been an ongoing controversy in the United States and other countries in recent years and was a major issue in the 2016 presidential campaign of Donald Trump.

Immigrants may be first generation (moved from another country to the United States), second generation (children of first-generation immigrants), or third generation (grandchildren of first-generation immigrants). In general, first-generation immigrants experience more loss and grief than second- and third-generation immigrants, but the reaction to immigration differs by the degree of choice about migration, accessibility to the country of origin, gender and age, stage of family life cycle, number of family members immigrating and left behind, community social supports, and experiences with discrimination in the country of origin and the country of adoption (Falicov, 2016). Many losses are involved with migration, including loss of the family members and friends left behind, loss of familiar language, and loss of customs and traditions. Involuntary immigrants often have been traumatized in their country of origin and have no option to visit home. Other immigrants are able to make frequent visits home and maintain transnational families who are in frequent contact. Families may migrate together or in sequential stages, whereby one or two family members immigrate first, followed by others later.

In cases of sequential migration, family roles and relationships must be reorganized over time. The first immigrating family member must now perform some roles not carried out in the home country, whether those were domestic chores, paid labor, or managing finances. Likewise, the spouse left in the home country must now take on roles that had been filled by the immigrating family member. If the trailing spouse later immigrates, the spousal roles will have to be renegotiated, as happens when military families reunite. One difference in the reunifications of immigrant and military families is that sequential immigration may happen over a period of years and have unexpected delays, and the separations can be much longer than for military families. When children are left behind for a number of years, they may have trouble reattaching to the parents.

Immigrant families face a number of challenges. If they come from a non- English-speaking country, the language barrier will be a serious

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impediment to becoming comfortable in the new country. They will be unable to read street signs, job announcements and applications, food labels, and communications from the children’s schools, unless they live where language translations are commonly used. Because children learn new languages more easily than adults, parent and child roles often are reversed as children become the language and cultural brokers. Children also learn the new cultural norms more quickly than parents, and this may cause intergenerational tension about the appropriate level of acculturation, how much of the old to maintain and how much of the new to adopt. Parents may not understand the new culture’s norms about child- rearing and find themselves at odds with the school system and perhaps with the child protective system. Immigrant wives often come from cultures with traditional gender roles but need to engage in paid work in the United States to keep the family afloat. This often results in more independence and status for wives than they were accustomed to in their home countries and can cause marital conflict if men want to hold on to the traditional gender hierarchy. Research has found increased male-to- female violence in Asian families when wives earn as much or more than their husbands (Chung, Tucker, & Takeuchi, 2008). Many immigrant families come from collectivist cultures where harmony is valued over individual ambition and may feel a great deal of tension about how to respond to mainstream cultural pressures toward individualism. They may have had both the support and control of the extended family in the home country and find themselves struggling to maintain family stability with a much more limited support network.

Critical Thinking Questions 10.4

Think of the economic and cultural locations of your family of origin and your current family. What experiences have you had with family economic and cultural diversity that will be helpful to you in your social work career? What are the limitations in your experience with family economic and cultural diversity? What can you do to build your understanding and skills in this area?

Challenges to Family Life Contemporary families of all types face many stressful situations that challenge their ability to provide nurturance and the necessary resources

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for healthy development of family members. Every historical era and every culture presents its own set of challenges to families. In the following sections, we discuss three challenges to contemporary families: family violence, divorce and relationship dissolution, and substance abuse.

Family Violence The family is the social group from whom we expect to receive our greatest love, support, nurturance, and acceptance. And yet family relationships are some of the most violent in many societies. Research indicates that men are as likely as women to be victims of intimate violence, but women are more likely to miss work, report depression, be injured, receive death threats, and be killed by their partners (Jasinski, Blumenstein, & Morgan, 2014). Children are even more vulnerable to violence within the family than adults. Children are abused by parents, but physical violence between siblings may be the most common form of family violence, and sexual abuse by siblings is receiving increasing attention. Older adults are sometimes abused by their family caregivers, and teenage children sometimes abuse their parents, particularly their mothers (Gelles, 2010; World Health Organization, 2016).

It is very difficult to produce accurate statistics about the amount of family violence in different categories because the family is the most intimate of social groupings; what happens in families is usually “behind closed doors,” away from the watchful eyes of strangers, relatives, and neighbors. In addition, different definitions of violence are used by different researchers. The data presented here are the best available. Globally, 30% of women who have been in a relationship report that they have experienced some form of physical or sexual violence by a partner (World Health Organization, 2014). In the United States, 22.3% of women and 14.0% of men report being the victim of severe physical violence by an intimate partner. Female victims frequently report multiple types of intimate partner violence (for example, rape, physical violence, and stalking) whereas male victims only report physical violence (Centers for Disease Control and Prevention, 2017c). The available data suggest that 4 out of 5 victims of intimate partner violence are female and that intimate partner violence has been declining in the past 2 decades (Catalano, 2012).

The World Health Organization (2016) reports that, worldwide, a quarter of all adults report having been physically abused as children, and 1 in 5

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women and 1 in 13 men report having been sexually abused as a child, but the report does not stipulate how many of these incidences of abuse were perpetrated by family members. In the United States, an estimated 9.2 per 1,000 children were judged to be victims of child maltreatment by parents or other caregivers in 2015. Of these situations where the type of maltreatment is known, 75.3% involved child neglect, 17.2% involved physical abuse, 8.4% involved sexual abuse, and 6.2% involved psychological maltreatment (Child Welfare Information Gateway, 2017). National surveys find much higher numbers of child maltreatment than these official numbers (see Finkelhor, Ormrod, Turner, & Hamby, 2005). One research team found that 35% of 2,030 children in a national survey reported being physically assaulted by a sibling in the past year (Finkelhor et al., 2005).

Elder abuse is defined as including physical abuse, psychological or emotional abuse, sexual abuse, financial exploitation, and neglect or abandonment. The World Health Organization (2016) estimates that 1 in 6 older adults is abused each year worldwide, when all forms of elder abuse are measured. They further report that 90% of the abusers are family members. There are no official statistics on elder abuse in the United States, but the best available data indicate that about 10% of noninstitutionalized older adults are abused each year, when all forms of elder abuse are measured (Lachs & Pillemer, 2015). Perpetrators of elder abuse are most likely to be male adult children and to have a history of substance, mental, or physical health problems (Lachs & Pillemer, 2015). One researcher found that verbal mistreatment and financial abuse were much more common than physical mistreatment of older adults (Laumann, Leitsch, & Waite, 2008).

In many high-income countries, adolescent-to-parent abuse (APA) is gaining attention as a significant social problem. APA refers to abusive behavior toward a parent by a son or daughter who is in the adolescent years. Large-scale studies from the United States, Canada, Europe, and Australia suggest that 6.5% to 10.8% of adolescents have hit their parent(s) at least once during their adolescent years. Much higher rates of verbal aggression are reported. All studies indicate that mothers are 4 times as likely as fathers to be the victims of APA, and male adolescents are more likely than female adolescents to be the perpetrators (Holt, 2016).

Exposure to family violence of various kinds, either as victim or observer,

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has long-term negative impact on mental and behavioral health. Victims of intimate partner violence report high rates of post-traumatic stress disorder and depression. Children who are victims or observers of family violence have been found to be more likely than nonvictimized children to demonstrate both externalizing (hostile and aggressive) and internalizing (withdrawal, anxiety, and depression) behaviors (McFarlane et al., 2017). Renner and Boel-Studt (2017) explored the relationship between internalizing and externalizing behaviors of children and three types of family violence experienced by them—direct physical abuse, exposure to adult intimate partner violence, and exposure to the physical abuse of a sibling. They found that these three types of family violence had different effects on children of different ages. All of them were associated with externalizing behavior of children of some age, but none of them was associated with internalizing behavior. In other words, children of different ages may process family violence differently. Exposure to intimate partner violence was associated with increased externalizing behaviors among children ages 3 to 5. Exposure to physical abuse of a sibling was associated with increased externalizing behaviors among children ages 6 to 12. And direct physical abuse was associated with increased externalizing behaviors among adolescents. A long line of research demonstrates long- term negative physical and mental health effects of childhood exposure to family violence.

How is it that the social group assigned the societal task of providing love and nurturance becomes a setting for so much violence? Research indicates that family violence is multidetermined and identifies a number of associated factors. Stress, social isolation, economic distress, substance abuse, mental health problems, and intergenerational modeling have all been found to increase the risk of family violence (Gelles, 2010; Newman, 2017). The United States is a relatively violent society, and violence is often seen as an appropriate way to resolve disputes (Hutchison, 2007). There are cultures of the world and subcultures in the United States that believe men have the right to beat women and parents have the right to beat children.

It can be argued that the very nature of family life makes it a breeding ground for conflict. Family members spend a great deal of time together and interact intimately in good times and bad. They tend to stir each other’s most intense emotions, both positive and negative. If family members do not have good conflict resolution skills, they may not have a

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repertoire of behaviors other than violence to resolve conflicts.

Intervention in situations of family violence requires careful assessment, and even with the best assessment, it is difficult to predict future behavior. The decision that must be made is whether protective steps are necessary: Must children be removed? Are restraining orders necessary? Must the abused partner flee for safety? There are no ideal solutions. Removing children from abusive households may be necessary to protect them physically, but this solution carries its own risks. Children suffer emotional damage from the separation and loss and may blame themselves for the family disruption. They may be vulnerable to further abuse in the foster home if they have intense care needs. There are also risks to leaving children in homes where they have been abused, including the risk that the child will be killed. Unfortunately, the available resources are not often sufficient to meet a distressed family’s needs. Clearly, no one solution fits every situation of child abuse.

The literature on domestic partner violence has proposed some useful typologies for thinking about intervention in such situations (Friend, Bradley, Thatcher, & Gottman, 2011; Holtzworth-Munroe & Stuart, 1994; Johnson, 1995, 2008). Domestic partner violence can be one-way or mutual; mutual violence can be mutual fighting or involve self-defense or retaliation against a primary aggressor. It may be considered minor, involving shoving, pushing, grabbing, and slapping, or severe, involving choking, kicking, hitting with an object, beating up, or using a knife or gun. Mutual fighting tends to be less severe and more infrequent than other forms of intimate partner violence and does not usually escalate. It involves both partners who use physical means to resolve conflicts. On the other hand, one-sided use of severe forms of violence, sometimes called intimate terrorism, typically occurs more frequently and escalates over time. Many of the perpetrators of this type of violence are involved in other antisocial behaviors as well. Friend and colleagues (2011) distinguish between two types of intimate partner violence, situational and characterological, and have developed a screening instrument that successfully makes this distinction. These two types correspond to the typologies discussed earlier: situational violence is mutual, low-level violence used as a means of conflict resolution, and characterological violence is severe violence used to induce fear and control the victim.

Just as with child abuse, different types of intervention are required for

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different types of domestic partner violence. Protective removal is imperative for intimate terrorism or any form of escalating violence. On the other hand, systemic couples work, in which couples are taught other methods of conflict resolution, may well be appropriate for couples who occasionally use mutual violence to resolve conflict. Support for this idea comes from a research project that looked at mutual and one-way spouse abuse in the army. The researchers found about even rates of these two types of intimate violence in 1998. After 4 years of prevention and education programs, mutual abuse had decreased by 58%, whereas one- way abuse had decreased by only 13% (McCarroll, Ursano, Fan, & Newby, 2004). This finding suggests that further attention to matching the intervention to the specific situation may be fruitful. It is recommended that couples where characterological violence is involved should not be engaged in conjoint treatment because such treatment puts the victim at risk of retaliation (Friend et al., 2011). The typologies discussed here do not cover every type of intimate partner violence situation, but they do make a good start at thinking about the multiple factors involved in family violence.

Divorce and Relationship Dissolution Most people who get married do not anticipate that they will divorce, and many people who cohabit hope to stay together long term, and yet divorce and relationship dissolution are very common. Almost all societies have mechanisms for dissolving marriages, whether it is divorce or civil or religious annulment. Worldwide, divorce rates tend to be higher in wealthier nations; for example, divorce rates are lower in the newly industrializing nations of Latin America and Asia than in the wealthy late- industrial nations of western Europe and North America (Newman, 2017). In the United States, however, the divorce rate is highest among low- income families.

There is much complexity in the analysis of divorce rates, but the divorce rate in the United States appears to have increased steadily from the late 19th century through the 1970s, with a sharp drop in the 1950s and a steep incline beginning in the 1960s. It peaked in 1981 and has been dropping slightly since then but is still one of the highest in the world; the marriage rate has also been dropping in the same period (Ciabattari, 2017; Greene, Anderson, Forgatch, Degarmo, & Hetherington, 2012). Recent estimates indicate that 40% of women married to men in the United States will

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divorce before their 15th anniversary (Copen, Daniels, Vespa, & Mosher, 2012). Same-sex marriage is too recent around the world to allow adequate analysis of the divorce rate among same-sex couples. Second and third marriages are more likely to end in divorce than first marriages. The average length of a marriage that ends in divorce is 8 years, and the average age of first divorce is 30. In the United States, divorce rates are highest among couples with lower income, less education, and early relationship formation.

Divorce and relationship dissolution is a process, not a single event. For the partners it is a process of uncoupling. The first step toward divorce is not usually mutual. It typically begins with one person who has a nagging feeling of dissatisfaction but a lot of ambivalence about moving toward divorce. In the United States and most European countries, two thirds to three quarters of divorces are initiated by women. Marital conflict often escalates as one party begins to disengage emotionally, and the divorce decision frequently ends up being mutual (Ahrons, 2016).

The divorce and relationship dissolution process must be negotiated in multiple dimensions, including legal divorce, physical divorce, financial divorce, emotional and social divorce, and parental divorce (Ciabattari, 2017). Where there was a legal partnership contract, legal divorce must be negotiated in the legal system. The legal divorce process is an adversarial one that often fuels animosity between the partners. Alternative legal processes, such as mediation and collaborative divorce, have been developed to promote a less adversarial process, but these approaches are not accessible to all families.

Physical divorce must also occur; a couple or family who once resided under one roof must develop a plan for living in separate places. At least some member(s), and maybe all, of the family will have to relocate. Where there are children or other co-residing family members, decisions must be made about who resides with whom. Belongings of all types must be separated. Marriage is not just a legal relationship; it is also an economic one. Financial divorce is an important part of the divorce process. Partners must disentangle their financial interdependence and resolve issues about fairness in the distribution of financial resources. On average, women’s family income declines about one third after divorce, and the economic consequences of relationship dissolution are also high for women in cohabiting relationships.

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No matter who initiates the process of divorce or relationship dissolution, emotional and social divorce is stressful. Two people who have thought of themselves as a couple must develop independent identities. All involved family members experience a sense of loss, and many experience anger and blame (Ahrons, 2016). Social networks must be renegotiated. Where does the divorced family fit with their former network of coupled friends? What happens to the patterns of interactions with shared friends? How much interaction will partners have with the former partner’s kin? New friendships are often formed and social networks are reorganized.

When the divorcing couple has children, a primary legal decision is how to care for the children; this decision is central to the parental divorce process. Both legal custody (who has legal rights and responsibilities to make decisions about the children) and physical custody (where the children will reside) must be decided. In the past, legal custody and physical custody always went to the same parent, to the father in the 19th century and to the mother more recently. Today, both parents often share legal custody and the child resides primarily with one parent. When custody decisions are disputed, general practice recently has been that each parent’s postdivorce parenting responsibilities should be based on their predivorce involvement with the child. Joint custody, both legal and physical, has become more common.

Family studies researchers have been particularly interested in how children are affected by divorce. A long line of research has found that children who experience a parental breakup have lower educational achievement, lower levels of psychological well-being, and more problems in their own marriages (see Amato, 2010). Recently, however, family researchers have taken a new look at this research and concluded that it fails to adequately represent the wide variety of outcomes for children in both married and divorced families (Ahrons, 2016; Ciabattari, 2017). They note that most of the research has focused on averages and not looked at the differences within each group. They further note that the average reported differences between children of divorced families and children of married families are quite small. One of the most commonly cited findings is that 20% of children whose parents are divorced experience behavioral or mental health problems, compared to 10% of children whose parents are married. Another way of looking at this is that four out of five children whose parents are divorced do not experience such negative outcomes. One research team who has studied the diversity of outcomes for children

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after divorce found that 18% declined on measures of well-being, 14% improved, and 68% had no change (Amato & Anthony, 2014). Longitudinal studies have also found that children whose parents divorce have often begun to have behavioral and academic problems before the divorce (Strohschein, 2005), similar to the problems found in children living in high-conflict married families (Amato, 2005). One other issue in the research is that it typically does not account for differences in relationship stability of both the residential and nonresidential parents following divorce.

Research clearly identifies three factors that contribute to healthy adjustment of children to divorce: (1) having basic economic and psychological needs met; (2) ongoing interaction with important people in their lives; and (3) a generally supportive and cooperative relationship between their parents. There is consistent evidence, however, that the economic well-being of women and children declines after divorce. And shared parenting after divorce or other breakup is almost always challenging. Hetherington and Kelly (2002) found that divorced co-parents fell into three categories: conflicted (25%), cooperative (25%), and parallel (50%). Parallel co-parents avoid fighting, but they also avoid talking with each other; both parents interact positively with the children but do not coordinate with each other.

Researchers are finding that fathers are more involved in their children’s lives after a breakup than was the case in past eras. One research team studied father involvement 12 years after divorce or relationship dissolution, including both formerly married and never married fathers (Cheadle, Amato, & King, 2010). They found that the largest group of fathers (38%) had stable and frequent involvement with the children over the 12-year period, 32% had low involvement during the 12 years, 23% were highly involved in the years following the breakup with declining involvement over time, and 8% increased their involvement during the 12 years. Fathers who were active in child-rearing while in the home are likely to stay involved after divorce or relationship dissolution.

It seems clear that divorce is a crisis for most adults, lasting for approximately 1½ to 2 years. Stress increases in the run-up to the divorce, during the divorce, and in the immediate aftermath. However, the stress level typically subsides within a year after divorce as families adjust relationships and routines (Demo & Fine, 2010). There is evidence that

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African American women get more social support than White women following divorce (Orbuch & Brown, 2006).

Substance Abuse Substance abuse is often part of the fabric of family life and usually affects the partner relationship and child development. For the purposes of this discussion, substance abuse is defined as serious and persistent problems with alcohol and/or other substances and does not refer specifically to a clinical diagnosis. Substance abuse is often described as a family problem, not only because of its effect on the entire family system but also because of the growing evidence of a strong genetic component in the etiology of substance abuse (Stoltenberg, 2014). The effect of substance abuse on the partner relationship has received less research attention than the impact of parental substance abuse on children. A brief discussion of the partner relationship is followed by a fuller discussion of the impact of parental substance abuse on children.

Leonard and Eiden (2007) reviewed the evidence about the impact of alcohol abuse on marital satisfaction and marital violence. They concluded that alcohol abuse has an adverse effect on marital satisfaction and stability, especially among couples where one partner is abusing alcohol and the other partner is not. They also found evidence of a strong association between excessive alcohol consumption and intimate partner violence. Consistent with a family life course perspective, they found evidence that family transitions can affect patterns of alcohol use for both men and women, with excessive drinking declining in the transition to marriage and during pregnancy and increasing in the postnatal period. There is also strong evidence that excessive alcohol use increases after divorce but may decrease for women divorcing from spouses with alcohol problems. In a study of the impact of partner alcohol problems on women’s physical and mental health, Dawson and colleagues (Dawson, Grant, Chou, & Stinson, 2007) found the cohabiting and married partners of alcohol abusers to be at risk for numerous health problems. They found that partner alcohol problems more than tripled the likelihood of mood disorders and more than doubled the likelihood of intimate partner violence, multiple injuries, anxiety disorders, and being in fair or poor health.

According to a 2012 national survey, 10.5% of children 17 years old and

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younger live with at least one parent who abuses drugs or alcohol (Substance Abuse and Mental Health Services Administration, 2012). Although research finds that parental substance abuse does not always lead to an unacceptable level of parenting (Coyle et al., 2009; Havnen, Breivik, Stormark, & Jakobsen, 2011), there is much empirical evidence that parental substance abuse often impairs parental functioning. Brynna Kroll (2004) reviewed the empirical literature on the experiences of children who grow up in families where adult use of alcohol and other substances is problematic. A number of negative effects on children were noted. In all the reviewed studies, secrecy and denial about the substance abuse were organizing features of family life, cutting the family off from extended family and community supports. Children often become afraid and mistrustful of outsiders who try to help, fearing being taken from their parent(s), among other fears.

Two more recent reviews of the research on the impact of parental substance abuse on children suggest that the impact varies by the age of the child (Bosk, Alst, & Scoyoc, 2017; Neger & Prinz, 2015). Prenatal exposure to alcohol and other drugs can have a negative effect on the developing brain and regulatory functions, and increase the likelihood of difficult temperament, irritability, sleep and feeding disturbances, excessive crying, and physical ailments such as gastrointestinal problems. Being parented by a substance-abusing parent during the first 3 years of life increases the likelihood of insecure and disorganized attachment and problems in speech and language development. School-aged children living with substance-abusing parents demonstrate higher levels of aggressive behavior, fewer friends, and more peer conflict than children living with parents with no substance abuse problems. Adolescents of substance abusing parents have higher rates of psychopathology, depression, anxiety, and substance abuse. Adult children of alcoholics report pervasive loss and grief, including loss of feeling loved, loss of a reliable parent, loss of a “normal” lifestyle, and loss of childhood itself (Mackrill & Hesse, 2011). Parental substance abuse during childhood is also associated with young-adult difficulties with romantic partnerships (Fischer, Lyness, & Engler, 2010).

Although not all substance-abusing parents abuse their children, there is an increased risk of child maltreatment while using (Bosk et al., 2017; Neger & Prinz, 2015). Given that substance abuse is often characterized by cycles of relapse and recovery, parental substance abuse does not mean

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that everything falls apart, particularly during phases of abstinence or reduced use, but parental conflict and fighting do typically increase during periods of excessive substance use. Children’s lives are often dominated by the needs, feelings, and behaviors of substance-abusing parents. The children sometimes become caregivers to their parents, putting them to bed when they are drunk or cleaning up after a parent who urinates on the floor. There is considerable evidence that substance-abusing parents engage in less monitoring of their children’s behavior.

Although parental substance abuse is a risk factor in child development, some substance-abusing parents are able to manage family life in a way that supports healthy child development. James Coyle and colleagues (Coyle et al., 2009) were interested in family functioning in families affected by parental alcohol abuse, particularly in the dimensions of family functioning that allowed these families to be resilient. Their statistical analysis identified families who were functioning at above-average, average, and below-average levels, according to standardized measures. Their research provides support for Froma Walsh’s (2016) model of family resilience, in which aspects of belief systems, family organization, and communication processes allow families to be resilient in the face of adversity. They found that families who functioned well on one of these dimensions functioned well on all three. Levels of social functioning were not related to social class or parental education. They did find, however, that Black families with a substance-abusing parent were more likely to have above-average or average functioning than White and Native American families, even though the Black families were, overall, in the lower end of the range of economic resources and reported more stressful life events.

Other research that has looked at the strengths of substance-abusing parents has focused on those parents in treatment. This research finds that these parents are self-critical about their abilities to parent while abusing substances but also report making attempts to combine their substance abuse with efforts to ensure that the needs of their children were being met. The desire to look after their children properly or to get the children back from substitute care is a powerful motivator to stop using alcohol and/or other drugs (Fraser, McIntyre, & Manby, 2009; Tracy & Martin, 2007).

In a study of mothers in treatment, 68% of whom had “lost” children to

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substitute care, Tracy and Martin (2007) found that 90% of the mothers viewed their relationships with their children as close, and 84% reported that their children provide as much support for sobriety as the adults in their lives do. The emotional care provided by children of substance- abusing parents is often noted in the literature by such terms as role reversal, parental child, or parentification, all of which suggest a negative impact on the child of providing such care. One research team (Godsall, Jurkovic, Emshoff, Anderson, & Stanwyck, 2004) examined the relationships between parental alcohol misuse and parentification and children’s self-concept. They found that African American child research participants scored higher on self-concept than European American children. They suggest that the concept of parentification, and similar concepts, may not be applicable to African American families and other collectivist-oriented families where close kinship networks are valued. They further suggest that considerable caregiving responsibilities in the context of close kinship ties may not have negative effects for children who are also receiving support and caring. Caregiving by children may be a part of a pattern of “filial responsibility” and not interpreted as unjust by the children.

In interpreting their finding that African American families with alcohol- abusing parents score better on family functioning than other such families, Coyle et al. (2009) note that Froma Walsh’s model of family resilience indicates that flexibility in family structure in times of adversity serves as a shock absorber and fosters family resilience. As noted earlier, Walsh also identifies family belief systems as sources for resilience, and Coyle et al. (2009) note that other researchers have found that cultural pride, kinship, spirituality, and high expectations for children are common in African American families. Coyle et al. (2009) suggest that struggling families may best be helped by identifying possible cultural beliefs, locating resources outside the nuclear family, becoming more flexible in family roles, and improving communication. You may recognize this as consistent with Walsh’s model of family resilience that identifies belief systems, organizational patterns, and communication as the ingredients for family resilience.

The evidence is clear, however, that many families with a substance- abusing parent do not fare well, and many of these families end up in the child welfare system, especially if the mother is the one with a substance abuse problem. In the United States, it is estimated that 40% to 80% of

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child welfare cases have a substance abuse component (Bosk et al., 2017), and a similar pattern has been noted in other countries (Borczyskowski, Vinnerljung, & Hjern, 2013). The opioid epidemic is currently overwhelming the child welfare system, just as the earlier crack cocaine and methamphetamine epidemics did. Caregivers with substance abuse problems are more likely than other caregivers in the child welfare system to lose custody of their children, and their children are likely to remain in foster care longer than other children. In recent years, child development scholars have argued for services that address both substance abuse problems and parenting difficulties. Some inpatient treatment facilities have begun to provide dual treatment services that allow parents to bring their children into treatment with them and focus the treatment on both substance abuse and parenting difficulties (Neger & Prinz, 2015). Family- based in-home treatment is another model of care (Hanson, Saul, Vanderploeg, Painter, & Adnopoz, 2015). Bosk and colleagues (Bosk et al., 2017) argue that we need new child welfare policy and new models of practice with families with a substance-abusing parent. They suggest that existing policy and practice models are based on the idea of substance abuse as an acute problem that can be “cured,”—a problem found even with dual treatment programs—but in reality it is a chronic, relapsing condition. What is needed, they argue, are policies and interventions that anticipate relapse and can respond to the chronic nature of substance use disorders.

Critical Thinking Questions 10.5

Three challenges to family life are discussed in the previous section: family violence, divorce and relationship dissolution, and substance abuse. If you were to be my coauthor on this chapter for the seventh edition of the book, what advice would you give me about the most important challenges facing families today? Are family violence, divorce, and substance abuse new or enduring challenges for families in the United States? Do these challenges appear to occur across cultural lines—across traditional, modern, and postmodern cultures (review Chapter 8 for descriptions of these three types of culture)?

Implications for Social Work Practice This discussion of families and family life, in the context of larger social

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systems, suggests several practice principles.

Assess families from a variety of theoretical perspectives. Given recent economic shifts, be particularly aware of the impact of changes in larger systems on families’ resources and functioning. Recognize the diversity of family structures represented by the families with whom you work and be sensitive to the relative strengths and weaknesses of each of these family structures. Develop awareness of economic diversity among families and the different economic and other resources available to the families you serve. Develop awareness of cultural diversity among families and a commitment to culturally sensitive practice that involves ongoing learning both about and from families that are different from your own. Use appropriate family assessment tools, including the genogram, ecomap, and timeline, to help you develop a more comprehensive understanding of the families with which you work. Give families credit for struggling well in adverse circumstances. Understand policies and changes at the state and national levels and the ways they affect both your own work and the lives of all families —particularly lower-income, stressed families. Where appropriate, encourage family members to become involved in neighborhood, local, state, and national efforts for positive change. As appropriate, work toward your agency’s becoming involved in policy and advocacy work on behalf of families, including development of needed programs and services.

Key Terms ABC-X model of family stress and coping 313 cohabiting 319 differentiation of self 307 exchange and choice perspective on families 308 family 303 family ecomap 308 family economic stress model 329 family investment model 330 family of origin 306

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family resilience perspective 314 family stress, coping, and resilience perspective 313 family systems perspective 306 family timeline 314 feminist perspective on families 312 genogram 307 intersectionality feminist theory 312 life course developmental perspective on families 313 lone-parent families 321 multilevel family practice model 308 nonnormative stressors 314 normative stressors 314 stress pileup 314 symbolic interaction perspective on families 310 transition points 313

Active Learning 1. Theory and your family. We have used different theoretical lenses to

look at the family of Bobby Sharpe. If you were a social worker working with a family similar to the Sharpes, you would want to be aware of how your own family experiences influence your practice with families. You can use theory to help you do that as well. To begin this process, reflect on the following questions related to your family of origin and your childhood:

What value was placed on connectedness, and what value was placed on the differentiated self? What were the external boundaries—who was in and who was out of the family? What were the commonly shared beliefs? What roles did family members play? What were the patterns of communication? Were there any transition points that were particularly difficult for your family? What made those transitions difficult? How traditional were the gender roles in your family? How was power distributed? Can you recall any periods of stress pileup? If so, how did your family cope during those periods? How did your family use belief systems, organizational patterns, and communication to be resilient in the face of adversity? After you have reflected on these questions, write a brief paper addressing the following points:

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Summarize your reflections on each question. How do you think your experiences in your family of origin might serve as a barrier or an aid in work with a family similar to the Sharpe family?

2. Visualizing your family. Sometimes we learn new things about families when we prepare visual representations of them. There are several tools available for doing this. You will use three of them here to visualize your own family.

Referring to Exhibit 10.2, prepare a multigenerational genogram of your family, going back to your maternal and paternal grandparents. Referring to Exhibit 10.3, prepare a family ecomap of your current family situation. Referring to Exhibit 10.4, prepare a family timeline, beginning at the point of your birth or earlier if you think there were significant earlier events that need to be noted.

After you have prepared these materials, work in small groups in class to discuss how useful each tool was in helping you think about your family of origin. Were any new insights gained from using these visual tools? What is your overall reaction to using tools like these to understand your family?

Web Resources

Administration for Children & Families (ACF): www.acf.hhs.gov

Site of ACF, a government agency that is part of the U.S. Department of Health and Human Services, contains fact sheets about children and families and information about ACF programs such as child support enforcement, Head Start, and Temporary Assistance for Needy Families (TANF).

Council on Contemporary Families: www.contemporaryfamilies.org

Official site of the Council on Contemporary Families, a nonprofit organization that promotes an inclusive view of families, contains information and research on families, along with links to other Internet resources.

Families and Work Institute: www.familiesandwork.org

Site contains information on work–life research, community mobilization forums, information on the Fatherhood Project, and

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http://www.acf.hhs.gov

http://www.contemporaryfamilies.org

http://www.familiesandwork.org

frequently asked questions.

Forum on Child and Family Statistics: www.childstats.gov

Official website of the Federal Interagency Forum on Child and Family Statistics offers easy access to federal and state statistics and reports on children and families, including international comparisons.

National Council on Family Relations (NCFR): www.ncfr.org

Site contains publications, news, and professional resources.

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http://www.childstats.gov

http://www.ncfr.org

11 Small Groups

Elizabeth P. Cramer

Chapter Outline Learning Objectives Case Study 11.1: The Sexuality and Gender Group at a Women’s Residential Substance Abuse Treatment Facility Small Groups in Social Work

Therapy Groups Mutual Aid Groups Psychoeducational Groups Self-Help Groups Task Groups Virtual Groups

Dimensions of Group Structure Group Composition

Heterogeneity Versus Homogeneity Homogeneity/Heterogeneity in Group Composition: Social Justice Issues

Basic Group Processes Theories of Group Processes

Psychodynamic Theory Symbolic Interaction Theory Status Characteristics and Expectation States Theory Exchange Theory Self-Categorization Theory

Group Development Stage Theories and Models Process Models

Group Dynamics Formal and Informal Leadership Formal and Informal Roles Communication Networks Group Cohesiveness

Interdisciplinary Teams and Leadership

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Interdisciplinary Teams and Social Work The Social Worker’s Role on Interdisciplinary Teams Social Workers and Leadership

Implications for Social Work Practice Key Terms Active Learning Web Resources

Learning Objectives 11.1 Analyze one’s own emotional and cognitive reactions to a case study. 11.2 Define small groups and identify some of their uses in social work practice. 11.3 Summarize and give examples of three dimensions of group structure. 11.4 Compare the benefits and drawbacks of heterogeneity and homogeneity in group membership. 11.5 Analyze the potential usefulness for social work practice of five theories of group process: psychodynamic theory, symbolic interaction theory, status characteristics and expectation states theory, exchange theory, and self-categorization theory. 11.6 Describe four characteristics of group dynamics 11.7 Summarize the role of social workers in interdisciplinary teams. 11.8 Apply knowledge of small groups to recommend guidelines for social work engagement, assessment, intervention, and evaluation.

Case Study 11.1 The Sexuality and Gender Group at a Women’s Residential Substance Abuse Treatment Facility The sexuality and gender group at the women’s residential substance abuse treatment facility meets twice a month. This is a support group for lesbian, bisexual, and questioning women (those women who are unsure of their sexual orientation). Women who identify as transgender also attend the group. Women in the treatment facility are informed about the group by their counselors, and participation in the group is strictly voluntary. The facilitator is a licensed clinical social worker who is also a social work professor and a

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lesbian. The composition of the group can change each session because women are entering and exiting the facility regularly. Typically, 8 to 15 women attend the group. The duration of the treatment program is 90 days; however, some of the women choose to leave the program before treatment has been completed. Many of the women in the group are parents; some of them have brought their children into treatment with them because one of the treatment programs at this facility allows women and their children to come into residence. Most of the women in this group identify as African American or Hispanic and range in age from 19 to 50. The facilitator is Caucasian, Jewish, and in her early 40s. The following is an account of one of the group sessions.

It’s a hot day, and Deb is driving her non-air-conditioned car to the substance abuse treatment facility to facilitate the sexuality and gender group. She’s been facilitating this group, which was the first of its kind at this facility, for about a year. It has been a good learning experience for her, and she has grown quite attached to the group. She particularly is impressed with the candidness of the group members and often refers to this population of women as superb “BS detectors,” because they are not afraid to call each other out when denial or deceitfulness surfaces. For a moment, Deb feels sorry for herself because she doesn’t have air-conditioning in her car and she lives in the South, but then she remembers that most of the women in group do not even own cars. That moment of self-pity quickly passes.

The group members are already in the lounge where group meets when Deb arrives. She smiles and acknowledges each of the group members through eye contact. She notices that out of the dozen women in the room, about eight of them were there for the last group session. Deb introduces herself and makes a point to say that she is a lesbian but not in recovery, although she has worked with many women who are in recovery. She mentions where she works and how long she has been facilitating this group. She then asks the women to introduce themselves using first names. In their introductions, some of the women mention why they have come to group or how long they’ve attended group. Two of the women share that they were curious about the group but don’t identify as lesbian or bisexual; however, they have considered same-sex relationships and have had feelings of same-sex attraction. One of the group members notes that she has recently exited the prison system and had relationships with other women while she was incarcerated but never while “on the streets.”

Deb describes the purpose of the group as a place for members to talk about sexual orientation, whether they are lesbian, bisexual, or questioning. Deb stresses that what is said in the room stays in the room and that members should refrain from sharing someone’s story with others outside of the group.

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Confidentiality is especially important to emphasize in residential programs. Deb also mentions that the group is open and that members can freely discuss what they want to.

Deb usually has a loosely planned agenda for each group session but also waits to see what issues may get raised in the introductions and check-in at the beginning of the group. Today, she brought the documentary film All God’s Children to show the group (Mosbacher, Reid, & Rhue, 1996). The film highlights the experiences of African American lesbians, gays, and bisexuals, particularly related to family, church, and community. It’s a powerful film and reminds the group members that their sexual orientations are not experienced in a bubble; rather, the intersections of faith, neighborhood, geography, and other identities and characteristics influence how they experience their sexual orientations.

One part of the film seems to arouse much energy and discussion: whether a person is born gay or makes a decision or choice to be gay. Tamika, one of the younger women in group, strongly asserts that a person chooses to be gay. She shuns the labels of lesbian and bisexual; instead, she prefers to allow herself to date or fall in love with whoever is attractive to her, whether that person is male, female, or transgendered. Monica, a woman in her early 50s, disagrees that sexual orientation is a choice. She shares a story of how she “knew” she was a lesbian when she was 12 and she fell head over heels for a girl in her neighborhood. She tried to suppress those feelings and pretended she was into boys all through middle school and the beginning of high school. By her junior year, she just couldn’t pretend anymore. She secretly would date girls, but no one in her family or her church knew. To this day, many years later, she has never openly said to any of her family members that she is a lesbian. They all seem to know that she is, but it isn’t discussed. She experienced a deep hurt at her church when her pastor delivered a sermon that Monica thought was very antigay. Her parents insisted that she attend church. She really didn’t want to go to church after that sermon, but she also didn’t want to tell her parents the reason why. That wasn’t the first and last time that antigay remarks were made in her church. Gail, usually quiet in group, shares that her experience at church has been the opposite of Monica’s. Her family attended a progressive church and persons of all sexual orientations were welcomed. She still hesitated to come out to her family members when she first began dating women but then eventually began to disclose to the family members to whom she felt closest. Their positive responses encouraged her to continue to disclose to other family members and close friends.

The discussion of the film moves the group into deeper core themes related to their sexual orientation and their addiction. As the facilitator, Deb looks

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for opportunities to work the parallel process in group—to note the similarities between the negative consequences of an addiction and the experience of being a sexual minority who is often discriminated against and ostracized. A few of these common issues include shame, fear, emotional dependence, despair, and loneliness. Shame is a particularly powerful emotion; the women in the group connect shame to experiences they’ve had as sexual minorities and the guilt and embarrassment about behaviors in which they’ve engaged while they were using drugs. Negative judgments from others about their sexual orientations and/or their addictions exacerbated the shame. One of the group members shares with the group about how she would get high in order to allow herself to be intimate with women. She thought it was the only way she could mask her fear and shame about her attraction to other women. Many of the group members struggle with feelings of internalized homophobia. In the group, Deb emphasizes how acceptance of oneself is important to group members’ emotional health.

The group is coming to a close. Most of the women have spoken in group today. The film seemed to strike a chord with many of them. On the way back to her workplace, Deb thinks about all the group members and what they shared that day. She feels fortunate to be let in to the inner lives of the women during a time when they are working hard to heal.

Small Groups in Social Work Much of human behavior takes place in small groups. The sexuality and gender group is a type of small group with special relevance to social work practice, but most people also become involved in other types of small groups: friendship groups, task groups at work, self-help groups, or sports teams, to name but a few. Donelson Forsyth (2011) reminds us that “people, no matter what they are doing—working, relaxing, studying, exercising, worshipping, or sleeping—are usually in a group rather than alone” (p. 19). We interact with others in many sizes of groups; the focus of this chapter is on small groups. We carry out our relationships with significant others in small groups, but it is important to remember that small groups also provide the structures on which communities, organizations, and the larger society are built.

Exhibit 11.1 ● Benefits of Small Groups

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In a mobile society, small groups serve a useful function. Exhibit 11.1 shows how group members may benefit from belonging to a small group. Small groups offer individuals an opportunity to meet others and work together to achieve mutual goals. They provide social support; they socialize us to the norms, values, behaviors, and skills for living in a given society; they provide a sense of belonging; they provide us with companionship and conversation; and they help us to connect to the wider world. Robert Putnam (2000) suggests that in our rapidly changing globalized society, small groups are an important source of social capital, or connections among individuals based on reciprocity and trustworthiness.

Small groups may be formally defined in a number of ways. A few scholarly definitions of small groups, along with examples from the sexuality and gender group, are displayed in Exhibit 11.2. Although these definitions differ, there is general agreement that small groups are more than a collection of individuals who may have similar traits or be in physical proximity. Persons who live on the same block may be in proximity but have little social interaction and not perceive themselves as a group. Thus, we may define a small group as “two or more people who interact with each other because of shared interests, goals, experiences and needs” (Ballantine et al., 2018, p. 129).

Exhibit 11.2 ● Definitions of Small Groups Exhibit 11.2 ● Definitions of Small Groups

Author(s) Definition Example

Newman

Set of people who interact more or less regularly and

Members of the sexuality and gender group interact in this group twice a month and identify as a group of

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Newman (2017)

regularly and who are conscious of their identity as a unit

and/or gender identities that are different from the norm. They are able to use the group to become more accepting of their identities.

Ritzer (2016)

A relatively small number of people who over time develop a patterned relationship based on interaction with one another

Members of the sexuality and gender group develop a culture within the group over time, which emphasizes open communication, confidentiality, and willingness to be truthful with each other.

Ballantine, Roberts, & Korgen (2018)

Two or more people who interact with each other because of shared interests, goals, experiences, and needs

The sexuality and gender group offers a space for the members to openly discuss what it is like to be a sexual minority and a recovering addict. Group members support each other in achieving recovery from their addiction and positive acceptance of their sexual orientation.

A significant element of social work practice today is group work, which serves people’s needs by bringing them together in small groups. Group work emerged in the United States in the late 1800s and early 1900s. Early group work took place within the settlement houses, YMCA/YWCA, Jewish community centers, and the Boy Scouts and Girl Scouts. These groups focused primarily on recreation, social integration, immigration issues, character building, and social reform. We are now seeing a resurgence in recreation and social skill–building groups, reminiscent of early group work (see Rosenwald et al., 2013). Social skills groups with elementary-age children (Lane et al., 2003), children diagnosed with autism spectrum disorder (Leaf et al., 2017), and adolescents (Tucker, 2009); hoops groups (basketball) with adolescent males (Hansen, Larson,

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& Dworkin, 2003); and physical activity, reminiscence, and motivation groups for older adults (Hughes et al., 2005; Melunsky et al., 2015) are three examples.

By the 1930s and 1940s, formal organizations were promoting group work. In 1935, the Group Work Section of the National Conference on Social Work emerged, and in 1937, the American Association for the Study of Group Work formed. The American Association of Group Workers, which started in 1946, later merged with other organizations to become the National Association of Social Workers (NASW).

During World War II, group work became popular in hospitals and other clinical settings in the United States, resulting in some tension between group workers and caseworkers. Following the war, the philosophy of group work shifted from a strengths focus to a more problem-focused orientation. Nevertheless, group workers continued to attempt to influence the social work profession as a whole. During the 1960s and 1970s, social work education included courses on group work, and some students majored in group work. But then group work content declined as social work education shifted its focus to individuals and families. Ironically, at the same time, joining groups became more common in the United States. The 1980s and 1990s saw the rise of mutual aid groups (Gitterman & Shulman, 2005), today a popular type of social work group.

With today’s concern about cost containment, groups are viewed as a financially prudent method of service delivery, and the use of groups by social workers is on an increase (Sweifach, 2015). In addition, empirical studies have shown the effectiveness of groups in addressing a number of social, health, and emotional problems, such as mental illness and substance abuse (Drake, Mueser, Brunette, & McHugo, 2004; Lau, Chan, Li, & Au, 2010) and cancer (Khng, Woo, & Fan, 2016; Spiegel & Classen, 2000). One researcher (Garrett, 2005) found that a small sample of school social workers makes extensive use of group work methods. Social workers’ use of groups in empowerment and feminist practice encourages a focus on the individual in the sociopolitical environment and is thus especially helpful for clients who desire a path for activism as a component of their healing (Lee & Hudson, 2017). Group work content is coming back into the social work curriculum, and social work students are being exposed to group work through their field placements. Furthermore, graduating students have informed me that potential employers ask if they

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have had course content on group work. And yet research on group work content in social work curricula suggest a need for social work students to receive more education on group processes and skills of group facilitation (LaRocque, 2017; Sweifach, 2015). Sweifach (2015) argues that the two most important skills for group workers are skill in facilitating mutual aid and skill in managing group conflict. LaRocque (2017) warns that use of manualized group treatment is not a substitute for good group facilitation by a leader who understands group process.

A number of scholars have established classifications for groups encountered in social work (see, e.g., Kottler & Englar-Carlson, 2015; Toseland & Rivas, 2017; Zastrow, 2015). This chapter focuses on five: therapy groups, mutual aid groups, psychoeducational groups, self-help groups, and task groups. Exhibit 11.3 compares these five types of groups on several major features—purpose, leadership, size, duration—and gives examples of each. As you read about them, remember that groups may not fall exclusively into one category; rather, they may share elements of several group types. For example, a group for parents and friends of seriously mentally ill persons may include psychoeducational material about the nature of mental illness and its impact on family members, provide mutual aid to its members through discussion of taboo areas, and offer a therapeutic component in the examination of family patterns and dynamics. In recent years, all types of groups have been meeting in virtual format, and we take a look at this trend in this section.

Therapy Groups One common type of group is known as the therapy group, or psychotherapy group. Group psychotherapy uses the group milieu to enable individuals to work out emotional and behavioral difficulties. The individuals in the group often reproduce their emotional and behavioral problems within the group setting, thus giving the leader and group members an opportunity to provide feedback about them (DeLucia-Waack, Kalodner, & Riva, 2014). An example of this type of group is a therapy group for adult incest survivors.

Therapy groups typically have fewer members and meet for a longer duration than self-help, psychoeducational, or mutual aid groups. Such a group may have six or fewer members, may be led by a person who considers himself or herself to be a therapist, may meet weekly for a year

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or more, and may involve intrapsychic exploration of thoughts and emotions. Talk or verbal therapy groups are not the only type. Increasingly popular are art therapy groups, which have demonstrated the standard therapeutic factors of verbal therapy groups as well as some factors unique to art therapy (Wood, Molassiotis, & Payne, 2011). In addition, therapy groups do not necessarily meet for long periods. Brief treatment models, which usually last 6 weeks or less, are becoming more and more popular in a managed care environment.

Exhibit 11.3 ● Types of Groups Exhibit 11.3 ● Types of Groups

Type of Group Purpose Leadership Size Duration

Therapy

Uses group modality to assist individuals to resolve emotional and behavioral problems

Typically led by a trained clinician or psychotherapist

Typically small, sometimes six or fewer members

Brief therapy groups usually meet for 6 weeks or less. Long-term psychotherapy groups can last years.

Mutual aid

Uses mutual aid processes to create a helping environment within the group milieu

Typically led by a facilitator who may be a professional or layperson trained to lead the group. The leader may or may not have experienced the issue on which

These groups may be small (fewer than 5 persons) or large (12 or more), especially if run in a drop-in

Drop-in mutual aid groups may be ongoing for a number of years with members coming in and out of the group. Time-limited mutual aid groups typically run for 4

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the group is focused.

format. to 12 weeks.

Psychoeducational

Focuses on the provision of information about an experience or problem

Typically led by a trained professional

Limiting the group size is usually not as critical with these types of groups because of their purpose.

One-time meetings of psychoeducational groups may be offered on a regular schedule; they might be offered in a series of sessions (e.g., a 4-week educational series); or they might be offered on an as-needed basis.

Self-help

Uses the commonality of the problem or issue to build social support among members

Typically led by a layperson who has experience with the problem (e.g., a person in recovery from alcohol and drug addiction)

Typically, because self-help groups operate on a drop-in basis, the group size is not limited.

Most often, self- help groups are run on a drop-in basis; however, some may be offered in a time- limited format.

Task

Created to accomplish a specific task or to advocate around a particular

These groups may be led by professionals or nonprofessionals; leaders may be appointed or

Often limited in size to successfully accomplish the task. When advocating

Meet until the task has been accomplished or the desired social change has been

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social issue or problem

elected. for change, membership may be larger.

accomplished

Photo 11.1 Therapy group. Members in therapy groups share experiences and obstacles they have encountered. Group therapy assists individuals in resolving emotional and behavioral problems.

Mutual Aid Groups In mutual aid groups, members meet to help one another deal with common problems. The members of the group thus become as important to its success as the facilitator (Steinberg, 2014; Sweifach, 2015). In the sexuality and gender group, we witness many benefits of mutual aid groups:

Sharing data: coming-out stories, events in the members’ lives related to their sexual orientation and addiction

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Engaging in a dialectical process of discovery: theories about sexual orientation, insight into when one first felt one was not heterosexual Discussing taboo subjects: open discussion of intimacy, admitting shame or guilt about feelings or behaviors related to addiction and/or sexual orientation Realizing that one is not alone (all in the same boat): others who are not heterosexual and have had similar feelings regarding coming out and disclosure Finding support: a place to be oneself in a homophobic society Making mutual demands: challenges to internalized self-hatred, dishonesty about one’s feelings and behaviors, and unhealthy coping mechanisms that lesbian and bisexual women may use as a way to live in two worlds Problem solving: disclosure decisions for individuals and the larger issue of self-disclosure of stigmatized identities (as a sexual minority and a recovering addict) Rehearsing new behaviors: role-playing of disclosure scenarios or confrontations with people who make antigay jokes Finding strength in numbers: reading literature and watching films that portray the lived experiences of “out” lesbian and bisexual women of various races, ethnicities, faiths, and abilities offers positive role modeling to group members

In general, mutual aid groups are led by someone, either a professional or a trained individual, who identifies with the population the group targets. For example, the facilitator of the sexuality and gender group self- identifies as a lesbian. In fact, some mutual aid groups form as an alternative to professionally led therapy groups. In this way, they may be similar in purpose to self-help groups. There is no requirement, however, that in order to be an effective leader, one must have “been there.” The groups may be time-limited (for example, a 10-week group for siblings of children with disabilities) or ongoing (such as a weekly support group for incarcerated males).

Mutual aid groups also have the potential for activism. A group of people may meet initially to gain support and share concerns but may transform some of their healing energy into social change efforts. For instance, members of a mutual aid group for battered women may attend a Take Back the Night march (to protest violence against women) as a group and then courageously approach the microphone to speak about their own

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then courageously approach the microphone to speak about their own experiences of victimization and empowerment.

Psychoeducational Groups Psychoeducational groups, in which social workers and other professionals share their knowledge and expertise to educate group members about a specific life problem or developmental issue, are becoming more common in the United States (Brown, 2011). The topics include problems such as substance abuse and divorce as well as more general interests, such as child development or the aging process. Those who participate are primarily looking for information rather than intervention for emotional and behavioral problems. Thus, the format of group meetings may be a lecture by the group leader or a guest speaker with minimal group discussion. The group could be a one-time workshop, or it could last several sessions.

Although a psychoeducational group is not a therapy group, it can be therapeutic when members share feelings and concerns. An example is a one-time group meeting for family and friends of persons in a drug rehabilitation center. The stated purpose may be to provide education about the recovery process to family members and friends, but during the session, group members may share feelings about their loved one’s addiction and how it has affected their lives.

Self-Help Groups In general, self-help groups are not professionally led, although a professional may serve in the role of consultant. These groups are composed of people who voluntarily meet because of a common identity or life situation, thus offering members an opportunity to receive assistance from others who are also struggling with similar issues. An informal leader may emerge in a self-help group, or leadership may be rotated among the membership. Self-help groups are often used as a supplement to professional treatment. For example, someone who is receiving outpatient substance abuse treatment may be referred to Alcoholics Anonymous; someone in a family preservation program may be referred to Parents Anonymous. Self-help groups often have no limit on their life span and have rotating membership (people come and go from

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It appears that humans have developed and maintained self-help groups for ages (Teshome, Zenebe, Metaferia, & Biadgilign, 2012). Although there is no trustworthy estimate of the number of self-help groups in the United States and around the world, there is much evidence that both face-to-face and virtual self-help groups are numerous. Self-help groups have several benefits. People are able to offer help to others, as well as receive help, which produces psychological rewards (Toseland & Rivas, 2017). In addition, self-help groups can run with few resources. For example, a religious institution might donate space for meetings, and there generally are no costs for the group facilitators.

Self-help groups offer their members some of the social functions mentioned in the beginning of this chapter—a chance to meet others and have meaningful interactions, a place to feel as though one belongs and to give support to others. In short, self-help groups offer a social support system. As discussed in Chapter 5, social support has been shown to help people prevent and overcome disease and to maintain good psychological health. In addition, some believe that attending a self-help group is less stigmatizing than a “treatment” or “therapy” group, the latter being more often associated with those who are seriously ill or have major problems in living. Some people view self-help groups as a form of support by and for laypersons (“folks just like me”), and the idea of attending one can be much less intimidating than a therapy or mutual aid group. The absence of agency affiliation for many self-help groups is attractive to those who would rather think of themselves as getting support from people in similar situations than going to an agency for assistance. Yet others may find comfort in knowing that a particular self-help group has an affiliation with a national, state, or local organization. Self-help groups can demonstrate helping characteristics (e.g., universality, support, and communication of experiential knowledge) similar to those of mutual aid groups.

Photo 11.2 Mothers support group. Here, mothers join together to share stories, struggles, and insights about the adjustment of becoming a parent.

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Another benefit of self-help groups is their potential for activism. One study found that parents of children with cancer who were members of self-help groups were significantly more involved than other parents of such children in working to improve the medical system in which their children were involved (Chesney & Chesler, 1993). Another researcher (Tesoriero, 2006) found that women’s self-help groups in India become active in community action projects and sometimes move their activism beyond the local community. Another study of microcredit self-help groups with widowed and abandoned women in rural India found that the program resulted in an increase in self-efficacy among the women as well as the development of a collective political voice (Newransky, Kayser, & Lombe, 2014). A study of women’s postpartum depression self-help groups (Taylor, 1999) found that these groups incorporate consciousness raising and advocacy with medical and mental health professionals and politicians to effect change in institutional responses to women experiencing postpartum depression.

Task Groups

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Most of us have been involved in task groups, such as a committee at school or work or a task force in the community. It appears that the use of task groups is increasing in the workplace (Kottler & Englar-Carlson, 2015). In social work practice, task groups are often short term and formed to accomplish specific goals and objectives. Task groups are used frequently by social workers involved in planning, administration, community organizing, and social action roles but are much less common in other social work roles. An example is a needs assessment committee formed at an agency to determine the problems and concerns of the population the agency serves. Although members of other types of groups may take on tasks (e.g., researching a subject and presenting it to the group), the task group is created with the express purpose of completing some specific task.

Task groups are often formally led by professionals appointed or elected to chair the group. Leaders may be chosen because of their position in the agency or their expertise in the area. Task groups formed in the community to advocate for change may be led by community members or co-led by professionals and community (lay) members.

In task groups as well as other kinds of groups, members fulfill what are commonly referred to as “task and maintenance” roles. The task specialist focuses on the goals set by the group and the tasks needed to accomplish them. These may include providing information to aid group discussion, giving directions for how to proceed with a task, or summarizing members’ ideas. Maintenance roles refer to those that enhance the social and emotional bonding within the group. These include inquiring about how close members feel to each other, encouraging open and respectful discussion of conflicts, and inviting reluctant members to participate in group discussion (Coyne, 2014).

Critical Thinking Questions 11.1

In what types of small groups have you participated? What benefits have you derived from participating in small groups? What frustrations have you faced from participation in small groups?

Virtual Groups

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Virtual groups are those where members do not meet face-to-face, meeting instead by telephone or through the Internet. Any of the discussed group types can and has used technology, either as the primary format for running the group or as a supplement to a group that meets face-to-face. Technological advances have made it possible to have telephone conversations among a number of people at very little cost. During the past 2 decades, some social workers and other helping professionals have been using the telephone to offer therapeutic and support groups (Toseland & Larkin, 2010; Toseland & Rivas, 2017). During this same period, computer-mediated support groups have proliferated in the United States and around the world (Jones & Meier, 2011). We’ll look first at telephone- mediated groups and then at computer-mediated groups.

Telephone-mediated groups have not been rigorously evaluated to date, but Toseland and Rivas (2017) reviewed the available literature on telephone support groups. They found that these groups are most often used with persons with chronic and long-term illnesses or with caregivers of frail older adults. Their review found both advantages and disadvantages of telephone-mediated groups, but the findings from outcome studies were overwhelmingly positive for the types of groups noted earlier. Some researchers found that in some situations, telephone- mediated groups are more cohesive than face-to-face groups. They found that in telephone groups members no longer focus on personal features such as skin color or other social status cues. Other advantages of telephone groups include convenience of meeting in one’s own home, reduced time needed to participate because of no travel time, ability to reach people in rural areas and across greater distances, ability to reach people who are homebound or caring for someone who can’t be left alone, and greater levels of self-disclosure. Additionally, persons with inconsistent access to computers and the Internet, or those who have difficulties understanding or manipulating online environments, may find that telephone groups are more accessible than computer-mediated ones (Gonzales, 2016; Wagner, Hassanein, & Head, 2014). As a form of synchronous interaction, telephone groups offer the opportunity for immediate knowledge and support exchange among participants (Park & Bonk, 2007) versus the wait-for-feedback format of asynchronous online groups where one posts a request or response on an online group discussion board and waits for others to respond later.

Disadvantages of telephone groups include difficulty for leaders to track

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individual participation and interpret subtle verbal cues; difficulty for group members to gauge each other’s reactions because of the lack of visual cues; difficulty of including members with hearing problems; concerns about confidentiality when other members of the household are present; distortions related to technological problems or background noise; and inability to use hands-on program activities, flip charts, and other visual aids. Some researchers noted more hostility in telephone-mediated groups than in face-to-face groups, and others noted less hostility. Toseland and Larkin (2010) provide useful guidelines for developing and leading telephone groups. They suggest that social group workers use the same skills in telephone-mediated groups as with face-to-face groups but need to be more active to ensure clear communication because of the lack of visual cues.

Computer-mediated groups are commonly identified as “any virtual social space where people come together to get and give information or support, to learn or to find company” (Wright, 2016, p. 67). Online support has become increasingly popular over the last decade. Currently, approximately 20% of all Internet users have sought out support from online groups (Wright, 2016). This could be attributed to the diverse outlets for group support that computer technology offers, including e- mail-based groups, chat rooms, blogs, newsgroups, podcasts, video conferencing, and discussion forums. Computer-mediated support allows people with similar concerns and interests from diverse areas of the world to convene in virtual space (Chung, 2014).

Research indicates that computer-mediated groups provide benefits to some of the same groups of people that benefit from telephone-mediated groups: people living in rural areas, people who are homebound, older adults, and caregivers who cannot leave their care recipients (Jones & Meier, 2011; Wright, 2016). In addition, computer-mediated groups are becoming more common in cancer treatment (Elwell, Grogan, & Coulson, 2010; Vilhauer, 2014). The benefits of such virtual groups include decreased symptoms of depression and anxiety, and increased sense of connectivity and group belonging (Wright, 2016). Groups conducted within virtual environments, such as Second Life, have the additional capability of creating a dimensional space in which group members can interact in facsimile to an authentic group experience (Reinsmith-Jones, Kibbe, Crayton, & Campbell, 2015). Group identity and group cohesiveness do not appear to require member co-presence. On the other

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hand, miscommunication has been found to be more frequent in computer- mediated team meetings (Levi, 2014). Jones and Meier (2011) note that like face-to-face groups, computer-mediated groups must develop “coherent and compelling missions, recruit and retain members, establish and enforce group norms, and manage conflict” (p. 103).

Some people enjoy the anonymity of web-based groups. In some of these groups, the use of pseudonyms and withholding other identifying information enables participants to speak more freely about sensitive topics that they would be resistant to discuss in face-to-face encounters (Zilberstein, 2015). Social workers who refer clients to web-based groups may want to first discuss the potential negative consequences of using such groups. For example, because of the anonymity of the site, participants may engage in antagonistic and inappropriate behavior not unsimilar to what one can experience in an ineffectively moderated face- to-face setting (Zilberstein, 2015). A good group moderator will intervene in such behavior. Also, cyberstalking is another danger for those who desire to participate in web-based groups (Hitchcock, 2006).

Although accessibility and versatility are positive attributes of technologically-based groups (Chung, 2014), this level of convenience can come at a cost. Virtual groups demand skills that may require additional training from their participants. Additionally, though virtual groups allow members from all over the world to connect, additional time must be spent to navigate schedules across varying time zones (Janutaite., Vosyliu-te., Vizgirdaite., & Taras, 2015). It is a challenge for social workers to stay current with constant technological advances.

In deciding whether to use virtual groups, attention must be paid to groups that have limited access to technology. For example, slightly over half of adults with disabilities use the Internet, whereas over three quarters of people without disabilities use the Internet; there is also a large disparity between people with disabilities who have Internet access at home (41%) versus people without disabilities who have Internet access at home (69%) (Fox, 2011). Although people with low incomes are gaining increased access to technology, their access is routinely unstable and undependable (Gonzales, 2016). The digital divide is shrinking but still exists.

Students facilitating groups using social network sites need to be particularly careful of potential ethical issues, especially personal privacy, boundaries, safety, and client confidentiality (Judd & Johnston, 2012).

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Students should act differently on their professional social network sites than their personal ones; on a professional social network site, students need to be especially aware of “the presentation of a professional self” (Judd & Johnston, 2012, p. 7). The picture you thought was hilarious of you during spring break in Cancun may not sit well with clients. Therefore, privacy settings on students’ personal social network sites should be monitored in case clients happen upon their personal sites. Recently, several social work organizations jointly published the “Standards for Technology in Social Work Practice,” which include important considerations for students and practitioners when they intend to use technology to provide social work services (NASW, ASWB, CSWE, & CSWA, 2017). Among their recommendations is that social workers using technology to deliver services should assess potential participants’ level of familiarity and comfort with technology; whether language translation software is available and will be used; and the accessibility of the technology, including access to the Internet, for various populations, including persons with disabilities.

Dimensions of Group Structure The sexuality and gender group serves a variety of functions. But that one group cannot provide all group members’ needs. Group members are also involved in friendship circles, 12-step groups, and educational classes. Each group plays a unique part in group members’ lives. For example, friendship circles are important to maintaining recovery when those friends reinforce the attitudes and behaviors that support staying clean and sober. But all these groups are obviously structured quite differently. They can be categorized along three dimensions.

1. How they develop. The types of groups encountered in social work have typically been organized for a purpose. Such formed groups have a defined purpose and come about through the efforts of outsiders, such as an agency (Toseland & Rivas, 2017). Examples of formed groups include not only therapy groups, mutual aid groups, psychoeducational groups, self-help groups, and task groups but also such groups as college classes, PTAs, and choirs. Natural groups, in contrast, “come together spontaneously based on naturally occurring events, interpersonal attraction, or the mutually perceived needs of members” (Toseland & Rivas, 2017, p. 12). Families, peer groups,

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street gangs, and a group of patients who have befriended each other in a psychiatric hospital are examples of natural groups.

2. How long they last. A time-limited group is one with a set time for termination; an ongoing group has no defined end point. Both formed and natural groups may be time limited or ongoing, short or long term. A formed group, for example, may last for a 2-hour period (e.g., a focus group) or for months or years (e.g., the sexuality and gender group noted in the case example). A natural group may last a lifetime (a group of close friends from high school) or just through some event (tablemates at a workshop).

3. How they determine membership. Finally, both natural and formed groups may be open or closed or may fluctuate between open and closed. Open groups permit the addition of new members throughout the group’s life. In closed groups, the minimum and maximum size of the group is determined in advance, before the group begins or as it is being formed, and others are prohibited from joining once that limit is reached. A group can start off open and then become closed. An example is a group of people who have been attending a drop-in support group for women in abusive relationships who decide after a few months that they would like to close the group to do some more intensive work in group sessions. Alternatively, a closed group may open up, as when the number of members has decreased considerably and new members are needed to keep the group going.

These three dimensions of group structure interact in complex ways. The sexuality and gender group is a formed group, yet it is open and ongoing. Attendance has ranged from 8 to 15 persons, and the group may continue indefinitely. An example of a closed natural group is an informal group of middle school girls who call themselves the “lunch bunch.” The five girls eat lunch together every day and have let it be known among their peers that no others are welcome. An example of a formed, time-limited, closed group is a 12-week group for men and women going through a divorce. Interested persons must register prior to the group’s beginning, and once the first session begins, no new members are permitted. An example of an ongoing, open, formed group is a bereavement group that meets every Tuesday evening at the local hospital and allows anyone who would like support to join the group on any Tuesday. Another example is a group that spontaneously meets at the basketball courts on Sunday afternoons to play ball. Whoever shows up can get into a game, with no predetermined limit to the number of people allowed to play.

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Group Composition Another important element of small groups is their composition—the types of people who are members. Natural groups often have implicit or explicit rules about who gets to belong and who doesn’t. Take the previous example of the lunch bunch: The girls determined who would belong. Formed groups have rules of membership, too. A sorority or fraternity establishes a process to select who will belong. Sometimes social workers work with naturally occurring groups and do not make decisions about group composition. But for many groups facilitated by social workers, the social worker decides which members are included in the group. Space constraints and personnel issues may determine the size of the group, but the social worker must still make decisions about who gets to belong. One of the most important issues is how to manage diversity in the composition of the group.

Heterogeneity Versus Homogeneity Diversity is becoming more common in the workplace, schools, and the community, and social work groups are increasingly heterogeneous. The degree of heterogeneity (diversity) or homogeneity (sameness) of groups may vary along several dimensions, such as age, race, sexual orientation, gender, level of education, skills, coping style, religion, socioeconomic status, disabilities, and problem areas or strengths. In natural groups, heterogeneity or homogeneity may be affected by such variables as the location (some geographic areas are highly homogeneous), preferences of group members (people tend to form natural groups with those with whom they feel some connection), and social norms and values (acceptance or condemnation of mixed groups).

Usually social work groups are homogeneous on one or a few of these dimensions and heterogeneous on the rest. For example, the sexuality and gender group is homogeneous regarding sexual orientation and substance abuse but quite heterogeneous on other dimensions, including race, age, socioeconomic status, disabilities, educational status, occupation, age at first awareness of sexual orientation, and amount of disclosure of sexual orientation to others.

Which is better for group work, heterogeneity or homogeneity? The best

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answer is “It depends.” First, there is much agreement that homogeneity in members’ purposes for joining the group is essential. Beyond that, Magen and Mangiardi (2005) recommend two principles of composition that seem to have widespread acceptance. The first principle, which they attribute to Fritz Redel, is that “groups should be homogeneous in enough ways to insure their stability and heterogeneous in enough ways to insure their vitality” (Magen & Mangiardi, 2005, p. 355). The second principle, the Noah’s ark principle, they attribute to Irvin Yalom. This principle recommends that group composition should not isolate any one member on an important characteristic, such as age, race, or gender. Differences among people may be overridden by the overall purpose of the group, however. I am reminded of a friend who spoke to me of her experiences attending a support group for family members who had lost their loved ones. As the only African American group member, she said she felt like a “fly in a milk carton,” but her fellow group members were the only people she knew who truly understood her grief.

Often heterogeneity/homogeneity is a matter of perception. For example, in several studies of racially mixed groups, European American group members had a different perception from African American members regarding the racial balance of the group (Davis, 1984). If the group was in proportion to the population of African Americans in the geographic area, then the European American members perceived the group as balanced. If the group had equal numbers of White and Black members, the Black members viewed the group as balanced. In such situations, however, the White members perceived the group as imbalanced because the number of African Americans exceeded the psychological threshold of tolerance for European American members. In another study conducted by the same researcher and colleagues (Davis, Strube, & Cheng, 1995), the researchers tested perceptions of African American and White male participants in task groups with three racial mixtures: 25% African American, 50% African American, and 75% African American. They found that the harmony of the group atmosphere, the success of the group, and the perceived satisfaction with group decisions were all more favorable when either African Americans or Whites were in the majority and least favorable in groups in which neither African Americans nor Whites were in the majority (50% White, 50% African American). Most important, both the African American and White group members had similar reactions to the three racial configurations. In another study, Asian persons showed higher levels of participation and leadership skills in work groups

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that were racially balanced or all Asian compared with Asians in White- dominated groups (Li, Karakowsky, & Siegel, 1999).

Group workers must also give serious thought to whether to have gender homogeneity or gender heterogeneity in group membership. Clearly some group purposes call for gender homogeneity, but gender heterogeneity is often seen to be of value to maximize the range of ideas generated in a group. Research indicates that gender composition is an important variable in group interaction. Researchers have found that women speak more often and have greater influence in groups with gender homogeneity than in groups that include men. One research team found that women speak less than their equal share when they are in the minority in a group and at equal rates when they are in a large majority (Karpowitz, Mendelberg, & Shaker, 2012). Women gained greater influence as their numbers grew. These researchers also found that when group decisions are made unanimously rather than by majority vote, women are not disadvantaged in either voice or authority when they are in the minority. Another research team (Toosi et al., 2012) found that racial diversity in group composition changed the gender dynamics. In racially homogeneous groups, White women spoke less than White men and had less influence, but in racially diverse groups, White women spoke as much as men and had as much influence. These researchers emphasize that no social identity stands alone, and researchers and group workers must consider how identities interact with each other.

Contemporary research indicates that group composition may be more complex than once thought. But in the group work literature there is still strong support for Yalom’s (1995) observation that for “long-term intensive interactional group therapy,” heterogeneous groups appear to be better (p. 255). Yalom is speaking here of homogeneity or heterogeneity of psychological problems. Homogeneous groups are generally not beneficial for long-term psychotherapeutic work that involves personality change, because they tend to remain at superficial levels and don’t challenge individuals’ behavioral patterns and dynamics as much as heterogeneous groups. Homogeneous groups, on the other hand, are often better for “support or symptomatic relief over a brief period” and “for individuals with monosymptomatic complaints or for the noncompliant patient” (Yalom, 1995, p. 255). Homogeneous groups tend to build commitment more quickly, offer more immediate support to members, and have better attendance and less conflict. And given the research cited earlier, there are good reasons to consider composing groups segregated by race and

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ethnicity to allow for more intensive exploration of common problems.

An interesting research finding is that the heterogeneity/homogeneity issue takes on less importance the briefer and more structured the group. Compositional issues are more significant in groups that are less structured and that focus on group interaction (Yalom, 1995). In the sexuality and gender group, the homogeneity of sexual orientation and recovery from addiction provide the safety and support to explore the heterogeneous aspects of the group.

For task or work groups, heterogeneity has been shown to positively influence group productivity. Among the 42 student project groups examined in one study, racial/ethnic diversity was positively associated with group efficacy (Sargent & Sue-Chan, 2001). Another study of work groups assessed diversity by race, age, sex, and functional background in their contribution to quality of innovation (the usefulness of an idea or the impact it might have on a business) and quantity of innovation (the number of new ideas the group produces) (Cady & Valentine, 1999). These four dimensions of diversity had no significant impact on quality of innovation. There were significant differences in quantity of innovation, however. As gender diversity increased, the number of new ideas decreased, and conversely, when racial diversity increased, the number of new ideas increased. Another study found that increasing the dimensions of diversity in work group membership mitigates the negative effects of tensions between majority and minority group members based on a single trait such as gender or race (Valenti & Rockett, 2008).

Homogeneity/Heterogeneity in Group Composition: Social Justice Issues As social group workers think about group composition, they do so in the contexts of an increasingly diverse society and a profession committed to the promotion of social justice. At the most basic level, that means social group workers will recognize the equal rights of all people in their communities to access social work groups. Promotion of social justice may, at times, mean the development of groups that are homogeneous on an important identity dimension, where people can speak about common experiences, receive social support, and develop solidarity. Such groups can lead to empowerment, and social group workers can support self-

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advocacy while also advocating for the group when appropriate.

At other times, promotion of social justice will mean being intentional about having a group that is heterogeneous on important social identity issues, while being homogeneous on group purpose. In developing such heterogeneous groups, the group worker should avoid having a token member of a marginalized community group (the Noah’s ark principle). When working with heterogeneous groups, the group worker must work to ensure that all members have a voice and are treated with dignity and respect, paying particular attention to power dynamics that members bring into the group from the world beyond the group. It is important for social workers to consider the potential for social work groups to create a safe place to discuss topics of diversity, oppression, and privilege that are avoided in most places of human interaction. For example, Richards- Schuster and Aldana (2013) describe one program that fosters youth dialogues on race and ethnicity. This type of program is a great opportunity for social workers to promote social justice. Additionally, group workers should continuously strive to improve their cultural responsiveness by “systematically examining culture, identity, acculturation, privilege, and oppression within a process approach to resolve a lack of understanding and create cultural empathy” (Ibrahim, 2010, p. 272).

Critical Thinking Questions 11.2

We live in an increasingly diverse world. What experiences have you had with small groups that were heterogeneous in race or ethnicity? What experiences have you had with small groups that were heterogeneous in gender? What did you see as the benefits of heterogeneity? What challenges were presented by heterogeneous membership?

Basic Group Processes To be effective, group workers need tools for understanding the group processes in which they participate. Group processes are those unique interactions between group members that result from being in a group together. How people behave in groups is of interest to us because we spend much of our time in groups, and groups have a strong influence on

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our behaviors.

Theories of Group Processes The fields of social psychology and sociology have been in the forefront of empirical research on group processes. Five of the major theories of group processes are discussed in this section: psychodynamic theory, symbolic interaction theory, status characteristics and expectation states theory, exchange theory, and self-categorization theory. Each one helps us understand, among other things, why and how certain members of a group develop and maintain more power than other members to influence the group’s activities.

Psychodynamic Theory

You were introduced to the psychodynamic theoretical perspective in Chapter 2. When applied to small groups, psychodynamic theory “focuses on the relationship between the emotional unconscious processes and the rational processes of interpersonal interaction” (McLeod & Kettner-Polley, 2005, p. 63). It is assumed that understanding the emotional processes in a group is essential for accomplishing the group’s task. The psychodynamic theoretical perspective is especially important to therapy groups where understanding emotional processes is the central task of the group, but some group leaders argue that it is an important perspective for increasing the effectiveness of any type of group. Small groups can be challenging because they satisfy our need to belong, and yet they also arouse our fears about social acceptance and social competence (Geller, 2005).

McLeod and Kettner-Polley (2005) identify three broad assumptions of psychodynamic theory for understanding small groups:

1. Emotional, unconscious processes are always present in every group. 2. Emotional, unconscious processes affect the quality of interpersonal

communication and task accomplishment. 3. Group effectiveness depends on bringing emotional, unconscious

processes to group members’ conscious awareness.

Group leaders in a psychodynamic therapy group would look for opportunities to assist group members to identify how their interactions within the group may mirror their patterns of interactions with others

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outside of the group; in other words, the group experience becomes a microcosm of members’ lives outside the group. For example, a female group member who tends to defer to the opinions of male group members and who is afraid to confront them may be demonstrating a general theme in her life of being intimidated by males because of childhood experiences of severe physical abuse by her father.

Symbolic Interaction Theory

In Chapter 4, you read about symbolic interaction theory and how it is used to understand the self. This theory is also used to understand what happens in small groups. According to symbolic interaction theory, humans are symbol-using creatures. We make meaning of the world by interacting with others through symbols—words, gestures, and objects. Some small-group theorists find it helpful to think about the small group as a place where symbols are created, exchanged, and interpreted and to think about individual and social change happening as meanings are made and changed through the use of symbols (Frey & Sunwolf, 2005). In fact, they think that a group is itself a symbol used to describe a relationship people understand themselves to have with each other. Group members create a sense of being a group through their symbolic actions with each other, through their language and their behaviors over time. Groups may use such symbols as metaphors, stories, and rituals to communicate and build cohesion. In this way, they also build a culture with its own symbols and meanings. The symbols provide group identity and stimulate commitment to struggle with the tensions of group life.

The symbols used in a group, and the meaning made of those symbols, are influenced by the environments in which the group is embedded (Frey & Sunwolf, 2005). Group members are also members of other groups and bring symbolic meanings with them from these groups. This may lead to tension and conflict in the group as members struggle to develop shared meaning about who they are as a group, what their goals are, and how they will operate as a group.

An example of symbolic interaction within a group is a ritual developed by the chapter author and a cofacilitator for a support group for incarcerated battered women. At the beginning and end of each session, the group would light five candles and recite five affirmations related to the group’s theme, loving and healing ourselves: “I am worthy of a good life,” “I am

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worthy of positive friendship,” “I am a loveable person,” “I desire inner healing,” and “I will recognize the good things about myself and others.” The lighting of the candles symbolized bringing to awareness the inner strength and healing power of each woman in the group.

Status Characteristics and Expectation States Theory

Status characteristics and expectation states theory proposes that the influence and participation of group members during initial interactions are related to their status and to expectations others hold about their ability to help the group accomplish tasks (Bianchi, 2010). Status characteristics are any characteristics evaluated in the broader society to be associated with competence; they may be either specific or diffuse. Let’s look first at an example of a specific status characteristic. Joan and Bob are both members of a task force formed in a housing project community to increase healthy social interactions among the children and beautify the grounds. Joan, who is known to be artistic, makes a suggestion that the group involve children in painting murals on communal buildings and then hold a contest for the best mural. Bob, who is not known to be artistic, suggests that the group solicit volunteer contributions from local artists who would donate paintings and other artwork to display on the inside of buildings. It can be expected that group members will be more willing to go along with Joan’s idea than with Bob’s because of Joan’s greater perceived expertise in artistic matters. Their performance expectations— predictions of how well an act will accomplish a group’s task—are influenced by this specific status characteristic.

In the sexuality and gender group, Beverly carries some influence. She has attended group sessions for almost 3 months and is one of the core members who come to the group consistently. As an influential member, she is expected to articulate and enforce the group’s rules and to assist new members in acclimating to the group. Group members expect Beverly to share her insights about the coming-out process and recovery from addiction, and they perceive her as a knowledgeable person, especially when discussing issues faced by African American lesbians.

Now let’s look at an example of a diffuse status characteristic. In the sexuality and gender group, Beverly is perceived as a knowledgeable person regarding coming out and the unique issues faced by African American lesbians. But in another setting, the color of Beverly’s skin

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might negatively influence how she is perceived by other people. Stereotypes about African Americans may cause other people to question Beverly’s interests, skills, or values. Such stereotypes are the basis of diffuse status characteristics whereby the power and prestige of group members are correlated with their status in the external world, regardless of their specific characteristics relative to the task at hand.

For example, if people expect that someone using a wheelchair is incapable of playing basketball for a charity fund-raiser, then they will act as if a person using a wheelchair is unable to play basketball. They may disqualify that person from playing, thereby demoralizing the individual with the disability and preventing the person from contributing to the success of the fund-raiser.

Gender is an influential diffuse status characteristic in our society, perhaps because it can often be easily discerned. In mixed-gender groups, males have greater participation and influence than females, and males or females with traditionally masculine personality traits are likely to exhibit more dominant behavior (Karpowitz et al., 2012; Toosi et al., 2012). In same-sex groups, gender is not an initial status differential; instead, members develop expectations of each other based on other status characteristics, such as education, race, or experience. Regardless of gender, a person’s perceived ability also affects performance expectations. For example, a female may be perceived as incapable of handling a complex mechanical problem in a work group, but she may be able to develop influence if she shows she can accomplish the task successfully (Schneider & Cook, 1995).

One assumption of status characteristics and expectation states theory is that people rely on their stereotypes in the absence of proof that those characteristics are irrelevant. In the psychological literature, this phenomenon is often referred to as “self-fulfilling stereotypes” (Snyder, 2014). In our example of assumptions people may make about persons using wheelchairs, the burden of proof would be on the persons using wheelchairs to demonstrate that they could indeed play basketball, thus establishing the inapplicability of others’ assumptions about the disability.

Exchange Theory

Sometimes in coming-out groups, those who have been out for the longest

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time have implicit power over those newly out, the “baby dykes.” A “let me show you the ropes and tell you what this is about” attitude can be used to gain power and influence over another person and to create dependency: “You need me to help you understand what you are getting yourself into.” But social power can also be used in a positive way in a coming-out group, as when those who have been in the lesbian community for a long time offer support and information to others with the intention of providing mutual aid. To understand power as a social commodity, we can look to exchange theory (Brown, Tang, & Hollman, 2014; Lovaglia, Mannix, Samuelson, Sell, & Wilson, 2005), which assumes that human interactions can be understood in terms of rewards and costs.

According to exchange theory, social power is what determines who gets valued resources in groups and whether those resources are perceived as being distributed in a just manner. Conflicts within the group often revolve around power issues among members—those who want the power in the group, those who have power and don’t want to give it up, and those who don’t want others to have power over them.

Groups are particularly vulnerable to conflicts over power because social power arises within the context of the group itself rather than being an innate quality of an individual. Power not only determines the distribution of group resources but also influences people’s expectations of others’ abilities, even when the power results from structural conditions and not from innate personal ability (Lovaglia, 1995). Emotion also has an impact on perceived power and influence, regardless of status. If a person has negative emotions toward a high-status person, the power of the high- status person will lessen (Lovaglia, 1995).

Power differences among group members can create status differences but don’t necessarily have to. Group members may rate more highly the abilities and influences of high-power members, which may in turn influence expectations for high-power members, but negative feelings toward high-power members may mitigate their influence.

The exercise of social power often brings with it a concern about justice, fairness, and equality. Most of us would agree that power should not be exercised to the special benefit or detriment of some group members. However, justice is a relative rather than absolute term. Any two persons may have quite different ideas about what constitutes justice. For some, justice would be an equal distribution of resources; for others, justice

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would be an equitable (but not necessarily equal) distribution.

How persons evaluate the equity of a situation depends on such factors as cultural values, self-interest, the situation, the relationships between those affected, and personal characteristics (Hegtvedt, 1994). People tend to operate more from self-interest in impersonal conditions than when they have personal bonds with others. The status of the person for whom justice claims are being considered also affects the definition of justice, the perception of injustice, and the resolution of injustices. In addition, what may be perceived as fair on an individual level may be perceived as unfair when viewed from a group perspective. For example, suppose a group member is in crisis and asks for extended time in the group. The other five group members agree to give the person an extra 10 minutes because of the crisis. This extension, however, requires each group member to give up 2 minutes of his or her floor time. Giving one individual an extra 10 minutes may not seem like much, but that one action has a cost for five other group members. And what if one group member decides that he or she has a pressing issue to discuss and does not want to give up the 2 minutes? How the group would resolve this dilemma relates to its spoken and unspoken guidelines for handling matters of justice within the group.

Self-Categorization Theory

Self-categorization theory builds on social identity theory, which, as discussed in Chapter 5, is a stage theory of socialization that articulates the process by which we come to identify with some social groups and develop a sense of difference from other social groups. Self- categorization theory expands social identity theory by suggesting that in this process, we come to divide the world into in-groups (those to which we belong) and out-groups (those to which we do not belong). We begin to stereotype the attributes of in-groups and out-groups by comparing them with each other, with bias toward in-groups. When we encounter new group situations, we are more likely to be influenced by in-group members than by out-group members (Haslam & Reicher, 2015). We give more credence to those similar to us than to those different from us, particularly when situations are conflicted or unclear. Doing so is consistent with our categorization schemes, but it also helps us maintain distinctive and positive social identities (Abrams, Hogg, Hinkle, & Otten, 2005; Hogg, 2005). So, in this approach, we are influenced in group situations by members of our in-groups, whether or not they hold high status in society.

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An example of this is Katie, a member of the sexuality and gender group, who was raised in an evangelical Protestant church. Katie struggled with her sexuality and what she was taught in church about homosexuality. Katie received approval from her counselor to go into the community on a day pass so that she could accompany her sponsor to a Metropolitan Community Church service. She immediately “felt at home” there. She felt she had found a place where both her sexual orientation and faith could be affirmed—a place where she could belong.

Researchers have studied the impact of both status characteristics and self- categorization on social influence in group settings, recording who agrees with whom and who defers to whom. They have found that group members are influenced by both status characteristics and social identity. More specifically, they found that group members are more highly influenced by high-status members who also belong to the in-group than by either a low-status in-group member or a high-status out-group member (Kalkhoff & Barnum, 2000).

Critical Thinking Questions 11.3

The psychodynamic perspective on groups proposes that emotional processes in the small group affect the effectiveness of the group. Some proponents of this perspective argue that dealing with the emotional processes in the group is important in any type of group, not just therapy groups. What do you think about this argument? How important are emotional processes to mutual aid groups, psychoeducational groups, self-help groups, and task groups? Can you think of an example where unconscious emotional processes interfered with task accomplishment in a task group of which you were a member?

Group Development To understand the unique nature of groups and why they are effective in helping people, we need to examine the ways groups develop over time. Two common ways of viewing group development are by the stages the group passes through and by the processes that facilitate the work of a group. This section provides a brief overview of stage theories and models and then discusses an example of the analysis of processes that facilitate the work of groups.

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Stage Theories and Models

A variety of scholars have attempted to delineate the life cycle of small groups. Both progressive stage models and cyclical models have been proposed (Coyne, 2014). Progressive stage models propose stages that are sequential, with each stage building successively on accomplishments in prior stages. Cyclical models suggest that groups may move back and forth in group processes in a cyclical rather than linear manner (Donigian & Malnati, 2005). Most small-group scholars recognize that groups do not always progress in a linear fashion but find progressive models to be helpful when thinking about group development. Researchers who focus on the stages of group development have reached no consensus as to how many stages there are, the order in which they appear, or the nature of those stages. Exhibit 11.4 displays five progressive models commonly cited in the group work literature. Note, however, that controlled experiments investigating group stages are rare. Most theories of group stages have been developed by observing patterns and changes in groups, usually after the group has disbanded. Because most of the stage theories have been based on studies of time-limited, closed groups, they may not be applicable to open-ended or ongoing groups.

Exhibit 11.4 ● Stage Models of Group Development Exhibit 11.4 ● Stage Models of Group Development

Author(s) Number ofStages Stages

Garland, Jones, & Kolodny (1976) Five

Preaffiliation

Power and control

Intimacy

Differentiation

Separation

Forming

Storming

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Tuckman & Jensen (1977) Five Norming

Performing

Adjourning

Northen (1988) Five

Planning and intake

Orientation

Exploring and testing

Problem solving

Termination

Brabender & Fallon (2009) Five

Formation and engagement

Conflict and rebellion

Intimacy and unity

Integration and work

Termination

Kottler & Englar-Carlson (2015) Four

Induction

Experimental engagement

Cohesive engagement

Disengagement

Most progressive stage theorists agree, however, on some basic principles: Groups don’t necessarily move through each stage in order, groups may revert to an earlier stage, stages are not distinct entities but may be a blend or combination, the group’s development is influenced by the leader and the members, and groups do not need to reach the most advanced

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developmental stage in order to be effective (Coyne, 2014).

Photo 11.3 Small group. This exercise class is an example of a small group that comes together to accomplish a goal: fitness.

Process Models

If stage theories are inadequate for explaining how groups develop, what are we to use instead? The chief alternative is process models, which identify what goes on in groups and how those processes affect group members and their interactions. The advantage of process analysis is that it focuses on the interactions among group members rather than creating norms for development.

A good example of a process model is that developed by Irving Yalom, one of the best-known group psychotherapists. Yalom and Leszcz (2005) describe 11 factors that shape the functioning of therapeutic groups. These factors are listed and defined in Exhibit 11.5.

Some of Yalom’s therapeutic factors may operate to a degree in groups other than therapy groups. For example, universality and imparting of

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information are two of the mutual aid processes described earlier in this chapter. In addition, certain factors may be more significant at particular stages of group development than at others. One study of 12 time-limited outpatient psychotherapy groups found that the development of cohesion varied according to the stage (or phase) of psychotherapy (Budman, Soldz, Demby, Davis, & Merry, 1993). For example, in the earliest stage of the group, members sharing issues about their lives outside the group built cohesion; however, too much focus on the therapist during this stage tended to be countercohesive. In the sexuality and gender group, several therapeutic factors are evident at different times. When group members feel they can trust each other, catharsis and interpersonal learning are likely. When new members attend the group, they often desire to experience an instillation of hope, universality, imparting of information, and development of socializing techniques.

Group Dynamics The overall development of the group is overlaid with patterns of interactions that can be characterized as group dynamics—such issues as how leaders are appointed or emerge, which roles members take in groups, how communication networks affect interactions in groups, and how groups develop cohesiveness.

Exhibit 11.5 ● Therapeutic Factors Involved in Group Development

Therapeutic Factor Definition

Instillation of hope

Confidence and optimism in the ability of the group and individual members to resolve issues and grow

Universality Sense that others share similar problems andfeelings and that one is not alone

Imparting of Leader’s and group members’ sharing of information and guidance around problems and

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information concerns

Altruism Benefits experienced when one realizes that onehas helped another person

Corrective recapitulation of primary family group

(Re)experience of relationship patterns like those in one’s family of origin while learning different approaches to relationships

Development of socializing techniques

Examination of patterns of interacting with others and acquisition of new social skills

Imitative behavior

Observation of how other group members handle their problems and feelings and recognition of how those methods apply to one’s own situation

Interpersonal learning

Process of learning about oneself through interaction with others

Group cohesiveness

Sense of belonging that group members have and sense of acceptance and support they feel in the group

Catharsis Sharing of deep and sometimes painful emotions with nonjudgmental acceptance from group members

Existential factors Search for meaning and purpose in one’s life

Formal and Informal Leadership

Formal leaders are appointed or elected to lead the group by virtue of such characteristics as their position in the organization or community and their interest or expertise in relation to the group’s focus. Informal leaders may emerge in groups where no formal leader exists or where formal leaders

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are established. In the latter case, a group member may feel more comfortable in a helper or leader role than as a client in the group, thereby mimicking the actions of the formal leader.

Both formal and informal group leaders have a two-pronged focus: the individuals in the group and the group as a whole. Task-oriented leaders facilitate problem solving within the context of the group; process- oriented leaders, also known as social-emotional leaders, identify and manage group relationships (Myers & Anderson, 2008). Any given leader usually fluctuates from one role to the other, although people tend to be either more task oriented or more process oriented. Leadership of virtual groups and teams can be an especially complicated endeavor because of such factors as the geographic dispersion of members and the potential for unevenness in members’ ease and comfort with technology (Hunsaker & Hunsaker, 2008).

In natural groups, leaders may be formal or informal. A friendly softball game at the diamond on a Saturday morning may evolve into a complex hierarchy of leaders and followers as various activities are negotiated— who is on what team, who bats first, how long the game will last, who will decide batting order, and so on—and such process issues as team morale and cohesiveness are promoted.

Leaders of formed groups also take on various roles, depending on the purpose and structure of the group. A facilitator of a group for children with ADHD is a formal leader who may provide structured activities, support, and guidance for the children. Similarly, the leader of a one-time debriefing group may provide support and information to rescue workers after a fire. Informal leaders of formed groups might include a person who evolves into a leadership role in a work group assigned to some project.

Groups often have co-leaders, or one appointed leader and one or more group members who serve as self- or group-appointed co-leaders. At times, co-leaders may offer the group a nice balance of facilitation styles with one person having a more process-oriented style and the other person having a task orientation. Good communication and processing skills between co-leaders is essential to effective group leadership.

Gender, class, and race influence leadership (both who takes leadership and the perception of leaders by group members). Status differences based on gender influence the behaviors of both male and female group

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members, including their reactions to male and female group leaders (Karpowitz et al., 2012; Toosi et al., 2012). Both males and females tend to respect male leadership more quickly and easily. Males in a female-led group tend to challenge the leader(s) and expect female leaders to be more nurturing than male leaders. Persons of color may distrust White leaders “from the system” (Davis, 1995, p. 49), because such leaders may be perceived as not being sensitive or responsive to minorities’ needs. In addition, the significant difference in life experiences of persons of color and Whites may create a wide gap between White leaders and group members who are persons of color. White leaders of groups that include minorities may want to prepare themselves for three questions: “1. Are we people of goodwill? 2. Do we have sufficient mastery/skills to help them? 3. Do we understand their social realities?” (Davis, 1995, p. 53). White group leaders should also remember that their behavior should be purposeful, and they should demonstrate respect, examine their own attitudes and beliefs regarding clients who are different from them, use culturally appropriate techniques, know the resources in the larger society that may be of help to their group members, make every effort to “get off to a good start,” and expect success (Davis, 1995, p. 55). These same principles apply when middle-class group workers work with groups who are poor.

For at least 60 years, researchers have investigated the psychological traits of people who emerge as leaders in groups without a formal leader, and a number of traits have been identified. One research team (Ensari, Riggio, Christian, & Carslaw, 2011) reported on meta-analyses of the research on leadership emergence in leaderless groups. They found several traits associated with informal leadership in these groups: extraversion, intelligence, and social skills. They further found that men who appear authoritarian and self-confident are likely to emerge as leaders but that men are no more effective leaders than women. Using a large database of twins from Sweden, another research team (Chaturvedi, Zyphur, Arvey, Avolio, & Larsson, 2012) investigated the often-asked question, Are leaders born or made? They found that genetics explained approximately 40% of the variance in leadership emergence for both men and women. They also found that the contribution of genetics to leadership emergence in women varied across the female life course, being highest in the period of midcareer. This preliminary research suggests that, like other aspects of human behavior, informal leadership is related to both nature and nurture.

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Formal and Informal Roles

In addition to formal and informal leadership roles within the group, group members fill a variety of other roles. Those roles serve a purpose for the group as a whole and simultaneously fulfill group members’ personal needs (Myers & Anderson, 2008). Formal roles are assigned and may include leader, recorder, and adviser. Informal roles emerge through group interaction. They may be an outgrowth of a group member’s self-concept, cultural background, or gender, but they are also based on expectations members have of each other. A group role can be defined as “a repeatable pattern of communicative behaviors that members come to expect from each other” (Myers & Anderson, 2008, p. 267). Roles can continue to evolve as the work of the group changes over time; however, members in a group often adopt a role that is close to their own personality (Davies & Kanaki, 2006). In 1948, Benne and Sheats provided a description of three archetypal role domains. These include group task roles (patterns that move the group’s purpose forward), group building and maintenance roles (patterns that maintain the cohesiveness of the group), and individualistic roles (patterns that seek personal satisfaction to the detriment of the group). For example, members with a task orientation may take on the role of implementer, which involves the personal qualities of reliability and discipline and includes the ability to move the group into decision making and to turn people’s ideas into action. Members attuned to the cohesiveness of the group (a group maintenance function) tend to have the personality characteristics of peacemaker and diplomat and may help the group to calm intense reactions and better listen to each other. An example of an individualistic role would be an aggressor or a person who expresses disapproval of the values, beliefs, or actions of others; attacks the group or the issue on which the group is working; and demeans others to inflate oneself (Davies & Kanaki, 2006). Regardless of the attributes of the group members, positive group experiences rely on a good dispersion of roles that both support and counterbalance each other. In other words, well- functioning groups tend to have individuals who, taken as a whole, balance each other out with their individual strengths and weaknesses (Davies & Kanaki, 2006).

Roles of group members allow for division of labor but may have both positive and negative aspects. Group members may play useful task roles such as information seeker, information provider, summarizer, and technical adviser. They may also play important socioemotional roles such

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as encourager, process observer, gatekeeper who helps other members participate, and tension releaser. Sometimes these same roles can become dysfunctional for the group. The peacemaker, for example, may serve the function of reducing conflict and anxiety within the group—but perhaps at the cost of suppressing efforts to work through or resolve conflict within the group. The clown or jester reduces anxiety and stress in the group by joking but also enables the group to avoid a painful subject.

In the course of group interactions, members may develop roles that have been variously referred to as dysfunctional (Coyne, 2014), deviant (Myers & Anderson, 2008), and “problem members” (Yalom & Leszcz, 2005). Such roles include the monopolizer, the silent member, the aggressor, the help-rejecting complainer, the scapegoat, the avoider, the rescuer, and the recognition seeker. These problematic roles, like functional ones, are negotiated between the member and the group and may be attempts by both the member and the group to cope with underlying feelings about being in the group. Group leaders must help individual members and the group as a whole find more useful ways of interacting.

Roles are a social construction. They reflect group members’ expectations and both produce and reproduce elements of the social structure. Roles are not necessarily fixed and rigid. Rather, they develop through give-and-take within the group (Myers & Anderson, 2008). Myers and Anderson (2008) suggest that members of healthy groups play a variety of roles and avoid role rigidity. Group leaders may need to assist members to broaden their role repertoire.

Communication Networks

Groups function more effectively when members are able to communicate easily and with competence. Social workers who lead groups can set the tone for the group by being clear, direct, respectful, and compassionate in their own communication. The free flow of ideas among members enhances productivity, particularly in task groups.

Communication networks are the links among members—who talks to whom, how information is transmitted, and whether communication between members is direct or uses a go-between. Sociograms may be used to depict the physical arrangement of these communication channels. Typically, the formal leader occupies the central position in a

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communication network, like the hub at the center of spokes on a wheel (Toseland & Rivas, 2017). However, an informal leader may take the role of information giver and controller.

Group members’ satisfaction with a group tends to be higher in group- centered “web” networks, where information passes freely among all group members, than in leader-centered “wheel” networks (Exhibit 11.6 diagrams these patterns). Leader-centered networks are the more efficient configuration for task groups addressing simple problems, however. Decentralized networks are more effective if the group is attempting to solve more complex problems (Levi, 2014). Group-centered communication patterns are associated with increased social interaction, group morale, goal commitment, and creativity (Toseland & Rivas, 2017).

Exhibit 11.6 ● Common Communication Patterns in Groups

Communication patterns may also be affected by whether the group meets face-to-face or uses telephone or computer technology. Enhancing the leaders’ and members’ auditory skills for group participation may be important for telephone groups because of the absence of visual cues and in-person interaction. An active leader role in telephone and computer groups may be necessary to confront monopolizers and encourage those who are silent (Toseland & Larkin, 2010).

Group Cohesiveness

Group cohesiveness is a dynamic process reflected in the tendency for the group to stick together and be unified in the pursuit of its objectives and the satisfaction of member emotional needs (May et al., 2008). Small- group researchers examine two dimensions of group cohesiveness: task cohesion is the degree to which group members work toward a common goal, and social cohesion is the level of intimacy and positive regard among group members. Groups that are cohesive tend to have higher rates of attendance, participation, and mutual support. But cohesiveness does

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not mean the absence of conflict or dislike among group members. Even a cohesive group may sometimes experience bickering, frustration, or alienation. Cohesion is thought to be dynamic: It changes in extent and form throughout the life of a group. Thus, measuring the degree of group cohesiveness across contexts can be a challenge (Carron & Brawley, 2000). It is important for group leaders to try to prevent heterogeneous groups from splitting into coalitions that are not committed to the interest of the whole group (Jones, 2005).

The group leader can foster group cohesion by listening to members, validating their experiences, modeling genuine concern for each member, and recognizing members’ supportive interactions and constructive participation (Toseland & Rivas, 2017). Some groups may develop rituals or habits to increase cohesiveness among members. For example, a gang member may receive a tattoo as an initiation rite, the group may name itself (e.g., the “lunch bunch”), a member who has been in the group for 6 months may receive a pin, or a group member may be expected to call another member when he or she is having difficulty.

The American Psychological Association systematically evaluated the factors involved in intervention effectiveness and found cohesion in group therapy to be demonstrably effective (Norcross & Wampold, 2011). Cohesive teams have also been found to be more effective than teams with low levels of cohesion (Northouse, 2018). However, there can be negative effects of group cohesion if it leads to pathological conformity that sacrifices individuality, a phenomenon known as “group think” (Toseland & Rivas, 2017).

Critical Thinking Questions 11.4

Think about a small group in which you have participated that was particularly effective. What aspects of group dynamics do you think contributed to this effectiveness? Now, think of a small group in which you have participated that was particularly ineffective. What aspects of group dynamics do you think contributed to this ineffectiveness?

Interdisciplinary Teams and Leadership In recent years, many organizations, including those where social workers

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work, have implemented organizational team structures to respond to rapidly changing conditions (Levi, 2014). “A team is a specific type of group composed of members who are interdependent, who share common goals, and who must coordinate their activities to accomplish these goals” (Kogler Hill, 2013, p. 287). Because it is anticipated that work teams will continue to be a part of organizational structure for the near future, it is important for social workers to understand what makes a team successful. Many scholars argue that team leadership is the primary ingredient of team success, and social workers will need to be prepared to function as team leaders.

Interdisciplinary Teams and Social Work Social workers may be involved, on a regular or occasional basis, in a special type of group known as an interdisciplinary team. Interdisciplinary teams are composed of a group of professionals representing a variety of disciplines, working in organized collaboration to solve a common set of problems (Oliver & Peck, 2006). They may include consumers or clients. Examples include Child Study and Early Intervention teams (Kropf & Malone, 2004), medical teams in hospital units (Kitchen & Brook, 2005), geriatric care teams (Cummings, 2008), end-of-life teams (Day, 2012), child abuse and neglect teams (Lalayants & Epstein, 2005), and coordinated community response (CCR) teams to address domestic violence and sexual assault (Mederos & Perilla, 2003). Interdisciplinary teams are not new, but federal policies and regulations now require their use in a number of service sectors in the United States and other countries. Teams may be formed formally or informally and may have representatives from within or outside an agency. It is important that social workers have a good understanding of other professions and the roles of other members of interdisciplinary teams. In addition, social workers must educate other team members about their own areas of expertise. Learning to work well with team members regardless of differing perspectives and job responsibilities enables social workers to better achieve their desired outcomes (Reese, 2011).

The Social Worker’s Role on Interdisciplinary Teams There is a very large social work literature, going back more than 2

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decades, on social work participation in interdisciplinary teams. This literature is much too large to summarize here, and this discussion is limited to selected literature on interdisciplinary teams in hospice and child welfare settings. Two major themes in this literature are discussed: How effective are interdisciplinary teams, and what are the special problems social workers face on interdisciplinary teams?

There are very few controlled studies of the effectiveness of interdisciplinary teams. In one survey of hospice interdisciplinary teams, Reese and Raymer (2004) found that a higher level of team functioning was correlated with fewer hospitalizations, lower home health costs, lower labor costs, and lower overall hospice costs. Lalayants and Epstein (2005) reviewed the research on child abuse and neglect teams. Although they found no rigorous controlled studies, they did find that referral sources, team members, and service recipients perceived a number of advantages of such teams: increased coordination and collaboration between agencies, increased information exchange, a broader range of viewpoints being heard, enhanced communication, and increased moral support and confidence.

The research on child abuse and neglect teams also reports a number of problems or challenges faced by these teams, including difficulty developing shared goals and objectives, conflicting theories and ideologies about child maltreatment, turf disputes, power struggles, agency territorialism, confusion about leadership roles, and more time-consuming decision making (Lalayants & Epstein, 2005). The research literature on social work participation in hospice teams has suggested that social workers are underused and underappreciated on these teams and that turf issues are a major barrier. Recent research suggests, however, that hospice directors have experienced a considerable increase in their understanding of and respect for the role of social workers on the hospice team over the past 25 years (Reese, 2011). Hospice social workers report that the most important factor in effective hospice teams is communication, both formal communication and informal “getting to know you” types of communication. Team-building exercises have been reported to improve communication and mutual appreciation (Oliver & Peck, 2006). Olshever (2011) proposes that hospice teams need to do a better job of integrating patients and families into the team. She also suggests that social workers with knowledge and skills for working with small groups can be helpful in managing team dynamics.

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Social Workers and Leadership Social workers may at times be elected or appointed to lead interdisciplinary teams. Although there are many definitions of leadership, the definition by Northouse (2018) is “a process whereby an individual influences a group of individuals to achieve a common goal” (p. 323). Northouse’s definition acknowledges that leadership is a process rather than a trait of an individual, it involves inspiring others, and it takes place within the context of groups working toward goal achievement. Social workers can bring their unique social work values, ethics, and training in interpersonal communication to bear on their leadership styles. Although relational skills can be useful in leading interdisciplinary teams, a task orientation can also be beneficial for enacting the work of the team. Social work leaders need to know how to manage conflict and power dynamics in the team, attend to individuals’ needs and strengths, and establish group norms (Toseland & Rivas, 2017). Over time, there has been a call for social workers to assume more leadership in interdisciplinary collaboration in several fields, including developmental disabilities (Kropf & Malone, 2004), legal services (Maidenberg & Golick, 2001), adolescent health services and other medical settings (Craig et al., 2016; Mizrahi & Abramson, 2000; NASW Virginia, 2003), and failing to thrive in infants and children (Marino, Weinman, & Soudelier, 2001).

There is some evidence that social workers in leadership positions on interdisciplinary teams would benefit from an understanding of corporate management functions, namely planning, organizing, coordinating, encouraging, monitoring, and evaluating (Veeder & Dalgin, 2004). In one study, the presence of five management outcome variables, including coordinating an interdisciplinary team, predicted successful cases (Veeder & Dalgin, 2004). Social workers might also find it useful to use a self- analysis of leadership traits, such as the Leadership Trait Questionnaire, to measure their personal characteristics of leadership or to examine their leadership style using an instrument such as the Leadership Style Questionnaire to assess task and relationship factors (Northouse, 2018).

Although social workers may find themselves naturally gravitating to certain leadership styles, one approach to leadership has been termed situational. Proponents of this approach note that “different situations demand different kinds of leadership. From this perspective, to be an effective leader requires that a person adapt his or her style to the demands

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of different situations” (Northouse, 2013, p. 99). Leaders using the situational approach would balance directive and supportive roles given the changing competence and commitment of members to carry out a task. There are times when the leader may need to assume a more directive style, whereas in other situations, the leader may find that a more supportive role would be appropriate. “Effective team leaders need a wide repertoire of communication skills to monitor and take appropriate action” (Kogler Hill, 2013, p. 290); they focus constantly on both task and socioemotional aspects of the group. There are many other theories of leadership with which social workers can familiarize themselves (see Northouse, 2013).

Research on team effectiveness suggests that effective teams have these traits:

Clear, motivating goals Results-driven structure Competent team members Unified commitment Collaborative climate Standards of excellence External support and recognition Principled leadership (Kogler Hill, 2013)

Additionally, highly effective interdisciplinary team leaders demonstrate respect for the knowledge and contributions of members, positive regard for members’ personal characteristics and their working styles, a high degree of trust of each other, and a communication style that promotes consensus decision making (Supiano & Berry, 2013).

It is important to note that many of the functions just noted need not be carried out exclusively by the formal leader. Teams may have a cadre of experienced and competent members who take on and share leadership activities. In other situations, teams have no designated formal leader, and the group works as a self-managed team. The important issue is that teams develop processes for monitoring progress toward goals and executing necessary actions (Kogler Hill, 2013).

Critical Thinking Questions 11.5

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You probably have had experience working in task groups of one type or another. You have probably also had an opportunity to observe different leadership styles and the impact leaders have on group effectiveness. From your experiences, how would you describe what makes someone a good leader? How would you describe what makes someone a bad leader?

Implications for Social Work Practice The overview of formed and natural groups in this chapter suggests a number of principles for social work assessment, intervention, and evaluation.

In the assessment process with individuals or families, identify any natural or formed groups to which the person or family belongs. Ecomaps or sociograms may be used to identify such groups. In the assessment process, determine whether the group modality or another intervention modality would be most appropriate for the client. In the assessment process with a potential group member, gather background information such as the motivation for joining the group, the expectations the person has of the leader and other group members, the strengths the person could offer the group, and previous experience with groups. Be aware of various groups in your community for referral and networking purposes. Develop and implement small groups when it is clear that a group would benefit the population you serve. Determine what type(s) of groups would be most appropriate for that population. Consider groups for prevention when appropriate. Collaborate with colleagues from other disciplines to cofacilitate groups in interdisciplinary settings. Seek to build alliances with natural and self-help groups that reinforce or supplement the services you are providing. In the groups you facilitate, understand the stated and unstated purposes and functions of the group and pay careful attention to issues of group structure, development, composition, and dynamics. Develop a plan for evaluating the effectiveness of a group prior to its formation, if possible. Use the information from ongoing evaluation to make needed changes in the group.

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Be aware of how managed care and technology affect the use of groups as a practice modality and carefully consider ethical implications.

Key Terms brief treatment model 349 closed group 354 communication networks 365 formed group 354 group cohesiveness 366 group dynamics 362 group work 346 interdisciplinary team 366 leadership 367 mutual aid group 349 natural group 354 ongoing group 354 open group 354 performance expectations 358 process-oriented leader 363 psychoeducational group 350 self-categorization theory 360 self-help group 350 small group 346 status characteristics 358 status characteristics and expectation states theory 358 task group 352 task-oriented leader 363 therapy group 347 time-limited group 354

Active Learning 1. Compare the sexuality and gender group with a small group of which

you are a member in terms of how it developed, its duration, how membership was determined, heterogeneity versus homogeneity, cohesiveness, and leadership.

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2. In a small group formed by your instructor, attempt to solve this problem: Draw a square. Divide it into four identical squares. Remove the bottom left-hand square. Now divide the resulting shape into four identical shapes. Work on the problem for 15 minutes. Observe the overall process in the group, the diversity of membership in the group, and the roles of each member while engaged in problem solving. Write up your observations.

3. In personal reflection, think about your behavior and roles in important groups throughout your life, groups such as your family of origin, friendship groups, social groups, sports teams, work groups, therapy groups, and so on. What roles have you played in these different groups? Are there any patterns to the roles you have played across various types of groups? Do you notice any changes in your roles over time or in different types of groups? How do you understand both the patterns and the changes?

Web Resources

Association for Specialists in Group Work (ASGW): www.asgw.org

Site maintained by a division of the American Counseling Association that promotes quality in group work training, practice, and research.

Google Groups: https://groups.google.com

Site for creating or finding groups on the Internet, including support-related groups.

International Association for Group Psychotherapy and Group Processes: www.iagp.com

Site contains information about the association, contact information for the board, membership information, and an electronic forum.

International Association for Social Work with Groups (IASWG): http://iaswg.org

Formerly the Association for the Advancement of Social Work with Groups, this professional organization promotes group work practice, research, and education. Information about state chapters, conferences, and group work projects is available on the

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http://www.asgw.org

https://groups.google.com

http://www.iagp.com

http://iaswg.org

site as well as a resources page, which includes information on group-related journals, IASWG practice standards, sample group work course syllabi, and member publications.

Self-Help Group Sourcebook OnLine: www.wtcmhmr.org/selfhelp

Provides a guide to locate self-help and support groups.

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http://www.wtcmhmr.org/selfhelp

12 Formal Organizations

Elizabeth D. Hutchison

Chapter Outline Learning Objectives Case Study 12.1: Changing Leadership, Changing Times at Beacon Center A Definition of Formal Organizations Perspectives on Formal Organizations Rational Perspective

The Ideal-Type Bureaucracy Scientific Management Human Relations Theory Management by Objectives (MBO) Decision-Making Theory

Systems Perspective Political Economy Model Institutional Theory of Organizations Learning Organization Theory

Interactional/Interpretive Perspective Organizational Culture Model Managing Diversity Model Appreciative Inquiry Model of Organizational Change

Critical Perspective Theory of Gendered Organizations Organizations as Multiple Oppressions Nonhierarchical Organizations

Burnout: A Negative Organizational Outcome Social Work and Formal Organizations

Technology and Social Service Organizations Social Work Leadership in Formal Organizations Culturally Sensitive Care Systems Implications for Social Work Practice Key Terms Active Learning

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Web Resources

Learning Objectives 12.1 Analyze one’s own emotional and cognitive reactions to a case study. 12.2 Describe three components of a definition of formal organizations. 12.3 Critique four theoretical perspectives on formal organizations (rational, system, interactional/interpretive, and critical). 12.4 Summarize the major research findings on burnout. 12.5 Identify types of formal organizations in which social workers work. 12.6 Recommend uses of information and communication technologies in social service organizations. 12.7 Analyze the leadership role of social workers in formal organizations. 12.8 Apply knowledge of formal organizations to social work engagement, assessment, intervention, and evaluation.

Case Study 12.1 Changing Leadership, Changing Times at Beacon Center Beacon Center (BC) has seen many changes in a 40-year history of providing services to persons who are homeless in River Run, the midsize midwestern city where it is located. It was established in 1980, thanks to one woman, Martha Green, and her relentless pursuit of a vision.

While serving as executive director of the YWCA, Martha became increasingly concerned about the growing homeless population in River Run. During the late 1960s and 1970s, she had worked in several positions in River Run’s antipoverty agency, and she was well known throughout the city for her uncompromising advocacy efforts for families living in poverty. Martha was a skilled advocate and service planner, and she soon pulled together supporters for a new social service agency to address the special needs of homeless persons. A mix of private and public (both federal and local) funds were secured, and BC opened with Martha Green as director, working with the assistance of one staff social worker. The agency grew steadily, and within a decade it had a staff of 15, as well as several subcontracted programs.

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Martha valued client input into program development and made sure that client voices were heard at all levels: at city council meetings, in community discussions of program needs, in BC discussions of program needs and issues, in staff interviews, and at board meetings. She remained uncompromising in advocacy efforts and often angered city officials because she was unyielding in her demands for fair treatment of homeless persons. She advocated for their right to receive resources and services from other social service organizations as well as for their right to congregate in public places.

By the same token, Martha and the staff consistently reminded clients of their obligations as citizens and, gently but firmly, held them to those obligations. Clients were sometimes angered by this call for responsible behavior, but they appreciated the tireless advocacy of Martha and the staff. They also appreciated that they were kept fully informed about political issues that concerned them, as well as about actions taken by BC in relation to these issues.

Martha also had a vision regarding staff relationships. She was committed to working collaboratively, to trusting frontline workers to make their own decisions, and to securing the participation of all staff on important policy decisions. This commitment was aided by the fact that Martha and her staff came from similar backgrounds and had deep family roots in River Run. Rules were kept to a minimum, and staff relationships were very personal. For example, a staff member needing to keep a medical appointment would make informal arrangements with another staff member to exchange an hour of service, with no need to “go through channels” or invoke formal sick leave. Martha believed in hiring the best-trained and most experienced staff for frontline positions and, over the years, hired and retained a highly skilled, committed core staff. She had high expectations of her staff, but she was also a nurturing administrator who was concerned about the personal well-being and professional development of each staff member. She established a climate of mutual respect where people could risk disagreeing. Martha also developed family-like relationships with the members of her board.

Martha spent some time every week working in each program area to ensure that she understood the agency’s programs as they were experienced by clients and frontline staff. She kept staff fully informed about economic and political pressures faced by BC and about her actions regarding these issues. She regularly sought their input on these issues, and decisions were usually made by consensus. On occasion, however, around really sensitive issues— such as the choice between forgoing a salary increase and closing a program —she asked staff to vote by secret ballot to neutralize any potential power dynamics.

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Over the years, BC became known as an innovative, client-centered service center, as well as a hardheaded advocacy organization. Staff and board members took pride in being part of what they considered to be a very special endeavor—one that outstripped other social service organizations in its expertise, commitment, and compassion. Clients were not always satisfied with the services but generally acknowledged among themselves that they were lucky to have the dedication of BC.

Martha retired after 18 years and relocated with her husband to be closer to their children. An acting director was appointed at BC while a search for a permanent director was under way. The acting director had worked several years at BC and shared much of Martha’s administrative and service philosophy. She was not as good, however, at juggling the multiple demands of the position. Staff and clients felt a loss of support, board members lost some of their enthusiasm and confidence, and antagonists in the community saw an opportunity to mute some of BC’s advocacy efforts. Staff maintained a strong commitment to the rights of homeless persons, but they lost some of their optimism about making a difference.

After 8 months, Helen Blue, a former community college administrator, was hired as the new executive director. Like Martha Green, she was of European American heritage, but she had only lived in River Run for a few years. She was excited about this new professional challenge but had a vision for BC that was somewhat different from Martha’s. She was concerned about the alienation that had resulted, in some circles, from BC’s hard-hitting advocacy stance, and she favored a more conciliatory approach. For example, after meeting with city officials, she assigned staff social workers the task of convincing clients to stop congregating in the city park near BC and to stay out of the business district during business hours. After meeting with directors of other social service organizations, she directed staff to be less demanding in their advocacy for clients. Helen was also concerned about the lack of rules and the looseness of attention to chain of command, and she began to institute new rules and procedures. Staff meetings and open community meetings with clients became presentations by Helen. Staff were no longer allowed to attend board meetings and were not informed about what happened at them. Frontline staff often found their decisions overturned by Helen. When the first staff resignation came, Helen hired the replacement with no input from staff, clients, or board members.

Helen stayed a few years at BC and then decided to return to community college administration. Since she left, BC has had three executive directors, two that stayed for only a short time. The current CEO, Roderick Wallace, has been with BC for 12 years and has guided it through a major funding and program expansion. When he came to BC, the organization was floundering,

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both financially and by reputation. He spent time with different groups of stakeholders—staff, board members, clients, community leaders, and representatives of other social service organizations—to learn their vision for the organization. He invited the staff to begin to attend board meetings again. Working collaboratively with other organizations, he brought in some new federal and local funds to expand health care coverage for homeless persons. His meetings with stakeholding groups identified two issues for BC: (1) the need for a more ethnically diverse staff and board (Roderick is African American as are many clients) and (2) the need to improve information technology to support administrative functions and program accountability. Roderick has had some success in both areas, but the introduction of greater ethnic diversity of the staff has introduced new tensions that continue to bubble up from time to time.

In the recession of 2009, as funding streams became more restricted at a time of growing homelessness caused by home foreclosures and a weakened economy, Roderick encouraged the board to begin a strategic planning process to ensure financial stability and continued service quality, with some success on both fronts. BC has forged new partnerships in the community and expanded the comprehensiveness of its health care services. Today, BC is a nationally respected community health care center with a special focus on homeless persons, providing coordinated care, primary health, behavioral health, and dental care services. Programs include a 20-bed medical respite facility and 21-bed transitional housing program. It operates in four locations, with an administrative staff of 18 and a clinical staff of 44. Roderick depends on a dedicated professional staff to ensure the quality of the programs. As the organization has grown, the structure has become more complex and specialized, but he emphasizes to all stakeholders the importance of staying flexible in a highly volatile environment.

A Definition of Formal Organizations Beacon Center is an example of a formal organization, but those of us who live in complex societies encounter numerous formal organizations in a given day, and certainly over our life course. You were probably born in a hospital. There is a good chance that you began to attend a house of worship at an early age. You may have been enrolled in a child care or education center by the age of 4. You have, by now, spent close to 2 decades in school. Along the way, you may have joined organizations such as Girl Scouts, Boy Scouts, YMCA, YWCA, or other athletic clubs. You may also have participated in programs offered by civic and social service organizations as a member, recipient of services, or volunteer. You

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probably manage your finances with the assistance of a bank or credit union, and you meet your basic survival needs as well as fulfill your consumer wants through a variety of business organizations. You depend on your telecommunications provider to stay connected to friends, family, school, work, news, consumer products, and much more. You may have been, or currently are, a member of a sorority or fraternity, and you may be a student member of the National Association of Social Workers (NASW). You probably have been a paid employee of at least one formal organization, and you most likely are enrolled, or soon will be, in a field practicum in a social service organization like Beacon Center. When you die, a news organization may announce your death, a public organization will issue a death certificate, and your loved ones will probably seek the service of several other organizations to plan your funeral.

For those of us who live in contemporary complex societies, formal organizations are pervasive in our lives, a most important but usually taken-for-granted part of life. But what, exactly, are they? A formal organization is a collectivity of people with a high degree of formal structure, working together to meet common goals. This definition, like most found in the organization literature, has three key components: a collectivity of people, a formal structure, and the common purpose of working together to meet common goals.

Photo 12.1 Formal organizations are defined as a collectivity of people with a high degree of formality, working together to meet common goals.

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This definition leaves a lot of room for variation. Formal organizations differ in size, structure, culture, and goals. They also perform a variety of functions in contemporary society and influence human behavior in many ways. Keep in mind that formal organizations are intricately woven into the fabric of life in contemporary society, that formal organizations can be both functional and dysfunctional for society or for specific groups, and that some members of organizations benefit more than others from organizational goals and structure. They meet our needs, help us fulfill goals, and nurture our development. They also make stressful demands, thwart our goals, inhibit our holistic development, and constrain our behavior.

The purpose for introducing theory and research about formal organizations in this chapter is threefold: (1) to help you understand the pervasive and multifaceted influence of formal organizations on human behavior—yours as well as your clients’, (2) to assist you in understanding the organizations in which social workers practice, and (3) to help you work for positive change in your professional organizations.

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Perspectives on Formal Organizations Gene Davis (2015) notes that organization theory has been a “vibrant interdisciplinary endeavour for six decades” (para. 1). It reflects the work of scholars from psychology, sociology, political science, and management. Almost 4 decades ago, the ways of thinking about organizational life in the United States had grown so numerous, and so fragmented, one observer noted that the state of organization theory can be described as “more of a weed patch than a well-tended garden” (Pfeffer, 1982, p. 1). That is still an apt description of current theorizing about organizations (Netting, Kettner, McMurtry, & Thomas, 2017; Walsh, Meyer, & Schoonhoven, 2006). Likewise, the research on organizations and the related prescriptions for organizational administration reflect great variety. Nevertheless, three generalizations can be made about the abundant multidisciplinary literature on formal organizations in the United States.

1. The preponderance of early theories of organizations assumed that a rational organization structure (bureaucracy) would ensure the effective and efficient accomplishment of organizational goals, which were assumed to be clear and specific. Contemporary theories challenge the rationality of formal organizations, but the image of the modern organization as a rational instrument (machine) of efficiency and predictability has had a lasting influence on theories of organizations (Godwyn & Gittell, 2012).

2. Early theories focused on what happens inside organizations and ignored all aspects of their external environments. In contrast, contemporary theories generally propose some sort of relationship between organization and environment (Garrow & Hasenfeld, 2010). Attention to the effects of the physical environment, both external and internal, on organizational life has been lacking, suggesting a possible new direction for organizational theory and research.

3. Most organizational theory has been biased toward the interests of owners and managers rather than those of workers (Morgan, 2006). In recent years, critical theorists have challenged this one-sided view of organizations and raised questions about domination and oppression in organizational life (Garrow & Hasenfeld, 2010; Morgan, 2006).

Before going further, it is important to recognize that national culture has a great influence on theories developed, and this is nowhere more true than

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in theorizing about formal organizations. Geert Hofstede (2010) argues that nationality has a large influence on organization theories, noting particularly that European organization theory shares some commonalities with that of the United States, but there are also some striking differences. Indeed, Hofstede suggests philosophical differences in the way scholars in different European countries theorize about organizations. In his analysis, Hofstede (2001) asserts that organization theory is always constructed according to a worldview about where organizations come from, the foundation on which they are built. This worldview, he argues, is tied up in culture and varies from nation to nation. Here is what he suggests as the worldview undergirding organization theory in selected countries (2001, p. 381):

Britain: systems China: the family Eastern Europe: efficiency France: power Germany: order Japan: Japan Netherlands: consensus Nordic countries: equality United States: the market

Organization theorists have suggested the possibility of developing a more globally relevant theory of organizations (see Soulsby & Clark, 2007). They note that existing theories of organizations have been developed and studied in stable-market economic systems, usually in North America and Europe. However, at the moment, it appears that around the world, in Asia, Arab countries, eastern Europe, and Russia, business schools are using translations of North American books on organization theory (Czarniawska, 2007). It is possible that scholars in other countries will develop original theory as they try to adapt existing theory to fit their unique situations.

As noted earlier, Hofstede (2010) suggests that organization theory in the United States is strongly influenced by the high reverence for the market expressed in U.S. culture. You will probably note the market theme in some of the dominant organization theories in the United States. Often for social workers, particularly as we navigate human service organizations, this worldview is alienating and seems at odds with our ethic of care.

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Indeed, this is a major challenge to U.S. social workers, and perhaps increasingly to social workers in other countries in a globalized economy: how to provide caring services in organizations operating within a societal context that reveres the market.

Please keep the important role of culture in mind as you read the discussion of theoretical perspectives in this chapter, which focuses primarily on organization theory developed in the United States. There has been little cross-pollination of organization theory across national lines. Several people have attempted to organize the weed patch of U.S. organizational theory into a garden—to bring some order to the diversity of viewpoints without denying the complexity and multifaceted nature of contemporary formal organizations (e.g., Bolman & Deal, 2017; Garrow & Hasenfeld, 2010; Greenwald, 2008; Morgan, 2006). Here we use a classification system that includes four perspectives: the rational perspective, systems perspective, interactionist/interpretive perspective, and critical perspective. None of these perspectives, taken individually, accounts for all functions of organizations, but taken together, they elaborate the multifaceted nature of organizations reflected in those functions. Each perspective encompasses both classical and contemporary theories, and each has relevance for social work practice. Although I have tried to organize the weed patch of organizational theories in this chapter, I warn you that even though I discuss only a small portion of existing theories, you most likely will feel overwhelmed by the number of theories discussed in this chapter. When you feel overwhelmed, I suggest you stop and ask, “Do I know any organizations that operate like this?”

As you read about these perspectives, you may want to keep in mind one author’s suggestion (Walsh et al., 2006) that to be useful, contemporary research on organization theory needs to address three basic questions: (1) How can we understand current changing organizations (the theory question)? (2) How can we live in these organizations? (3) How can we more healthily live with these organizations? James Walsh and colleagues (2006) argue that existing theories of organizations fail to consider the powerful impact that contemporary organizations have on human “social and material lives and on our planet’s ecosystem” (p. 661) and that new theorizing is needed that takes these issues into account (see Marti, Etzion, & Leca, 2008, for a similar argument). This argument is consistent with social work’s interest in social, economic, and environmental justice, and in the following discussion, I have tried to incorporate contemporary

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theories that are beginning to address these issues. The rational perspective is presented first because it continues to dominate the study of organizations (Godwyn & Gittell, 2012; Netting et al., 2017).

Critical Thinking Questions 12.1

Think of a formal organization of which you have been a part, for which you have positive feelings. What words come to mind when you think of this organization? Now, think of a formal organization of which you have been a part for which you have negative feelings. What words come to mind when you think of this organization?

Rational Perspective When Helen Blue became the executive director at Beacon Center, she was concerned about the lack of administrative formality, the lack of rules, and the ambiguous chain of command, among other things. She also wanted greater administrative authority over planning and decision making. As BC has grown in scope and complexity, Roderick Wallace has continued to value rules and clear chains of command, and he has added greater specialization and specification of roles, specifying, for example, the difference between what a nurse practitioner does and what a medical assistant does. These concerns reflect the rational perspective on organizations, which views the formal organization as a “goal-directed, purposefully designed machine” (Garrow & Hasenfeld, 2010, p. 34). It assumes organizations can be designed with structures and processes that maximize efficiency and effectiveness, concepts that are highly valued in this perspective. Efficiency means obtaining a high ratio of output to input, achieving the best outcome from the least investment of resources. Effectiveness means goal accomplishment. Five theories in this tradition are summarized here: the ideal-type bureaucracy, scientific management, human relations, management by objectives, and decision-making theory. Exhibit 12.1 summarizes the central ideas of these theories.

Exhibit 12.1 ● The Rational Perspective on Formal Organizations Exhibit 12.1 ● The Rational Perspective on Formal Organizations

Major theme: The organization is a goal-directed, purposefully

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designed machine (closed system).

Theory Central Idea

The ideal- type bureaucracy (Weber, 1947)

Formal rationality—rules, regulations, and structures—is essential to goal accomplishment.

Scientific management (Taylor, 1911)

The most effective organizations maximize internal efficiency, the “one best way.”

Human relations theory (Mayo, 1933)

Human relationships are central to organizational efficiency and effectiveness.

Management by objectives (Drucker, 1954)

Managers should focus on the desired outcome (objectives) and create an organizational design to achieve that outcome; strategic planning is key to organizational success.

Decision- making theory (March & Simon, 1958)

Organizational rationality has limits.

The Ideal-Type Bureaucracy

In the modern era, formal organization is often equated with bureaucracy. Indeed, Max Weber (1947), the German sociologist who formulated a theory of bureaucracy at the beginning of the 20th century, saw bureaucracy and capitalism as inseparable. Although he had concerns about the negative impact of bureaucracies, Weber proposed a

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bureaucracy as the most efficient form of organization for goal accomplishment. The characteristics of Weber’s ideal-type bureaucracy are presented in Exhibit 12.2.

Exhibit 12.2 ● Weber’s Ideal-Type Bureaucracy Exhibit 12.2 ● Weber’s Ideal-Type Bureaucracy

Ideal-Type Bureaucracy

Clear hierarchy and chain of command

Clear division of labor based on specialized skills

Formal rules of operation

Formal and task-oriented communications

Merit-based recruitment and advancement

Keeping of files and records for administrative action

Impersonal relationships between organizational members

Distinctions between the public and private lives of organizational members

Weber (1947) was enthusiastic about the advantages of the ideal-type bureaucracy over other ways of organizing for goal accomplishment, but he did not see bureaucracies as problem free. (Note: Weber did not use “ideal-type” to mean superior; instead he used it to mean an abstract model against which other organizations could be compared.) He was concerned about the dehumanizing potential of bureaucracies—their potential to become an iron cage of rationality, trapping people and denying many aspects of their humanity. Researchers have noted that excessive use of rules and procedures often limits the efficiency and effectiveness of bureaucratic organizations.

Despite the potential negative effects of bureaucracies, they continue to be the predominant form of organization in contemporary modern and

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postmodern societies, and the goal of maximization of efficiency is taken for granted. There is evidence, however, that some newer organizations are using less bureaucratic structures. This is true for human service organizations as well as organizations formed for other purposes (Hasenfeld, 2010a). Indeed, as Mary Katherine O’Connor and Ellen Netting (2009) suggest, most organizations that employ social workers have been influenced by the rational perspective but do not typically operate purely from this perspective. Moreover, as is the case with other types of organizations, their research has found that newer social service organizations are less likely than older ones to have traditional bureaucratic cultures. This means that a rational perspective will be less useful in understanding these newer organizations than it might be for understanding older social service organizations. How closely do the social work organizations you have worked in fit the ideal-type bureaucracy? How much emphasis is put on efficiency? Helen Blue and the executive directors who followed her wanted to move Beacon Center closer to the ideal-type bureaucracy than it was under Martha Green’s leadership.

Martha Green, Helen Blue, and Roderick Wallace might all be interested in one researcher’s findings that client satisfaction decreased as the level of bureaucracy increased in transitional housing programs for homeless families (Crook, 2001). In addition, conflict among residents increased as the level of organizational bureaucracy increased. The indirect impact of organizational bureaucracy on clients is called trickle-down bureaucracy. How about for you? Do you think of bureaucracy as a good or bad way to organize? There is no doubt that bureaucracy has gotten a bad name in many circles.

Scientific Management

Another early 20th-century approach to formal organizations has had lasting influence. Frederick W. Taylor’s (1911) scientific management, sometimes referred to as Taylorism, was directed toward maximizing internal efficiency. The set of principles Taylor developed to guide the design of organizations was widely adopted by both industry and government, first in the United States and then worldwide. These principles are listed in Exhibit 12.3.

Exhibit 12.3 ● Taylor’s Scientific Management Exhibit 12.3 ● Taylor’s Scientific Management

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Scientific Management

Time and motion studies to find the “one best way” to perform each organizational task

Scientific selection and training of workers

Training focused on performing tasks in the standardized one best way

Close managerial monitoring of workers to ensure accurate implementation of task prescriptions and to provide appropriate rewards for compliance

Managerial authority over planning and decision making, with no challenge from workers

In his provocative book The McDonaldization of Society, George Ritzer (2018) proposes that McDonald’s Corporation is a prototype organization, whose organizational style is dominating much of the world. This relatively new type of organization, which operates on the combined principles of bureaucratization and scientific management, has four key traits:

1. Efficiency, which is valued in a fast-paced society 2. Calculability, with an emphasis on quantity rather than quality of

products and services 3. Predictability, with the assurance that a Big Mac will be the same in

San Francisco as it is in Washington, DC, or Hong Kong 4. Control, with workers trained to do a limited number of things

exactly as they are told to do them and with maximum use of nonhuman technology

Ritzer gives many examples of the proliferation of the McDonald’s model, including shopping malls; packaged tours; managed medical care; the criminal justice system; weight loss organizations; the “junk-food journalism” of USA Today; the use of machine-graded, multiple-choice examinations; reliance on GPAs, PSATs, SATs, and GREs for evaluating educational potential; franchised hotels; planned communities; and

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franchised childcare centers.

Principles of scientific management are frequently followed in social service organizations. For example, some organizations undertake task and workload analyses to improve effectiveness and efficiency, and managers develop procedures, regulations, and decision trees to be implemented by direct service workers. The recent emphasis on best practices and evidence-based practice is derivative of scientific management thinking, but these practices do not typically conceive of “one best way.” Have you encountered any of these in your field setting? Although Helen Blue initiated more procedures and regulations and believed in managerial authority over planning and decision making, she did not share scientific management’s enthusiasm for “one best way” of delivering services. The same can be said for Roderick Wallace.

Human Relations Theory

Human relations theory introduced a new twist on maximizing organizational efficiency and effectiveness. The theory grew out of a series of studies conducted by Elton Mayo (1933) and associates at the Hawthorne plant of the Western Electric Company in the 1920s and 1930s. Seeking to improve the rationality of the organization, the researchers were studying the effects of working conditions, such as intensity of lighting, on productivity. As expected, the researchers found that productivity increased as the lighting intensity increased. To their surprise, however, productivity continued to increase even when they began to dim the lights in an attempt to confirm their findings. The researchers concluded that technical rationality—the development of rational structures, procedures, and processes—is not sufficient to ensure maximum productivity. Social factors, they concluded, are as important as, if not more important than, technical factors in accomplishing organizational goals. They based this conclusion, which became the central proposition of a new theory, on their observation that productivity appeared to be related to worker morale and sense of social responsibility to the work group.

Photo 12.2 Formal organizations have important influences on human behavior—think about the impact McDonald’s has had on human eating behaviors and our concept of fast food.

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This interpretation of the research findings has been criticized on the basis of the Hawthorne effect—the tendency of experimental participants to perform in particular ways simply because they know they are being studied. In other words, critics have suggested that the participants in the study may have become more productive simply because they knew their behavior was being studied.

Regardless of the validity of the initial findings, subsequent research led to the human relations theory of organizational management, which emphasized the heretofore unrecognized importance of human interaction in organizational efficiency and effectiveness. As the theory developed, it also proposed that democratic leadership is more effective than authoritarian management in securing worker cooperation.

The human relations approach has been a favorite theory in social service organizations because it calls attention to how staff attitudes about the work situation can influence how they relate to clients (see Garrow & Hasenfeld, 2010). The social workers at Beacon Center did indeed respond more cooperatively to Martha Green’s democratic leadership than to Helen Blue’s more authoritarian leadership. Furthermore, it appears that staff

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cohesion did “trickle down” to improve consumer satisfaction as well.

It is important to note, however, that human relations theory is still in the rational tradition. Like scientific management, it focuses on maximizing efficiency and effectiveness, and it endorses the interests of owners and managers. Managers must become leaders capable of securing the cooperation of workers, but they are still in control of the organization. Although the consideration of human interaction opens the possibility of nonrational factors in organizational life, human relations theorists still assume that, with “leadership skills,” human interactions can be as rationally managed as structures and procedures. With its emphasis on human relationships, however, human relations theory serves as a bridge to the interactional/interpretive perspective.

After losing ground during the 1950s, human relations theory was reinvigorated in the 1960s by organizational humanism and a subfield called organizational development. These theories suggest that organizations can maximize efficiency and effectiveness while also promoting individual happiness and well-being. Douglas McGregor (1960), for example, a proponent of organizational humanism, identified two opposing sets of assumptions from which managers view workers (summarized in Exhibit 12.4). McGregor suggested that Theory X calls for directive management, but Theory Y calls for greater democratization of decision making in organizations. In your work experiences, have you encountered either of these theories about workers? If so, how did you react as a worker?

Exhibit 12.4 ● Assumptions of Theory X and Theory Y Exhibit 12.4 ● Assumptions of Theory X and Theory Y

Assumptions of Theory X Assumptions of Theory Y

Workers have an inherent dislike of work.

Workers see work as a natural activity.

Workers prefer to be Workers are self-directed when working on

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told what to do.

projects to which they are committed.

Workers respond to money as the primary motivator.

Workers seek responsibility when organizational goals are congruent with their needs. They have more creative contributions to make than organizations generally allow.

Source: Based on McGregor, 1960.

Management by Objectives (MBO)

In the 1950s, Peter Drucker (1954) suggested that organizational goals and objectives should be the primary concern of organizational managers, an approach called management by objectives. Managers should focus on the desired outcome (objectives) and work backward to create an organizational design to achieve that outcome. The planning process, known as strategic planning, is the key to organizational success. Both short-range and long-range planning are seen as important, although most organizations that follow the MBO approach have not gone beyond short- range planning. You may recall that Roderick Wallace saw strategic planning as the way to manage the challenge of the economic recession.

Decision-Making Theory

In the 1950s, another group of organizational theorists in the rational tradition began to write about the limits to organizational rationality. Herbert Simon (1957) presented a decision-making theory of organizations, focusing on how decisions of individuals in organizations affect the organization as a whole.

James March and Simon (1958) argued that administrators cannot be perfectly rational in their decision making, because they face many constraints that limit their alternatives: incomplete information about alternatives for action, incomplete understanding of the consequences of those actions, and the incapacity to explore more than a limited number of alternatives at a time. March and Simon used the term bounded rationality to describe this limited rationality of organizational actors. They also suggested that bounded rationality leads administrators and

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other organizational actors to satisfice rather than maximize when making decisions—to seek satisfactory rather than perfect solutions and to discontinue the search for alternatives when a satisfactory solution is available. Cognitive psychologist Daniel Kahneman (2011) has presented research from several disciplines to support the argument that human rationality is much more limited than usually assumed.

Although the rational perspective on organizations has been dominant in the design of organizations, including social service organizations, and has had some positive impact on productivity, it has been criticized on a number of grounds. It fails to consider external pressures on organizational decision makers. As suggested by decision-making theory, it overstates the rational capacity of organizational actors. It fails to attend to the issue of power in organizational life. Garrow and Hasenfeld (2010) suggest that the rational perspective fails to take the moral basis of human service organizations into account.

Systems Perspective Martha Green and Helen Blue had different styles of managing what happened inside Beacon Center, but they also had different styles of managing external pressures and resources. Martha focused on giving homeless persons a voice in efforts to secure political and economic resources for Beacon Center; Helen focused on conciliation with community and political leaders. In her own way, however, each was attentive to Beacon Center’s relationship with its environment, and Roderick Wallace has continued to pay attention to the multifaceted environment. He recognized the challenge that the recession presented to social service organizations, and he has been diligent in seeking community partners and external funding for expanding services for homeless persons in River Run. In this respect, they all have negated the rational perspective’s view of the organization as a closed system that can be controlled by careful attention to internal structure and processes. During the 1950s and 1960s, the rationalist view of organizations was challenged by the systems perspective. All subsequent theorizing about organizations has been influenced by the systems perspective.

The systems perspective on organizations builds on the fundamental principle that the organization is in constant interaction with its multiple environments—social, political, economic, cultural, technological—and

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must be able to adapt to environmental change. Some systems theorists suggest mutual influence between organizations and their environments; other theorists see the influence as unidirectional, with organizational structure and processes being determined by the environment. A second important principle of the systems perspective is that organizations are composed of interrelated subsystems that must be integrated to achieve the organization’s goals and meet environmental demands. Finally, in contrast to the rational approach, the systems perspective holds that there are many ways, rather than one best way, to reach the same ends. The idea that a system can attain its goals in a variety of ways is known as equifinality.

Several systems theories of organizations have been developed over time, but we look at only three here: the political economy model, institutional theory, and the learning organization theory. These three theories are summarized in Exhibit 12.5.

Exhibit 12.5 ● The Systems Perspective on Formal Organizations Exhibit 12.5 ● The Systems Perspective on Formal Organizations

Major theme: The organization is in constant interaction with multiple environments.

Theory Central Idea

Political economy model (Wamsley & Zald, 1973)

The organization depends on the environment for political and economic resources.

Institutional theory (Meyer & Rowan, 1977)

Organizations are embedded in social institutions and influenced by institutional arrangements at the societal level.

Learning organization theory (Argyris & Schön, 1978)

The organization must be able to learn and change in a rapidly changing environment.

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Political Economy Model

The political economy model focuses on the dependence of organizations on their environments for necessary resources and on the impact of organization–environment interactions on the internal structure and processes of the organization (Wamsley & Zald, 1973). More specifically, it focuses on two types of resources necessary to organizations: political resources (legitimacy and power) and economic resources. The greater the dependence of the organization on the environment for either of these types of resources, the greater the influence the environment will have on the organization. Likewise, the greater control one unit of the organization has over resources, the more power that unit has over the organizational processes. Researchers have applied the political economy model to study China’s transition to a market economy and have found that political connections can substitute for market connections as organizations attempt to innovate and survive in the new economy (Nee & Opper, 2010; Zhou, 2013).

The political economy model is particularly potent for clarifying how social service organizations resolve such important issues as which clients to serve, which services to provide, how to organize service provision, and how to define staff and client roles (Garrow & Hasenfeld, 2010). Both Martha Green and Helen Blue were trying to read their political and economic environments as they made these kinds of decisions, but their different ways of thinking led them to attend to different aspects of the environment. Roderick Wallace appears to be taking a broad look at the agency’s political and economic environments. The political economy model recognizes clients as resources and as potential players in the political arena. Social workers have an important role to play in facilitating their inclusion in the political process, a role that was part of Martha Green’s vision for Beacon Center.

Institutional Theory of Organizations

The political economy model tends to overlook the role of society and of major social institutions in shaping the form of formal organizations, but this is the major focus of the institutional theory of organizations. The key institutions that provide rules for formal organizations, such as social service organizations, are thought to be the political institution, the economic institution, the education institution, the professions, and public

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opinion (Garrow & Hasenfeld, 2010; Hotho & Saka-Helmhout, 2017; Meyer & Rowan, 1977). Hotho and Saka-Helmhout (2017) argue that different types of national governments lead to the development of different forms of welfare and health care organizations. Certainly, we can see the way that governmental funding streams, and the priorities that govern them, have influenced BC to move much more toward a model of integrated health care rather than the original focus as a homeless drop-in center. We can also see the different ways that health care is organized in countries with single payer systems, compared to the United States where health care systems are much more fragmented. Institutional theory emphasizes the interdependence between societal institutions and the intersectional way they influence organization forms. Education systems affect skill sets and professional identities, which in turn affect the form organizations take. Shortell (2016) draws on institutional theory to consider how U.S. health care systems are currently shaped by professional, governmental, and economic market forces to become patient-centered teams providing evidence-based medicine.

DiMaggio & Powell (1983) suggest three processes by which organization forms conform to institutional rules: (1) coercion by state and legal forces such as accreditation processes, (2) imitation of the most successful and respected organizations, and (3) transmission of professional norms. Through these processes, organizations in the same sector tend to develop the same organizational form. From this point of view, we would expect that BC would be similar in form to other integrated health centers serving homeless and other marginalized people. Indeed, with BC’s growing national reputation, it may become a model for other centers. Institutional theory emphasizes the organization’s need to be seen as credible and legitimate (Shortell, 2016). Some research finds that the tendency for all organizations within a sector to begin to take on the same form is overstated in institutional theory (Davis, 2015), but Garrow and Hasenfeld (2010) argue that the institutional perspective adds depth to understanding human service organizations because they are particularly influenced by societal institutions.

Learning Organization Theory

Learning organization theory was developed on the premise that rational planning is not sufficient for an organization to survive in a rapidly changing environment such as the one in which we live. Formal

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organizations must become complex systems capable of constant learning (Argyris, 1999; Argyris & Schön, 1978, 1996; Senge, 1990). The learning organization is one that can do the following:

Scan the environment, anticipate change, and detect “early warning” signs of trends and patterns. In a social work context, this facility means understanding services from the points of view of clients as well as those of a variety of actors in the environment. It seems that Martha Green was more tuned in to the points of view of clients than Helen Blue was. On the other hand, Helen Blue seemed more sensitive to the points of view of some collaborating agencies. Roderick Wallace was attuned to the warning signs in the economic environment during the recession, but he also depends on the clinical staff at Beacon Center to stay attuned to the points of view of clients. Question, challenge, and change customary ways of operating. Certainly, Helen Blue, like many new administrators, was questioning and challenging Martha Green’s customary ways of operating. The important issue, however, was whether she was developing ways of operating that allowed and encouraged ongoing questioning, challenging, and changing. Roderick Wallace was hopeful that the strategic planning process would lead to questioning customary ways of operating. Ongoing growth requires dialogue, expression of conflicting points of view, and some risk taking. Martha Green tried to develop a climate that allowed such dialogue, but the lack of staff diversity may have limited the nature of that dialogue. Allow the appropriate strategic direction to emerge. The learning organization needs vision, norms, values, and limits to guide organizational behavior (Morgan, 2006). But these should serve as guideposts, not straitjackets. Even these guideposts must be open for questioning. Ironically, both Martha Green’s egalitarian vision and Helen Blue’s vision of a more hierarchical organization had the potential to become straitjackets. Organizations need to be willing to look at both the benefits and the downside of their favored ways of operating—and to alter their strategic direction accordingly. Gareth Morgan (2006) emphasizes the importance of organizational limits, the “thou shalt nots” that guide organizational behavior. He suggests that Western organizations have put great emphasis on developing goals and objectives but have downplayed the limits needed to guide the actions taken to achieve those goals. There have been many reports of corporate misbehavior in the beginning years of the 21st

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century, in both the private and public sectors, including social welfare organizations. Perhaps that is why we have been seeing an increasing call for “strong ethical leadership” in both sectors (Northouse, 2018). There is growing concern that organizations have established too few limits on behavior as they compete in a globalized and increasingly competitive and complex world. Evolve designs that support continuous learning. The challenge is to avoid anarchy on one hand and overcentralization on the other. The learning organization develops methods for shared decision making and avoids overdefining its members’ actions. From this perspective, Beacon Center was more likely to be a learning organization under the leadership of Martha Green and Roderick Wallace than under the leadership of Helen Blue.

Theories in the systems perspective have advanced organizational understanding by calling attention to the influence of the external environment on organizations. They provide useful concepts for considering how organizations survive in turbulent environments, and, indeed, Uhlenbruck, Meyer, and Hitt (2003) suggest that learning organization theory is an appropriate theoretical approach for understanding how organizations in former socialist countries successfully adapted to the transition to market economies. But the systems perspective has little to say about the moral purposes of social service organizations or how organizations can be positive rather than negative forces in society. Stephen Gill (2010) has proposed, however, that learning organization theory is an appropriate model for nonprofit organizations. As we can see from the experience of Beacon Center, we live in a world that values the kind of order Helen Blue wants to bring to Beacon Center, and there can be much environmental resistance to the development of learning organizations. As Beacon Center continues to grow, Roderick Wallace is attempting to balance the need for order with the need to be open to new environmental conditions. If nothing else, the idea of the learning organization serves as a bridge between the systems perspective and the interactional/interpretive perspective.

Critical Thinking Questions 12.2

Think back to your earlier ideas about the characteristics of an organization for which you have positive feelings. Can you use specific theoretical concepts from the rational or systems perspective to talk

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about that organization? Now, think of your ideas about the characteristics of an organization for which you have negative feelings. Can you use specific theoretical concepts from the rational or systems perspective to describe that organization?

Interactional/Interpretive Perspective As I have been suggesting, when Helen Blue became executive director at Beacon Center, she wanted to introduce more “rational order” and have fewer internal voices speaking about the kind of place the center should be. It might be said that she found Martha Green’s vision for Beacon Center to be too interactional and interpretive. Theories of organizations within the interactional/interpretive perspective on organizations are quite diverse, but they all share three basic premises: (1) Organizations provide members with a sense of connection and meaning; (2) organizations reflect the worldviews of the creators; and (3) organizations are social constructions of reality created by ongoing interactions and emerging relationships (Godwyn & Gittell, 2012). Human relations theory can be thought of as a forerunner of the interactional/interpretive perspective because it recognized the importance of human relationships in organizations. However, it was interested in how those relationships can be managed to meet the goal of organizational efficiency, not in the way ongoing mutual relationships help to shape reality in the organization. Three types of interactional/interpretive theories are discussed here: the organizational culture model, managing diversity model, and appreciative inquiry model of organizational change.

Although the rational perspective on organizations has received the most attention in the organizational literature, the interactional/interpretive approach is actually older. In the early 1900s, Mary Parker Follett (1918) suggested that organizational reality is created by relationships; she did not focus on either workers or managers but on the relationships that connected them. Her philosophy took account of both mutual influence and egalitarianism.

The interactional/interpretive perspective rejects both the rational and systems perspectives. Contrary to the rational perspective, the interactional/interpretive perspective focuses on processes rather than organizational goals, emphasizes flexibility rather than control and reason, and is interested in a diversity of approaches rather than one right way.

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From this perspective, organizations are seen as increasingly fragmented into multiple realities, and they should be studied through multiple voices rather than through the unitary voice of the manager. Contrary to the systems perspective, the interactional/interpretive perspective emphasizes human agency in creating organizations and challenges the constraining influence of external forces.

Different interactional/interpretive theorists focus on different themes in relation to the basic premises just stated. The three separate approaches summarized in Exhibit 12.6 provide some sense of these differences.

Organizational Culture Model

Edgar Schein (1992) focuses on organizations as cultures whose members have shared experiences that produce shared meanings, or interpretations. Organizations, therefore, exist as much in the heads of their members as in policies, rules, and procedures. The organizational culture model views organizations as ongoing, interactive processes of reality construction, involving many organizational actors, not just managers and owners. Organizational culture is made up of language, slogans, symbols, rituals, stories, and ceremonies (Morgan, 2006) but also of mundane, routine, day- to-day activities. For example, under Martha Green’s leadership, the slogan “client input” was an important feature of the Beacon Center culture, buttressed by the day-to-day practice of soliciting client opinions.

Exhibit 12.6 ● The Interactional/Interpretive Perspective on Formal Organizations

Major theme: The organization is a social construction of reality.

Theory Central Idea

Organizational culture model (Schein, 1992)

Organizations are cultures with shared experiences and shared meanings.

Managing diversity Organizational systems and practices should maximize the potential advantages

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model (Cox, 1993) of diversity in organizational membership.

Appreciative inquiry model of organizational change (Cooperrider & Srivastva, 1990)

Organizational change is best accomplished by engaging all organizational stakeholders in a positive examination of the organization’s past, present, and future.

When we become new members of an organization, some aspects of its culture are immediately obvious. But other aspects are more difficult to decipher, causing us to feel uncomfortable and confused. For example, after one day in a field practicum agency, we may understand the cultural norms about casual versus professional dress and extended versus brief lunch hours, but it may take us several weeks to decipher whether we are in a cooperative or competitive culture. There may be a clear slogan about commitment to clients, but it may take some time to decipher how that commitment is implemented, or whether it is.

Organizational culture is always evolving, and it is not always unitary. In many organizations, competing beliefs and value systems produce subcultures. Given the evolution of organizational culture and rapid societal changes, it is not unusual to find a split between the old and new guard or to find cultural divisions based on organizational function. For example, fund-raisers in social service organizations may speak a different language from clinicians in the same agency. The result may be cultural fragmentation or cultural warfare.

According to the organizational culture approach, organizations interact with their environments based on their interpretive schemes. It could be said that when Martha Green was executive director, Beacon Center saw itself as more humane than, and therefore superior to, other organizations serving homeless persons. Founders, staff, and board members had certain definitions of other agencies and of their client group that they used to influence referring agencies, funding sources, and clientele. They clearly saw themselves as proactive, capable of influencing their environments. This interpretive scheme could serve as a motivating factor, but it could also create barriers to their effective work with clients or other organizations. Indeed, other agencies often felt a certain resentment toward the arrogance and self-righteousness of Beacon Center under Martha Green’s leadership. Under Helen Blue, on the other hand, clients and staff

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resented not being included in decisions. Roderick Wallace sees his biggest challenges as managing issues related to staff diversity and keeping the organization open to continuous learning.

Criticisms of the organizational culture approach are twofold (Morgan, 2006). One criticism is leveled at theorists who write about managing organizational culture. These theorists are sometimes criticized for being biased in favor of management and potentially exploitative of employees. They are also criticized for overstating managers’ potential to control culture, negating the role of multiple actors in the creation of shared meaning. The second criticism of the organizational culture approach is that it fails to take account of the fact that some members have more power than others to influence the construction of culture.

Managing Diversity Model

In the 1990s, organizational theorists developed an approach to organizational management called the managing diversity model. Given the trend toward greater diversity in the labor force, several social scientists (e.g., Cox, 1993, 2001; Kossek, Lobel, & Brown, 2006; Mor Barak, 2014; Mor Barak & Travis, 2010) have suggested that contemporary organizations cannot be successful unless they learn to manage diverse populations. Diversity is a permanent, not transitory, feature of contemporary life.

The purpose in managing diversity is to maximize the advantages of diversity while minimizing its disadvantages. Taylor Cox (1993), a leading proponent of the model, says, “I view the goal of managing diversity as maximizing the ability of all employees to contribute to organizational goals and to achieve their full potential unhindered by group identities such as gender, race, nationality, age, and departmental affiliation” (p. 11). He argues that this goal requires that a new organizational culture must be institutionalized, a culture that welcomes diversity (Cox, 2001).

Mor Barak and Travis (2010) analyzed a decade of research about the linkages between organizational diversity and organizational performance. This research can be divided into the study of individual outcomes, work group outcomes, and organizational outcomes. The results were mixed in terms of individual outcomes, with some researchers finding that job satisfaction improves when workers find a higher proportion of people

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satisfaction improves when workers find a higher proportion of people similar to themselves in values and ethnicity and other researchers finding no such association. Likewise, mixed results were found regarding diversity and work group outcomes. Some researchers found that the quality of ideas produced by work groups increased as racial and ethnic diversity increased, other researchers found that racially diverse groups had more emotional conflict than racially homogeneous work groups, and still other researchers found no relationship between extent of diversity of work group cohesion and performance. The results were also mixed regarding the relationship between diversity and organizational performance, but the majority of studies report positive relationships in both the corporate sector and the human service sector, meaning that organizational performance improves as diversity in the workforce increases. Roderick Wallace recognizes some of the tension related to racial and ethnic diversity in the Beacon Center staff, but he has also seen new ideas and new understandings come out of the tension.

Management of diversity is still a young idea and a long distance from the one right way of the rational perspective, which has dominated modern thinking about organizations. Pioneering organizations in the United States have begun to develop specific tools to assist organizations to become more effective at managing diversity. They emphasize a vision that values the reflection of diversity in hiring and promotion policies, diversity training, language training, use of identity-based advisory groups, incorporating minority perspectives into organizational norms and culture, affirmative action programs, mentoring programs, and company-based social events (Cox, 2001). Mor Barak (2014) emphasizes the need to recognize different cultural expectations about interpersonal relationships in the workplace. Mor Barak and Travis (2010) note that social service organizations have historically served a diverse client population but have not historically hired a diverse workforce. Although the workforce in social service organizations has been gradually becoming more diverse, it lags the diversity of the clients served.

Appreciative Inquiry Model of Organizational Change

The appreciative inquiry model of organizational change (AI)—a change model, not a theory—seeks to engage all stakeholders in

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of what it can become to build its optimal future by examining past successes. Cooperrider and Srivastva (1990) developed the model of AI after consulting on an organizational change process using the traditional problem-based approach in which they observed that focusing on organizational problems deflated the group’s energy. They experimented with using an organizational change model that began with engaging organizational stakeholders in examining the positive core of the organization. They found that, in contrast to earlier consultations, this approach produced vibrancy and life-giving energy as stakeholders shared memories of the organization’s past successes (Newhard, 2012).

Over time, five core principles of AI were articulated (see Cooperrider, Whitney, & Stavros, 2008):

The constructionist principle. The destiny of an organization is entwined with the understanding of the organization. The simultaneity principle. The act of questioning brings change. The anticipatory principle. Social conversation constructs the future. The poetic principle. An organization’s people create its reality. The positive principle. Positive questions bring about a positive and transformational outcome.

If you think back to the eight theoretical perspectives discussed in Chapter 2, you may recognize that the first four of these principles reflect a social constructionist perspective and the last principle, the positive principle that is central to AI, represents the humanistic perspective.

The AI approach assumes an open and ever-evolving organizational culture based on input from all stakeholders (Newhard, 2012). The process of appreciative inquiry involves four steps:

Stakeholders are encouraged to recall and tell stories about events when the organization was most vibrant, energetic, and lively. Stakeholders envision a future that builds on the recalled past success. Stakeholders consider all the structures, procedures, and processes that can support the envisioned future and create a map to reach it. The map of the future is enacted as a tangible organizational change.

Although all theories of organizations have some undergirding assumptions about organizational change, AI focuses specifically on organizational change. It can be a very useful approach to human service

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organizations desiring change.

Critical Perspective Although it may appear that Martha Green administered Beacon Center from an interactional/interpretative perspective, it is probably more accurate to describe her worldview as a critical perspective on organizations. She tried to minimize the power differences in her organization, and when she asked her staff to vote on sensitive issues, she invoked the secret ballot to neutralize any possible power dynamics. Critical theorists share the interactional/interpretive perspective’s bias about the role of human interaction and meaning making in human behavior, but critical theory undertakes, as its central concern, a critique of existing power arrangements and a vision for change suggested by this critique. More specifically, critical theories see organizations as instruments of exploitation and domination, where conflicting interests are decided in favor of the most powerful members. This focus distinguishes the critical perspective from the interactional/interpretive perspective, which generally ignores or negates issues of power and the possibility that people in power positions can privilege their own versions of reality and marginalize other versions, thus controlling the organizational culture.

The critical perspective has roots in Robert Michels’s work in the early 20th century. Michels (1911/1959) wrote about the “iron law of oligarchy” (rule by the few), arguing that as bureaucracies grow, they always end up under the control of a very narrow, elite group. The elite make decisions with an eye toward preserving their own power, and other voices are suppressed (Morgan, 2006). Gareth Morgan draws on the work of a diverse group of theorists and researchers to identify several ways in which organizations serve as “instruments of domination”:

Formal organizations create and continually reproduce patterns of social inequality through organizational hierarchies. Employees are exposed to work conditions that are hazardous to their health and welfare—such as working with toxic materials or dangerous equipment—and to work expectations that interfere with personal health maintenance and family life. Employees experience mental health problems caused by job insecurity in a downsizing and globalizing economy.

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The critical perspective on organizations has been more popular in Europe than in the United States. Exhibit 12.7 summarizes three contemporary critical approaches to formal organizations discussed here: theory of gendered organizations, organizations as multiple oppressions, and nonhierarchical organizations.

Exhibit 12.7 ● The Critical Perspective on Formal Organizations Exhibit 12.7 ● The Critical Perspective on Formal Organizations

Major theme: Organizations are instruments of domination.

Theory Central Idea

Theory of gendered organizations (Acker, 1990)

Women are disadvantaged in workplaces because male dominance is embedded in organizational structures and processes.

Organizations as multiple oppressions (Hearn & Parkin, 1993)

Organizations exclude and discriminate against multiple groups.

Nonhierarchical organizations (Follett, 1924)

Organizations run by consensus, with few rules and with informality, are least likely to oppress employees.

Theory of Gendered Organizations

Throughout the 1960s, 1970s, and 1980s, feminist scholars joined with other critical theorists to call attention to ways in which women are disadvantaged in organizations. Joan Acker (1990) presented a theory of gendered organizations, arguing that existing organizational theory presents organizations as gender-neutral entities, when in fact, women and men are affected differently by participation in organizations. She contended that the disadvantage women experience in organizations is usually attributed to the gendered attitudes and behavior that are brought into (and contaminate) gender-neutral organizational processes and

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structures. On the contrary, she claimed that assumptions about gender are embedded in the documents and contracts used to create and maintain organizations. She argued that gendering occurs in several ways, including the construction of divisions of labor along gender lines, the construction of symbols and images that explain and reinforce those divisions, and the establishment and reinforcement of patterns that enact dominance and submission. She further argued that sexuality is used to control women in organizations, and sexual harassment is a component of organizational structure and culture.

Twenty-two years later, Acker (2012) wrote that gender inequalities in the workplace “survive in spite of powerful women’s movements, laws mandating equality, massive movement of women into the paid labor force, and the achievement of gender equality in college graduation” (p. 215). She added that her years of research indicate the existence of a “gendered substructure” of often-invisible processes in the day-to-day lives of organizations, where gendered assumptions are embedded and reproduced and gender inequality is perpetuated. She suggested that organizations operate on an image of the “ideal worker” who is unencumbered by family responsibilities and able to work endless hours, an image that is seen as being associated with masculinity. Among the gendered processes she identified are processes of job classification and wage determination. Her research consistently found that in these processes, more value is attributed to jobs with material or physical tasks than to jobs with people-caring tasks. She gives the example of groundskeepers receiving higher wages than childcare workers. She raised the questions: Who develops these classifications and wage systems? What are they thinking when they develop them? Do they recognize that they are treating “men’s jobs” differently from “women’s jobs”?

In her earliest work, Acker (1990) recognized that both gender and class were embedded in organizations and noted that they are intertwined. Critics argued that the research that emanated from the theory of gendered organizations highlighted gender and paid less attention to ways that organizations were also “raced,” “sexualized,” or “classed” (see Britton & Logan, 2008). Acker (2006) responded by offering the concept of “inequality regimes” that include structures and processes that create and maintain class, gender, and racial inequalities. In 2012, she indicated that her analysis of gendered organizations was incomplete because it ignores race and class and raised the question of the best way to conceptualize

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intersectionality in organizations.

Organizations as Multiple Oppressions

The theory of gendered organizations was influenced by feminist critiques throughout the 1970s and 1980s of the failure of traditional organization theories to consider gender issues. Hearn and Parkin (1993) recognized what Acker (2006, 2012) later came to recognize, that other groups besides women are also marginalized by formal organizations and organization theory and that whole groups of people feel voiceless, powerless, abused, manipulated, and unappreciated in the organizations in which they participate.

Hearn and Parkin (1993) recommend viewing organizations as multiple oppressions—social constructions that exclude and discriminate against some categories of people. According to these authors, oppression happens through a variety of processes, including “marginalization, domination and subordination, degradation, ignoring, harassment, invisibilizing, silencing, punishment, discipline and violence” (p. 153). These processes may also be directed at a variety of organizational actors, including “staff, members, employees, residents, patients and clients” (p. 153). Organizational domination can become compounded by multiple oppressions. Hearn and Parkin cite the example of a children’s home where children were being sexually abused by male staff, and female staff were dissuaded, by intimidation, from reporting the situation. This idea that multiple oppressions are usually embedded in organizational life has also been addressed in a book by Sharon Kurtz (2002), who argued that addressing the situation of only one oppressed group will never get to the heart of the matrix of domination in organizations.

According to Hearn and Parkin (1993), frequently oppressed groups include women, younger and older people, persons with disabilities, those of lower economic class, persons of color, and sexual minorities. No doubt, if they were writing today, they would include persons who are gender variant. These groups may be excluded from organizations; admitted only in subordinate roles as clients, patients, or students; or admitted but discriminated against within the organization. If groups that are excluded or otherwise oppressed develop their own organizations, dominant groups construct a hierarchy of organizations that maintains the oppression, as when a Black organization is viewed as inferior to similar

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White organizations.

Critical theory, with its focus on domination and oppression, reminds us that mainstream organizational theory is theory for the elite and not theory for the exploited. Therefore, our understanding of organizations is incomplete and biased. If you have felt somewhat alienated in reading about other theories in this chapter, you may be reacting to this bias. However, critical theory has been criticized for being ideological, giving priority to the voices of oppressed persons, just as Martha Green was criticized for giving too strong a voice to homeless persons. Critical theorists reply that their focus is no more ideological than is recognizing only the voices of the elite.

The critical perspective on organizations has special relevance to social workers. It helps us recognize the ways in which clients’ struggles are related to oppressive structures and processes in the formal organizations with which they interact. It can help us to understand the ways in which social service organizations are gendered, with women constituting the majority of human service workers and men assuming key administrative roles. It also calls our attention to the power imbalance between clients and social workers and helps us think critically about how we use our power. We must be constantly vigilant about the multiple oppressions within the organizations where we work, as well as those with which we interact, as we try to promote social justice.

Nonhierarchical Organizations

Helen Blue preferred a more hierarchical organizational structure than the one developed at Beacon Center under Martha Green’s leadership. A constant theme in critical theory is that hierarchical organizational structures lead to alienation and internal class conflict. Critical theorists directly challenge the rational perspective argument that hierarchy is needed to maximize efficiency; they point out that in fact hierarchy is often inefficient but is maintained because it works well to protect the positions of those in power. For example, the staff at Beacon Center wasted much time and energy trying to find ways to thwart Helen Blue’s decisions. Design professionals argue that it is difficult to do creative work within a hierarchical organization (Johansson & Woodilla, 2008).

The idea of the nonhierarchical organization is not new. Mary Parker

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Follett (1924) proposed that organizations, like other human collective efforts, should be based on nonhierarchical power, on energy that comes from the egalitarian interactions of people and ideas. Human relations theorists have recommended “participatory management,” which involves lower-level employees in at least some decision making, for several decades. Historical evidence indicates that since the 1840s, experiments with nonhierarchical organizations have accompanied every wave of antimodernist social movements in the United States (Rothschild-Whitt & Whitt, 1986). There have also been unsuccessful experiments with power sharing in French organizations (Hofstede, 1996). Beginning in the 1970s, feminist critiques of organizational theory helped to stimulate renewed interest in nonhierarchical organizations (Kravetz, 2004). Nevertheless, such organizations constitute only a small portion of the population of formal organizations, and research on nonhierarchical organizations constitutes a very small part of the massive body of research on organizations (Garrow & Hasenfeld, 2010; Iannello, 1992).

Exhibit 12.8 lists the traits of a model of nonhierarchical organization that Kathleen Iannello (1992) calls the consensual model. Studies of nonhierarchical organizations summarize some of the special challenges, both internal and external, faced by consensual organizations (Ferree & Martin, 1995; Kravetz, 2004; Rothschild-Whitt & Whitt, 1986). Internal challenges include increased time needed for decision making, increased emotional intensity due to the more personal style of relationships, and difficulty incorporating diversity. External challenges are the constraints of social, economic, and political environments that value and reward hierarchy (Garrow & Hasenfeld, 2010).

Exhibit 12.8 ● Traits of a Consensual Model of Formal Organizations

Authority vested in the membership rather than in an elite at the top of a hierarchy

Decisions made only after issues have been widely discussed by the membership

Rules kept to a minimum

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Personal, rather than formal, relationships among members

Leadership based on election, with rotation of leadership positions

No financial reward for leadership roles

No winners and losers in decision making—decisions made based on unchallenged “prevailing sentiment” (consensus)

Source: Iannello, 1992.

Based on her study of two successful feminist organizations, Iannello (1992) proposed that the internal challenges of the nonhierarchical organization could be addressed by what she calls a “modified consensual organization” model. Critical decisions continue to be made by the broad membership, but routine decisions are made by smaller groups; members are recognized by ability and expertise, not by rank and position; and there are clear goals, developed through a consensual process. Similarly, reporting on the life course of five feminist organizations initiated in the 1970s, Diane Kravetz (2004) found that these organizations developed “modified hierarchies” as they grew and faced new external challenges. They gradually delegated authority to individuals and committees but retained some elements of consensus decision making.

The available evidence suggests that feminist organizations in which membership crosses either ideological or cultural lines have not been successful in operating by consensus (Barnoff & Moffatt, 2007). Under Martha Green’s administration, most decisions at Beacon Center were made by consensus, but Martha was sometimes criticized for building a staff with little ideological or cultural diversity. Roderick Wallace has been very intentional about increasing staff diversity and encourages staff and client input, but Beacon Center cannot be considered a nonhierarchical organization under his leadership.

One trend to watch is toward worker-owned corporations, in both the United States and Europe. Sometimes these corporations are not truly democratic, with strong worker input into decisions, but evidence indicates they are moving toward greater democratization (Alperovitz, 2005). The fact that the number of worker-owned companies in the United States increased from 1,600 in 1975 to 11,000 in 2003 seems to be a sign that the idea of shared leadership is gaining in popularity (Alperovitz, 2005). In

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their book The Citizen’s Share, Blasi, Freeman, and Kruse (2013) report on their 10-year study of profit-sharing and employee-owned businesses and argue that these arrangements offer a viable path for rebooting the U.S. economy and restoring the middle class.

Given the increasing diversity of the workforce in the United States, management of difference and conflict can be expected to become an increasing challenge in organizational life. This is as true for social work organizations as for others. The literature on consensual organizations has failed to address the difficult challenges of diverse ideological and cultural perspectives among organizational members—issues that are the focus of the managing diversity model. This is an area in which social work should take the lead.

In Canada, one notable exception has occurred. Feminist critiques of social service organizations have led to growing interest in anti-oppressive social work practice at both the direct practice and organizational practice levels. The anti-oppression model seeks to develop social service organizations free from all types of domination and privilege (Barnoff & Moffatt, 2007; Morgaine & Capous-Desyllas, 2015). This is not an easy task, and researchers have identified some barriers to these efforts. First, they have found that when groups of women encounter each other, they develop a hierarchy of oppression, in which women in different identity groups engage in ongoing competition about which group is most oppressed, with the different groups failing to look beyond their own experience to recognize the plight of other oppressed groups. Second, tension often develops between White women and women of color when White women try to control the agenda but lack awareness of how they are using White privilege to advance their own positions in the organization. Lisa Barnoff and Ken Moffatt (2007) conclude that anti-oppressive social work practice can be advanced only when privilege is a central concept in the discussion of oppression. Members of different identity groups need to recognize their own sources of privilege and give serious thought to how exercise of that privilege results in the subordination of others.

Critical Thinking Questions 12.3

Think back to your earlier ideas about the characteristics of an organization for which you have positive feelings. Can you use specific theoretical concepts from the interactional/interpretive or critical

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perspective to talk about that organization? Now, think of your ideas about the characteristics of an organization for which you have negative feelings. Can you use specific theoretical concepts from the interactional/interpretive and critical perspective to describe that organization?

Burnout: A Negative Organizational Outcome It was suggested at the beginning of this chapter that formal organizations meet our needs, assist us to fulfill goals, and nurture our development— but that they also make stressful demands, thwart our goals, inhibit our holistic development, and constrain our behavior. Robert T. Golembiewski (1994) used more colorful language to talk about the negative effects of organizations, suggesting that “organizational life bends people out of shape, and may even make them crazy” (p. 211).

For over 4 decades, researchers have attempted to answer the question of whether organizational membership is hazardous to your health. The answer is that organizational membership is often hazardous to health, and burnout is the identified hazard. Burnout is a “prolonged response to chronic emotional and interpersonal stressors on the job, and is defined by the three dimensions of exhaustion, cynicism, and inefficacy” (Maslach, Schaufeli, & Leiter, 2001, p. 397). Most burnout researchers trace the term burnout as it is used today to Freudenberger (1974) who used the term to describe the gradual emotional depletion, loss of motivation, and decreased commitment that he observed in volunteers at a free clinic in New York’s East Village. At about the same time, Maslach (1976) made a similar observation about a phenomenon she found in interviews with a variety of human service workers, including workers in health care, education, social work, psychotherapy, legal services, and law enforcement. She found that the workers often reported feeling emotionally exhausted, developing negative attitudes about their clients, and feeling incompetent at work.

Burnout is most often studied using the Maslach Burnout Inventory (MBI) (Maslach & Jackson, 1981). The MBI, first developed for use with social service workers and later revised for use with teachers, analyzes three dimensions of burnout: (1) emotional exhaustion, or a feeling of being near the end of one’s rope; (2) depersonalization, or a strong tendency to distance oneself from others, thinking of them as things or objects; and (3)

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reduced personal accomplishment, which refers to perceptions of doing well on a worthwhile project. In recent years, the MBI has been revised for use in other occupations that are not as people oriented. The three dimensions of burnout have been conceptualized in the broader terms found in the previous definition of burnout: exhaustion, cynicism, and inefficacy (reduced personal accomplishment) (Schaufeli, 2017).

Burnout was introduced as a concept in North America but has now been found in research around the world. The concept was introduced by researchers in western Europe and Israel in the 1980s; in eastern Europe, Asia, the Middle East, Latin America, Australia, and New Zealand in the 1990s; and in Africa, China, and the Indian subcontinent in the 21st century (Schaufeli, Leiter, & Maslach, 2009). International research has noted high levels of burnout among public-sector workers, social workers, teachers, workers in business organizations, and physicians and other health care providers (Baer et al., 2017; Kim, Ji, & Kao, 2011; Peterson et al., 2008; Tomic & Tomic, 2008; Yeh, Cheng, & Chen, 2009). Researchers are also finding high levels of burnout among college and university students, a phenomenon known as school burnout (Cooper, Seibert, May, Fitzgerald, & Fincham, 2017). The high level of hazard in so many settings suggests that social workers need to be attuned to symptoms of job-related burnout in their clients and in themselves.

Burnout has been found to be associated with absenteeism, turnover, lower productivity and effectiveness at work, decreased job satisfaction, reduced commitment to the job or organization, and deterioration in physical and mental health. Burnout can be contagious, causing interpersonal conflict and disrupting work. It is hazardous to both the individual and the organization. Sweden and the Netherlands have established medical diagnoses for burnout, and these diagnoses have implications for compensation and treatment (Schaufeli et al., 2009).

After the first 25 years of research on the subject, researchers found six dimensions of work life to be associated with burnout (Maslach et al., 2001):

1. Workload. Work overload makes too many demands and exhausts people’s capacity to recover. Workload has been found to be directly related to the exhaustion dimension of burnout. Cross-national comparisons have found that workers in North America have higher levels of burnout than workers in western Europe, particularly higher

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levels of exhaustion and cynicism (Maslach et al., 2001). 2. Control. People may have inadequate control over the resources

needed to do their work, or they may be given responsibilities without the authority to do the work. These situations are associated with inefficacy (reduced personal accomplishment). The social workers at Beacon Center missed Martha Green’s trust in them to make their own decisions, and they chafed at their diminishing control over their work and the direction of the organization after Helen Blue became the administrator. Roderick Wallace has attempted to return authority to line staff.

3. Reward. Organizations may fail to provide appropriate rewards for the work people do. There may be inadequate financial rewards, but social rewards, such as recognition and appreciation for contributions made, may also be missing. In addition, the work itself may not have intrinsic rewards because it does not feel important and useful. Lack of reward is associated with inefficacy.

4. Community. In some organizations, people do not have a sense of positive connections to others. People may work in isolation from others, their interactions may be impersonal, or there may be chronic and unresolved conflict with others on the job. Social support from supervisors has been found to be particularly important.

5. Fairness. There may be inequity of workload or pay, or work evaluations and promotions may be handled unfairly. Feelings of being treated unfairly are associated with exhaustion as well as with cynicism about the workplace.

6. Values. Sometimes people face situations where the job requires them to compromise their ethical standards. Or they may find a discrepancy between what the organization says it values and the day-to-day activities in the organization. Increasingly, human service organizations face a conflict between the competing values of high- quality service and cost containment. The original social workers at Beacon Center put high value on advocating for their homeless clients, and they were alienated by Helen Blue’s request that they become more moderate in those efforts.

After 35 years of research and practice related to burnout, Schaufeli and colleagues (2009) found that the two most important contributors to burnout are (1) a persistent imbalance of work demands over resources, and (2) personal values that differ from organizational values. They found that, in the current era of globalization and neoliberalism, when work

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demands increase, such as more clients to serve, resources usually do not keep pace, resulting in insufficient staff, equipment, supplies, and space. In terms of value conflicts, contemporary employees are more likely than employees in prior eras to view organizations’ missions, visions, and values with skepticism. They often experience a tension between the organization’s stated values and the values they see enacted. Schaufeli et al. (2009) report that public-sector organizations often state goals that far exceed their resources because few societies devote sufficient resources to meet the needs of the population. They predict that the principles of globalization and neoliberalism will continue to produce burnout throughout service organizations.

It has been suggested that social work is an occupation with above-average risk of burnout, but research has not supported this suggestion. One research team compared the burnout profiles for five occupational groups —teaching, social services, medicine, mental health, and law enforcement —in the United States and Holland (Schaufeli & Enzmann, 1998). They found that the comparisons differed by nation. In the United States, the levels of cynicism were higher for social service workers and mental health workers than for the other occupational groups, but they were about average in Holland. Other than that, the levels of burnout were about average for social service workers in both countries. In the United States, researchers have been particularly interested in burnout among child welfare workers, who are thought to be especially vulnerable to burnout. One researcher (Kim, 2011) found that public child welfare workers experience higher levels of burnout than child welfare workers in private settings but do not differ from other groups of social workers in the study. Another research team found that job stress and work–family conflict are associated with emotional exhaustion among public child welfare workers, and age of worker, work–family conflict, and organizational support are associated with depersonalization. Younger workers were more vulnerable to burnout than older workers, and burnout decreased as perceived organizational support increased (Lizano & Mor Barak, 2012). We know that our work as social workers has many satisfactions as well as many stressors, but further research is needed to discover which way the balance tilts and why.

Mary Guy and colleagues (Guy, Newman, Mastracci, & Maynard-Moody, 2010) have examined the relationship between emotional labor and burnout. They define emotional labor as “the engagement, suppression, or

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evocation of the worker’s emotions necessary to get the job done” (p. 292). They argue that emotional labor is the key feature of the therapeutic relationship between social worker and client. Their research indicates that emotional labor can lead to burnout, but it can also lead to job satisfaction. When it leads to burnout, the worker feels emotional exhaustion, stress, cynicism, and lack of effectiveness. When emotional labor leads to job satisfaction, the worker feels energetic, involved, and a sense of accomplishment. Guy et al. (2010) found that social workers are more likely to experience burnout if they have to fake their emotional expressions in the course of their work and if they lack confidence in their ability to perform emotional work.

One small-scale research project attempted to discover the balance of job satisfaction and burnout among one sample of child welfare social workers. David Conrad and Yvonne Kellar-Guenther (2006) investigated burnout among child protection workers in Colorado. They sought to understand the relationship between compassion fatigue (reduced capacity for empathy caused by an overexposure to suffering), burnout (emotional exhaustion, depersonalization, and inefficacy), and compassion satisfaction (fulfillment from helping others and from positive collegial relationships). They found that about 50% of their sample suffered from compassion fatigue, only 7.7% suffered from burnout, and 75% had high levels of compassion satisfaction. Furthermore, they found that the respondents with higher compassion satisfaction had lower levels of burnout and compassion fatigue than respondents with lower levels of compassion satisfaction. This is consistent with the findings of Guy et al. (2010) that emotional labor can lead to job satisfaction as well as burnout, and it may help to explain earlier findings that social workers are not much more prone to burnout than people in other occupations. These findings suggest that the concept of compassion satisfaction is worthy of further attention by social work researchers.

In the late 1990s, burnout researchers attempted to put a more positive light on burnout. They suggested that burnout is an erosion of work engagement, which is characterized by energy, involvement, and efficacy. When engagement is eroded, “energy turns to exhaustion, involvement turns to cynicism, and efficacy turns into ineffectiveness” (Schaufeli et al., 2009). Some burnout researchers joined with the newly developing field of positive psychology to create a field of positive occupation behavior that focuses on worker engagement (Luthans, 2003).

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Social Work and Formal Organizations You have probably learned already that social work is a diverse profession; we use diverse methods to address a diversity of social problems—and we work in diverse types of organizations. We work in hospitals, outpatient health and mental health clinics, in-home programs, nursing homes and other residential programs, crisis shelters, prisons and jails, government social service agencies, private family and children’s agencies, schools, the workplace, community centers, social movement organizations, research centers, planning organizations, social entrepreneurial organizations, and private practice, among other places.

We can think about the differences among the organizations in which social workers are found in several ways. One is to divide them into host organizations, social work–oriented organizations, and human service organizations (Popple & Leighninger, 2011). In host organizations—such as schools, the workplace, correctional facilities, the military, and hospitals —social service is not the primary purpose of the organization. Social workers in these settings work with other disciplines to meet organizational goals, and they often serve as mediators between clients and the organization. In contrast, social work–oriented organizations have social service delivery as their purpose and are staffed primarily by social workers. Family and children’s agencies and government social service programs are examples of social work–oriented organizations. Social workers also work in human service organizations, whose staff come from a variety of disciplines but work in a coordinated fashion to provide an array of services. Community health centers and drug treatment programs are examples of human service organizations.

Another way to think about formal organizations in which social workers work has traditionally been to divide them into public and private organizations. Public social service organizations are those funded and administered by local, state, or federal government; private social service organizations are privately funded and administered. This distinction made some sense in earlier eras, but it is not as useful in the contemporary era. Today, many public agencies contract programs out to private organizations, and many private organizations, like Beacon Center, receive public as well as private funding. The Social Security Act of 1935 ushered in an era of government dominance in both the funding and administering of social service programs, but for the past few decades, we have seen

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increasing privatization of social services, shifting the administration of programs back to private organizations (Karger & Stoesz, 2018). This trend is based on the neoliberal belief that privatization will lead to more efficient and effective service delivery (see Chapter 9 for a discussion of neoliberalism). It has been estimated that more than half of public social service dollars are contracted to private organizations (O’Connor & Netting, 2009).

Among private service organizations, the distinction between nonprofit and for-profit organizations is increasingly important but also increasingly blurred. Social workers have a long history with nonprofit organizations, also called voluntary agencies and nongovernmental organizations (NGOs), but their extensive involvement in for-profit organizations is more recent and has been increasing steadily since the 1970s. In the past 2 decades, corporations have played an increasing role in Medicaid, the State Children’s Health Insurance Program, child welfare, and mental health (Karger & Stoesz, 2018). Large for-profit organizations have had the resources to move quickly into new markets and have become serious competitors for nonprofit organizations in vying for government contracts. Some nonprofit organizations are responding by developing partnerships with for-profit organizations; others are changing to for-profit status. Indeed, many nonprofits use some profit-making programs, such as thrift stores, to shore up their income base. There is general agreement that for- profit organizations will continue to have a large presence in the social service landscape in the future. This is despite current research that indicates they have not met their promise to cut costs (Karger & Stoesz, 2018).

The entry of for-profit organizations into the social service arena poses questions raised by many observers: Will for-profit organizations, in search of profitable business opportunities, voluntarily serve the common good? Will they engage in advocacy and community-building activities that are the hallmark of the social work profession and the history of nonprofit organizations? Will they deny service as a cost-cutting measure, particularly service to clients with the most entrenched problems? Will they cut staff to increase profit? Historically, social service agencies funded advocacy and community-building activities out of surplus from other programs. Social workers will need to be vigilant to see that these important social work functions do not disappear. There is also some fear that very large for-profit organizations will have undue influence on social

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welfare policy in a way that protects their own financial interests (Karger & Stoesz, 2018).

Organizations in which social workers’ work have not been immune to the economic trends is discussed in Chapter 9. Downsizing and the resulting “do more with less” climate have increased work-related stressors, and increasing economic inequality is producing stubborn social problems that must be addressed with shrinking resources. Social workers, like other workers, are increasingly involved in “contingent” labor situations—that is, in part-time, temporary, and contractual arrangements. There is increasing evidence that social service organizations favor clients who can pay, or who qualify for payment by a third party, and fail to serve people who are poor or have the most challenging problems (Karger & Stoesz, 2018). Unfortunately, social welfare organizations, particularly in the nonprofit sector, have not been immune to the fraud and scandal that have embroiled many large corporations in the past decade. Given these challenges, a solid grounding in organizational theory can be an important tool in the social work survival kit.

Social service organizations, like other organizations, are trying to survive in turbulent, complex times. They must continuously adjust their services in response to changing societal trends, such as growing diversity in the population and lifestyles and growing inequality. In recent times, they have had to adapt to a political environment that shifted from thinking of social service organizations in terms of social care to an emphasis on the market and personal responsibility (Hasenfeld, 2010a). It is unclear whether recent failures in the market will undermine popular reverence for the market model.

Photo 12.3 The 100,000-square-foot Children and Family Services Center in Charlotte, North Carolina, is an innovative marriage of public- and private-sector organizations.

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Two types of human service organizations are becoming more prominent in the social service landscape: hybrid organizations and social entrepreneurial organizations. Hybrid organization is the name given to organizations that combine political advocacy and service provision in their core identity (Minkoff, 2010). This type of social service organization has a history in organizations developed by women, Blacks, and other ethnic groups in the 1960s, and sexual minorities during the AIDS epidemic in the 1980s. These organizations make a strong commitment to service to typically underserved populations, but they also engage in advocacy work that is often focused on changing the perspectives of political figures and the general public on specific social problems. For example, homeless service organizations like Beacon Center have attempted to change public perception of homelessness, pushing for a framework that focuses on homelessness as the failure of housing policy rather than a consequence of personal failings. In the corporate world, hybrid organizations are those created explicitly to respond to social and environmental concerns as well as meet financial objectives (McMullen & Warnick, 2016). Advocacy work by nonprofit organizations has been steadily increasing in the past few decades (Meyer, 2010).

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A social entrepreneurial organization is one formed by a social entrepreneur who recognizes a social problem and uses ideas from business entrepreneurs to organize, create, and manage a new venture to bring about social change related to that problem. The most famous social entrepreneurial organization is the Grameen Bank developed by Muhammad Yunus, a Bangladeshi economist who was the winner of the 2006 Nobel Peace Prize. The idea of using social entrepreneurship to solve social problems is spreading around the world (Karger & Stoesz, 2018).

Yeheskel Hasenfeld (2010b) has asked the question, “What is different about human service organizations?” In answering it, he identifies six attributes that set human service organizations apart from other organizations:

1. They engage in moral work, making judgments about what constitutes good behavior and a good society.

2. They get their legitimacy from the broader institutional society. 3. They must negotiate different interest groups that have different goals

for the organization. 4. Client–staff relationships are the primary vehicle of service provision. 5. Emotional labor is their primary resource and must be harnessed

through recruitment, training, and supervision. 6. They are gendered organizations where women are the majority of the

frontline workers, matching the societal ideology that emotional work is women’s work.

Technology and Social Service Organizations The information and communication revolution has presented new challenges and opportunities to social service organizations. Information and communication technology (ICT, also called IT) is an integral part of most social service organizations, and Waldman (2016) suggests that it is the major force transforming social service delivery today. It is improving the accessibility and quality of information and services but also creating new challenges. Waldman (2016) suggests that technology is evolving more rapidly than the ability of society and social service organizations to control and regulate its use.

Netting and colleagues (2017) suggest a set of questions to ask when assessing a social service organization’s use of ICT:

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Does the organization have integrated technology systems for mailings, reimbursement, case tracking, and management data? Does the organization maintain a website, a Facebook page, a Twitter feed, or any other type of social network presence? Does the organization use electronic information resources for fund- raising, grant applications, volunteer coordination, or other planning activities? Do all line staff have desktop, laptop, or tablet computers and/or smartphones? Do they have access to the Internet, word processing, e- mail, text messaging, data security and firewall software, and other applications? Is this technology up to date?

Netting et al. (2017) suggest that even small social service organizations need both software and hardware that allow the entry and retrieval of client, management, and fiscal data; Internet access; and the capacity for e- mail and text messaging. Mobile devices are needed by social workers who make frequent client visits or travel to multiple office sites. In addition, many social service organizations will want a website that allows online completion of forms, provides links to resources, and assists clients to communicate with staff, among other features. Some social service organizations also add Facebook pages or other social networking efforts. Information technology (IT) specialists are increasingly needed to develop, maintain, and update technology systems.

The costs of ICT are prohibitive for many small and economically poor social service organizations (Schoech, 2014). When Roderick Wallace became the executive director of Beacon Center in 2001, he quickly realized that he needed to find the resources to improve the organization’s information technology. One researcher reviewed the applications of nonprofit organizations for technology innovation grants in the state of Georgia and found that social service organizations proposed a higher number of ICT innovations than other types of nonprofit organizations (Jaskyte, 2012). They proposed innovations in ICT for both administrative and service activities. In the administrative area, they proposed upgraded ICT for donor, member, client, and volunteer databases; internal communication and scheduling; online outcome databases; online donations; streamlining communication with community partners; and online surveys and assessments. In the service area, they proposed upgraded ICT for online client education and to provide counseling and other services online. They expected ICT to help them increase the number

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of clients served, attract more donors and volunteers, and improve their communications with community partners. Another challenge for social service organizations is that IT salaries are much higher than social service salaries, and it is difficult to compete for IT talent. Communication can also be difficult between social service practitioners and IT personnel, because they speak different languages and have different cultures (Schoech, 2014).

Here are a few examples of recent innovations in the use of ICT to enhance service provision. Tweeting has been used by advocacy organizations to influence social change (Guo & Saxton, 2014). Automated risk assessment matrices are used to guide child welfare decisions about the safety of children. Entitlement benefits, such as Temporary Assistance to Needy Families (TANF) and Supplemental Nutritional Assistance Program (SNAP), are automated, with recipients receiving debit cards rather than checks. The Affordable Care Act required the conversion of all medical records to electronic format (Waldman, 2016).

There is a growing research literature on the use of Internet and wireless- supported interventions for a variety of social work roles. Much of the research addresses online counseling and psychotherapy, psychoeducational websites, and online support groups. The results of this research indicate positive outcomes of these technologically supported interventions but raise questions of confidentiality and access (Barak & Grohol, 2011). In one study, 20 veterans in outpatient treatment for alcohol abuse and dependence at a veterans hospital were given an iPod loaded with recovery-related audio podcasts. Most participants indicated that they used the device regularly, thought it was useful, and wished they had access to this type of support earlier (Shaw, Sivakumar, Balinas, Chipman, & Krahn, 2013). Another study investigated the interest in an online coping skills training program for women living with a partner with a drinking problem and found that interest was high (Rychtarik, McGillicuddy, & Barrick, 2013). Both innovations were seen as an adjunct to ongoing face-to-face service provision. A federal demonstration project experimented with the use of smartphones to increase the protective factors and mitigate adverse experiences of foster youths. The social service providers were given a web-based application designed to increase communications between foster youths, their service providers, and their mentors. The youths found the smartphones to be useful, enjoyable, and a

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good way to stay connected to their foster care workers and mentors as well as family and friends. They reported that the texting and messaging components of the phones were the most valued features. Some issues arose about which features would be loaded on the phones (Denby, Gomez, & Alford, 2016). Web-based clinician training has also been evaluated, and the findings indicate that clinicians can be successfully trained on evidence-based psychotherapy interventions using web-based programs. Clinicians find the online training to be useful and report that the most beneficial training comes from a combination of web-based and in-person training (Martin, Gladstone, Diehl, & Beardslee, 2016).

Waldman (2016) highlights some of the issues that arise in ICT use in social service organizations, including the following:

Using a planning process that ensures IT hardware and software meets the needs of all the organization’s users and constituents Budgeting for system maintenance and updating Protecting personal information in databases Developing sufficient control on who uses the databases Creating ongoing opportunities for face-to-face interactions to augment electronic communication Developing backup systems in case of hacking and other compromises to the system

Critical Thinking Questions 12.4

Were you surprised to read that some researchers have found that social workers are no more likely than workers in other fields to experience burnout? Explain your answer. What do you think of the concept of compassion satisfaction? How have you seen information and communication technologies used in human service organizations? What is one idea you have about a way for social workers to make good use of these technologies?

Social Work Leadership in Formal Organizations With the pervasive influence of formal organizations in complex societies, attention has turned to a fascination with organization leadership. Books

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are being written, academic programs in leadership studies are being developed, and professional associations are developing “leadership initiatives.” This intense focus on leadership seems to be driven by a frustration with the performance and impact of formal organizations and by a hope that we can engineer and manage them better—in such a way so as to minimize their adverse effects and magnify their positive ones (Northouse, 2018). This concern applies to the formal organizations where social work is practiced, as well as to other formal organizations that affect our lives and those of our clients.

In Chapter 11, we presented Northouse’s (2018) definition of leadership: “a process whereby an individual influences a group of individuals to achieve a common goal” (p. 323). Northouse (2013) makes a distinction between assigned leadership and emergent leadership. Assigned leaders occupy organizational positions that carry with them formal authority to influence others toward a common goal. They might be in a position called director, department head, administrator, supervisor, committee chair, or team leader. An emergent leader, on the other hand, is someone whose influence is recognized by others regardless of position; the emergent leader has personal authority rather than formal authority.

As social workers carry out their work in formal organizations, they may act sometimes as assigned leaders and sometimes as emergent leaders. O’Connor and Netting (2009) argue that every social worker carries leadership responsibility in the organizations where he or she works; such responsibility goes with being a social worker. They define leadership as “an attitude about responsibilities in an organization based on professional skills and a set of values that compel an individual to act” (p. 29).

There are several theories of leadership (see, e.g., Northouse, 2013), and different perspectives on organizations call for different approaches to leadership. Certainly, you can imagine how the approach to thinking about leadership from a scientific management perspective is different from the approaches of an interactional/interpretive or critical perspective. In addition, it seems obvious that the nature of the organization itself will render some ways of leading more effective than others. Social work leaders pay attention to all this. Despite the complexity, some core leadership competencies can be identified. They include the following: problem-identification, problem-solving, and solution-generating skills; the ability to critically analyze our own beliefs and attitudes; the ability to

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critically analyze the beliefs and attitudes of others; the ability to forgo early judgments; the ability to conceptualize and articulate a vision and a plan; and good written, verbal, and nonverbal communication skills. In the contemporary, globalized, multicultural world, social work leaders must be able to live with change and flux, live with ambiguity, and recognize multiple perspectives on situations. We must know how to maneuver bureaucracies and complex systems, manage diversity, and recognize and struggle against the multiple oppressions we encounter in our own and other organizations. Every social worker is responsible to build this ambitious set of capabilities.

Globalization is leading to a need to develop and maintain effective organizations that cross national borders. Increasingly, social workers work in and provide leadership to transnational service and advocacy organizations (Cox & Pawar, 2013). Hofstede, Deusen, Mueller, and Charles (2002) suggest that transnational organizations are often unsuccessful because of cultural differences in attitudes about goals and appropriate traits of leaders. Such organizations need leaders who can become competent in cross-cultural awareness and communication. To that end, House, Hanges, Javidan, Dorfman, and Gupta (2004) have engaged in study of the attitudes about leadership in 62 societies. They have found that societies vary in their attitudes about leadership on a number of identified dimensions: uncertainty avoidance, power sharing, collective spirit and action, gender egalitarianism, assertiveness, future orientation, performance orientation, and humane orientation. For U.S. social workers working in transnational organizations, it is important to know that in this research the Anglo cluster of societies—which includes the United States, Australia, Ireland, the United Kingdom, White South Africa, and New Zealand—puts much more value on performance orientation and much less value on collectivism than respondents in other societies.

Culturally Sensitive Care Systems Issues of diversity, and managing diversity, are important for all formal organizations, but they take on special urgency in social service organizations. Social workers have a commitment to provide competent service to diverse populations. (We take a broad view of diversity, including, but not limited to, gender, gender identity and expression, race,

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ethnicity, social class, religion, disability, age, and sexual orientation.) In the past 2 decades, a growing body of literature has recommended ways of providing culturally competent practice (e.g., Lum, 2011). When I lived in Washington, DC, in an area where one public school might serve a student body representing well over 100 national heritages, I came to think in terms of providing culturally sensitive practice, rather than culturally competent practice. As Ruth G. Dean (2001) so aptly stated, to work effectively across cultural lines typically requires that we begin with a recognition that we are not competent in the culture of another, and from this position of “informed not knowing” (Laird, 1998), we establish a goal to understand. This idea of informed not knowing has come to be called cultural humility (Netting et al., 2017).

Although there is much an individual social worker can do to provide more culturally sensitive practice, individual efforts will not go far unless the vision of cultural sensitivity is encoded into the fabric of social service organizations. Some effective guidelines for developing a culturally sensitive system of care can be gleaned from a number of sources. As you read the following traits, keep in mind that some social service organizations serve a multicultural population, whereas others target a specific cultural group. Increasingly, we are paying attention to the intersectionality of identities in the populations we serve.

The organization is located where it is accessible to the targeted population, and it is decorated in a manner appealing to the population. Particular attention is paid to the accessibility of the physical environment for people with a variety of disabilities. A name is chosen for the organization that is acceptable to the targeted population. For example, for some ethnic groups, “mental health services” or “behavioral health services” carries a social stigma, and these words should be avoided when naming the organization. A name like Beacon Center carries no such stigma. The agency website is user-friendly for diverse populations. Diversity is reflected in the board of directors, administrators, and professional and nonprofessional staff, in accordance with the targeted population. The organization is engaged in an ongoing audit of the diversity represented at all levels, from clients to the board of directors. The organization conducts or supports ongoing training and communication about diversity issues and multicultural

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communication. A collection of resource materials on culturally diverse groups is available to staff. Ongoing efforts are made to create a climate where people can recover from multicultural miscommunications. This is especially important where there is a multicultural staff and multicultural client population. The ability to work cross-culturally is included in job descriptions and in the hiring process. Ongoing efforts are made to involve minority staff members in information networks and decision-making processes. Staff are actively engaged in learning about the community and its norms, values, and formal and informal resources, as well as the ways in which it is changing. They use what they learn in ongoing program planning. They pay particular attention to the cultural understanding of and preferences for caregiving and care receiving. Staff engage in active outreach, attending local functions, giving talks at community organizations, and so forth, particularly when the targeted population is not inclined to use formal social services. Outreach activities help build credibility. The staff maintains working relationships with other organizations that serve the same population, such as ethnic agencies, agencies for sexual minority clients, or disability service centers.

Critical Thinking Questions 12.5

What does it mean to be a leader? What makes a “bad leader”? A “good leader”? How might ideas about good and bad leaders be influenced by culture? Why do you think there has been so much fascination with the issue of organizational leadership in recent years?

Implications for Social Work Practice Several principles for social work action are recommended by this discussion of formal organizations.

Be alert to the influence of formal organizations on the client’s behavior. Be particularly alert to the ways in which the social service organization where you work, as well as other social service organizations to which you frequently refer clients, influences client

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behaviors. Develop an understanding of the organizational goals of the social service organization where you work and how the tasks you perform are related to these goals. Develop an understanding of the shared meanings in the social service organization where you work and of the processes by which those meanings are developed and maintained. Develop an understanding of the forces of inertia and other constraints on rational decision making in the social service organization where you work. Develop an understanding of the social, political, economic, cultural, and technological environments of the social service organization where you work. Develop an understanding of the sources of legitimacy, power, and economic resources for the social service organization where you work and an understanding of how they influence internal decisions. Collaborate with colleagues at the social service organization where you work to understand and enhance the creative use of diversity. Collaborate with colleagues at the social service organization where you work to facilitate the inclusion of clients in the political process, internally and externally. Collaborate with colleagues at the social service organization where you work to develop an understanding of multiple oppressions within the organization. Be attuned to the symptoms of job-related burnout in yourself, your colleagues, and your clients. Collaborate with colleagues to create a culturally sensitive care system.

Key Terms appreciative inquiry model of organizational change 385 bounded rationality 380 bureaucracy 377 burnout 390 critical perspective on organizations 386 decision-making theory 380 emotional labor 392 formal organization 374

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Hawthorne effect 379 human relations theory 378 hybrid organization 394 institutional theory of organizations 382 interactional/interpretive perspective on organizations 383 iron cage of rationality 377 learning organization theory 382 management by objectives 380 managing diversity model 385 nonhierarchical organization 388 organizational culture model 384 organizational humanism 380 organizations as multiple oppressions 388 political economy model 381 privatization 393 rational perspective on organizations 377 satisfice 380 scientific management 378 social entrepreneurial organization 395 systems perspective on organizations 381 theory of gendered organizations 387

Active Learning 1. In the case study at the beginning of the chapter, you read about the

transition in leadership at Beacon Center. You have also read about four theoretical perspectives on formal organizations. Imagine that you, and not Roderick Wallace, are the current CEO at Beacon Center. Working alone or in small groups of four or five, consider the following points: What vision would you have for Beacon Center? What would you want to keep the same as it had been, and what would you want to change? Use theory to back up your position.

2. Examine aspects of diversity in your workplace, your field practicum agency, or another organization you are familiar with. What can you observe or discover about diversity in the organization on the following variables: gender, age, social class, religion, ethnicity, race, and disability? Compare the diversity found among management to that among the line workers and clientele. What changes would you suggest for the organization in terms of diversity?

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Web Resources

Alliance for Nonprofit Management: www.allianceonline.org

Site contains resources, affinity groups, and webinars.

ARNOVA: www.arnova.org

Site presented by the Association for Research on Nonprofit Organizations and Voluntary Action contains a member directory, conference information, publications, and a job center.

Center on Nonprofits and Philanthropy: www.urban.org/policy- centers/center-nonprofits-and-philanthropy

Site maintained by the Center on Nonprofits and Philanthropy at the Urban Institute contains publications, a press room, events, and resources.

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http://www.allianceonline.org

http://www.arnova.org

http://www.urban.org/policy-centers/center-nonprofits-and-philanthropy

13 Communities

Elizabeth D. Hutchison

Chapter Outline Learning Objectives Case Study 13.1: A Rural West Virginia Community Struggles to Recover Case Study 13.2: An Evolving Online Support Community A Definition of Community Territorial Community and Relational Community Social Workers and Communities: Our History Theoretical Approaches to Community

Contrasting Types Approach Spatial Arrangements Approach Social Systems Approach Social Capital Approach Conflict Approach

Implications for Social Work Practice Key Terms Active Learning Web Resources

Learning Objectives 13.1 Compare one’s own emotional and cognitive reactions to two case studies. 13.2 Define community, territorial community, relational community, and sense of community. 13.3 Summarize key points in the history of social work and

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communities. 13.4 Critique five theoretical approaches to the study of communities (contrasting types, spatial arrangements, social systems, social capital, and conflict). 13.5 Analyze the major tensions in social work’s approach to communities, including community as context or target of practice, agency orientation versus social action, conflict model of practice versus collaborative model, and expert versus partner in the change process. 13.6 Apply knowledge of communities to recommend guidelines for social work engagement, assessment, intervention, and evaluation.

The author wants to thank Soon Min Lee for contributions to earlier versions of this chapter.

Case Study 13.1 A Rural West Virginia Community Struggles to Recover A lot has changed in West Virginia over the last 50 years. This is especially true for one southern West Virginia county. In the 1960s, coal was king, and the county’s economy was booming. In the county seat, storefronts were full and streets were busy. The county’s population was just over 120,000 residents in 1965. However, by 1990, the population had shrunk to 35,000, and in 2016 it was estimated to be just over 19,000. Today when you visit the county seat, instead of busy streets you are met by empty storefronts. The one bright spot in the middle of downtown is a cinema that still generates business. But what happened? How does one county lose over 100,000 residents? The business climate is so bleak that the only Walmart in the county managed to stay open for just 10 years, closing its doors in 2016. How does this happen? What happened in that 50-year span? Obviously, the well-documented downturn in the coal industry has played a role. And some people left the county after they lost their homes to the 2001 floods. But is there more?

The opioid epidemic has garnered a lot of national attention over the last several years. If you were looking for a blueprint of a community ravaged by the epidemic, this county could serve as that blueprint. With the majority of jobs in the county being blue-collar labor, and with so many jobs now gone, it is almost a perfect breeding ground for the opioid epidemic. The county’s struggles have received national attention with high-profile visits from both Senator Bernie Sanders and TV personality Anthony Bourdain.

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One in three families in the county are living beneath the federal poverty level. More than half of those families include children under the age of 5. A high level of poverty is common in communities highly impacted by the opioid epidemic. In many areas where the major industry requires high physical demands, such as coal mining, the popularity of prescribing opioids for pain exploded in the 1990s and spurred an opioid addiction crisis that hasn’t slowed down.

Dependence on opioids impacts the ability of people to get jobs other than coal mining. In 2010, the Federal Bureau of Prisons opened a federal correctional institution in the county. This was met with a lot of excitement and hope because it would create new jobs for residents. However, due to failed drug tests and a high rate of disability, there were not enough eligible county residents to fill the positions. Current employees of the facility are mostly from neighboring counties in West Virginia and Virginia. The facility was so desperate to fill the positions they even started offering a shuttle service from neighboring counties.

The impact of the opioid crisis is not just felt in the economy; it is also felt by other systems in the region, including the judicial system and police department. The police force often stays busy dealing with issues related to the opioid crisis, and most of the court hearings in the area are drug related. There is one hospital in the community to deal with all emergency issues, which means if there is a crisis involving an addicted individual, the person ends up there. This puts strain on the staff of the facility who are caring for people in the most vulnerable of situations. It easily leads to an overworked/underpaid mentality.

Some are trying to make a difference in the community, however. There is one outpatient community mental health facility in the area. Although demand is high, they are doing what they can to manage the caseload to get folks the help they need. The foster care system is working hard to provide children with safe and nurturing families. The Reconnecting Initiative has also been in action over the past 6 years. The initiative is a partnership of businesses, nonprofit agencies, governmental agencies, and foundations that is sponsored by the teachers union in West Virginia. Much of the focus of the initiative has been to address issues in the county’s school system, and its staff reports success in a 10% rise in high school graduation rates. Another focus of the initiative is to get teachers to stay in the region. As part of the Reconnecting Initiative, a juvenile drug court opened in the county in 2013, the 16th program like it in West Virginia. An adult drug court also opened in the county in 2015, graduating its first class of three in 2017.

Even with these challenging issues, the sense of community is still strong.

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When someone in the community is in trouble, a neighbor is usually willing to lend a helping hand. This sense of community is even felt by people who grew up there and moved away. Even though many people have negative things to say about the community, you can always find people who grew up there who have something positive to say and who stand up for the community. People who still live there are always willing to welcome those who moved away back home, but it can be a bit more challenging for people viewed as outsiders to be accepted in the community.

Another important factor in understanding the community is that it is very conservative politically. With promises to bring coal back and put miners back to work, Donald Trump soundly won every county in West Virginia in the 2016 election. In this county, he won with nearly 75% of the vote. When speaking with people in the community, you quickly learn that Trump’s talk about coal has brought a lot of hope. The conservative mind-set also means there is very much a “pick yourself up by the bootstraps and get to work” mentality when it comes to assistance programs. Even though almost half of the residents in the county receive some form of public assistance, there is still a stigma about receiving any kind of help. This mind-set also impacts drug treatment efforts in the community.

—R. Shawn Allen

Case Study 13.2 An Evolving Online Support Community After she lost a child to suicide, Karyl Beal discovered that her local community lacked adequate support for parents mourning their children’s suicides. She decided to start an online support group for parent survivors and founded Parents of Suicide (POS) as an e-mail-based mailing list in 1998. During the formation phase, there were fewer than 20 members, and a strong sense of intimacy and bonding quickly developed. Within a year, POS entered a period of rapid growth. Over the first 3 years, membership expanded to more than 400, grew to 600 in 2003, and to 900 members in 2009.

As the e-community grew, two issues emerged. First, member diversity and conflicts and complaints grew. Among the complaints was too much religious content in the messaging. Second, the original sense of intimacy and bonding was lost. POS leaders responded to these issues by establishing guidelines for group interaction. Members were also asked to note a topic in the e-mail subject line, so that members could avoid reading messages they

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might find offensive, such as religious messages. The guidelines addressed confidentiality by prohibiting the copying or forwarding of messages without the sender’s permission. Potential members were asked to complete an application and joined on a probationary status. As the membership grew too large for members to keep up with all the e-mails, subgroups were formed. Another approach for dealing with the diminishing intimacy was to organize some face-to-face gatherings with the possibility for online participation in some of the activities.

In 2000, POS shifted from a strictly e-mail-based mailing list to a web-based discussion forum. Members could continue to interact by e-mail, but web features were added. A separate memorial website was created to commemorate their children’s lives. A sister group called Family and Friends of Suicides (FFOS) was established to support survivors who were not parents. An online biweekly newsletter was developed to publicize events, describe members’ joys and concerns, and welcome new members. A private, password-protected chat room was implemented to allow members to communicate in real time. An administrative database, a suicide reference library, and a suicide grief support forum were added. In 2007, a Faces of Suicide website was created, and in 2009, a Facebook POS-FFOS grief support community was added. The POS website is no longer active but continues to be available to those who wish to visit its memorial wall. The Facebook grief support community continues to flourish with 1,800 members as of 2018.

—Case study based on Jones and Meier, 2011

A Definition of Community We see two types of community in the two case studies, a rural county in West Virginia and an online support community. But exactly what is community? This question has not been an easy one for social scientists. In fact, George Hillery’s 1955 review of the sociological literature found 94 distinct definitions of community, and many new definitions have been proposed since that time (see Krause & Montenegro, 2017). In the 1970s, Seymour Sarason (1974) struggled to define the related concept of sense of community and concluded that even though sense of community is hard to define, “you know when you have it and when you don’t” (p. 157). Shawn Allen thinks he sees a great sense of community in the West Virginia county he describes in Case Study 13.1.

How should we interpret the fuzziness of the concepts of community and

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sense of community? Some suggest that any concept with so many meanings is unscientific, and its potential utility is therefore highly suspect. On the other hand, Larry Lyon (1987) suggested that the multiplicity of definitions of community is evidence that the concept is meaningful to scholars with diverse interests and perspectives. More recently, Robert Chaskin (2013) noted that the concept of community is both ubiquitous and ambiguous. A variety of groups are referred to as communities, including professional groups, ethnic groups, neighborhoods, social movements, and online discussion groups (Veinot & Williams, 2012). I agree with Lyon and Chaskin that a concept such as community should not be discarded simply because it has been hard to define. Over the past 3 decades, sociologists have in fact worked to develop greater agreement about the meaning of community, and community psychologists have been equally diligent about developing greater clarity for sense of community. Both lines of inquiry are relevant to social work.

Sociological attempts to reach agreement on the definition of community have centered on the report that approximately three fourths of the 94 definitions found in the sociological literature included the same three elements: geographic area, social interaction, and common ties (Hillery, 1955). Understanding of what community is in the rural West Virginia county (Case Study 13.1) seems very similar to this, but Parents of Suicide (Case Study 13.2) would surely argue that community can be built across geographical distance. Historically, community did have a geographic meaning in sociology. More recently, however, two different sociological meanings of community have developed: community as a geographic or territorial concept and community as an interactional or relational concept. The two case studies at the beginning of this chapter represent both meanings, and in this chapter, we discuss both meanings of community because both appear to have relevance for human behavior in the contemporary era. Indeed, researchers are finding more similarities than differences in these two types of community (Obst & White, 2004; Obst, Zinkiewicz, & Smith, 2002a, 2002b). We use the following definition to cover both territorial and relational communities: Community is people bound either by geography or by webs of communication, sharing common ties, and interacting with one another.

Shawn Allen describes a strong sense of community in a rural West Virginia county, and the Parents of Suicide online community quickly

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developed a strong sense of intimacy and bonding. In 1974, Seymour Sarason proclaimed the enhancement of the “psychological sense of community” as the mission of community psychology. He saw the basic characteristics of sense of community as

the perception of similarity with others, an acknowledged interdependence with others, a willingness to maintain this interdependence by giving to or doing for others what one expects from them, the feeling that one is part of a larger dependable and stable structure. (p. 157)

These characteristics of sense of community are very similar to the “common ties” element of the definition of community. The elements of community and sense of community are presented in Exhibit 13.1. We look more closely at the concept of sense of community in a later section.

Exhibit 13.1 ● Essential Elements of Community and Sense of Community Exhibit 13.1 ● Essential Elements of Community and Sense of

Community

Community (from community sociology literature)

Linked by geography or webs of communication

Common ties

Interaction

Sense of Community (from community psychology literature)

Similarity with others

Interdependence

Mutual exchanges to fulfill needs

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Sense of belonging Sources: Based on Hillery, 1955; Sarason, 1974; Wellman, 1999.

Territorial Community and Relational Community Some would argue that community in the contemporary era is based on voluntary interaction (relational community), not on geography or territory (territorial community). For people in the rural West Virginia county, it is territorial, but for Parents of Suicide it is relational. For many people, however, it is both relational and territorial. Many of us maintain a sense of community in our local neighborhoods while at the same time building a sense of community online and with far-flung communities where we once lived but have left. Indeed, it appears that some people who no longer live in that rural West Virginia county continue to feel a sense of community with it. What about for you? Are your strongest supports based on territorial or relational community?

In premodern times, human groups depended, by necessity, on the territorial community to meet their human needs. But each development in communication and transportation technology has loosened that dependency somewhat. Electronic communication now connects people over distant spaces, with a high degree of both immediacy and intimacy. The development of the World Wide Web in the early 1990s allowed rapid growth in the use of e-mail; beginning in the mid-1990s, hundreds of millions of people around the world began to use e-mail to communicate with other individuals and to develop e-mail discussion groups. Parents of Suicide is one of many support communities that developed using e-mail. Toward the end of 2004, Web 2.0 technologies, a second generation of the World Wide Web that allows people to collaborate and share information online, came to prominence. Web 2.0 includes blogs, microblogs like Twitter, wikis, podcasting, multimedia sharing sites, and social networking sites (SNS) (Fuchs, 2017). Parents of Suicide has used some of these features. By 2008, a major research study of the use of digital technologies by adults in 17 industrialized nations found an average one third of leisure time spent using these technologies (Harrison & Thomas, 2009). In 2018, 70% of people in the United States used social media to connect with one another, read news content, share information, and entertain themselves (Pew Research Center, 2018). Facebook, the most widely used social

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network worldwide, reportedly had 2.2 billion users communicating in 142 different languages in 2017, with 1.74 billion users accessing the site by mobile devices (The Statistics Portal, 2017). The Parents of Suicide community currently does much of its connecting with each other by way of Facebook. Other SNS have sprung up in specific countries—for example, Cyworld (Korea), Hyves (Holland), LunarStorm (Sweden), Mixi (Japan), Orkut (Brazil), QQ (China), and Skyrock (France), but some have closed down or become gaming sites only because of competition from Facebook. SNS are online platforms that allow users to create a public profile and interact with other users on the website. Users input a list of people with whom they share a connection. This meets the earlier definition of community: linked by webs of communication, common ties, and interaction. Recently, a boom in the growth of mobile social network applications, such as Foursquare, has been connecting virtual and territorial communities (Zhang et al., 2017).

For a number of years, researchers have been finding that local ties make up a decreasing portion of our social connections, interpreting that finding to mean that territorial community is no longer important in our lives (Hunter & Riger, 1986; Wellman, 1982; Wellman & Wortley, 1990). A more careful look at this research suggests, however, that even highly mobile people continue to have a lot of contacts in their territorial communities. One study in Toronto (Wellman, 1996) found that if we study ties, the number of people with whom we have connections, it is true that the majority are nonterritorial. However, when we study contacts, our actual interactions, two thirds are local, in the neighborhood or work setting. It is most likely true that for people in the rural West Virginia county from Case Study 13.1, both ties and contacts are largely territorial, although many people living there continue to have both ties and contacts with people who have moved away from the community, and, no doubt, many of them also keep active electronic ties beyond the community. Two recent trends are stimulating a robust reexamination of territorial community. In the first trend, as seen in the case study in Chapter 14, the climate change and environmental justice movement focuses on environmental hazards in local territorial communities (Case, 2017). In the second trend, community-based approaches to health improvement target local territorial communities (Aveling, Martin, Herbert, & Armstrong, 2017). It is imperative for communities like the rural West Virginia county to work at the community level to fight the opioid epidemic.

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When technology opens the possibilities for relational communities, it does not spell the death of territorial community, but there have been conflicting findings about this. One research team found that Internet- wired suburbanites were more likely than their nonwired neighbors to engage in “active neighboring,” actually using the Internet to support neighboring (Hampton & Wellman, 2003). A widely publicized 2006 study by McPherson et al. (2006) found the opposite. This study found that from 1985 to 2005, people in the United States became more socially isolated, the size of their discussion networks declined, and the diversity of their networks decreased. More specifically, the researchers found that people had fewer close ties in their neighborhoods and with voluntary associations (e.g., clubs, neighborhood associations). They suggested that use of the Internet and mobile phones pulls people away from neighborhoods and other locally based social settings. It is likely, however, that many if not most members of the Parents of Suicide online community continue to have regular interactions in their territorial communities. Using the same database used by McPherson et al. (2006), with data collected 2 years later, DiPrete and colleagues (DiPrete, Gelman, McCormick, Teitler, & Zheng, 2011) found that people in the United States are not as isolated as suggested by the data used by McPherson, but their social networks are increasingly segregated along racial, social class, religious, and political lines.

Photos 13.1a and 13.1b Communities are linked together by geography and webs of communication, common ties, and interaction. Contrasted here are two types of neighborhoods, a suburban neighborhood in the United States and the village of Cantondougou on the Ivory Coast.

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To address the inconsistencies in research, the most comprehensive study of social isolation and new technology in the United States was reported by researchers with the Pew Internet & American Life Project (Hampton, Sessions, Her, & Rainie, 2009). These researchers undertook a study to compare the social networks of people who use particular technologies with those of demographically similar people who do not use these technologies. Here are their major findings about the trends in social networks since 1985. In interpreting these data, it is important to remember that the use of these technologies is changing rapidly and data are quickly outdated.

There has been a small to modest drop in the number of people reporting that they have no one to talk to about important matters; 6% of adults report they have no one with whom they can discuss such matters. The average size of people’s core discussion networks has declined, with a drop of about one confidant. The diversity of people’s core discussion network has markedly declined.

However, the research also indicates that use of technology is not the driving force behind these changes. Here are their findings about the relationship between new technology and social networks:

People who own a cell phone and use the Internet for sharing photos and messages have larger core discussion networks than those who do not use this technology. People who use these technologies have more nonkin in their networks than people who do not. People who use the Internet to share photos are more likely to have discussion partners that cross political lines. People who use Internet social networking sites have social networks that are about 20% more diverse. In-person contact remains the most frequent way to have contact in the geographical community. The mobile phone has replaced the landline as the most frequently used medium for communication. Text messaging tied with the landline as the third most popular way

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to communicate, but it is likely that this ranking no longer holds in 2018. Those who use SNS are 25% less likely to use neighbors for companionship, but use of other technologies is associated with higher levels of neighborhood involvement. Internet users are less likely to depend on neighbors to provide concrete services.

Wendy Griswold (2013) proposes that people can have ties to both relational and territorial communities at the same time. Griswold recognizes the possibility that new technologies will simply allow us to develop and maintain a larger network of increasingly superficial relationships. But she also points out the possibility that the new capacity to be immediately and intimately connected across space could help us to develop more shared meanings and become more tolerant of our differences. Jeffrey Boase (2008) found that people who draw heavily on all types of available technology have larger and more diverse personal networks than people who make less use of available technology. One research team recently reviewed research from 2000 to 2015 and found eight technologies that have been used to alleviate social isolation among older adults (Khosravi, Rezvani, & Wiewiora, 2016). Another research team found that the relationship between social media use and social isolation was mediated by personality type, with individuals high in conscientiousness using social media to maintain good face-to-face relationships and reduce social isolation (Whaite, Shensa, Sidani, Colditz, & Primack, 2018).

As social workers concerned about social justice, however, we must understand the multiple implications of inequality of access to new technologies. These technologies open opportunities for relational community and the multitude of resources provided by such communities. Skill in using new technologies is also increasingly rewarded in the labor market. Unless access to these technologies is equalized, however, territorial community will remain central to the lives of some groups— most notably, young children and their caregivers; older adults; poor families; people in isolated rural communities, and many persons with disabilities, who have their own special technological needs. On the other hand, new technologies may make it easier for some people with disabilities to gain access to relational community, even while inaccessible physical environments continue to block their access to territorial

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community.

Although both territorial and relational communities are relevant to social work, social work’s commitment to social justice has led to continued concern for territorial communities. That same commitment also requires social workers to work toward equalization of access to both territorial and relational community.

Critical Thinking Questions 13.1

Review the cited research in the previous section about the impact of new technologies on territorial and relational community. Which technologies have you used in the past week to keep in touch with people you know? Which type of technology do you use the most these days to build and maintain relationships? Do you use different types of technology to keep in touch with different people or for different types of situations? How important is territorial community to you? What methods do you use to stay in touch with your territorial community?

Social Workers and Communities: Our History From the earliest history of social work in the United States, social workers have been interested in the health of communities and the influence of community on individual behavior (Brueggemann, 2013). Social work grew from two different approaches to social problems, one of which—the settlement house movement—was community focused. (The other was the social casework approach, which focused on individual and family adjustment.) Social workers in the settlement houses provided a wide range of services to help poor families cope with the challenges of poverty, including day nurseries, employment bureaus, a place to take a shower, English classes for immigrants, health clinics, pasteurized milk, information on workers’ compensation, legal assistance, and emergency financial assistance. Their interests went beyond helping individual families, however; they were also interested in identifying and addressing community conditions that jeopardized the health and well-being of neighborhood families. They campaigned for social reforms such as tenement protection, improved sanitation, and labor reform. In addition, the settlement house social workers were interested in building a sense of

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mutual support in the poor neighborhoods where they were located. They developed dance, drama, and arts classes; sports and hobby clubs; summer camps; cultural events; and libraries. During this same period, African American social work pioneers developed settlement houses and engaged in active community work to “improve the collective social functioning of their racially segregated communities” (Carlton-LaNey, 1999, p. 312).

Social work’s interest in community has ebbed and flowed since then, with more interest shown in some periods than in others. Stanley Wenocur and Steven Soifer (1997) suggest three peak periods of intense social work interest in community in the United States: the Progressive Era at the turn of the 20th century, the Depression years of the 1930s, and the civil rights era of the 1960s. Contemporary critiques of social work suggest that the profession replaced its original focus on community with a preoccupation with personality problems of individuals (Reisch, Ife, & Weil, 2013; Thompson, 2002). The social work literature, however, reflects a recent expansion in community practice in the United States and around the world (Weil, Reisch, & Ohmer, 2013a). It is hard to say what mix of societal trends has produced this recent expanded interest in community practice, but some have credited the far-reaching impact of economic and cultural globalization, growing social inequality, massive movements of refugees, the devolution of policy decisions about social welfare programs to the state and local levels in the United States, and social work’s renewed commitment to the goal of social justice (Brueggemann, 2013).

Theoretical Approaches to Community Social workers traditionally have turned to community sociology for theory and research on community. Although the early history of sociology is intertwined with the study of community, attention to community has waxed and waned among sociologists. Each new wave of sociological interest in community has been stimulated by concern about how modernization is destroying the fabric of traditional community (Studdert & Walkerdine, 2016). Although they have called for a different type of focus, sociologists in both the United States and the United Kingdom have, in recent years, called for sociology to make the study of community more central to sociology (Collins, 2010; Studdert & Walkerdine, 2016). Scholars in a variety of disciplines have been interested in how globalization interacts with local cultural norms in the development,

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maintenance, and deterioration of community (Francescato & Tomai, 2001). They have been particularly interested in social inequalities and conflicts between communities of competing interests in a globalized, postmodern world. These scholars identify strong and hotly contested group-based variations in norms, values, and behavior.

Community has also emerged as an important concept in psychology. In the midst of concern about the ineffectiveness of existing psychotherapeutic methods, the concept of community was discovered—or rediscovered—by the community mental health movement in the 1960s and 1970s. The field of community psychology developed and became Division 27 of the American Psychological Association in the United States (Heller, 1989). During the 1980s, community psychology was also established as a division in some European countries, and in 1995, the European Network of Community Psychologists was formed (Francescato & Tomai, 2001). Community psychologists Krause and Montenegro (2017) propose that three trends in communities are calling for community psychologists to rethink their approach to community: (1) communities are less tied to geographic space, (2) communities may have shorter temporal duration than in the past, and (3) community boundaries are often less clear. Like social workers, community psychologists have turned to the sociological literature for community theory, but they have also developed their own theory of psychological sense of community.

In a 1979 paper presented to the Community Section of the American Sociological Association, Roland Warren (1988) suggested that theorizing about community, like sociological theory in general, includes multiple perspectives. He recommended that multiple theoretical approaches be used to understand communities because each approach explains particular aspects of community. Four decades later, it still seems wise for social workers to follow Warren’s advice and use multiple theoretical approaches for understanding multidimensional community. That approach is, of course, consistent with the multidimensional approach of this book.

Five perspectives on community seem particularly relevant for social work: the contrasting types approach, spatial arrangements approach, social systems approach, social capital approach, and conflict approach. The second of these, the spatial arrangements approach, applies only to territorial communities, but the other four can be applied equally well to both relational and territorial communities. In combination, these five

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approaches to community should enable you to scan more widely for factors contributing to the problems of living among vulnerable populations, to recognize community resources, and to think more creatively about possible interventions. Using approaches that are not only varied but even discordant should assist you in thinking critically about human behavior and prepare you for the often ambiguous practice situations you will encounter.

Contrasting Types Approach The people in the rural West Virginia county are described as having a strong identification with the community and close personal relationships. The relationships of the Parents of Suicide community were based on emotionalism in the early phase of the community, but as the community grew, new guidelines for interaction and more formal contracts were imposed to manage conflicts in the community. These issues are at the heart of the oldest theory of community, Ferdinand Tonnies’s (1887/1963) concepts of gemeinschaft and gesellschaft (translated from the German as community and society). Actually, Tonnies was trying to describe contrasting types of societies, rural preindustrial societies (gemeinschaft) versus urban industrial societies (gesellschaft), but his ideas continue to be used by community sociologists today to understand differences between communities, both spatial and relational (Ballantine et al., 2018; Memmi, 2006; Ritzer, 2016). In gemeinschaft communities, relationships are personal and traditional; in gesellschaft communities, relationships are impersonal and contractual. It appears that the rural West Virginia community can be thought of as a traditional gemeinschaft community whereas the Parents of Suicide community began as a very gemeinschaft community but became more of a gesellschaft community over time. The defining characteristics of gemeinschaft and gesellschaft communities are listed in Exhibit 13.2.

Exhibit 13.2 ● Gemeinschaft and Gesellschaft Communities Exhibit 13.2 ● Gemeinschaft and Gesellschaft Communities

Gemeinschaft Gesellschaft

Strong identification with community Little identification with community

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Authority based on tradition Authority based on laws and rationality

Relationships based on emotionalism

Relationships based on goal attainment and emotional neutrality

Others seen as whole persons Others seen as role enactors

Tonnies (1887/1963) saw gemeinschaft and gesellschaft as ideal types that will never exist in reality. However, they constitute a hypothetical dichotomy against which the real world can be compared. Although Tonnies’s work is more than a century old, the gemeinschaft/gesellschaft dichotomy has proven to be a powerful analytical construct, and it continues to be used and validated in community research (see Greenfield, 2014). It is also reflected in later typological theories. For example, Charles Cooley (1902) proposed that the social world can be defined in terms of primary groups (intimate, face-to-face groups to which we form attachments) and secondary groups (less intimate, more impersonal groups). Mark Granovetter (1973) made a distinction between strong ties and weak ties. Strong ties entail frequent contact between members, emotional intensity in interactions, and cohesion. Weak ties are impersonal and superficial, connecting acquaintances rather than friends. Some theorists have envisioned more of a continuum than a dichotomy, such as Robert Redfield’s (1947) folk/urban continuum and Howard Becker’s sacred/secular (1957) continuum.

Tonnies (1887/1963) shared the view of other early European sociologists, such as Max Weber and Émile Durkheim, that modernization was leading communities away from gemeinschaft and toward gesellschaft. Capitalism, urbanization, industrialization, and most recently electronic technology, have all been proposed as causes of the movement toward gesellschaft. Many typology theorists lament the “loss of community” that occurs in the process. But some theorists suggested that electronic technology moved us into a third type of community—sometimes referred to as a postgesellschaft, or postmodern, community—characterized by diversity and unpredictability (Griswold, 2013; Lyon, 1987; Smith, 1996). This view has become more prominent with increasing globalization, and it seems reasonable to think of the Parents of Suicide community as

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increasing diversity in its membership.

Howard Becker (1957) sees the evolution of community in a different light. He suggests that modern society does not always move toward the secular but instead moves back and forth a great deal on the sacred/secular continuum. To Becker, the sacred is best characterized by reluctance to change (traditional authority in Tonnies’s gemeinschaft), and the secular is best characterized by readiness to change (emotional neutrality in Tonnies’s gesellschaft).

Tonnies and other theorists who have studied communities as contrasting types have focused their attention on territorial communities. Indeed, empirical research supports the idea that territorial communities vary along the gemeinschaft/gesellschaft continuum (Cuba & Hummon, 1993; Hunter & Riger, 1986; Keane, 1991; Woolever, 1992). More recently, however, Barry Wellman (1999) and research associates have attempted to understand contrasting types of relational communities that are based on networks of interaction rather than territory. In his early work, Wellman (1979) identified three contrasting types of communities:

1. Community lost. Communities that have lost a sense of connectedness, social support, and traditional customs for behavior

2. Community saved. Communities that have retained a strong sense of connectedness, social support, and customs for behavior

3. Community liberated. Communities that are loosely knit, with unclear boundaries and a great deal of heterogeneity

Wellman (1999) suggests that as societies change, community is not necessarily lost but becomes transformed, and new forms of community develop. Daniel Memmi (2006) argues that online communities are just another form of community and another example of the long-term evolution of looser social relationships. There are differences of opinion about whether community is lost or merely transformed in the exportation of labor around the world. As you ponder this question, think about a personal story told by Rhacel Salazar Parreñas (2008) in her book The Force of Domesticity. While she was doing fieldwork about the families of Filipina migrant domestic workers in a city in the Philippines, she ended up spending a night in jail with her cousin, Mimi, in a remote small town. She was surprised that word of their incarceration reached relatives in the United States before anyone in her Filipino household or neighborhood knew anything about it.

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knew anything about it.

Wellman and associates have continued to study the idea of contrasting types of relational communities for more than 20 years, seeking to understand multiple dimensions of communities. Their work (e.g., Wellman & Potter, 1999) suggests that it is more important to think in terms of elements of communities rather than types of communities. Using factor analytic statistical methods, they have identified four important elements of community—contact, range, intimacy, and immediate kinship/friendship—described in Exhibit 13.3. These elements are configured in different ways in different communities and in the same community at different times.

Exhibit 13.3 ● Four Elements of Communities Exhibit 13.3 ● Four Elements of Communities

Contact Level of interaction; how accessible community members are for contact and how much contact they actually have

Range Size and heterogeneity of communitymembership

Intimacy

Sense of relationships being special; desire for companionship among members; interest in being together in multiple social contexts over a long period of time; sense of mutuality in relationships, with needs known and supported

Immediate kinship/friendship

Proportion of community membership composed of immediate kin (parents, adult children, siblings) versus friends

Source: Based on Wellman & Potter, 1999.

Social workers might benefit by recognizing both the gemeinschaft and gesellschaft qualities of the communities they serve as well as the histories of those communities. Approaches like Wellman and Potter’s multiple elements of communities could be helpful in this regard.

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If we think of the rural West Virginia county, we think of a community whose spatial arrangements have undergone a severe transformation over 50 years. Fifty years ago, when coal mining was booming, the county seat had full storefronts and busy streets. Prosperity was evident in the housing stock where coal barons lived. Today, when you visit the county seat, both the storefronts and the streets are empty. Some houses are boarded up, but many were destroyed in the 2001 floods. The cinema still stands and is a point of pride and a place that people get together.

Photo 13.2 Teenagers can often be characterized as a community held together via social bonds; they share a common spirit, trust, art, and emotional connection. In this case, they also share a common territory.

Beginning with Robert Park’s (1936) human ecology theory, a diverse group of sociological theorists have focused on community as spatial arrangements. Their interests have included city placement; population growth; land use patterns; the process of suburbanization; the development of “edge” cities (newly developed business districts of large scale located on the edge of major cities); and the relationships among central cities, suburbs, and edge cities. They are also interested in variations in human

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on the edge of major cities); and the relationships among central cities, suburbs, and edge cities. They are also interested in variations in human behavior related to the type of spatial community, such as rural area, small town, suburb, or central city, and more recently, in how human health and well-being are related to physical features of the community (Sternberg, 2009).

Symbolic interactionists have studied how symbolic images of communities—the way people think about their communities—are related to spatial arrangements (Wilson & Baldassare, 1996). A survey of a random sample of Denver employees found that a large majority thought of themselves as either a “city person” or a “suburbanite” (Feldman, 1990). Participants largely agreed about the spatial attributes that distinguish cities from suburbs. On the whole, both city people and suburbanites reported a preference for the type of spatial community in which they resided. Recently, however, there is evidence that, after 50 years of movement from U.S. cities to the suburbs, many suburbanites no longer want suburban life. Cities and high-density inner suburbs are now growing faster than the suburbs (Gallagher, 2013). Two of the reasons for this trend are a desire to spend less time in the car and a desire to live where human interactions are more convenient. The future of this suburban to urban migration is unclear. Stay tuned.

One research team set out to discover the meanings that residents of seven distressed neighborhoods in one midwestern city make of the physical aspects of their neighborhoods (Nowell, Berkowitz, Deacon, & Foster- Fishman, 2006). They used photovoice methodology, putting cameras in the hands of participants and asking them to use the cameras to tell a story about their community. They found that physical aspects of the neighborhood carry many meanings for the residents. Positive physical landmarks, such as parks and monuments, communicate a message of pride and identity, but physical conditions such as dilapidated houses, graffiti, and overflowing garbage convey negative meaning that invites frustration and shame. The researchers concluded that community physical conditions are important because they carry symbolic meanings for the residents. It could be a powerful intervention to use photovoice methodology to engage the residents of the rural county in West Virginia in telling a story about their community.

The multidisciplinary theory on human behavior and the physical

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elements of environmental design that encourage social interaction as well as those that encourage a sense of control and the motivation to look out for the neighborhood. They have identified such elements as large spaces broken into smaller spaces, personalized spaces, and spaces for both privacy and congregation. One research team that studied the spatial arrangements in a suburban region found that people who had a sense of adequate privacy from neighbors’ houses also reported a greater sense of community (Wilson & Baldassare, 1996). Another researcher found that opportunities to visit nearby shared space and having views of nature from home are correlated with increased neighborhood satisfaction (Kearney, 2006). Still another researcher found that neighborhood physical environments that provide opportunity for physical activity are particularly valued by children and recommends that social work assessment with children should include aspects of the child–neighborhood relationship (Nicotera, 2005). Recently, new urbanist designers have been interested in aspects of community design that encourage physical activity for people of all ages; they are thinking of the health benefits that physical activity provides (see discussion in Chapter 7).

Early settlement house social workers at Hull House in Chicago developed color-coded community maps for assessing the spatial arrangements of social and economic injustices in local neighborhoods (Schoech, 2013). Social work planners and administrators have recently returned to the idea of geographical mapping, making use of advancements in geographic information system (GIS) computer technology that can map the spatial distribution of a variety of social data (Mandayam & Joosten, 2016). In recent years, GIS has been used to map (1) the distribution of supermarkets in areas of high concentration of diet-related deaths (Giang, Karpyn, Laurison, Hillier, & Perry, 2008); (2) where foster care children are placed in relation to schools, community services, transportation, and other types of community resources (Potter, 2005); (3) the geographical distribution of rates of child physical abuse, neglect, and sexual abuse (Ernst, 2000); and (4) the clustering of outdoor advertisements for unhealthful products near child-serving institutions in low-income and minority communities (Hillier et al., 2009). GIS is also being used to map public health risk factors and to examine the match of physicians to community needs (see Cervigni, Suzuki, Ishii, & Hata, 2008); to study residents’ views of neighborhood scale (Coulton, Jennings, & Chan, 2013); to target neighborhoods for community-building initiatives (Huber, Egeren, Pierce, & Foster-Fishman, 2009); and to study race disparities in

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2013); to target neighborhoods for community-building initiatives (Huber, Egeren, Pierce, & Foster-Fishman, 2009); and to study race disparities in the national distribution of hazardous waste treatment, storage, and disposal facilities (Mohai & Saha, 2007). It has been used to evaluate family reunification goals (Rine, Morales, Vanyukevych, Durand, & Schroeder, 2012) and to develop programs for foster youth transitioning to independent living (Batsche & Reader, 2012). It has great utility for program evaluation as well as program planning (Rine et al., 2012). Huber et al. (2009) emphasize that community resources and community risk factors can be identified through the use of GIS. It might be helpful if the community mental health center in the rural county of West Virginia could map the distribution of opioid emergencies in their county.

GIS holds much promise for future social work planning, administration, and research. Amy Hillier (2007), a leading proponent of the use of GIS by social workers, emphasizes the important role GIS can play in identifying where social work clients live in relation to both resources and hazards. She also argues that GIS has the potential to empower community groups, particularly disenfranchised groups, but that it is rarely used this way by social workers. One challenge for social service organizations is the lack of staff training in the use of GIS software and hardware (Hillier & Culhane, 2013). If you have access to GIS technology, you might want to do some mapping of your territorial community: its ethnic makeup, socioeconomic class, crime rate, libraries, parks, hospitals, social services, and so on. If you do not have access to GIS, you can accomplish the same task with a good map blowup and multicolored pushpins.

Thinking about territorial communities as spatial arrangements can help social workers decide which territorial communities to target, for which problems, and with which methods. Just as the early settlement house social workers were interested in hazards in the physical environments of their immigrant neighbors, contemporary interest in environmental hazards encountered by poor and minority communities is reinvigorating an interest in geographical communities. Recently, there has been considerable interest in protecting community water supplies in places like Flint, Michigan (Duntley-Matos et al., 2017), and in Indigenous communities in both Canada and the United States (see Case, 2017). Community-based approaches are being used to improve the health of specific populations (see Aveling et al., 2017). Community mapping of and community-based responses to the opioid epidemic are receiving

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cleanup and revitalization (Delgado & Staples, 2013). The January 2018 edition of the Journal of Community Practice focused on engaging youth in community work (Santiago & Smith, 2018).

Social Systems Approach A third way to think about communities is as social systems with cultures and patterns of interactions. The social systems perspective focuses on social interaction rather than on the physical, spatial aspects of community. Social interaction in a community can be understood in two ways: as culture and as structure (Griswold, 2013). Exhibit 13.4 shows the differences between these two aspects of community. Shawn Allen has examined some of the structure of the rural West Virginia county described in Case Study 13.1; more specifically, he has examined some of the institutions, economic factors, and political factors. Jones and Meier (2011) studied some of the changing culture of the Parents of Suicide online community, especially some of the language, patterns of meaning, common knowledge, and symbols used in interactions in that community.

Exhibit 13.4 ● Aspects of Community Culture and Community Structure

Community Culture

Use of language

Pattern of meanings

Typical practices

Common knowledge

Symbols that guide thinking, feelings, and behaviors

Community Structure

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Community Structure

Network of relationships

Institutions

Economic factors

Political factors Source: Based on Griswold, 2013

For thinking about community in terms of its culture, symbolic interaction theory is promising because of its emphasis on the development of meaning through interaction. Ethnography is also particularly useful for studying community culture. The goal of ethnographic research is to understand the underlying rules and patterns of everyday life, in a particular location or among a particular group, from the native point of view rather than the researcher’s point of view. One example of this is work by Italian community psychologists Donata Francescato and Manuela Tomai (2001). Their method of building a profile of a territorial community of interest combines demographic data with ethnographic methods that include “environmental walks, drawings, movie scripts, narratives, and telling jokes” (p. 376). For the movie script, they ask different groups in the community to develop a plot for a movie script about the future they imagine for the neighborhood; sometimes these different groups perform parts of their “movies” for each other. A movie script exercise might be helpful to both the rural West Virginia community and the Parents of Suicide online community to help them think about the future they would like to see for their communities. Francescato and Tomai have used the movie script method to build understanding between Blacks, Afrikaners, and Asian Indians in a college town in South Africa; old farmers and young students in an Austrian town; and immigrants and locals in several neighborhoods in Italy.

Community can also be studied in terms of its structure. Roland Warren (1963, 1978, 1987) made significant contributions to the understanding of patterns of interactions in communities. Warren pointed out that members of communities have two distinctive types of interactions. The first are those that create horizontal linkage, or interactions with other members of the community. The second are interactions that create vertical linkage, or

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Communities with strong horizontal linkage provide a sense of identity for community members, but without good vertical linkage they cannot provide all the necessary resources for the well-being of community members. Communities with strong vertical linkage but weak horizontal linkage may leave community members searching and yearning for a sense of community. Horizontal linkage seems to be strong in the rural West Virginia county, but distrust of “outsiders” could be limiting vertical linkages and access to external resources for addressing economic and opioid addiction challenges the community is facing. Likewise, the horizontal linkages appear relatively strong in the Parents of Suicide online community, but it is not clear how well that community is linked to other communities.

More recently, a similar distinction has been made by scholars who write about community as social capital (to be discussed later; see Putnam, 2000). They differentiate between bonding social capital and bridging social capital. Bonding social capital is inward looking and tends to mobilize solidarity and in-group loyalty, and it leads to exclusive identities and homogeneous communities. It may also lead to strong out-group hostilities. This type of social capital is often found in minority ethnic enclaves that provide psychological, social, and economic support to members. It is also found in many rural communities like the rural West Virginia community described in Case Study 13.1. Bridging social capital is outward looking and diverse, and it links community members to assets and information across community boundaries. This type of social capital appears to be very weak in the rural West Virginia county. Robert Putnam (2000) describes the difference between the two types of social capital this way: “Bonding social capital constitutes a kind of sociological superglue, whereas bridging social capital provides a sociological WD-40” (p. 23). One research team (Ellison, Steinfield, & Lampe, 2007) found that the SNS Facebook is particularly useful for bridging social capital but much less useful for bonding social capital, and yet the POS and FFOS grief support communities use it for support and bonding. Tomai et al. (2010) found that both bridging and bonding social capital increased for youth who joined an online community of high school students outside Rome; however, increased intensity of use was associated with increased bridging social capital but not with increased bonding social capital.

For 3 decades, network theorists and researchers have been using network analysis to study community structure (Borgatti & Halgin, 2011). They

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For 3 decades, network theorists and researchers have been using network analysis to study community structure (Borgatti & Halgin, 2011). They suggest that communities, like small groups and organizations, should be thought of as networks of social interaction (Rainie & Wellman, 2014). They have tended to define community as personal community, which is composed of ties with friends, relatives, neighbors, workmates, and so on. Community is personal because the makeup of community membership varies from person to person. Another name for personal community is network, which has been defined as “a set of actors with a set of ties of a specified type” (Borgatti & Halgin, 2011, p. 1169). Network theorists suggest that new communication technologies, particularly the Internet, have played a large role in transforming community from solidarity community, which seeks the participation of all members in an integrated fashion, to what Barry Wellman has called community as networked individualism, where individuals operate in large, personalized, complex networks (Boase, Horrigan, Wellman, & Rainie, 2006). Some network theorists value this transformation (see, e.g., Boase et al., 2006). Others argue that communication technologies, and particularly the Internet, can and should be used to develop solidarity community, which is friendlier, richer, and more socially binding than networked individualism, which they argue is a North American idea (see, e.g., Day & Schuler, 2004). We saw the challenges faced by the Internet-based Parents of Suicide community as members attempted to build and maintain solidarity. It seems that both sides of the argument about the benefits and costs of networked individualism are correct. Certainly, we know that the Internet has been used to develop support communities as one form of solidarity community. Research indicates that the use of asynchronous (not simultaneous) communication can speed up the development of close relationships, but researchers have also found that e-communities have a shorter life span than other types of communities. As e-communities go, the Parents of Suicide community has had remarkable longevity (Jones & Meier, 2011).

In the mid-1990s, just before Karyl Beal innovated the Parents of Suicide e-mail-based support group, the Internet was a tool accessible only to the technically elite, but a decade later, it was a part of everyday life for a large majority of people. That represents an unusually rapid diffusion of innovation, which has been accompanied by debates about whether it is helping to build or destroy community. In 2004–2005, the Pew Internet & American Life Project undertook a research project to study this question

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have in their social networks: core ties, or our closest relationships, and significant ties, or relationships that are only somewhat closely connected. They found surprisingly large networks among the respondents, a median of 15 core ties and 16 significant ties. There was no difference in the number of core ties between Internet users and nonusers, but Internet users were found to have larger numbers of significant ties. Although the digital divide has been narrowing over time, it continues to raise important concerns about equal access to virtual communities.

Network analysis has been used to study social ties in both territorial and relational communities. In doing so, researchers have found that for many people, community is based more on relationships than territory. One research team (Lee & Campbell, 1999) did find, however, that barriers of segregation and discrimination make neighborhood relationships more important for Blacks than for Whites. They found that Blacks have more intimate and long-standing ties with neighbors than Whites do in similar neighborhoods, and they engage in more frequent contact with neighbors.

Critical Thinking Questions 13.2

If we put a camera in your hands, what story would you tell about your territorial community? What images would you capture, and what meaning would you make of those images? Would you classify your territorial community as gemeinschaft or gesellschaft? What are the communities of which you are a part? Think of the community most meaningful to you and list five words that describe the culture of that community. How would you describe the horizontal and vertical linkages of that community?

Social Capital Approach When Shawn Allen talks about sense of community in the rural West Virginia county, he is talking about the quality of the connections community members make with each other and the commitment they feel to one another. He is thinking about community as a social bond that unifies people. Similarly, when Jones and Meier (2011) write about the lost sense of intimacy and bonding in the Parents of Suicide e-community, they are describing a declining commitment to each other.

In the midst of globalization, it is not unusual to hear both the general

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In the midst of globalization, it is not unusual to hear both the general public and social scientists lamenting the weakening of community bonds and talking longingly about searching for community, strengthening community, or building a sense of community. These concerns have been consistently voiced in public opinion polls for some time in the United States, and they were the subject of Robert Putnam’s (2000) best-selling book Bowling Alone: The Collapse and Revival of American Community. To be sure, concerns about the waxing and waning of community are not new, but the nature of those concerns has shifted over time. In the past couple of decades, community psychologists and community sociologists have turned to the concept of social capital to conceptualize this social bond aspect of community (Saegert & Carpiano, 2017).

In simplest terms, social capital is community cohesion, which is thought to be based in dense social networks, high levels of civic engagement, a sense of solidarity and equality among members, and norms of reciprocity and trustworthiness (see Kay, 2006; Putnam, 1993; Saegert & Carpiano, 2017). In Bowling Alone, Putnam (2000) argues that for the first two thirds of the 20th century, social capital was expanding in the United States, but that tide reversed in the final decades of the century. He calls for reconnection and revitalization of networks, civic engagement, solidarity and equality, and reciprocity and trustworthiness. Putnam (2000) presents much empirical evidence to build a powerful argument for the loss of community in the United States.

Although respecting his empirical analysis, network researchers are critical of Putnam’s conceptual analysis. They argue that community has been changing rather than declining and that although people in the United States may not be participating in group-based community activities to the same extent as in the past, their networks remain large and strong (Boase et al., 2006). They see no inherent disadvantage to the more fragmented nature of contemporary social networks, whereas Putnam (2000) suggests that it takes dense integrated networks that exist over time to build cohesion and trust. The work of Robert Sampson and colleagues (see Sampson, 2003; Sampson, Morenoff, & Earls, 1999) seems to support and expand this concern of Putnam’s. They have proposed a theory of collective efficacy, which is “the capacity of community residents to achieve social control over the environment and to engage in collective action for the common good” (Sampson, 2003, p. S56). Collective efficacy involves a working trust, a shared belief in the neighborhood’s ability for

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Research indicates that as collective efficacy in a neighborhood decreases, a host of individual and social ills increase. Collective efficacy has been found to be associated with fewer behavior problems in young children (Ma & Grogan-Kaylor, 2017), fewer post-traumatic stress symptoms in older adults following national disasters (Heid, Pruchno, Cartwright, & Wilson-Genderson, 2017), and greater likelihood that community members will engage in behavior to mitigate climate change (Wang, 2018). It is important to note, however, that Sampson and colleagues (1999) have found that the spatial dynamics and quality of the physical environment of the neighborhood have an impact on collective efficacy. It appears that economic displacement, natural disaster, and the opioid epidemic have seriously eroded the collective efficacy in the rural West Virginia county described in Case Study 13.1, but some people are trying to make a difference. The Reconnecting Initiative is made up of a strong coalition of businesses, nonprofit agencies, governmental agencies, and foundations.

Manyena (2006) wrote of community resilience rather than collective efficacy. He was particularly focused on how communities deal with natural disasters like the flooding that occurred in southern West Virginia in 2001. He suggested that when faced with adversity, resilient communities have the capacity to use the disturbance to evolve new structures, processes, and relationships to “bounce forward.” You may recall that is much like Froma Walsh’s (2016) theory of family resilience. Bouncing forward seems to be exactly what the Parents of Suicide e- community did when it faced turbulent times during its growing phase. Environmental activists argue that environmental activism can reenergize a troubled community in ways that enhance cooperation, build new ways of thinking about community systems, and transform community relationships (Case, 2017; Hopkins, 2008). Perhaps activism about the opioid epidemic could revitalize southern West Virginia communities.

This idea of a social bond among community members is what Seymour Sarason (1974) had in mind when he declared the enhancement of a psychological sense of community (PSOC) as the mission of community psychology. We looked earlier at Sarason’s definition of sense of community (see Exhibit 13.1). Community psychologists David McMillan and David Chavis (McMillan, 1996; McMillan & Chavis, 1986) turned to the literature on group cohesiveness to understand how to enhance the social bonds of community. They presented a theory of PSOC that

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social bonds of community. They presented a theory of PSOC that identified four essential elements.

1. Membership is a sense of belonging, of being part of a collective, something bigger than oneself. Membership is based on boundaries, emotional safety, personal investment, and a common symbol system. Boundaries clarify who is in and who is out, and they protect against threat. Personal investment in a community is enhanced when we feel that we have worked for membership. Common symbols facilitate integration of the community, in part by intentionally creating social distance between members and nonmembers. However, communities built on exclusion, rather than inclusion, contribute to the fragmentation of social life.

2. Influence is bidirectional. On the one hand, members are more attracted to a community where they have some sense of control and influence. On the other hand, to be cohesive, a community has to be able to exert influence over members. In this way, behavioral conformity comes from the need to belong, and conformity promotes cohesiveness.

3. Integration and fulfillment of needs refers to individual reinforcement or reward for membership. The community must be rewarding to its members, but McMillan and Chavis (1986) conclude that “a strong community is able to fit people together so that people meet others’ needs while they meet their own” (p. 13).

4. Shared emotional connection is based on a shared history and identification with the community. It is enhanced when members are provided with “positive ways to interact, important events to share and ways to resolve them positively, opportunities to honor members, opportunities to invest in the community, and opportunities to experience a spiritual bond among members” (McMillan & Chavis, 1986, p. 14).

Based on this definition of PSOC, McMillan and Chavis (1986) developed a 12-item Sense of Community Index (SCI) that has been used extensively for research. PSOC is one of the most widely studied concepts in U.S. community psychology (Townley, Kloos, Green, & Franco, 2011). Sense of community has been found to be related to positive health behaviors, positive mental health, and citizen participation. Some research teams caution that the SCI was developed and validated in Western societies and may not be a good fit for the meaning of community for non-Western

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Law, 2009; Xu, Perkins, & Chow, 2010). Measures of sense of community have been developed for specific cultural groups, including gay men (Proescholdbell, Roosa, & Nemeroff, 2006), Italians (Prezza & Costantini, 1998), and individuals with serious mental illness (Townley & Kloos, 2011).

Photos 13.3a and 13.3b Two contrasting communities: (top) a tribal community in Ethiopia and (bottom) a member of the Second Life (online) community.

An Australian research team (Obst et al., 2002a, 2002b) has used McMillan and Chavis’s theory of PSOC to compare PSOC in territorial and relational communities. More specifically, the researchers asked 359 science fiction aficionados attending the World Science Fiction Convention to complete questionnaires rating PSOC both for their fandom community and their territorial community. Research participants reported significantly higher levels of PSOC in their fandom communities than in their territorial communities. They also found that although the ratings on all dimensions of McMillan and Chavis’s four theorized dimensions of PSOC were higher in the fandom communities than in the geographical communities, the dimensions received essentially the same rank ordering in both communities. The researchers also suggest that a fifth dimension, conscious identification with the community, should be added to McMillan and Chavis’s theory of PSOC. They found this cognitive identification to be an important component of PSOC. Other researchers have found that social bonding and intimacy take time to mature in computer-mediated

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social bonding and intimacy take time to mature in computer-mediated communication (Harrison & Thomas, 2009).

Some community psychologists have introduced the concept of multiple psychological senses of community (MPSOC). They note that people live in multiple territorial and relational communities, such as neighborhood, city, rural county, workplace, university, religious group, sports league, SNS, and so on, and have multiple senses of community representing each of these communities (Brodsky, 2009). Beard and Sarmiento (2010) chronicle how immigrants from Oaxaca, Mexico, to Southern California establish hometown associations to maintain a positive sense of community in both their sending community and receiving community. The associations in Southern California hold social and cultural events, such as fiestas and danzas, to fund-raise for community- planning projects back in their hometowns in Oaxaca. In his PhD dissertation, Jeffrey Pesta (2014) tells a story of a rural transnational community spanning Obscuridad, Veracruz, Mexico, and Springfield, Minnesota, in the United States, a transnational community whose members maintain a psychological sense of community in two places. MPSOC has also been used to study Chinese migrants to New Zealand and Albanian and Sri Lankan migrants to Italy and found that a sense of community with one’s ethnic cultural group helps migrants to resist oppression by the receiving community. On the other hand, a sense of community with the receiving community helps to buffer the negative effects of migration (Li, Hodgetts, & Sonn, 2014; Mannarini, Taló, Mezzi, & Procentese, 2018). Such migrants live in transnational communities and develop an identity “inbetweenness” formed at the intersection of interdependent communities (Li et al., 2014).

In recent years, the social work literature has paid attention to the issue of community building. This literature often focuses broadly on community revitalization, in terms of the economic and physical as well as the social relationship dimensions of communities. The literature on youth leadership development is particularly noteworthy for its attention to building a sense of community among youth in neighborhoods. Recent social work literature on community youth development has returned to its settlement house roots, recommending the use of arts, humanities, and sports to build a sense of community, as well as to empower youth and help them build skills (Delgado & Staples, 2013; Tilton, 2009).

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antisocial as well as prosocial purposes. Think of the elements of social capital and sense of community and you will have to agree that they apply equally well to the Ku Klux Klan (KKK) and a neighborhood committee formed to welcome the influx of new immigrants. The literature on networks often suggests that birds of a feather flock together. It is quite possible, as the KKK example demonstrates, that groups can be socially cohesive and yet quite exclusionary, distrustful, and hostile (even violently so) to outsiders. That has led Putnam (2000) and others (Townley et al., 2011) to accede the dark side of social capital. Recently, community psychologists have noted that both sense of community and the positive value of diversity are core values in community psychology and acknowledge that these two values often conflict in community life (Neal, 2017; Neal & Neal, 2014; Townley et al., 2011). They often cite Putnam’s (2007) finding that trust is lower in ethnically diverse U.S. neighborhoods. A 2017 edition of the American Journal of Community Psychology was devoted to debating whether diversity and sense of community are truly incompatible values and if so, how community practitioners can manage these competing values. Zachary Neal (2017), editor of that edition, argues that community practitioners must recognize the incompatibility of these two values and make decisions about how to balance them in specific communities. Fisher and Karger (1997) have made a similar observation about social work.

Putnam (2000) notes that at the same time social capital was declining in the United States, social tolerance was growing. On another dark note, Australian public health educator Fran Baum (1999) states a fear that has also been presented by European community psychologists (see Riera, 2005):

Social capital may come to be seen as a shorthand way of putting responsibility on communities that do not have the economic, educational or other resources to generate social capital. Networks, trust and cooperation are not substitutes for housing, jobs, incomes and education even though they might play a role in helping people gain access to them. (p. 176)

I would suggest that the dark side of social capital calls for a conflict approach to understanding community.

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Conflict Approach The rural West Virginia community described in Case Study 13.1 has been losing ground as changes have occurred in the global labor market. It has become one of many communities around the world that has lost its economic base, but many of the residents hold tight to a belief that receiving assistance is shameful. Conflicts over religious messaging became a source of discord in the Parents of Suicide e-community. Conflict theory’s emphasis on dissension, power, and exploitation in community life adds another dimension to our understanding of their story.

Writing about how European approaches to community psychology differ from U.S. community psychology, Francescato and Tomai (2001) suggest that European theorizing is much more in the conflict tradition than U.S. theorizing. They propose that, particularly in continental Europe (Germany, Italy, Spain, and Portugal), the work of community psychologists shows that they “do not believe in the myth of the self-made man” (p. 372) that undergirds much of the work in the United States, which seems to be the belief system of many people in rural West Virginia. They further suggest that the longer historical view in Europe leads to more critical emphases in European theory on social and economic inequalities, the historical interpretations that have been presented by power elites to legitimize existing social hierarchies, and the historical collective struggles by which groups of people have become empowered. Indeed, they report that European textbooks on community psychology typically devote chapters to historical social struggles that have led to greater empowerment for specific groups. Francescato and Tomai (2001) argue that Putnam’s findings of declining social capital in the United States can be explained by U.S. fascination with neoliberal economics and individual success, which has led to increasing inequality. They insist that social capital cannot exist at the community level without state policy that supports it. In their view, community practice should involve strategies that focus on unequal power distribution and stimulate community participants to challenge community narratives that legitimize the status quo.

Writing from the United Kingdom, Isabelle Fremeaux (2005) criticizes the social capital approach on several fronts. She argues that it typically romanticizes community and fails to recognize the internal coercion and divisions often at play in communities. Failure to recognize the power

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politics operating in communities does damage to the least powerful members. And, much like Francescato and Tomai, she criticizes Putnam and other social capital theorists for neglecting to analyze the impact of the macro political and economic contexts on local networks. The rural West Virginia community and its struggle with economic, natural disaster, and opioid crises is an excellent example of the influence of macro political and economic contexts of community life. That community is influenced by conditions in the political, economic, educational, health care, and social welfare institutions. One strain of the community involves a population dependent on work with high physical demands, relying on a health care system that uses opioids as a primary form of treatment for the pains caused by such work, in the context of a pharmaceutical industry that has historically played an active role in getting opioid medications into such communities. One local lawyer is bringing a case against a pharmaceutical company for its role in the epidemic in southern West Virginia.

Some European social scientists argue that community is “as much about struggle as it is about unity” (Brent, 1997, p. 83). Community workers are often faced with heterogeneous settings with diverse opinions, attitudes, and emotional attachments (Dixon, Dogan, & Sanderson, 2005). Carles Riera (2005), a community development specialist from Spain, argues that managing the conflicts in such diversity should be the focus of community theorists and practitioners. Riera notes that European society, like U.S. society, is becoming more and more multicultural, caused by migrations from non-European countries as well as by the loosening of the borders of the European Union. Migrating groups often have strong internal cohesion, but the receiving communities are often fragmented. The task for community workers is to work for both inclusion and equality of opportunities in a framework of coexistence. The moderators of the Parents of Suicide e-community took notice of the growing discord about religious expressions in online communications and developed a solution that involved having members note a topic in the e-mail subject line so that members could avoid reading messages they might find offensive. If only all community conflicts could be so easily resolved.

In her presidential address to the American Sociological Association in 2010, Patricia Hill Collins argued that American sociologists need to reframe the idea of community as a political construct focused on power, an emphasis that would provide new ways of thinking about social

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inequalities. This view is consistent with the way European community psychologists think about community. Hill argued that community, like family, is generally considered to be a site of love, but in reality they are both sites of power relations. She acknowledges the power differentials within a given community but also notes power struggles between communities: “People routinely feel the need to celebrate, protect, defend, and replicate their own communities and ignore, disregard, avoid, and upon occasion, destroy those of others” (p. 11).

Riera (2005) describes a model of practice developed in Barcelona, Spain, called the Intercultural Mediation Programme. The program is three- pronged: It strives (1) to facilitate the resolution of intercultural community conflicts that occur in public spaces, (2) to facilitate the resolution of intercultural conflict situations among neighbors living in the same buildings, and (3) to provide information and advice to service professionals struggling with intercultural conflicts. The program is carried out by community mediator teams who use both linguistic and sociocultural interpreters.

Conflict theory is not new to U.S. social workers and social scientists, but its popularity has waxed and waned over time. Like European theorists, Robert Fisher and Eric Shragge (2000) argue that the worldwide spread of neoliberal faith in the free market (see discussion in Chapter 9) has “dulled the political edge” of community social workers (p. 1). It appears that this faith in the free market and the neoliberal philosophy that the governmental institution should keep its hands off the economic institution may also be dulling the edge of community activism in southern West Virginia. Fisher and Shragge (2000) argue for renewed commitment to a form of community social work willing to build opposition and use a range of confrontational tactics to challenge privilege and oppression. Given economic globalization, Fisher and Shragge (2000) recommend that effective community organizing will need to be tied to a global social movement (social movements are the topic of Chapter 14). To work effectively with community conflict, social workers must be able to analyze the structure of community power and influence (Martinez- Brawley, 2000). They must understand who controls which types of resources and how power brokers are related to one another. That means understanding the power held internally in the community as well as the power that resides external to the community. This type of analysis allows social workers to understand both the possibilities and limits of community

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empowerment. Emilia Martinez-Brawley (2000) suggests that social workers working in small communities should keep in mind that memories are usually long in such places, and conflictual relationships established on one issue may have an impact on future issues. Historical understanding is important.

Contemporary life also calls for the type of mediation programs recommended by Riera (2005). In many areas of life, from race relations to family relations, the mediator role is becoming more prominent for social workers. We will have to become more comfortable with conflict if we are to take leadership roles in healing these social fractures. In recent years, some rural communities have faced sudden influxes of refugees from a particular trouble spot in the world. Some of these communities have responded in exclusionary and punitive ways, whereas others have responded in inclusive and collaborative ways. It is more than likely that communities in the United States and other affluent countries will continue to face such influxes, and social workers should be able to assist communities in managing such change. One suggestion is that restorative justice programs similar to the ones used in criminal justice could be used to heal friction and conflict within neighborhoods (Verity & King, 2007). Restorative justice gatherings would allow storytelling and dialogue about social fractures and allow communities to move toward a more just future. This suggestion is consistent with Riera’s Intercultural Mediation Programme.

Critical Thinking Questions 13.3

Think of two different communities of which you are a part. Is social cohesion or social conflict more prominent in each of them? Explain. How diverse is each of them? How well is diversity tolerated in each of them?

Social Workers and Communities: Contemporary Issues As suggested in Chapter 9, modernization, capitalism, industrialization, urbanization, and globalization have great costs for society as well as benefits. The profession of social work was developed as one force to

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minimize the costs—a communal force to correct for extremes of individualism. In its efforts to promote the general social welfare, social work has always been involved with communities in some way. But, as suggested earlier, there is expanding interest in community among social workers around the world. The expanded interest in the United States has been nurtured by the Association for Community Organization & Social Administration (ACOSA), formed in 1987, and by the journal started by ACOSA, Journal of Community Practice. The 2005 publication of The Handbook of Community Practice (Weil, 2005) was a major advance in knowledge building for community social work practice, and the second edition (Weil, Reisch, & Ohmer, 2013b) continues to elevate the social work discussion about community practice.

The nature of social work’s relationships with communities has changed over time, however, and there are long-standing disagreements about appropriate roles for social workers in communities. Depending on the preferred community model or perspective, social workers can play a number of roles in the community, such as guide, facilitator, expert, therapist, organizer, administrator, activist, broker, or educator. Here, we summarize the issues involved in four of these points of disagreement.

Community as Context for Practice Versus Target of Practice Social workers who view community as a context for practice focus on working with individuals and families, although they recognize the ways in which communities provide opportunities and barriers for client behaviors and agency responses. They are most likely to enact the therapist role but may also engage in individual or family education. In contrast, social workers who view community as a target of practice focus on enhancing the health of the community. They are most likely to enact the organizer, activist, broker, and educator roles.

There seems to be a growing consensus that social work needs to recognize community as both context and target of practice (Chaskin, 2013; Weil et al., 2013a). During the 1990s, there was a reemergence of the idea of comprehensive multifocused community interventions (Mulroy, Nelson, & Gour, 2005). More recent initiatives to revitalize impoverished neighborhoods have combined resource development and individual asset

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building with efforts to strengthen sense of community (Padilla & Sherraden, 2005). Health promotion efforts are targeting the community as the seat for change and proposing models for community mobilization to improve health in impoverished and otherwise marginalized communities (see Campbell, 2014; Duntley-Matos et al., 2017). Community agencies are working to help individual families and to build strong and caring communities. For example, the wellbriety movement in Native American communities in the United States focuses on recovery from alcohol and other addictions at both the individual and community level (Coyhis & Simonelli, 2005; Moore & Coyhis, 2010). They use the metaphor of a “healing forest” to suggest that youth can’t get well in an unhealthy community. A similar continuum of practice has been developed for community building with and care of older adults (Mulroy et al., 2005).

Even with a combined, or comprehensive, community practice model, questions still arise about when to intervene with individuals and families and when to focus on larger collectivities and groups. Many projects focus almost exclusively on capacity building at the community level. For example, around the world, communities are engaging in community capacity-building projects as a strategy to prevent family violence in distressed neighborhoods (see Chan, Lam, & Cheng, 2009). They attempt to develop a sense of community, stimulate a sense of mutual responsibility, activate a process of communal problem solving, and improve access to resources. In a similar vein, the asset-building movement focuses on creating asset-rich communities for children and youth. These projects seek to engage adults in building supportive relationships with neighborhood children and youth, mobilize youth to become active participants in community life, and stimulate resource development and collaborative problem solving (see Green & Haines, 2012). On the other hand, the majority of social work interventions continue to occur at the individual and family level, with far too little attention to the context of individual and family lives.

In a much-cited work, Harry Specht and Mark Courtney (1994) called for putting the “social” back in social work with a “community-based system of social care” and elimination of the psychotherapeutic role. I would not recommend that the psychotherapeutic role be eliminated from social work’s repertoire, but social workers may have come to rely too heavily on this role. We may be using it for problems for which it is neither efficient nor effective. An integrated community practice should avoid an

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overreliance on one-to-one and family sessions, opting, where appropriate, for collective and group formats. Two recent models for this are family group conferencing and peacemaking circles used in child protection and youth services (see Boyes-Watson, 2005; Connolly, 2006). Studies of the effectiveness of these approaches have mixed findings (Dijkstra, Creemers, Asscher, Dekovic, & Stams, 2016), which may be due in part to the differences in outcome measures used.

Agency Orientation Versus Social Action Community social work practice has roots in a social action model of community organization, which was developed by leaders of the settlement house movement. This model of community practice is political, emphasizing social reform and challenge of structural inequalities. But by the 1930s, this social action model had been replaced by an agency-based model, which promoted social agencies and the services they provided (Fisher & Karger, 1997). This model of community practice is nonpolitical and puts little or no emphasis on social change. It is based on the assumption that the best way to strengthen communities is to provide social services. Proponents of the agency-based model of community organizing often focus on coordination of services across agencies (see Mizrahi, Rosenthal, & Ivery, 2013).

Saul Alinsky (1971), founder of one of the best-known community organizing training centers, was critical of the agency-based model of community social work. He did not think social justice was ensured by providing social services. A contemporary African social worker, Tlamelo Mmatli (2008), makes a similar argument. Mmatli argues that the main problems facing people in Africa are “unemployment, poverty, inequality, illiteracy, homelessness, child streetism, ill-health, HIV/AIDS, abuse of human right and civil liberties, civil conflicts and official corruption” (p. 297). He further argues that these problems require political advocacy, not social services.

This suggestion by Mmatli is consistent with the focus on policy practice as a social work intervention by some U.S. social workers over the past 3 decades (Jansson, Heidemann, McCroskey, & Fertig, 2013). Policy practice includes efforts to influence legislation, participation in political campaigns, efforts to change agency policies, or other activities related to policy reform. Policy practitioners work in many arenas around the world,

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including “national, state, and local legislatures; public agencies; public administrative or oversight agencies . . . ; nongovernmental agencies; think tanks”; and special boards or commissions (Jansson et al., 2013, p. 404). They must be able to analyze, develop, and use power; manage conflict; develop proposals; make effective presentations; work collaboratively with multidisciplinary task groups; and collect and analyze data.

I suggest that agency-based provision of social services, and interagency coordination of services, often do contribute to the well-being of communities. We need social workers who will advocate for the retention of threatened services as well as the development of new services, but we also need good program evaluation to guide those advocacy efforts. I also agree with DeFilippis, Fisher, and Shragge (2009) that although community-based nonprofit organizations are growing in number and influence, too many focus narrowly on service delivery and have lost sight of social and economic justice. DeFilippis et al. (2009) argue that it is possible to engage in both service provision and social action and provide examples of community organizations doing this. An integrated approach to community social work practice enhances community-based services, builds a sense of community, and advocates for social reform.

Critical Thinking Questions 13.4

When you decided to be a social worker, how did you think about the role of community in social work practice? Did you think of community as context of practice, target of practice, or neither? How do you think about the role of community in social work practice now? If this has changed over time, what led to that change? Which do you think is a better orientation for social work practice: an agency orientation or a social action orientation? Explain. Which might be more useful for working with the West Virginia county struggling to recover?

Conflict Model of Practice Versus Collaborative Model Over the years, social work has taken different positions on the question of whether social workers should lean toward conflict or collaboration, ebbing and flowing in its “tradition of nagging the conscience of America” (Fisher & Karger, 1997, p. 188). In liberal times, social work has been

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more willing to embrace conflict approaches; in conservative times, more collaborative approaches have been preferred (Fisher, 2005). In the early 1900s, social work reformers used social surveys to expose exploitive industries and disseminated the results widely in newspapers and magazines (Fisher & Karger, 1997). In the current era of transnational corporations and high transnational mobility, these methods might be revisited by contemporary social workers. Today, however, as suggested, the trend is away from challenging the establishment and toward creating partnerships among community groups, government agencies, and corporations (DeFilippis et al., 2009; Fisher, 2005).

In his historical review of community practice, Robert Fisher (2005) argues that the global context of contemporary community practice is dominated by a conservative, corporate-oriented ethos. In this climate, the market dominates, issues are seen as private and not public, and people are becoming more isolated from each other. In such a climate, social action approaches both inside and outside social work have been viewed as inappropriate. Social workers depend on political and financial support from governmental and private philanthropies, which have, for the most part, a heavy investment in the status quo (Mmatli, 2008).

The contemporary tension between conflict and collaborative models of practice is exemplified by two articles that appeared in the Journal of Community Practice in 2000. Robert Fisher, a social work educator from the United States, and Eric Shragge, a social work educator from Canada, contrast social action and community-building approaches to practice (Fisher & Shragge, 2000). Social action works for social change by organizing people to put pressure on governments or private organizations. It challenges social inequalities. Community development is based on an assumption of shared interests, rather than conflicting interests. It seeks to bring together diverse community interests for the betterment of the community as a whole, with attention to community building and an improved sense of community. Fisher and Shragge (2000) acknowledge that many community practitioners interweave social action and community development. They suggest, however, that the community development approach to community practice has become dominant. They lament this turn of events, arguing that we are in an era of growing inequality that requires more, not less, social action.

An article by Elizabeth Beck and Michael Eichler (2000) argues the other

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side of the coin. They propose consensus organizing, based in feminist theory, as a practice model for community building. Consensus organizing has four basic assumptions:

1. Power does not have to be redistributed; it can be grown. 2. Human behavior is motivated by mutual self-interest, not just

individual self-interest. 3. People are basically good, and power holders will make decisions that

improve community well-being when given the opportunity. 4. The wealthy and the poor, the powerful and the powerless can be knit

together rather than become adversaries.

Like Fisher and Shragge (2000), Beck and Eichler (2000) suggest that both social action and community development are needed, but they argue for an emphasis on community work that strengthens relationships. They claim that social action calls for a redistribution of power, but consensus organizing does not assert that redistribution of power is necessary to end oppression. Indeed, Beck and Eichler (2000) argue that conflict tactics often don’t reach the goal of redistribution of power anyway.

Contemporary social trends call for a contemporary style of community practice that draws on both conflict and collaborative models (Ohmer & Brooks, 2013). Community social workers need skills for exposing and challenging social injustice as well as for resolving conflict and building coalitions. The choice of tactics will depend on the specific circumstance. Michael Reisch (2013) astutely observes that in conservative times, social workers can use opportunities to work in collaborative, community-based projects to help create a radical vision of justice and fairness.

Some situations call for community social workers to elevate community conflict to challenge exploitation and oppression. Throughout this book, we emphasize the need for social workers to take a critical perspective that recognizes power and oppression as important factors in the negotiation of social life. A critical perspective also calls for social workers to challenge existing patterns of domination and oppression. With the trend toward devolution of government responsibilities to the local level, the local territorial community becomes increasingly important to these efforts. Social work research can identify and expose local patterns of exploitation. Community social workers can use consciousness-raising tactics to help oppressed groups think critically about their situations. They can use a variety of advocacy skills to make appeals for the rights and needs of

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oppressed groups. Many contemporary social critics “see grassroots community organizations as potentially the most effective progressive balance to the elite domination” (Fisher & Karger, 1997, p. 130).

Other situations call for community social workers to resolve community conflicts. Robert Fisher and Howard Karger (1997) remind us that “public life is about difference, and about learning to create a society by interacting with others who have different opinions and experiences” (p. 26). This notion seems to be left out of most of the community psychology literature on PSOC (Neal, 2017; Neal & Neal, 2014; Townley et al., 2011). Social work’s professional organizations have taken a position that values diversity. But they should go beyond that position and value the conflict that accompanies diversity. Communities often need help in negotiating their differences. Social workers can help to develop a civil discourse on controversial issues, a discourse that includes the voices of people previously marginalized and excluded. Community social workers can use a variety of conflict resolution skills to help different community groups understand and respect each other’s experiences and to engage in respectful and effective problem-solving activities.

There is considerable agreement among social work scholars that social workers should focus on helping to develop broad issues that can unite diverse groups in social reform efforts; two examples of such issues are financial security and environmental protection in a global economy. Recently, actions of the antiglobalization movement and the environmental justice movement have suggested that a spark of resistance is alive for these issues. But these efforts are less likely to succeed if they do not build greater solidarity between poor and middle-class people. Coalitions across cultural groups are also increasingly desirable. The social work literature is beginning to grapple with the complexities of coalition building (see Mizrahi et al., 2013).

Expert Versus Partner in the Social Change Process The traditional social planning model of community social work is based on the premise that the complexities of modern social problems require expert planners schooled in a rational planning model (Sager & Weil, 2013). In this model, the community power structure is the author of social

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change efforts. This is often referred to as a top-down approach to social change.

Community-building models of community social work take a different view: Community practice should support and enhance the ability of community members to identify their own community’s needs, assets, and solutions to problems. These approaches are commonly called participatory community planning. Social workers work in partnership with community members and groups and remain open to learning from the community (Gamble, 2013). This approach is often referred to as a bottom-up approach to social change.

Many local community development corporations (CDC) are experimenting with ways of building partnerships with community members for community revitalization. When one community intervention team encountered difficulties in getting community residents to focus on possibilities rather than problems, they borrowed the miracle question from solution-focused therapy:

Imagine you’ve gone to sleep and while you’re sleeping, you have a dream. And in your dream, Westlane becomes exactly the way you’d like to see it. . . . Keeping your eyes closed: What do you see that lets you know the goal has been accomplished, that your dream has become a reality. (Hollingsworth, Allen-Meares, Shanks, & Gant, 2009, p. 334)

Laura Ross and Mardia Coleman (2000) provide one model for community partnerships, a model they call urban community action planning (UCAP). They have adapted this approach from participatory rural appraisal (PRA), a grassroots approach used in rural areas of Africa, Latin America, and Asia. The PRA model is based on three assumptions:

1. Local knowledge. Community members have knowledge about local problems, but they need help to organize it.

2. Local resources. Community members have resources, but these resources need to be mobilized.

3. Outside help. Outside resources are available, but they need to be matched to community-identified priorities.

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Efforts at community building often rely heavily on leaders who are Indigenous to the targeted community to facilitate meaningful community participation. These efforts do not always run smoothly. Community practitioners have had little guidance on how to identify Indigenous leaders and how to prepare them to lead. Recent literature has begun to address this important issue, noting both aids and barriers to effective Indigenous leadership (Gray, Coates, & Yellow Bird, 2010).

A traditional social planning model is appropriate for problems requiring specialized technical knowledge. Community members are the experts, however, about community needs and assets. They also have the capacity to be active partners in identifying solutions to community problems. The Generations of Hope intergenerational communities project, which forms intentional communities where older adults serve as resources to foster and adoptive families, is an example of a community intervention that makes a distinction between tasks for which the professional is the expert and tasks for which community members are the experts (Eheart, Hopping, Power, Mitchell, & Racine, 2009). For example, staff are seen as the experts about who should live in the community, how to secure and manage financial resources and relationships with the external environment, and providing counseling and therapeutic support. But members of the community are considered to be the experts on the needs of families, and older adults in the community are the primary resources for children and families.

Critical Thinking Questions 13.5

What intercultural conflicts have you seen in or around your local territorial community or in your online community? What social justice issues are involved in those conflicts? What approaches to community practice do you think could be useful in helping to manage these conflicts?

Implications for Social Work Practice The preceding discussion of community has many implications for social work practice.

Be informed about the communities you serve; learn about their readiness to change, their spatial arrangements (for territorial

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communities), their cultures, their patterns of internal and external relationships, their social capital, and their conflicts. Avoid overreliance on individual and family sessions; make use of small- and large-group formats where appropriate. When working with individuals and families, assess their opportunities to be supported by and to make contributions to the community and assess the limits imposed by their territorial and relational communities. Recognize the central role of territorial community in the lives of many young persons and their caregivers, older adults, and poor families. If you are a social work planner or administrator, become familiar with computer-based geographical information systems for mapping social data. Where appropriate, strengthen interaction within the community (horizontal linkages) to build a sense of community and maximize the use of internal resources. Strengthen intercommunity interactions (vertical linkages) to ensure there are adequate resources to meet the community’s needs. Where appropriate, advocate for the retention of threatened social services, the coordination of existing services, and the development of new services. Where appropriate, collaborate with others to challenge exploitation and oppression in communities. Use consciousness-raising tactics to help oppressed groups understand their situations. Where appropriate, assist communities to negotiate differences and resolve conflicts. Where appropriate, assist in the development of coalitions to improve the resource base for community problem solving. Involve community members in identification of community strengths and community problems, in goal setting, and in intervention activities. When working with impoverished communities, work with other individuals and organizations, both inside and outside these communities, to develop comprehensive, multidimensional, integrated strategies.

Key Terms

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agency-based model 421 bonding social capital 414 bridging social capital 414 collective efficacy 416 community 404 community development 422 gemeinschaft 409 geographic information system (GIS) 412 gesellschaft 409 horizontal linkage 414 multiple psychological senses of community (MPSOC) 417 network 414 networked individualism 414 personal community 414 relational community 404 sense of community 404 social action model 421 social planning model 423 territorial community 405 vertical linkage 414

Active Learning 1. You have read about two types of communities, a geographic

community and a relational community. Now think about your own geographic community. Compare it to the rural West Virginia county described in Case Study 13.1, according to the following characteristics:

Gemeinschaft vs. gesellschaft Physical environment Sense of community Horizontal and vertical linkages Social capital

2. One research team has found that the majority of our ties to other people are nonterritorial, but two thirds of our actual interactions are local, in the neighborhood or work setting. To test this idea, for one day keep a record of all contacts you have with other people and the time spent in such contacts—face-to-face contacts as well as telephone and electronic contacts. What percentage of your contacts occurs in your neighborhood, at work, or at school?

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3. Visit a neighborhood house or center, a YMCA or YWCA, or another community action organization in your town or city. Interview the director or another staff member about the mission of the organization, asking him or her to address the following questions:

Is the focus on working with individuals and families or on enhancing the health of the community? Is the focus of the work political, emphasizing social reform and challenge of structural inequalities, or is it on providing and coordinating services? Are the methods used confrontational (“challenging the establishment”) or collaborative (“creating partnerships”)? How involved are community members in planning and carrying out the change activities of the organization?

Web Resources

The Annie E. Casey Foundation: www.aecf.org

Site maintained by the Annie E. Casey Foundation, a grant- making organization that works to build better futures for disadvantaged children and their families, contains a description of initiatives and projects and publications.

Association for Community Organization & Social Administration (ACOSA): www.acosa.org

Site includes recent publications, recent grants, regional news, and initiatives.

Communities That Care PLUS: www.communitiesthatcare.net

Site maintained by University of Washington Communities That Care, an organization that coaches communities across the country to use prevention science to reduce youth problems, contains news, how it works, research & results, and how to get started.

National Community Action Foundation (NCAF): www.ncaf.org

Site maintained by NCAF, an advocacy group for community action agencies, contains news, events, and current issues.

People’s Action: https://peoplesaction.org

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http://www.aecf.org

http://www.acosa.org

http://www.communitiesthatcare.net

http://www.ncaf.org

https://peoplesaction.org

Site maintained by People’s Action, an advocacy organization that helps neighborhood people take on corporate America and political institutions, contains news and information about campaigns.

United Neighborhood Houses of New York: www.unhny.org

Site maintained by United Neighborhood Houses of New York, a federation of 38 settlement houses in New York City, includes information about the settlement house movement, current activities of settlement houses in the United States, and job vacancies.

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http://www.unhny.org

14 Social Movements

Elizabeth D. Hutchison

Chapter Outline Learning Objectives Case Study 14.1: Fighting for Our Water, Land, and Air A Definition of Social Movements Social Movements and the History of Social Work Perspectives on Social Movements

Political Process Perspective Openness of the Political System Stability of Political Alignments Availability of Elite Allies International Relations

Mobilizing Structures Perspective Informal and Formal Structures Information and Communication Technology (ICT) The Life Course of Social Movements

Cultural Framing Perspective Frames for Understanding That a Problem Exists Frames for Recognizing a Window of Opportunity Frames for Establishing Goals Frames for Identifying Pathways for Action

Emerging Perspectives Social Movement Outcomes Social Movement Trends Social Movements and Contemporary Social Work Implications for Social Work Practice Key Terms Active Learning Web Resources

Learning Objectives

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14.1 Analyze one’s own emotional and cognitive reactions to a case study. 14.2 Analyze how social movements differ from other social groups. 14.3 Summarize the historical and contemporary relationships between social work and social movements. 14.4 Compare three theoretical perspectives on social movements (political process, mobilizing structures, and cultural framing). 14.5 Explain some of the outcomes of social movements. 14.6 Describe some trends in social movements. 14.7 Apply knowledge of social movements to recommend guidelines for social work engagement, assessment, intervention, and evaluation.

Case Study 14.1 Fighting for Our Water, Land, and Air In the early 1960s, Latino farm workers organized by Cesar Chavez fought for protection from harmful pesticides in the farm fields where they worked in California’s San Joaquin Valley. In 1968, residents of the West Harlem community of New York City fought unsuccessfully against the placement of a sewage treatment plant in their community. In 1982, the state government of North Carolina decided to dump 6,000 truckloads of soil laced with toxic PCBs in a hazardous waste landfill in poor, rural, overwhelmingly Black Warren County. The community was concerned that the hazardous waste would leach into drinking water supplies. Community members and their allies stopped the trucks by lying down on roads leading to the landfill. This action was followed by 6 weeks of marches and nonviolent street protests. Although the people of Warren County lost this battle, their protest drew national media attention and got the attention of people in other parts of the United States who were living with similar environmental injustice (Skelton & Miller, 2016). The protest in Warren County is considered the action that sparked the environmental justice movement and identified the environmental racism involved in forcing poor communities of color to absorb the costs of environmental pollution (Pellow & Brulle, 2015).

In May 2007, activists in the southern China city of Xiamen were fighting the construction of a chemical plant in their city. They sent out text messages from their cell phones encouraging recipients to participate in a protest at a particular location on June 1 at 8 a.m. Discussion of the hazards of the chemical plant was taken up by bloggers. On June 1, tens of thousands of protesters marched against the project, uploading photographs, videos, and

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text messages to blogging sites as they marched. When one blogging site was blocked, another blogger would pick up the material and distribute it. In December 2007, the Chinese government announced that the plant would be moved to another city, Guangzhou. In March 2008, residents of Guangzhou and nearby towns engaged in 3 days of protest against the decision to move the plant to their city. In one nearby town, the protesters staged a sit-in to block traffic on a main road. The local government sent loudspeakers to the street to deny that the plant would be moved to Guangzhou. In 2011, thousands of people used text messaging to organize protests against a similar plant in another part of China, and that plant was closed by local authorities (Tilly & Wood, 2013).

On August 14, 2010, the Keepers of the Athabasca, a network of First Nations, Metis, Inuit, and environmental groups in the Athabasca River area of northern Canada, held a healing walk along the road that passes the tar sands, also known as oil sands, operation. The walk was meant to expose the dark clouds of emissions and toxic ponds. It was interspersed with speakers and included a ceremony in which First Nation elders offered prayers to help heal the earth. The flyer that announced the walk gave this rationale for why such a walk was needed:

Because Mother Earth needs our help in the protection and healing of the land and water. Indigenous people are caretakers of the earth and we need to work together for the health and safety for the next generations. Others are welcome to join as we walk through the tar sands area and give strength and prayer to the earth and the people who have felt the devastation of tar sands development. (Indigenous Environmental Network, 2010)

In 2011, Indigenous and environmental groups took the fight to the United States. On November 6, several thousand protesters formed a human chain around the White House to try to convince President Obama to block the Keystone XL oil pipeline project (Goldenberg, 2011). In 2015, both the U.S. Senate and House of Representatives passed bills to allow the construction of the Keystone Pipeline, but President Obama vetoed it, and the Senate was unable to get enough votes to override the veto. In 2016, environmental and Native rights activists moved the fight to North Dakota in an attempt to halt the construction of the Dakota Access oil pipeline routed to travel through sacred Native burial ground and underneath the Missouri River, the primary source of drinking water for the Standing Rock Sioux. The original route, which had the pipeline crossing the Missouri River, north of Bismarck, North Dakota, had been protested by White communities who argued that the pipeline would contaminate their water supply, and the Texas oil company

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had adjusted the route. The activists, who called themselves the Standing Rock water protectors, argued that the pipeline would violate an 1851 treaty (Runge, 2016). They responded to the perceived threat with protests and litigation to slow, and eventually stop, the pipeline. As the protest picked up steam, thousands of protestors set up teepee and tent camps to block the construction. Celebrities such as actors Shailene Woodley and Mark Ruffalo, civil rights leader Jesse Jackson, hundreds of religious leaders, and at least 2,000 military veterans traveled to the site in solidarity with the Standing Rock Sioux (Worland, 2016). Environmental groups supported this effort because of their concerns about the large role fossil fuels play in increasing carbon dioxide in the atmosphere. In late October 2016, police in riot gear used tanks, armored vehicles, pepper spray, and a sound cannon to attack and arrest protesters, locking activists in dog kennels (Runge, 2016). Standing Rock chairperson David Archambault II insisted that the protest would remain nonviolent. Soon after he was inaugurated as president in January 2017, Donald Trump signed executive actions that put both the Dakota Access and Keystone XL pipelines back on the agenda. As this chapter is being written in early 2018, it is expected that the Indigenous people of North America will continue to fight for the protection of the water, land, and air that are so vital to health and well-being.

The protests in the San Joaquin Valley; West Harlem; Warren County, North Carolina; China; the Athabasca River area; and Standing Rock are local examples of a large, global environmental justice social movement, which has become known as the climate justice movement. The 350.org organization has become an important resource in that movement. It was founded by Bill McKibben and student activists in 2008, with the goal of building a “global grassroots climate movement that can hold our leaders accountable to science and justice” (350.org, 2018). The name of the organization refers to 350 parts per million (ppm), which many climate scientists propose as the safe upper limit for carbon dioxide in the Earth’s atmosphere. On October 24, 2009, 350.org organizers in 181 countries staged 5,200 demonstrations to demand action on climate change. The protests aimed to put pressure on international climate negotiators meeting in Copenhagen, but the negotiations ended in confusion. In 2012, McKibben traveled the United States on a “Do the Math” (about climate science) tour and again in 2013 on a “Summer Heat” tour with the goal of linking the global movement to local environmental justice issues. Along with author and activist Naomi Klein, he helped to launch a national fossil fuel divestment campaign to encourage individuals, pension funds, universities, and other groups and organizations to withdraw their investments from the 200 fossil fuel companies with the biggest carbon footprints. By 2014, more than 300 college divestment groups and universities began to divest, along with numerous cities and several foundations. A notable success was when

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the Rockefeller Brothers Fund, a foundation created by the grandchildren of oil industrialist John D. Rockefeller, announced that it would divest its fossil fuel holdings (Jobin-Leeds, 2016).

On September 21, 2014, a People’s Climate March, called by 350.org and sponsored by over 1,500 organizations, was held in New York City with companion demonstrations worldwide. Over 300,00 people participated in the New York march, with another 300,000 estimated to attend worldwide. In New York, the staging was divided into six sections, with “frontline” groups in the first section; these groups included people most impacted by climate change, including Indigenous peoples. Members of other social movements were also in attendance, including immigration, prison rights, queer liberation, workers’ rights, Indigenous rights, and education rights, along with environmental justice groups. Over the weekend of the march, thousands of presentations occurred throughout the city, including talks by Indigenous women from North Dakota. Another event was a tour of the South Bronx, where the asthma rate is high, due in large part to the diesel fumes from trucks routed through the South Bronx—where the residents are mostly people of color—and away from the more affluent parts of the city. Storytelling was an important part of the march (Jobin-Leeds, 2016). Another People’s Climate March was held in Washington, DC, along with 300 companion demonstrations on April 29, 2017. An estimated 200,000 people participated in the Washington, DC, march. Organizers proclaimed that they were protesting the environmental policies of the administration of recently elected U.S. president Donald Trump (Fandos, 2017). Many marchers chanted, “We’re here, we’re hot, this planet’s all we got.”

Leaders of the climate justice movement say it is a difficult cause because of an urgent time limit and economic and political machinery that moves slowly. In addition, they are fighting against an economic system in which it is extremely profitable to pollute and deplete the physical environment (Jobin-Leeds, 2016). “System change. Not climate change” has become a favorite slogan of the movement. Economic and political system change is a big goal.

A Definition of Social Movements What happens when a group of people, like the many people involved in campaigns for protecting water, land, and air, think that certain arrangements are unjust and need to be changed? Sometimes they work together to try to bring about the desired changes—not just for themselves but for a large group of people. These joint efforts are social movements

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—consciously organized and sustained attempts by ordinary people working outside of established institutions to change some aspect of society (Ballantine et al., 2018; Goodwin & Jasper, 2015).

We can think of social movements as either proactive or reactive (Ballantine et al., 2018). Proactive social movements seek to reform existing social arrangements and try out new ways of living together. The environmental justice, Occupy Wall Street, and LBGTQ movements are examples of proactive social movements. Reactive social movements, on the other hand, seek to defend traditional values and social arrangements. The climate change countermovement that consists of groups who spend large amounts of money to debunk the claims of the climate justice movement is an example of a reactive social movement.

Mario Diani (della Porta & Diani, 2006) identifies the following properties that distinguish social movements from other social collectivities. They

are involved in conflictual relations with clearly identified opponents, are linked by dense informal networks, and share a distinct collective identity. (p. 20)

It is protest that distinguishes social movements from other types of social networks, but a single episode of protest is not a social movement unless it is connected to a longer-lasting network of public action (Tilly & Wood, 2013).

Photo 14.1 Social movements can be categorized as proactive (trying out new ways of living and cooperating) or reactive (defending traditional values). The 2018 Women’s March on Washington was an action of a proactive social movement.

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©NurPhoto/Getty Images

Social Movements and the History of Social Work Like many of the world’s religions, some nation-states, labor unions, the YMCA/YWCA, and the Boy Scouts and Girl Scouts, the profession of social work is generally considered to have its origin in social movements. More specifically, the social work profession developed out of the confluence of two social movements: the charity organization society movement and the settlement house movement. You have probably studied these social movements in some of your other courses, so they are not discussed in great detail here. But as social workers, we should recognize how intertwined the history of social work is with social movements.

Both the charity organization society movement and the settlement house movement emerged out of concern during the late 1800s about the ill effects of industrialization, including urban overcrowding and economic instability among low-paid workers. Both social movements developed in Great Britain and spread to the United States. But from the beginning, their orientations were very different.

The charity organization society (COS) movement developed because private charity organizations became overtaxed by the needs of poor

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people. Middle- and upper-class individuals were fearful that a coalition of unemployed people and low-paid workers would revolt and threaten the stability of established political and economic institutions. Leaders of the COS movement saw poverty as based in individual pathology and immorality and set the goal of coordinating charity giving to ensure that no duplication occurred. Volunteer “friendly visitors” were assigned to poor families to help them correct character flaws and develop strong moral fiber. Leaders of the COS movement believed in private, rather than public, charity. The provision of efficient and effective service was the primary agenda of the COS.

The settlement house movement was stimulated by the same social circumstances but was based on very different values and goals. Whereas COS leaders focused on individual pathology, leaders of the settlement house movement focused on environmental hazards. They developed settlement houses in urban neighborhoods where “settlers” lived together as “good neighbors” to poor families and were actively involved in research, service, and reform. The settlers supported labor activities, lobbied for safe and sanitary housing, provided space for local political groups, offered day care, and provided a variety of cultural and educational programs. They published the results of their research widely and used it to push for governmental reform. Social reform—the creation of more just social institutions—was the primary agenda of the settlement house movement.

Over time, workers from the two social movements began to interact at annual meetings of the National Conference of Charities and Corrections, and social work as an occupation took shape. With efforts to professionalize the occupation of social work and, later, to win acceptance for the public social welfare institution, the social reform agenda of the settlement house movement lost ground. Direct service became the focus —specifically, individual and family casework in health and welfare agencies and social work with groups in the settlement houses and YMCAs/YWCAs. This transition away from reform toward a service model is not an uncommon trajectory of social movements. However, a century later, social work continues to experience a tension between service and social reform.

Although social work emerged from social movements, it is now a profession, not a social movement. Some social workers work for social

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movement organizations, however, and the social work profession struggles with its relationship to a variety of social movements. For example, Chapter 13 discusses the tensions in community social work around issues of social action. With the profession’s emphasis on social justice, we should understand how social movements emerge, are sustained, and accomplish goals. Competency 3 of the Council on Social Work Education’s 2015 Educational Policy and Accreditation Standards is “Advance human rights and social, economic, and environmental justice” (Council on Social Work Education, 2015, p. 7). Social work involvement in and collaboration with social movements is an essential way to advance social justice. That is why this chapter on social movements is included in this book and why the professional literature is beginning to make use of social movement theory and to call for greater social work involvement with social movements (see, e.g., Dudziak & Profitt, 2012; Manzanera- Ruiz & Lizárraga, 2017; Noble, 2015; Reisch, 2008). Although there are many social movements that oppose progressive efforts to advance human rights and social, economic, and environmental justice, this chapter focuses on those social movements that organize for justice.

Critical Thinking Questions 14.1

Have you participated in any social movement activities? If so, what were your reasons? If not, what have been the reasons? Are there particular historical social movements that you think have had a good impact on U.S. or global societies? Are there particular historical social movements that you think have had a detrimental impact on U.S. or global societies? Are there recent social movements you would like to know more about? If so, how might you go about learning about them?

Perspectives on Social Movements Early social science literature on social movements was based on a relatively unified perspective, commonly called strain theory. According to this theory, social movements develop in response to some form of strain in society, when people’s efforts to cope with stress become collective efforts. Different versions of strain theory focus on different types of social strains, such as strain due to rapid social change, social inequality, social isolation and lack of community, or conflicts in cultural beliefs (Buechler, 2011). Discussion in earlier chapters has built a case that

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each of these types of strain exists in the United States and around the world today.

Recent social science theory and research have been critical of social strain theory, however. Critics argue that strain is always present to some degree in all societies, but social movements do not always appear in response, and their intensity does not vary systematically with the level of strain (Goodwin & Jasper, 2015; Staggenborg, 2016; Tilly & Wood, 2013). These critics suggest that social strain is a necessary but not sufficient condition to predict the development of a social movement. Any social movement theory must start, they insist, with the condition of social strain, but other theories are needed to understand why a particular social movement develops when it does, what form the movement takes, and what the outcomes of the movement are. Some people have been outraged at corporate exploitation and depletion of natural resources—and with the way low-income communities are absorbing the costs—for a long time, but that outrage does not fully explain why the coalition of Indigenous and environmental groups flourished in the past decade.

Instead of focusing on social strains, some social psychologists have looked for psychological factors or attitudes that might explain which individuals are likely to get involved in social movements. Focusing on psychopathology, a variety of psychological characteristics have been investigated, including authoritarian personality, emotional conflicts with parents, alienation, aggression, and relative deprivation. Empirical investigations have found very little support for a relationship between such psychological characteristics and social movement participation, however. Indeed, research indicates that social movement activists tend to be people who are rich in relational resources and well-integrated into their communities. Research also indicates that a great many people who never join social movements have similar attitudes about movement goals to those of active movement participants (Goodwin & Jasper, 2015; Staggenborg, 2016). Recently, however, some social movement scholars have suggested it is time to take another look at what motivates people to participate in social movement activities (Castells, 2012). We examine some of those ideas later, under the discussion of emerging perspectives.

Theory and research about social movements have flourished in the past 5 decades, and in 2012 Roberta Garner and Mayer Zald suggested that the study of social movements is “hotter” than ever. I would agree that it is

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hotter than at any period since I started work on the first edition of this book in the mid-1990s. Throughout the 1970s, social movement scholars in the United States and Europe worked independently of each other and developed different theories and different research emphases. In the past 30 years, however, U.S. and European social movement scholars have worked together and engaged in comparative analysis of social movements across place and time (della Porta, Kriesi, & Rucht, 2009). Originally, these collaborative efforts focused only on social movements in the United States and western Europe. After the momentous political events in eastern Europe in the late 1980s, however, eastern European social movements received extensive and intensive investigation. More recently, the protest movements of the Arab Spring of 2011 have captured the attention of social movement scholars.

Several key issues are being explored by social movement scholars (see Staggenborg, 2016), including the following:

How and when social movements originate How social movements attract and maintain support What strategies and tactics social movements use What types of organizations are developed to support social movement goals How social movements spawn opposition and the difference that makes How and why social movements succeed and fail in achieving cultural and political changes

Three major perspectives on social movements have emerged out of this lively interest. I refer to these as the political process perspective, the mobilizing structures perspective, and the cultural framing perspective. There is growing agreement among social movement scholars that none of these perspectives taken alone provides adequate tools for understanding social movements (Buechler, 2011; Edwards, 2014). Each perspective adds important dimensions to our understanding, however, and taken together they provide a relatively comprehensive theory of social movements. Social movement scholars recommend research that synthesizes concepts across the three perspectives. The recent social movement literature offers one of the best examples of contemporary attempts to integrate and synthesize multiple theoretical perspectives to give a more complete picture of social phenomena.

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Political Process Perspective As you can see from the case study, the global climate justice movement did not emerge suddenly, and its recent buildup is linked to earlier efforts. Although this buildup is, no doubt, largely related to the sense of urgency created by scientific evidence of impending environmental crisis, it may also be related to political opportunities perceived by movement leaders. In the United States, for example, the 350.org organization was founded just as Barack Obama became president. Although the climate justice movement was disappointed that Obama did not move more swiftly and aggressively on climate justice issues, movement leaders knew that he was more committed to the concerns of the movement than previous presidents. They saw their protest activities as an important way to keep the pressure on him and other government leaders. They were buoyed by his veto of the House and Senate bills to allow the construction of the Keystone Pipeline. There is much speculation about what will happen to the movement now that President Donald Trump’s administration is overturning the climate justice actions taken by the Obama administration, including dropping out of the Paris Climate Agreement and signing executive actions to put both the Dakota Access and Keystone XL pipelines back on the agenda. Some speculate that the Trump administration’s skepticism toward climate change science and issues of environmental injustice will close opportunities for the movement, and others suggest that the threats are as likely as earlier opportunities to mobilize activists by creating feelings of outrage and urgency. These observations are in line with the political process (PP) perspective, whose main ideas are summarized in Exhibit 14.1.

Photo 14.2 Social work experiences a tension between service (helping those in need) and reform (changing organizational structures and systems). Here, workers fight for a living wage.

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Exhibit 14.1 ● Key Ideas of the Political Process Perspective Exhibit 14.1 ● Key Ideas of the Political Process Perspective

• Social movements emerge when political opportunities are open but may be emboldened by political threat.

• Political systems differ from each other, and change over time, in their openness to social movements.

• A given political system is not equally open or closed to all challengers.

• Success of one social movement can open the political system to challenges from other social movements.

• A given political system’s openness to social movements is influenced by international events.

• Opportunities for social movements open at times of instability in political alignments.

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• Social movements often rely on elite allies.

The PP perspective begins with the assumption that social institutions— particularly political and economic institutions—benefit the more powerful members of society, often called elites, and disadvantage many. The elites typically have routine access to institutionalized political channels, whereas disadvantaged groups are denied access. Power disparities make it very difficult for some groups to successfully challenge existing institutions, but the PP perspective suggests that institutions are not consistently invulnerable to challenge by groups with little power. Social movements can at times take advantage of institutional arrangements vulnerable to challenge. In 1994, it was not possible to get the U.S. House and the Senate to pass legislative action on environmental justice, but the environmental justice movement was able to persuade President Clinton to sign an executive order requiring all federal agencies to ensure environmental justice in their practices. Hazel Johnson, a local leader of the environmental justice movement in Chicago, was at his side when he signed the order (Pellow & Brulle, 2015). In 2015, the climate justice movement faced a Republican-controlled Senate and House hostile to climate justice issues, but it was able to take advantage of a president sympathetic to its concerns for slowing and ultimately halting the oil pipelines and willing to veto legislation that prevented that. Theories of social movements often underestimate the ability of challengers to mount and sustain social movements (Morris, 2004). The people of Warren County, North Carolina, only wanted to protect their community, and they have been surprised that their actions became the starting point for an environmental justice movement.

The political system itself may influence whether a social movement will emerge at a given time, as well as the form the movement will take. Social movement scholars have identified several influential dimensions of political systems and analyzed the ways in which changes in one or more of these dimensions make the political system either receptive or vulnerable to challenges (della Porta & Diani, 2006; Tarrow, 2006). Here, we examine four of those dimensions: openness of the political system, stability of political alignments, availability of elite allies, and international relations.

Openness of the Political System

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It might seem reasonable to think that activists will undertake collective action when political systems are open and avoid such action when political systems are closed. The relationship of system openness or closure to social movement activity is not that simple, however. They have instead a curvilinear relationship: Neither full access nor its total absence encourages the greatest degree of collective action. Some resistance stimulates movement solidarity, but too much resistance makes collective action too costly for social movement participants (Meyer, 2004). The nature of the political structure also affects the types of social movement activities that emerge in a given society. Researchers have found that France, with its highly centralized government and hostility to professional social movement organizations, is more prone to strikes, demonstrations, and collective violence than other European countries that are more fragmented and democratic in their governmental structures (Goodwin & Jasper, 2015).

More generally, but in a similar vein, democratic states facilitate social movements, and authoritarian states repress them (Tilly & Wood, 2013). Indeed, social movements as a form of collective action arose with the development of the modern democratic state (Marks & McAdam, 2009). However, because democratic states invite participation, even criticism, many challenging issues that might spark social movements are “processed” out of existence through electoral processes. It is hard to mount a social movement if it seems that the political system is easily influenced without serious collective action. On the other hand, the repression found in authoritarian states may serve to radicalize social movement leaders, as was evident during the Arab Spring uprisings of 2011 (Castells, 2012). Furthermore, as was evident in eastern Europe in the late 1980s, authoritarian states are not always effective in repressing challenges. The political leadership’s efforts to appease the population by offering small liberties had a snowball effect. Relaxation of social control in a previously repressive political system often has the unintended consequence of fueling the fire of long-held grievances. Governments can, and often have, radicalized a movement by repressing moderate participants or simply by repressing a movement too heavy-handedly (Goodwin & Japser, 2015). Research also indicates that although social movements have difficulty mounting in unsupportive political times, a flourishing social movement can remain strong when there is a shift of political elites from supportive to unsupportive (Goodwin & Jasper, 2015).

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Social movement researchers are interested in how police handle protest events. They have identified two contrasting styles of policing: the escalated-force model and the negotiated control model. The escalated- force model puts little value on the right to protest, has low tolerance for many forms of protest, favors little communication between the police and demonstrators, and makes use of coercive and even illegal methods to control protests. The negotiated control model honors the right to demonstrate peacefully, tolerates even disruptive forms of protest, puts high priority on communication between police and demonstrators, and avoids coercive control as much as possible. Social movement scholars suggest that in Western societies, including the United States, the escalated-force model lost favor and the negotiated control model became prominent after the intense protest wave of the 1960s (della Porta & Diani, 2006). They also argue, however, that preference for the negotiated control model has proven fragile in the face of the new challenge of transnational protest movements. In the United States, political activists have been spied on and disrupted in the name of the war on terror after September 11, 2001. In February 2003, in the weeks leading up to the beginning of the Iraq war, New York City authorities refused march permits to United for Peace and Justice, a coalition of more than 800 antiwar and social justice groups. Later that same year, the Philadelphia police commissioner classified the Free Trade Area of America (FTAA) as outsiders coming to terrorize the city; this was done to allow the city to receive $8.5 million in war-on-terror money (Bornstein, 2009). A given political system is not equally open or closed to all challengers at a given time; some social movements are favored over others. Even in a democracy, universal franchise does not mean equal access to the political system; wealth buys access not easily available to poor people’s movements (Bornstein, 2009).

The success of one social movement can open the political system to challenges by other social movements. For example, successful legislative action by the Black civil rights movement during the 1960s opened the way for other civil rights movements, particularly the women’s movement, which benefited from Title VII of the Civil Rights Act of 1964, which included prohibiting employment discrimination on the basis of sex (McAdam, 1996a). But a successful movement may also open the way for opponent movements, called countermovements, as well as for allied movements. The women’s movement has been countered by a variety of antifeminist movements, including the antiabortionist movement and a set of interrelated movements that focus on traditional gender roles for family

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life.

Stability of Political Alignments

PP theorists agree that the routine transfer of political power from one group of incumbents to another, as when a different political party takes control of the U.S. presidency or Congress, opens opportunities for the development or reactivation of social movements (Tarrow, 2006). At such times, some social movements lose favor and others gain opportunity. In the United States, in both the 1930s and the 1960s, changes in political party strength appear to have been related to increased social movement activity among poor people. Some observers note that social movements on the Left mobilized during the Kennedy and Johnson administrations, and social movements on the Right mobilized during the Reagan and George H. W. Bush administrations and again when Republicans took over Congress in 1994 (McAdam, McCarthy, & Zald, 1996); social movements on the Right also appear to have gained momentum when George W. Bush became president in 2000.

Here is a more recent example of how changing political alignments are related to social movement activity. In June 2012, in the midst of a presidential campaign, undocumented immigrant activists occupied President Obama’s campaign offices in a dozen cities to demand that he stop deportations of undocumented immigrants and enact the DREAM Act. The DREAM Act (Development, Relief, and Education for Alien Minors) was first proposed in 2001 as a pathway to citizenship for undocumented youth who had been brought to the United States as minors and lived in the United States for at least 5 years. It had been defeated several times in the U.S. Senate, most recently in May 2011. On June 15, 2012, President Obama announced that authorities would no longer deport certain DREAM Act–eligible undocumented youth through a program known as DACA (Deferred Action for Childhood Arrivals). In 2014, with Congress failing to enact immigration reform, President Obama announced that he would circumvent Congress and use executive action to protect about half of the undocumented immigrants from deportation and offer them temporary legal status (Jobin-Leeds, 2016). In July 2017, with a new president, a bipartisan DREAM Act was introduced in the Senate but has yet to be voted on. On September 5, 2017, President Trump ordered an end to DACA and urged Congress to pass a replacement before he phased out the protections in 6 months (Shear & Davis, 2017). Congress has not acted

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to protect DACA. As I write this, it is not clear how the DREAMER movement will respond to this very different political environment. Will supporters lose motivation for continued action, or will they be energized by outrage?

Edwin Amenta and colleagues (Amenta, Caren, & Stobaugh, 2012) take a slightly different view of the relationship between political regimes and social movement activity. They agree that political regimes on the Left spur the mobilization of Left-oriented social movements and political regimes on the Right spur the mobilization of Right-oriented social movements, but their research also indicates that Left regimes incite Right- oriented social movements, and even more so, Right regimes incite Left- oriented social movements.

Disruption of political alliances occurs at times other than political elections, for both partisan and nonpartisan reasons, and such disruptions produce conflicts and divisions among elites. When elites are divided, social movements can sometimes encourage some factions to take a stand for disenfranchised groups and support the goals of the movement. Disruptions in political alliances also occur when different branches of the government—such as the executive branch and the legislative branch—are at odds with each other, as happened in 2010 when the Democrats lost control of the House and Senate while Democrat Barack Obama remained president. Such conflict was the case in 2011 when protesters formed a human chain around the White House to pressure President Obama to block the Keystone XL pipeline. New coalitions may be formed, and the uncertainty that ensues may encourage groups to make new or renewed attempts to challenge institutional arrangements, hoping to find new elite allies. New coalitions formed during local environmental justice campaigns have often breathed new life into local progressive advocates (Pellow & Brulle, 2015).

The events in eastern Europe in the late 1980s and the Arab Spring of 2011 represent another type of political opportunity—one that has received little attention by social movement scholars—the opportunity that opens when a political regime loses legitimacy with those it governs. As reported in Chapter 9, many political analysts suggest that the current era is marked by a reduced capacity of nations to govern and increasing cynicism on the part of citizens about the ability of governments to govern. Some social movement scholars suggest that this sort of instability is contributing to the

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global spread of social movement activity (Castells, 2012).

Availability of Elite Allies

Participants in social movements often lack both power and resources for influencing the political process. But they may be assisted by influential allies who play a variety of supportive roles. These elite allies may provide financial support, or they may provide name and face recognition that attracts media attention to the goals and activities of the movement. Research indicates a strong correlation between the presence of elite allies and social movement success (Staggenborg, 2016). Celebrity actors Shailene Woodley and Mark Ruffalo, hundreds of religious leaders, civil rights leaders like Jesse Jackson, and 2,000 military veterans showed up to lend support and legitimacy to the Indigenous water protectors at Standing Rock. Many other celebrities, including Katy Perry, Orlando Bloom, Lupita Nyong’o, and Kerry Washington, announced their support of the protest on social media. Michael Moore and Cornel West showed up to address the assembly of Occupy Wall Street in 2011. When Harvard University students waged a sit-in that occupied the university president’s building for 21 days in 2002, demanding a living wage for all university employees, they were able to attract a number of elite allies, including Senator Edward Kennedy, former Labor secretary Robert Reich, chairman of the NAACP Julian Bond, and actors Ben Affleck and Matt Damon (Terkel, 2003).

Social movement participants often have ambivalent relationships with their elite allies, however. On the one hand, powerful allies provide needed resources; on the other hand, they may limit or distort the goals of the movement (della Porta & Diani, 2006). The early relationship between participants in the disability movement and actor Christopher Reeve is a good example of the tension that can develop between movement participants and their elite allies. When Reeve was paralyzed following an equestrian accident in 1995, the media quickly assigned him the role of star speaker for the disability community. Many in the disability movement were offended. Reeve’s personal agenda was to find a cure for spinal cord injuries, but the movement’s emphasis was on personal assistance for people with disabilities—on living with disability, not curing it. People in the disability movement were concerned that the emphasis on a cure would undermine their efforts to win public acceptance of their disabilities and to make their environments more accessible.

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International Relations

Since the 18th century, social movements have diffused rapidly across national boundaries, and the fate of national social movements has been influenced by international events. In the 19th century, the antislavery movement spread from England to France, the Netherlands, and the Americas (Tarrow, 2006). The mid-20th-century Black civil rights movement in the United States was influenced by international attention to the gap between our national image as champion of human rights and the racial discrimination that permeated our social institutions (McAdam, 1996a). The fight for the right of women to vote was first won in New Zealand in the 1880s; the United States followed almost 40 years later, in 1920. It took some time, but gradually the movement for women’s suffrage spread around the world (Sernau, 2017).

The recent revolution in communication technology is quickening the diffusion of collective action, as evidenced by recent democracy and justice movements. Democracy movements surged across the Arab world in 2011 after the successful democracy movements in Tunisia and Egypt. In the midst of the deep financial crisis that began in late 2007, unemployment reached 22% in Spain by 2011. After ignoring the severity of the situation for some time, the Spanish government, under pressure from Germany and the International Monetary Fund, instituted austerity policies that resulted in deep cuts in health, education, and social services. In protest, activists put out the call to occupy Barcelona’s Catalunya Square on May 16, 2011, an action so successful it was followed up on in 100 other Spanish cities as well as 800 cities around the world. The Occupy Wall Street action that began in the United States in September 2011 was modeled on this social movement (Castells, 2012).

Tarrow (2006) suggests that the international spread of social movements was aided by two growing trends. First, there was a growing attitude, after the end of the Cold War, that it is acceptable for nations to interfere with the affairs of other nations. Second, the end of classical colonialism—a policy by which one nation maintains control over a foreign nation and makes use of its resources—left a large number of weak states in its wake. With these two trends working together, opportunities were opened for minorities who were dispossessed in one nation to appeal for support from allies in another nation. It is also important to note that global social movements have been aided by human rights legislation from multistate

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governments such as the United Nations (Bornstein, 2009).

Critical Thinking Questions 14.2

Think of a social justice issue that you have some passion about. Are there any social movements currently working on this issue? If so, what are they? How open is the political system (in the United States or internationally) to social action about the issue? What types of elite allies might be helpful with opening political opportunities for the issue?

Mobilizing Structures Perspective The farm workers in the San Joaquin Valley, residents in West Harlem, Warren County community members, Keepers of the Athabasca, and the Standing Rock Sioux were aided in their organizing by local informal social networks in constant communication. The activists in China used various forms of communication technology to organize networks of protestors, as has been the case in the mobilizing of all recent protest activities of the environmental justice movement. Global organizations like 350.org have added human and material resources to what began as a grassroots movement. These views are consistent with the mobilizing structures (MS) perspective, which starts from this basic premise: Given their disadvantaged position in the political system, social movement leaders must seek out and mobilize the resources they need—people, money, information, ideas, and skills—to reduce the costs and increase the benefits of movement activities. In the MS perspective, social movements have no influence without effective organization of mobilizing structures —existing informal networks and formal organizations through which people mobilize and engage in collective action. Mobilizing structures are the collective building blocks of social movements. The main ideas of the MS perspective are summarized in Exhibit 14.2.

Exhibit 14.2 ● Key Ideas of the Mobilizing Structures Perspective

• Social movements must be able to mobilize various kinds of formal and informal networks.

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• Resource mobilization theory focuses on the coordination of movement activities through social movement organizations (SMOs).

• The network model focuses on mobilization of the movement through informal networks.

• Mobilizing structures have a strong influence on the life course of social movements.

• To survive, social movements must be able to attract new members and sustain the involvement of current members.

Informal and Formal Structures

MS scholars agree that social movements typically do not start from scratch but build on existing structures. They disagree, however, on the relative importance of informal versus formal structures. The MS perspective has two theoretical building blocks, one that emphasizes formal mobilizing structures and another that emphasizes informal mobilizing structures.

Resource mobilization theory focuses on the organization and coordination of movement activities through formal organizations called social movement organizations (SMOs) (Davis, McAdam, Scott, & Zald, 2005). Theorists in this tradition are particularly interested in professional social movement organizations staffed by leaders and activists who make a professional career out of reform causes (della Porta & Diani, 2006; Morris, 2004). The professional staff engages in fund-raising and attempts to speak for the constituency represented by the movement. There are advantages to professional SMOs, because social movements are more likely to meet their goals when they have a well-structured organization to engage in continuous fund-raising and lobbying. There are also problems, however. Professional SMOs must respond to the wishes of benefactors who may be comfortable with low-level claims only. Theda Skocpol (2003) argues that professionalization can lead to movement defeat by taming protest. This may explain why Occupy Wall Street (also known as the Occupy movement) was vehemently opposed to a leadership role for SMOs in its movement (Castells, 2012). Della Porta and Diani (2006)

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remind us that although social movements need organizations, organizations are not social movements. They insist that one thing that distinguishes social movements is that they are linked by dense informal networks.

Global social movements are being supported by growing numbers of transnational social movement organizations (TSMOs), or social movement organizations that operate in more than one nation-state. The number of TSMOs grew each decade of the 20th century, with particularly rapid growth in the last 3 decades of the century. There were 183 in 1973 and 1,011 in 2003 (Tilly & Wood, 2013). Some examples of TSMOs are Greenpeace and Amnesty International. The 350.org organization is also a TSMO operating in 188 countries.

In contrast to resource mobilization theory, the network model focuses on everyday ties between people, in grassroots settings, as the basic structures for the communication and social solidarity necessary for mobilization (della Porta & Diani, 2006; Tindall, 2004). The focus is thus on naturally existing networks based in family, work, religious, educational, and neighborhood relationships or such networks as those that can be found at alternative cafes and bookshops and social and cultural centers. Naturally existing social networks facilitate recruitment to movement activities and support continued participation. Research indicates that the best predictor of who will join in social movement activities is whether a person knows someone else already involved in the movement (Goodwin & Jasper, 2015). The early environmental justice movement was mobilized by such local informal networks. These natural networks are hard to repress and control because, in a democratic society, people have the right to congregate in their private homes and other informal settings.

Some social movement scholars argue that the shift in the organization of work to home-based work, smaller factories, and offshore industrial production is limiting the development of work-based networks of activism. On the other hand, the increased presence of women in higher education and places of employment is facilitating new ties between women. Not only do people get involved in social movements because of previous connections, but they also make new connections through their movement activities, connections that may generate continued loyalty. Proponents of the network model emphasize that individual, not just organizational, participation is essential for social movements, and they

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argue that social movements have participants, not members, and must find ways to keep participants involved (della Porta & Diani, 2006; Tindall, 2004).

Although resource mobilization theory and the network model disagree about the relative merits of formal and informal structures, they do agree that the costs of mobilizing social movements are minimized by drawing on preexisting structures and networks (Davis et al., 2005; Tindall, 2004). Black churches and Black colleges played an important role in the U.S. civil rights movement (Hutchison, 2012). The student movements of the 1960s benefited from friendship networks among activists of the civil rights movement (Oberschall, 1992). The global environmental justice movement depends on a broad coalition of organizations with a strong background in activism, including trade unions and other worker organizations, ethnic organizations, farmers, religious organizations, consumer groups, environmental groups, women’s groups, and youth groups (della Porta & Diani, 2006; Tarrow, 2006). Research indicates that the vast majority of active participants in the Occupy movement in the United States had participated in other social movements and been involved in activist networks on the Internet (Castells, 2012). Participants of several other social movements, including the immigration rights, prison rights, queer liberation, workers’ rights, and Indigenous rights movements, participated in the 2014 People’s Climate March. This collaboration across social movements is a growing trend that is discussed later in the section Social Movement Trends.

Several social movement scholars have noted the particularly “religious roots and character of many American movements” (McAdam et al., 1996, p. 18; Wood, 2002). They suggest that this link is not surprising, given the higher rates of church affiliation and attendance in the United States than in other comparable Western democracies.

Gemma Edwards (2014) argues that the mobilizing structures perspective has not paid enough attention to the relational nature of social movements. Social movement mobilization depends on participants developing a sense of collective identity, and the collective identity becomes the defining nature of the social movement.

Information and Communication Technology (ICT)

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Social movement leaders have always made use of new communication technologies to mobilize, using the telephone, radio, television, and computer as they became available (see Exhibit 14.3 for an overview of new communication technologies since the invention of the modern social movement). However, as new communication technologies became available, they did not replace previously existing technologies but were, instead, used alongside them. In recent years, the Internet and wireless communication networks have been used extensively in the mobilization of social movements, and the dynamic force of their use is the primary reason the study of social movements is so hot now (see Tufekci, 2017). Here are some fascinating examples of recent use of these technologies to mount social movements around the world.

Exhibit 14.3 ● A Selected History of the Development of New Information and Communication Technologies Exhibit 14.3 ● A Selected History of the Development of New

Information and Communication Technologies

Year Technology

1835 Invention of the electric telegraph

1876 Invention of the telephone

1895 Invention of the Marconi radio

1923 Introduction of the first working television system

1962 Launching of the first active communication satellite

1971 First e-mail sent

1973 Introduction of first handheld cell phone

1977 Introduction of microcomputers and the personal computermodem

Early Introduction of 2G digital cellular networks, allowing text

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1990s messaging and access to media content

Mid- 1990s Appearance of first search engines for WWW

1995 Public Internet established in United States

2001 Introduction of 3G cellular networks with fasterconnectivity

2002 Friendster social networking site (SNS) launched

2004 Facebook launched

2005 YouTube launched

2006 Twitter launched

2007 Tumblr launched

2009 Introduction of 4G cellular telephone networks

On December 17, 2010, street vendor Mohamed Bouazizi set fire to himself in front of a government building in a small town in Tunisia to protest the constant confiscation of his fruit and vegetables by the local police after he refused to pay them a bribe. A few hours later, hundreds of youth who had similar experiences with the police led a protest in front of the same building. Mohamed’s cousin, Ali, recorded the protest and distributed the video over the Internet. A few days later, spontaneous demonstrations were held around the country and continued despite brutal repression by the police. When the French government removed its support from dictator Ben Ali, he and his family fled Tunisia. The protesters were not satisfied, however, and the demonstrations continued. The protesters posted videos (of the protests and police brutality), messages, and songs on Facebook, YouTube, and Twitter. They used the Twitter hashtag #sidibouzid to debate and communicate. Bloggers played an active role, and Al Jazeera television broadcast images that had been posted on YouTube. The mobilization was not all digital, however. The protesters also occupied the Place du Gouvernement, the site of most

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government offices, and covered the walls of the government square with slogans. Hundreds of cars converged on the capital. The Tunisian protesters continued their actions throughout 2011 and were rewarded with open elections on October 23, 2011 (Castells, 2012; Tilly & Wood, 2013).

Inspired by the action in Tunisia, Asmaa Mahfouz, a business student in Cairo, Egypt, posted a video blog (vlog) on January 18, 2011, asking people to gather on Tahrir Square on January 25. Someone uploaded the vlog to YouTube, and it went viral. Tens of thousands of people converged on Tahrir Square on January 25, and more than 2 million people participated in demonstrations there over time. Demonstrators recorded the protests with their mobile phones and shared the videos on YouTube and Facebook, often with live streaming. They debated and communicated by Facebook, coordinated actions on Twitter, and made extensive use of blogs. Al Jazeera television played a major role in communicating the action to the Egyptian population. From the beginning of the protests, the Egyptian government took action to block social media websites. On January 27, it blocked text messaging and BlackBerry messaging. The protesters responded by using the old technologies of fax machines, ham radio, dial-up modems, and landlines. Hackers and techies around the world came to the aid of the protesters. Google and Twitter engineers designed a system that automatically converted a voice mail left on an answering machine into a tweet (Castells, 2012; Russell, 2011).

Moving to the United States in 2011, there was widespread outrage about a number of issues: the massive loss of homes and real estate value when the real estate market crashed, the near collapse of the financial system caused by speculation and greed, the use of taxpayer money to bail out financial institutions, and the payment of huge bonuses to millionaires who had caused the economic collapse—all coming after a presidential campaign that had created great hope among a large portion of the electorate, particularly young adults. This outrage occurred in the context of energized social movements in other parts of the world, particularly the Arab Spring. On July 13, 2011, Adbusters posted a call on its blog for people to converge on lower Manhattan on September 17 and set up tents, kitchens, and so forth and occupy Wall Street. About 1,000 people showed up, demonstrated against Wall Street, and occupied nearby Zuccotti Park. Videos of police repression were posted on YouTube, which mobilized more protesters to show up. With images and messages spreading across the Internet, occupations developed spontaneously in other cities, with

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approximately 600 Occupy demonstrations occurring around the country. The message of the movement was spread both internally and externally by Twitter, using the hashtag #occupywallstreet. Twitter networks were used to alert participants when police action was threatened; to distribute other types of information; and to post photos, videos, and comments. Tumblr was used to humanize the movement by providing a platform for personal, anonymous storytelling. As new Occupy camps developed around the country, most camps created their own websites with sections such as contact, how to get involved, supplies requested, resources, calendar of events and announcements, and message boards. Most camps also had a Facebook group (Castells, 2012).

Communication scholars suggest that the Internet and wireless communication technologies are a rich resource for social movements because they can be used to bypass mainstream media, which often ignores or distorts movement activity. Manuel Castells (2012), professor of communication technology at the University of Southern California, suggests that these technologies are a source of “mass self- communication,” because users can control the message they send. His research indicates that YouTube is probably the most powerful mobilizing tool in the early stages of a movement because the visual images arouse strong emotions in the viewer.

The widespread use of the Internet and wireless communication technologies in social movement mobilization is raising new questions for social movement scholars. Are dense, face-to-face networks still necessary to mobilize social movements? How essential is shared direct experience and face-to-face interaction to keep activists involved? The research on this question is still in the early stages, but evidence suggests that the greatest power comes from connecting virtual relationships with occupation of a shared physical space (Bennett, 2004; Castells, 2012). In recent large-scale social movements, new technologies have been used to call people to gather in specific physical spaces and to occupy those spaces over time. Castells (2012) suggests that these recent movements are creating a new hybrid form of space, “a mixture of space of places, in a given territory, and space of flows, on the Internet. One could not function without the other” (pp. 168–169).

Zynep Tufekci (2017), both an activist and social movement scholar, is not as optimistic as Castells, or as she once was, about the long-term impact of

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technology-generated protest. In her book Twitter and Tear Gas: The Power and Fragility of Networked Protest, she notes that communication technologies make it possible to orchestrate massive protests quickly and to grow a social movement rapidly. That is the power of protest organized through communication technology. However, she sees fragility in contemporary technologically networked social movements because they are skipping important steps of traditional social movements where mass demonstration is a culmination, not the beginning, of building collective capacities through formal and informal systems. She suggests that contemporary technology-mediated social movements may lack the staying power and the ability to change tactics over time of movements that were traditionally organized. One mass protest does not a social movement make. Tufekci (2017) also notes that technology-mediated social movements are vulnerable to hacking and governmental surveillance.

Photos 14.3a, b, c Both virtual and face-to-face networks helped mobilize the Arab Spring protest movements of 2011.

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The Life Course of Social Movements

Social movements are by definition fluid. The MS perspective asserts that mobilizing structures have a strong influence on the life course of a social movement, making time an important dimension. Although most social movements fade relatively soon, some last for decades. Movements typically have brief periods of intense activity and long latent periods when not much happens. One pattern for the movements that persist is as follows: At the outset, the movement is ill defined, and the various mobilizing structures are weakly organized (Kriesi, 1996; Marx & McAdam, 1994). Once the movement has been in existence for a while, it is likely to become larger, less spontaneous, and better organized. The mature social movement is typically led by the SMOs developed in the course of mobilization. That seems to be the current situation of the environmental justice movement, with the 350.org movement playing a major role in the continuation and scaling up of the movement.

Social movement scholars disagree about whether the increasing role of formal organizations as time passes is good or bad, however. Many suggest that movements cannot survive without becoming more organized and taking on many of the characteristics of the institutions they challenge (Tarrow, 2006). On the other hand, this tendency of social movements to become more organized and less spontaneous has often doomed them— particularly poor people’s movements—to failure (Skocpol, 2003). Organizations that become more formal commonly abandon the oppositional tactics that brought early success and fail to seize the window of opportunity created by the unrest those tactics generated. But that is not always the case. Sometimes SMOs become more radical over time, and most current large-scale social movements are strengthened by the support of many types of organizations (Goodwin & Jasper, 2015). One of the most important problems facing social movement organizers is to create mobilizing structures that are sufficiently strong to stand up to opponents but also flexible enough to respond to changing circumstances (Tarrow, 2006). That is the current test for the environmental justice movement as it engages a more hostile political environment.

Jo Freeman (1995) asserts that there is “no such thing as a permanent

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social movement” (p. 403). She suggests that every movement, at some point, changes into something else, often into many other things, through three basic processes:

1. Institutionalization. Some movements become part of existing institutions or develop durable SMOs with stable income, staff, and routine operations. The profession of social work is an example of a social movement that became institutionalized.

2. Encapsulation. Some social movements, or at least some parts of them, lose their sense of mission and begin to direct their activities inward, to serve members, rather than outward, to promote or resist change. That has been the trajectory of some labor unions (Clemens, 1996). Social work’s history also includes periods of encapsulation, when social workers became more concerned about “professional advancement and autonomy, status, and financial security” than about social justice and the public welfare (Reamer, 1992, p. 12). This appears to be the current state of the social work profession.

3. Factionalization. Still other movements fall apart, often disintegrating into contentious, competing factions. This is the current challenge of the LGBTQ social movement in the United States. The movement helped to bring about a major win with marriage equality, but it has been shaken in recent years by “queer” theorists and activists who challenge the idea of fixed sexual identities such as “gay,” “lesbian,” and “straight.” They also challenge the value of assimilationist goals like marriage equality.

It is too early to tell what the long-term trajectory of the environmental justice movement will be. It is already showing an inclination to merge with other movements focused on social, economic, and environmental justice. Will it lose its zeal and identity as it merges with the climate change movement, which has justice as a goal but perhaps not its main goal?

Critical Thinking Questions 14.3

Think again of a social justice issue you have some passion about. What existing networks might be available to organize change efforts regarding the issue? How could you use—or how have you used—the Internet and wireless communication technologies to participate in action about the issue?

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Cultural Framing Perspective The protesters in Warren County, North Carolina, developed a shared meaning about environmental racism, a meaning that resonated with people living in many other communities. Naming the new climate change movement organization 350.org was meant to be an urgent reminder of the ways that current social, economic, and political arrangements are threatening the water, land, and air so crucial to human well-being. The cultural framing (CF) perspective asserts that a social movement can succeed only when participants develop shared understandings and definitions of the situation. These shared meanings develop through a transactional process of consciousness raising, which social movement scholars call cultural framing. Cultural framing involves “conscious strategic efforts by groups of people to fashion shared understandings of the world and of themselves that legitimate and motivate collective action” (McAdam et al., 1996, p. 6). Exhibit 14.4 summarizes the central ideas of the CF perspective.

Social movement leaders and participants engage in a delicate balancing act as they construct cultural frames. To legitimate collective action, cultural frames must impel people to feel aggrieved or outraged about some situation they consider unjust. But to motivate people to engage in collective action, cultural frames must be optimistic about the possibilities for improving the situation. When the Standing Rock Sioux called themselves the “water protectors,” they signaled both that the water is in danger and that it can be protected. Consider the chant developed by the divinity students at Harvard during the Harvard sit-in for a living wage for university staff: “Where’s your horror? Where’s your rage? Div School wants a living wage.” The chant dramatized the severity of the situation and the fairness of their cause, but it also expressed hope for a solution. Simultaneously, social movements want to draw heavily on existing cultural symbols so that the movement frame will resonate with people’s cultural understandings while they add new frames to the cultural stock, thus sponsoring new ways of thinking about social conditions. The challenge of this balancing act is “how to put forward a set of unsettling demands for unconventional people in ways that will not make enemies out of potential allies” (Tarrow, 1994, p. 10). The living wage movement is wise in choosing to call its cause a “living wage” rather than a “minimum wage.” The notion that workers should draw a wage that allows them to “live” is morally persuasive, and even those who oppose the living

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wage movement have suggested that it is hard to take a public stance that you are opposed to such an idea (Malanga, 2003).

Table 14.4 ● Key Ideas of the Cultural Framing Perspective Table 14.4 ● Key Ideas of the Cultural Framing Perspective

• Social movements must be able to develop shared understandings that legitimate and motivate collective action.

• Social movements actively participate in the naming of grievances and injustices.

• Social movement leaders must construct a perception that change is possible.

• Social movements must articulate goals.

• Social movements must identify and create tactical choices for accomplishing goals.

• Contests over cultural frames are common in social movements.

• Social movements must be able to create cultural frames to appeal to diverse audiences.

Exhibit 14.5 ● Cultural Frames Used in Recent Social Movements Around the World

Cultural frames are “metaphors, symbols, and cognitive cues that cast issues in a particular light and suggest possible ways to respond to these

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issues” (Davis et al., 2005, pp. 48–49). Exhibit 14.5 presents some cultural frames provided by recent social movements around the world. You may not be familiar with many of these cultural frames, and I suggest you consult the Internet to learn more about those not familiar to you. How well do you think these cultural frames serve both to legitimate and to motivate collective action?

A complication in the process of constructing frames is that frames attractive to one audience are likely to be rejected by other audiences. The controversy over the Black Lives Matter movement is one of the best examples of this tension. The intent of movement leaders was to focus on the historical fact that Black members of U.S. society have long been far more likely to die at the hands of police than other members of society. The criticisms of the slogan suggested that the slogan meant that Black lives matter more than other lives. Different audiences hear slogans with different ears. Social movement groups “must master the art of simultaneously playing to a variety of publics, threatening opponents, and pressuring the state, all the while appearing nonthreatening and sympathetic to the media and other publics” (McAdam, 1996b, p. 344). Activists desire media attention because that is the most effective way to reach wide audiences, but they also know they cannot control the way the movement will be framed by the mass media. That is why some social movement scholars see so much promise in the use of the Internet and wireless communication technology that allow participants to control their own messages. The mass media are attracted to dramatic, even violent, aspects of a movement, but these aspects are likely to be rejected by other audiences (Stein, 2009). They are often more interested in scandal than in providing substantive information on movement issues (della Porta & Diani, 2006). ACORN, an SMO that was very helpful to the living wage campaign in the United States, became the subject of a highly publicized scandal in September 2009 regarding a few local staff caught in reportedly unethical behavior on hidden camera (Farrell, 2009). This scandal led to loss of federal funding and private donations, and by March 2010, ACORN announced that it was closing its offices after 40 years of successful advocacy efforts (Urbina, 2010). It was their success in fighting for the rights of poor people that led to a backlash from conservative forces that wanted to destroy them. That is a possibility with which successful social movements must always contend. Movement activists are particularly concerned about the impact of the mass media on their conscience constituency—people attracted to the movement because it

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appears just and worthy, not because they will benefit personally.

Social movement framing is never a matter of easy consensus building, and intense framing contests may arise among a variety of actors, particularly in the later stages. Representatives of the political system and participants in countermovements influence framing through their own actions and public statements, and internal conflicts may become more pronounced. Leaders and followers often have different frames for the movement, and there are often splits between moderate and radical participants. It is not at all unusual for movements to put forth multiple frames, with different groups sponsoring different frames. For example, Bill Hughes (2009) suggests that disability activism in the United Kingdom is splitting into two branches, the disabled people’s movement (DPM) and the “biological citizens.” The DPM takes the position that disability is a social phenomenon created by discrimination and oppression and suggests that impairment is irrelevant to disability. The “biological citizens” organize politically around specific diagnostic labels and embrace medical and scientific knowledge associated with their “condition,” with the goal of enhancing their ability to exercise citizenship. When a movement captures mass media attention, there is often an intense struggle over who speaks for the movement and which cultural frame is put forward.

Qualitative analysis of social movement framing has been a popular topic in the social movement literature. This literature indicates that cultural framing provides language, ideology, and symbols for understanding that a problem exists, recognizing windows of opportunity, establishing goals, and identifying pathways for action (Polletta, 2004).

Frames for Understanding That a Problem Exists

Social movements are actively involved in the “naming” of grievances and injustices. They do so in part by drawing on existing cultural symbols, but they also underscore, accentuate, and enlarge current understanding of the seriousness of a situation. In essence, they call attention to contradictions between cultural ideals and cultural realities. For example, the living wage movement calls attention to the discrepancy between working and receiving a wage that does not allow a person to rise out of poverty. Calling attention to this discrepancy is important in the United States, where the public tends to believe that people are poor because they don’t

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work. Perhaps the environmental justice movement could benefit by calling more attention to how cultural ideals of fairness conflict with the cultural realities that some communities absorb the health costs of industrial pollution. The international antiglobalization movement has used globalization as a catchword to symbolize the misery and exploitation caused by the dominance of market forces in contemporary life. Many of the ill effects of global markets, such as growing inequality, were present before antiglobalization activists were able to turn globalization into a negative symbol that could mobilize people to action. When 50,000 demonstrators protested against the World Trade Organization meeting in Seattle on November 30, 1999, they used a number of slogans to frame globalization as a problem (della Porta & Diani, 2006, p. 163):

The world is not for sale. No globalization without representation. We are citizens, not only consumers. WTO = Capitalism without conscience.

Some of these themes have been echoed in slogans of more recent social movements, as demonstrated in Exhibit 14.5.

In the United States, movement frames are often articulated in terms of rights—civil rights, disability rights, LGBTQ rights, animal rights, children’s rights. In Europe, where there is less emphasis on individual liberty, rights frames are far less common in social movements (Hastings, 1998; Tarrow, 1998). Recently, equality has been a powerful frame in the United States: “We Are the 99%,” “Real Democracy Now,” and “Marriage Equality.” The LGBTQ rights movement made the wise choice to use equality as the slogan as they pushed for same-sex marriage rights.

Photo 14.4 The Occupy Wall Street movement uses the slogan “We Are the 99%” to have an impact on the public discourse about democracy and economic justice.

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In the past 3 decades, fundamentalist religious movements have sprung up in many countries, including the United States. These movements have used morality frames, focusing on good and evil rather than justice versus injustice. Compared with Europe, the United States has historically produced a high number of such movements (Marx & McAdam, 1994). Prohibition, abolition, anticommunism, and antiabortionism have all had religious roots. A contemporary religious frame that crosses national boundaries as well as liberal and conservative ideologies is “reverence for life,” expressed in such disparate movements as the environmental, antiabortion, animal rights, antiwar, and anti–capital punishment movements.

Frames for Recognizing a Window of Opportunity

The perception of opportunity to change a troublesome situation is also culturally framed, to some extent (Castells, 2012). On occasion, it is easy to develop a shared frame that opportunity exists or does not exist, but most situations are more ambiguous. Social movement leaders must successfully construct a perception that change is possible, because an opportunity does not exist unless it is recognized. They typically attempt to overcome concerns about the dangers and futility of activism by focusing on the risks of inaction, communicating a sense of urgency, and emphasizing the openness of the moment. Naming a climate justice

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movement 350.org emphasizes the risk of inaction but also suggests a direction for change. Social movement leaders are intent on keeping hope alive, which is important to the climate justice movement in the United States at a moment when political institutions are hostile to the science that supports the movement.

Calibrating this type of frame is a difficult task. On the one hand, overstating an opportunity can be hazardous. Without “fortifying myths,” which allow participants to see defeats as mere setbacks, unrealistically high expectations can degenerate into pessimism about possibilities for change (Voss, 1996). On the other hand, “movement activists systematically overestimate the degree of political opportunity, and if they did not, they would not be doing their job wisely” (Gamson & Meyer, 1996, p. 285). Unrealistic perceptions about what is possible can actually make change more possible.

Frames for Establishing Goals

Once it has been established that both problem and opportunity exist, the question of social movement goals arises. Is change to be narrow or sweeping, reformist or revolutionary? Will the emphasis be on providing opportunities for individual self-expression or on changing the social order? At least three goals have been adopted by different segments of the antiglobalization movement: rejection, opt out, and reform. The rejectionists reject capitalism as an ethical economic form. The opt-out segment of the movement focuses on experiments in local sustainable economic development, which they hope will allow them to avoid participation in the global economic system dominated by large, transnational companies. The reformists see economic globalization as a potentially good thing but favor measures to reduce the power of transnational businesses (della Porta & Diani, 2006). U.S. social movements have generally set goals that are more reformist than revolutionary (Marx & McAdam, 1994). PFLAG National, the nation’s largest organization of parents, families, and allies united with LGBTQ people, is a fairly typical example of a contemporary U.S. social movement organization that has struck a balance between goals of individual change and changes in the social order. Exhibit 14.6 demonstrates how PFLAG strikes this balance in its statement of priorities, vision, and mission.

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Exhibit 14.6 ● Statement of Priorities, Vision, and Mission of PFLAG

Priorities

• Proud people

• Loving families

• Safe communities

• Diverse and inclusive world

Vision

PFLAG envisions a world where diversity is celebrated and all people are respected, valued, and affirmed inclusive of their sexual orientation, gender identity, and gender expression.

Mission

1. Support for families, allies, and people who are LGBTQ

2. Educations for ourselves and others about the unique issues and challenges facing people who are LGBTQ

3. Advocacy in our communities to change attitudes and create policies and laws that achieve full equality for people who are LGBTQ

Source: © PFLAG National, the nation’s largest organization of parents, families and allies united with LGBTQ people.

Typically, goals are poorly articulated in the early stages of a movement but are clarified through ongoing negotiations about the desired changes. Manuals for social activism suggest that modest and winnable objectives in the early stages of a movement help to reinforce the possibility of change (Gamson & Meyer, 1996). In the early days of the environmental

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justice movement, the focus was on specific local instances of environmental racism, particularly on stopping the building of incinerators and toxic waste sites in impoverished communities of color. Along with some defeats, the environmental justice movement has had many successes, including stopping construction of some coal-fired power plants; blocking fracking for natural gas in a number of areas; stalling the construction of oil pipelines; and convincing universities, cities, and foundations to divest from investments in fossil fuel companies. The current goals appear to be much more ambitious, a tandem effort to bring about climate justice and fundamental economic and political change that interrupts arrangements that create “eco haves and eco have nots”—to develop economies that don’t require people to choose between clean air, water, and earth or putting food on the table (Jobin-Leeds, 2016). Public education and collaboration with other social movements are essential actions to accomplish these more ambitious goals.

Social workers Ray MacNair, Leigh Fowler, and John Harris (2000) suggest that progressive, or proactive, social movements have a three- pronged goal: (1) They must confront oppression, (2) they must attend to the damaged identities of oppressed persons, and (3) they must “renovate” the cultural roles of both oppressor groups and oppressed groups. The environmental justice movement has paid a lot of attention to the first two of these goals. It has named the oppression, and it has actively engaged Indigenous and other devalued local community groups in the struggle. It is not clear how much work is being done on the third goal. Activist Bill McKibben argues that environmental injustice is a crime with criminals, but the emphasis on public education has the potential to speak to both oppressor groups and oppressed groups (Jobin-Leeds, 2016).

Three “identity movements”—the Black civil rights movement, the women’s movement, and the LGBTQ movement—demonstrate the process of goal setting (MacNair et al., 2000). Each of these movements has a long history of emerging, waning, and reemerging in the United States, changing its framing of the movement’s goals along the way. For these three social movements, the framing of goals followed an evolutionary path through six frames.

1. Assimilation. Persuade the mainstream to recognize the capabilities of the oppressed group while also working to uplift the oppressed group.

2. Normative antidiscrimination. Place the onus for change completely

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on oppressor groups and oppressive institutions. Take a confrontational approach of legal challenges and political lobbying. Recognize the positive attributes of the oppressed group.

3. Militant direct action. Reject the legitimacy of normal decision- making processes and attempt to disrupt them. Develop a “culture of rebellion” to energize disruptive actions (MacNair et al., 2000, p. 75).

4. Separatism. Avoid oppression by avoiding oppressor groups. 5. Introspective self-help. Focus on building a healthy identity. 6. Pluralistic integration. Appreciate themselves and promote

connections to other cultures.

Before we leave the discussion of goal framing, it is important to consider the position on goals taken by the Occupy movement. One demand was put forward in the beginning, a presidential commission to separate money from politics, but that did not become the unifying goal of the movement. Each Occupy campsite developed its own proposals, or no proposal at all (Tarrow, 2011). The movement has been criticized for having no clear goal or goals, but George Lakoff (2011) aptly described the Occupy movement as a moral movement whose aim was to have an impact on the public discourse about democracy and economic justice. It appears that the movement had some success in this regard, stimulating greater public dialogue about a number of issues related to democracy and justice, including the issue of fair wages. Public opinion polls taken in November 2011 indicate that almost 50% of the public agreed with the ideas at the heart of the movement (Castells, 2012).

Frames for Identifying Pathways for Action

Some of the most important framing efforts of a social movement involve tactical choices for accomplishing goals. Social movement scholars generally agree that each society has a repertoire of forms of collective action that are familiar to social movement participants as well as the elites they challenge (Tarrow, 2006). New forms are introduced from time to time, and they spread quickly if they are successful. In the United States, for example, marches on Washington have come to be standard fare in collective action, and activist groups exchange information on the logistics of organizing such a march on the nation’s capital. On the other hand, the sit-down strike is no longer as common as it once was, but occupying a physical space over time has been a hallmark of recent social movements. Contemporary social movements draw power from the large selection of

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forms of collective action currently in the cultural stock, and many movements have wisely used multiple forms of action (Staggenborg, 2016). The environmental justice movement has made use of public education; litigation; occupation of spaces to resist construction of toxic waste sites, incinerators, and pipelines; bus and walking tours; online campaigns; and both local and mass protest demonstrations. The movement has also made use of storytelling, songs, and art (Jobin-Leeds, 2016).

The repertoire of collective action is handed down, but there is some improvisation by individual movements. Let’s look at the use of a walk as a protest activity that has been handed down and improvised over time. Throughout March 1965, a group of demonstrators met violence as they attempted to walk the 54 miles from Selma, Alabama, to the state capitol in Montgomery to demand voting rights for the Black residents of Alabama. On March 21, 3,200 demonstrators left Selma again to walk to Montgomery, this time under the protection of federal troops. When they arrived in Montgomery 4 days later, the group had grown to 25,000. In 1966, Cesar Chavez led a group of farm workers on a 300-mile walk from Delano, California, to the state capitol in Sacramento, picking up walkers along the way, to call attention to the conditions of their labor. In 2006, Bill McKibben, college students from Middlebury College, and concerned local residents used the model of Selma and the farm workers to walk the 50 miles from Ripton, Vermont, to Burlington to draw attention to climate change; they also collected walkers along the way. The Keepers of the Athabasca innovated the idea of a healing walk to expose the damage to the water, land, and air caused by the tar sands oil project but also to engage in a healing ritual. Modeling Cesar Chavez, four young undocumented immigrants began a 1,500-mile walk from their homes in Miami to the White House in Washington, DC, on January 1, 2010, with the goal to bring undocumented youth out of the shadows. They said they were walking a Trail of DREAMs. These young Trail of DREAMs walkers wore T-shirts that bore the slogan “Undocumented and Unafraid” and said they were borrowing this idea of “coming out” of the shadows from the LGBTQ movement. In town after town, they were joined by other undocumented immigrants who were “coming out” (Jobin-Leeds, 2016).

Public marches are a standard part of the repertoire, but there have been innovations to the march in recent years, such as closing rallies and the incorporation of theatrical forms. Participants in the global justice

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movement are using some long-standing action forms such as petitions, reports and press releases, sit-ins, marches, lobbying, blockades, and boycotts. They are also using recent action innovations as well as developing new action forms. Their repertoire includes concerts, vigils, theatrical masks, puppets, electronic advocacy, documentaries, and “buycotts” (active campaign to buy the products) of fair trade products (Jasper, 2014). Marches in multiple locations, such as what happened in the People’s Climate March, is becoming a staple protest strategy, made possible by communication technology.

Just as social movement goals fall on a continuum from reform to revolution, forms of collective action can be arranged along a continuum from conventional to violent. Nonviolent forms of collective action are the core of contemporary U.S. movements, and nonviolence as a way of life was a cornerstone of the campsites of the Occupy movement. Standing Rock chairperson David Archambault II insisted that the Standing Rock protest would remain nonviolent, even when the police became aggressive in attacking and arresting the protesters. Nonviolent disruption of routine activities is today considered the most powerful form of activism in the United States and in other Western democracies with relatively stable governments (della Porta & Diani, 2006). The power of nonviolent disruption is that it creates uncertainty and some fear of violence yet provides authorities in democratic societies with no valid argument for repression. Violent collective action, on the other hand, typically destroys public support for the movement. Martin Luther King was ingenious in recognizing that the best path for the U.S. civil rights movement was “successfully courting violence while restraining violence in his followers” (McAdam, 1996b, p. 349). Consequently, it was the police who lost public favor for their brutality, not the demonstrators.

Some action forms, such as marches and petitions, are used to demonstrate numerical strength. Other action forms, such as conferences, concerts, documentaries, and buycotts of fair products, are used to bear witness to the substantive issues. Still other action forms are designed to do damage to the parties reputed to be to blame for an unfair situation. Small-scale violence does this, as do boycotts. Both action forms run the risk of escalating repression and alienating sympathizers, and boycotts also run the risk of harming workers (della Porta & Diani, 2006). It is true, however, that boycotts have often brought the desired results. Perhaps the best example of this is the Montgomery, Alabama, bus boycott, a social

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protest in which African Americans refused to ride city buses in protest of segregated seating. This boycott lasted one year and 15 days (December 5, 1955, to December 29, 1956) and ended in a U.S. Supreme Court decision that declared segregated seating on public transportation to be unconstitutional.

In an interesting development, a new organizing tactic has been used in peace and justice campaigns. Proponents of this tactic call it “creative play.” They argue that “changing entrenched systems of oppression requires shifts in emotional as well as intellectual attitudes” (Shepard, 2005, p. 52). Furthermore, “culture-poems, songs, paintings, murals, chants, sermons, quilts, stories, rhythms, weavings, pots, and dances can make such emotional and visceral breakthroughs possible” (Si Kahn, cited in Shepard, 2005, p. 52). One global movement, Reclaim the Streets (RTS), used street parties as its organizing tool. During the 2004 presidential election, Billionaires for Bush used humor to lampoon the role of money in U.S. politics. They appeared at both pro-Bush and anti-Bush rallies in tuxedos and top hats, and fake jewels and gowns, often carrying signs that read “Because Inequality Is Not Growing Fast Enough.” Paul Bartlett, a member of the Billionaires group, suggests that “performance with humor can disarm fear. When we laugh, we can listen, we can learn. . . . When people participate in a play, opportunities for new perspectives and transformation emerge” (cited in Shepard, 2005, p. 55).

Social movement scholars agree that for the past 200 years, social movement actions have become less violent (Tarrow, 2006). They also suggest, however, that beginning in the 1990s, violent social movements began to flourish again around the world. This trend was exemplified by White supremacist armed militias in the United States and militant Islamic fundamentalist movements in the Middle East, Central Asia, and Africa. Out of these two movements have come (respectively) the bombing of a state building in Oklahoma City and the somber events of September 11, 2001. It is unclear whether the increased violence of social movements will be a long-term trend and if so, whether existing theories of social movements will be relevant to the new forms of movement actions. The 2011 democracy movements in Tunisia and Egypt as well as the Occupy movement were nonviolent and experimented with new ways of peaceful protest. In 2017, there was tension in the U.S. resistance social movement of the Left, a movement that sprang up after Donald Trump was elected president, over the willingness of Antifa antifascist groups to use violence

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to oppose fascist and White supremacy groups (Lovett, Levitz, & McWhirter, 2017). Perhaps the future will hold both increased violence and further experiments with nonviolent protest.

Emerging Perspectives Some social movement scholars have suggested that the three dominant perspectives discussed—political process, mobilizing structures, and cultural framing—fail to attend to some important dimensions of social movements. Three emerging perspectives are discussed here.

First, a few social movements scholars argue that social movement researchers should take another look at the role of emotions in motivating people to participate in social movement activities. They contend that the social movement literature has fallen short by attending to rationality but not emotions of movement participants. Drawing on recent neuroscience research about the role of emotion in human behavior, Manuel Castells (2012) theorizes that the energy of a social movement “starts with the transformation of emotion into action” (p. 13). He suggests that anger is the triggering emotion in social activism, and extreme anger or outrage helps to override fear of the consequences of action. Enthusiasm and hope, which are generated in social interaction, also play an important role in overriding the fear of activism. Visual images are powerful stimulants of both anger and hope.

Deborah Gould (2009) applauds the rejection of earlier attempts to understand social movement actors in terms of psychopathologies but suggests that social movements are passionate political processes and emotions must be considered. She proposes that social movement researchers should study the role that emotions such as anger, indignation, hope, and pride play in motivating social movement involvement. She recounts her own qualitative research with lesbians and gays who participated in the AIDS activism group ACT UP, noting the important role that grief and anger about AIDS and the slow response to it played in moving participants to action. In another analysis, Karen Stanbridge and J. Scott Kenney (2009) suggest that victims’ rights advocates must manage the grief, fear, and anger related to the victim experience in their public protest action.

Second, Richard Flacks (2004) suggests that the literature on resource

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mobilization has failed to consider the fundamental differences in the way different members participate in social movements. He asserts that there may be very different explanations for the participation of leaders, organizers, and mass participants. He thinks we should be more interested in why some people come to see societal change as a major priority in their lives whereas others don’t and suggests that social movement scholars should study the biographies of activists to learn more about that. Studs Terkel was an activist, not a social movement scholar, but he was interested in exactly the same question that Flacks raises. For Terkel’s (2003) book Hope Dies Last, he interviewed 55 activists about what motivated them to activism. As the title of the book indicates, he found hope to be a major motivator.

From another perspective, Robert Putnam (2000) notes that many people are participating at a very superficial level in contemporary social movements, responding to direct mail campaigns with a one-time contribution but making no greater commitment to the cause. Putnam argues that this type of involvement in social movements fails to build the social capital built in grassroots coalitions like those driving the early environmental justice movement. There are, indeed, different ways to participate in social movements, and social movement leaders need to understand the different motivations involved.

Third, new social movement theory emphasizes the important role of collective identity in social movement mobilization. These theorists suggest that before a movement becomes visible, there is a period of latency when a new collective identity is emerging. They also emphasize the role of emotion, particularly the role of moral outrage, in movement mobilization.

Critical Thinking Questions 14.4

Think again of a social justice issue about which you have some passion. What are two or three cultural frames that would motivate people to engage in collective action on the issue? Review the cultural frames of recent social movements presented in Exhibit 14.5. Could any of those frames be extrapolated to motivate action on the issue about which you have some passion? How important do you think emotions are in motivating people to participate in social movement activity? Which, if any, of the cultural frames presented in Exhibit 14.5 arouse strong emotions in you? What types of emotions do they arouse? What

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cultural frames do you see being used in the environmental justice movement?

Social Movement Outcomes Because social movements are processes, not structures, they are not easy to research. The case study has been the predominant method used, with recent emphasis on comparative case studies. Unfortunately, one researcher may declare a particular movement a failure, whereas another researcher will see it as having succeeded. Often the impact of a movement cannot be determined until well past its heyday. Different analyses may be based, in part, on different guidelines for success, but the researchers may also be evaluating the movement from different time perspectives. This is a reminder, again, of the importance of the time dimension in changing person–environment configurations.

Social movements have a number of effects on societies, some of them intended and some unintended. A few movements attain many of their goals, others result in formal protest organizations that have longevity, and many, if not most, are suppressed and ignored. Social movements are often trying at the same time to change corporate or governmental policy, transform public attitudes, and bring about the personal transformation of the protesters. The environmental justice movement is certainly trying to do all three of these things. Sometimes movements help to bring about long-term changes, and other times, as the climate justice movement is finding, early successes are overturned when a strong backlash is mobilized and the movement must fight to overcome setbacks (Goodwin & Jasper, 2015; Staggenborg, 2016). The progress of social movements is almost never linear, which is why Tufekci (2017) writes about the fragility, as well as the power, of social movements.

Sidney Tarrow (1998) suggests that the power of social movements is cumulative and can be appreciated only from a long-term historical perspective. Many of the gains of social movements get reversed, but “they often leave behind incremental expansions in participation, changes in popular culture, and residual movement networks” (p. 202). Castells (2012) suggests that the real legacy of a social movement is the cultural change it produces. Research on social movements documents a range of direct and indirect effects. U.S. social movements of the past 100 years

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have accomplished an impressive list of specific federal legislation, including the Nineteenth Amendment to the Constitution that gives women the right to vote; the Civil Rights Act of 1964; Title IX, the federal law that prohibits gender-based discrimination in athletics and educational programs at institutions that receive federal funds; and the Americans with Disabilities Act of 1990. Considered by some scholars to be the most successful social movement in the United States since World War II, the Black civil rights movement has served as an organizing model, opened opportunities, and provided hope for other aggrieved groups. Because of social movements, the political system has become more open and responsive to previously ignored groups, and voicing grievances has become an expected part of life in a democratic country. New decision- making bodies, such as ad hoc committees and new governmental ministries, have been created in many nations (della Porta & Diani, 2006). Many SMOs have become a stable part of the social environment, and activist-oriented networks outlast the movements that spawned them. Research indicates that although individual activists are often temporarily disillusioned at the end of a social movement, in the long term, they are empowered and politicized by their participation (Tarrow, 1998).

More recently, as suggested earlier, the environmental/climate justice movement has had defeats. But it has also had some successes in stopping construction of coal-fired power plants; blocking fracking for natural gas; stalling the construction of oil pipelines; and convincing universities, cities, and foundations to divest of fossil fuel. Globally, the movement was a major force behind the development of the Paris Agreement, which strengthens the global resolve to combat climate change. The LGBTQ social movement has been a major force behind marriage equality in many countries, including the United States. The Trail of DREAMs walkers and other immigration activists were able to influence President Obama to develop the DACA program. These recent gains in governmental policy are fragile, but they have been accompanied by culture change that is probably long-lasting.

Although the success of a given social movement depends on its unique configuration of political opportunities, mobilizing efforts, and cultural frames, social movement researchers have identified some factors that influence success or failure. Some of these factors are outside the control of the movement, but some of them can be successfully manipulated by movement leaders. The most obvious factor is the ability to attract a large

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number of participants. The most successful movements tap into existing networks and associations that have a shared culture, a strong sense of solidarity, and a common identity. These groups are the most likely to be willing to make sacrifices and remain committed over time and to have shared symbols to frame the movement. Religious movements, for example, benefit from long-lasting and widely cherished religious symbols. Other forces, however, can serve as serious threats to the success of a social movement. Internal conflicts and factionalism weaken the chances for success, as does a strong opponent. Initial successes may stimulate strong countermovements, or a backlash may develop in reaction to the radical flank of a movement.

Social Movement Trends Social movement scholars generally agree that social movements will continue to be a part of the social landscape in the foreseeable future (McMichael, 2017). In fact, some have predicted that we are entering an era of “movement societies,” in which challenge and disruption of institutional arrangements will become a routine part of life (Tarrow, 2006). Della Porta and Diani (2006) predict that the antiglobalization movement will become a new political force in the world. They also see a trend toward the return of working-class movements and “mobilization by the dispossessed” (p. viii). They suggest that this may be happening because the size of social groups that lack full citizenship is growing around the world.

Tarrow (2006) suggests that the extraordinary international protests of the late 1990s and beginning years of the 21st century represent something new on the planet. Indeed, as suggested earlier, there has been a rapid expansion of TSMOs (McMichael, 2017). TSMOs have developed primarily in the areas of human rights, women’s rights, environmental protection, antiglobalization, and peace (McMichael, 2017). One benefit of TSMOs is that they can include people who speak out about an issue in one country while people are silenced in other countries. TSMOs rarely use violent, or even seriously disruptive, methods. Many observers suggest that given the globalization of the economy, any successful labor challenge to growing inequality will have to be international in scope, and there is evidence that this is, indeed, happening. That is one aim of the antiglobalization movement, which is made up of a collection of labor

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activists as well as environmentalists and feminists (McMichael, 2017).

Another strong trend that began in the 1990s was a shift from single-issue organizing to multi-issue organizing by TSMOs (Tarrow, 2006). Traditionally, social movements and the SMOs that supported them focused tightly on a single issue, such as poverty or gender equality. The majority of TSMOs still focus on single issues, but the number of multi- issue TSMOs doubled in the 1990s, growing twice as fast as the overall TSMO population (Davis et al., 2005). Increasingly, for example, TSMOs are bridging labor issues with such other issues as the environment, gender equality, peace, and global justice (della Porta & Diani, 2006). As demonstrated in the 2014 People’s Climate March, the environmental/climate justice movement is finding commonality with broader and deeper networks of movements. Organizing at the regional (southeastern United States) rather than global level, Paulina Helm- Hernández, of the Southerners on New Ground (SONG) movement organization, advocates for intersectional organizing, arguing that “power lies in linking issues” (cited in Jobin-Leeds, 2016, p. 18). Although SONG declares that it “is a regional Queer Liberation organization,” the vision presented on SONG’s website reads, “We envision a multi-issue southern justice movement that unites us across class, race, ability, gender, immigration status, and sexuality” (Southerners on New Ground, 2018). This idea of intersectional, multi-issue organizing is a major theme in contemporary social movement organizing at the local, regional, national, and international levels, a theme elaborated on in Greg Jobin-Leeds’s 2016 book When We Fight We Win.

Finally, it seems likely that the trend of blending technology-based organizing with face-to-face interactions in occupied spaces will continue and perhaps escalate. As we have noted at other points in this book, technological inventions are coming at a fast clip, and it is impossible to foresee what new communication technologies will be used in future social movement mobilization. Given the time it takes to get a book like this into your hands, it is highly likely that you are aware of the use of new technologies not discussed in this chapter.

Social Movements and Contemporary Social Work

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Early in this chapter, I suggested that the professionalization of social work was accomplished by sacrificing the social reform fervor of its settlement house tradition. Some social movement scholars have found it difficult, if not impossible, to be both a profession and a reform movement (Freeman, 1995). Other social work scholars see a dual focus on professional service and social reform as achievable and even natural. The history of social work is one of tension between the goals of professional service and social reform. This tension has been obvious in recent years. On the one hand, social workers and their professional organizations have devoted a lot of resources to obtaining licensure for clinical social workers and to securing private and public reimbursement for clinical social work services. On the other hand, social work’s leading professional organizations have recently revised documents, including the NASW Code of Ethics and CSWE’s Curriculum Policy Statement, to add forceful language about the social justice goals of the profession.

Philip Popple (1992) suggests that each generation of social workers must struggle anew with the tension between a conservative mandate from society for efficient service that manages problems of dependency and a liberal or radical mandate from the profession to promote social justice. He also suggests that social workers experience this tension differently in different political eras. In conservative political times, there is great disparity between the societal mandate for social workers to act as social control agents and the profession’s social reform tradition. In such times, the social reform goal is not prominent. In liberal political times, however, there is less tension between the two goals, and social work’s social reform goal is more visible. Popple’s analysis is consistent with a tenet of the PP perspective on social movements: Shifts in political alignments open or close opportunities for social movement activity. Even though the social work profession’s emphasis on social reform at any given time is influenced by political opportunities, the valuing of social justice is a permanent feature of social work in the United States (Popple, 1992). Thus, all social workers should be familiar with developments in social movement theory and research.

Some social workers practice in social movement service organizations (SMSOs), also known as social movement agencies, alternative social agencies, and hybrid organizations, which pursue social change while delivering services (Meyer, 2010). These organizations make a fundamental commitment both to social service provision and to advocacy

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efforts. They often attempt to provide revolutionary services oriented toward empowerment and cognitive liberation. Their advocacy efforts are often focused on reframing public understanding of social problems and their solutions. For example, SMSOs serving homeless persons have attempted to reframe homelessness as being a consequence of failed housing policies, rather than a consequence of individual failings. Likewise, rape crisis centers have focused on gaining public affirmation that rape is not the victim’s fault (Hasenfeld, 2010b).

Megan Meyer (2010) identifies five characteristics of SMSOs:

1. They are driven by controversial values that they see as socially beneficial.

2. They closely integrate service provision and advocacy roles. 3. They develop a close sense of community among their clients. 4. They often mobilize their members to advocate for change. 5. They typically develop a hybrid structure that incorporates elements

of both collective and bureaucratic forms of operation.

Some examples of SMSOs are feminist health and rape crisis centers, peace and conflict resolution organizations, and national women’s and racial minority organizations. Unfortunately, there is very little research on SMSOs, and our knowledge of them and their impact is limited.

Critics of existing social movement theory have suggested that SMOs can be divided into a reform or moderate tradition and a radical tradition (Fitzgerald & Rodgers, 2000). Radical social movement organizations tend to be organized nonhierarchically and operate with little structure. Their goal is usually radical change in social institutions, rather than social reform. Exhibit 14.7 contrasts the characteristics of moderate and radical SMOs. As you can see, existing social movement theories are a better fit with moderate SMOs than with radical SMOs (Fitzgerald & Rodgers, 2000).

Exhibit 14.7 ● Characteristics of Moderate and Radical SMOs Exhibit 14.7 ● Characteristics of Moderate and Radical SMOs

Moderate SMOs Radical SMOs

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Internal structure

Hierarchical leadership; formal bureaucratic organization; development of large membership base for resource generation

Nonhierarchical leadership; participatory democratic organization; egalitarian; “membership” based on involvement; Indigenous leadership

Ideology

Reform agenda; emphasis on being a contender in the existing political system; national focus

Radical agenda; emphasis on structural change; flexible ideology; radical networks; global consciousness

Tactics Nonviolent legalaction

Nonviolent direct action; mass actions; innovative tactics

Communication

Mainstream media and communication channels

Either ignored or misrepresented by mainstream media; reliance on alternative forms of communication (music, street theater, pamphlets, newsletters, digital technology, cell phones, text messaging)

Assessment of success

Measured in terms of reform of existing political/economic system; longevity

Measured in terms of contribution to larger radical agenda; subject to intense opposition and government surveillance; may be purposefully short-lived

Source: Based on Fitzgerald & Rodgers, 2000, Table 1.

This model helps us understand the dimensions of contemporary SMOs

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six feminist SMOs, Cheryl Hyde (2000) suggested that many social movement agencies fall somewhere between the moderate and radical SMO. The six agencies she studied had begun as grassroots organizations with traits consistent with the description of radical SMOs. They changed in varying ways over the years, however, falling on a continuum from moderate to radical at the point she studied them.

We are living in a time of growing inequality, distrust of governments, hot spots of ethnic hatred, and activism based on social identity. It is easy to get overwhelmed and feel powerless about the situations we confront. Social movement theory is an important ingredient in our social work survival kit. It helps us see, as the title of Sidney Tarrow’s (1998) book suggests, that there is “power in movement.” It provides a conceptual base to reinvigorate our social reform mission. We may take inspiration from some contemporary examples of courage and conviction that led to social change:

Rosa Parks, a tired seamstress on a public bus, helped launch the U.S. civil rights movement (Sernau, 2017). C. P. Ellis, a former Ku Klux Klan leader, started action that changed the racial climate of an entire community (Terkel, 1980). Craig Kielburger, a 12-year-old Canadian boy, began an international movement, Free the Children, to end child labor after reading a story about child workers in Pakistan (Sernau, 2014). In 1999, college students around the United States began a boycott of Reebok sports shoes, prompting improved conditions in that company’s Indonesian factories (Ivins, 1999). After the three major Icelandic banks collapsed in 2008, the “kitchenware revolution” called for the government to resign and for new elections to be held. With pressure from the streets, the new government nationalized the three major banks, compensated consumers for the loss of their savings, and arrested leading figures in the banking sector (Castells, 2012).

These are just a few of the empowering stories we can recall in our most discouraged moments to give us hope. But we must also remember that progress can be reversed. The need for justice-oriented social movements is constant.

Critical Thinking Questions 14.5

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Critical Thinking Questions 14.5

Do you see the goals of professional service and social reform as incompatible or as dual goals that can be fruitfully integrated? How prominent do you think the social reform goal is in the social work profession now? What factors do you think are influencing the current emphasis (or lack of emphasis) on social reform by the profession? How important are social movements in the search for social justice?

Implications for Social Work Practice This discussion of social movements recommends several principles for social work activism.

Become skillful in assessing political opportunities for social reform efforts. Become skillful in recognizing and mobilizing formal and informal networks for social reform activities. In conservative political eras, be vigilant about the temptation to encapsulate and lose sight of social work’s social reform mission. Become skillful at attracting new recruits to social reform activities and sustaining the morale and commitment of current participants. Become skillful in managing internal movement conflicts and avoiding factionalism. Become skillful in developing cultural frames that legitimate and motivate collective action. Assist social workers in direct practice to assess the benefits and costs to clients of involvement in social movement activities. Assist social workers in the traditional social welfare institution to recognize the important role that reform social movements play in identifying new or previously unrecognized social injustices and social service needs.

Key Terms charity organization society (COS) movement 431 conscience constituency 444 countermovement 435

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framing contests 444 mobilizing structures 437 mobilizing structures (MS) perspective 437 network model 433 political process (PP) perspective 433 proactive social movement 430 professional social movement organizations 438 reactive social movement 430 resource mobilization theory 438 settlement house movement 431 social movement organizations (SMOs) 438 social movement service organizations (SMSOs) 452 social movements 430 social reform 431 strain theory 431 transnational social movement organizations (TSMOs) 438

Active Learning 1. You read about some of the early history of the environmental justice

movement in the case study at the beginning of this chapter. This movement is more than 5 decades old. What, if anything, had you heard about this movement before reading the case study in the chapter? At this point, how do you evaluate its outcomes? How do you explain its successes? What challenges might lie ahead?

2. In this chapter, I suggest that successful social movements often open the way for countermovements. I also suggest that social movements may be either proactive or reactive. In considering these ideas, it is helpful to look at two social movements that hold competing views on issues related to women. Go to the websites of the National Organization for Women (NOW) at now.org and the National Right to Life Committee (NRLC) at www.nrlc.org. Study carefully the positions that each of these social movement organizations takes on the issue of abortion. What language and symbols does each organization use for framing the issue?

Web Resources

350.org: https://350.org

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http://www.nrlc.org

Web Resources

350.org: https://350.org

Site maintained by 350.org, a global grassroots climate movement, contains guides, templates, visuals, and resources to help when organizing against the climate crisis.

Amnesty International: www.amnesty.org

Site contains information about human rights by country, human rights by topic, human rights campaigns, and news.

Critical Social Work: www1.uwindsor.ca/criticalsocialwork

Site organized by the University of Windsor in Ontario, Canada, is an international, interdisciplinary e-journal whose goal is to promote dialogue about methods for achieving social justice.

GreaterGood: http://greatergood.com

Site maintained as part of a family of cause-related websites contains merchandise from leading online merchants, with a portion of the purchase going to a charity of choice.

Indigenous Environmental Network: www.ienearth.org

Site maintained by the Indigenous Environment Network, a North American organization with the goal of educating and empowering Indigenous Peoples to protect the environment, health, and all forms of life; contains videos, resources, and information on campaigns related to native energy, climate justice, food sovereignty, and saving the national forests.

National Resources Defense Council (NRDC): www.nrdc.org

Site maintained by the NRDC, a global organization of online activists, scientists, lawyers, and policy advocates around the globe fighting for the rights of all people to the air, the water, and the wild; contains information about the environmental justice movement, lists of climate experts, stories, and videos.

Wellstone: www.wellstone.org

Site maintained by the Wellstone organization that trains progressive leaders, includes information on impact, trainings,

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https://350.org

http://www.amnesty.org

http://www1.uwindsor.ca/criticalsocialwork

http://greatergood.com

http://www.ienearth.org

http://www.nrdc.org

http://www.wellstone.org

Glossary

ABC-X model of family stress and coping: A way of viewing families that focuses on stressor events and crises, family resources, family definitions and beliefs, and outcomes of stress pileup.

Accommodation (cognitive): The process of altering a schema when a new situation cannot be incorporated within an existing schema.

Accommodation (cultural): Process of partial or selective cultural change in which members of nondominant groups follow the norms, rules, and standards of the dominant culture only in specific circumstances and contexts.

Acculturation: A process of changing one’s culture by incorporating elements of another culture; a mutual sharing of culture.

Acquired immunodeficiency syndrome (AIDS): Disease caused by human immunodeficiency virus (HIV); involves breakdown of the immune system.

Adaptation: A change in functioning or coping style that results in a better adjustment of a person to his or her environment.

Affect: The physiological manifestation of a feeling.

Agency: The capacity to intentionally make things happen.

Agency-based model: A model of community social work practice that focuses on promoting social agencies and the services they provide.

Antibodies:

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Protein molecules that attach to the surface of specific antigens in an effort to destroy them.

Antigens: Foreign substances such as bacteria, fungi, protozoa, and viruses that cause the immune system to react.

Appreciative inquiry model of organizational change: A model of organizational change based on the premise that organizational change is best accomplished by engaging all organizational stakeholders in a positive examination of the organization’s past, present, and future.

Assimilation (cognitive): In cognitive theory, the incorporation of new experiences into an existing schema.

Assimilation (cultural): The process of managing cultural diversity whereby minority groups and new immigrants are expected to adopt the patterns and norms of the mainstream culture and cease to exist as a separate group.

Assistive devices: Those products designated by the medical community to help an impaired person to communicate, see, hear, or maneuver.

Assumption: Something taken to be true without testing or proof.

Atria: The two upper, thin-walled chambers of the heart.

Attribution theory: A theory of emotional behavior asserting that the experience of emotion is based on conscious evaluations people make about their physiological sensations in particular social settings.

Autoimmune disease: Disease that occurs when the immune system wrongly attacks systems it should be protecting.

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Axon: A conduction fiber that conducts impulses away from the body of a nerve cell.

Behavior settings: Settings where particular kinds of activities are performed. For example, a school classroom is a behavior setting where learning and teaching activities are performed.

Behavior settings theories: Theories proposing that consistent, uniform patterns of behavior occur in particular places, or behavior settings.

Behavioral perspective: An approach that sees human behavior as learned when individuals interact with their environments.

Bicultural socialization: Process whereby members of nonmajority groups master both the dominant culture and their own culture.

Bifurcate: Divide into two branches, as in labor force bifurcation into a core of stable, well-paid labor and a periphery of casual, low-wage labor.

Biophilia: A genetically based need of humans to affiliate with nature.

Blood pressure: Measure of the pressure of the blood against the wall of a blood vessel.

Bonding social capital: Community relationships that are inward looking and tend to mobilize solidarity and in-group loyalty; they lead to exclusive identities and homogeneous communities.

Boundary: An imaginary line of demarcation that defines which human and nonhuman elements are included in a given system and which elements are outside the system.

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Bounded rationality: The limited rationality of organization decision makers in decision- making theory of formal organizations.

Bridging social capital: Community relationships that are outward looking and diverse and that link community members to assets and information across community boundaries.

Brief treatment model: A type of practice modality characterized by a brief time period for intervention (usually 6 weeks or less) and practice techniques that are solution focused.

Built environment: The portion of the physical environment attributable solely to human effort.

Bureaucracy: A form of organization, considered by Max Weber to be the most efficient form for goal accomplishment, based on formal rationality.

Burnout: A process in which a previously committed worker disengages from his or her work in response to stress and strain experienced in the job.

Cardiovascular system: Biological system made up of the heart and the blood circulatory system.

Charity organization society (COS) movement: A social movement, brought to the United States from England in the late 1800s, that emphasized the delivery of services through private charity organizations.

Classical conditioning theory: A theory in the behavioral perspective that sees behavior as the result of the association of a conditioned stimulus with an unconditioned stimulus.

Closed group:

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A natural or formed group that is open to certain persons and closed to others based on such characteristics as age, gender, geographic location, or type of problem/issue; a natural or formed group that opens its membership for a certain time period and then closes the group when the ideal number of members has been reached or the time period has elapsed.

Cognition: Conscious thinking processes; mental activities of which the individual is fully aware. These processes include taking in information from the environment, synthesizing that information, and formulating plans of action based on that synthesis.

Cognitive mediation: The influence of thinking between the occurrence of a stimulus and one’s response to the stimulus.

Cognitive operations: Use of abstract thoughts and ideas that are not tied to sensory and motor information.

Cognitive social learning theory: A theory in the behavioral perspective that sees behavior as learned by imitation and through cognitive processes.

Cohabiting: When a couple lives together in a romantic relationship without marriage.

Collective efficacy: The ability of community residents to engage in collective action to gain control of the neighborhood.

Colonialism: The practice of dominant and powerful nations going beyond their boundaries; using military force to occupy and claim less dominant and powerful nations; imposing their culture, laws, and language on the occupied nation through the use of settlers.

Communication networks: The organization and pattern of communication among group

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members.

Community: People bound either by geography or by webs of communication, sharing common ties and interacting with one another.

Community development: A collaborative model of community social work that seeks to bring together diverse interests for the betterment of the community as a whole, with attention to community building and improved sense of community.

Concept: A word or phrase that serves as an abstract description, or mental image, of some phenomenon.

Conflict perspective: An approach to human behavior that draws attention to conflict, dominance, and oppression in social life.

Conscience constituency: People attracted to a social movement because it appears just and worthy, not because they will benefit personally.

Conservative thesis: A philosophy that inequality is the natural, divine order and no efforts should be made to alter it.

Control theories: Theories that focus on the issue of how much control we have over our physical environment and the attempts we make to gain control.

Conventional morality: In Kohlberg’s theory of moral development, a stage in which moral decisions are based on adherence to social rules.

Coping: A person’s efforts to master the demands of stress, including the thoughts, feelings, and actions that constitute those efforts.

Counterculture:

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A subculture that not only differs in significant ways from the dominant culture but also rejects the norms and values of the larger culture.

Countermovement: A social movement that arises to oppose a successful social movement.

Crisis: A major upset in psychological equilibrium as a result of some hazardous event, experienced as a threat or loss, with which the person cannot cope.

Critical consciousness: The ongoing process of reflection and knowledge seeking about mechanisms and outcomes of social, political, and economic oppression; requires taking personal and collective action toward fairness and social justice.

Critical perspective on organizations: A perspective that sees formal organizations as instruments of domination.

Critical race theory: A theory proposed by legal scholars who want to draw attention to racial oppression in law and society, calling attention to microaggressions, brief, everyday exchanges that send denigrating messages and insults to people of color or members of any other minority identity group.

Critical theorists: Theorists who argue that as capitalism underwent change, people were more likely to be controlled by culture and their consumer role than by their work position.

Critical thinking: Engaging in a thoughtful and reflective judgment about alternative views and contradictory information; involves thinking about your own thinking and the influences on that thinking, as well as a willingness to change your mind.

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Crowding: Unpleasant experience of feeling spatially cramped.

Cultural framing: A conscious effort by a group of people to develop shared understandings of the world and themselves.

Cultural framing (CF) perspective: An approach to social movements asserting that they can be successful only when participants develop shared understandings and definitions of some situation that impels participants to feel aggrieved or outraged, motivating them to action.

Cultural humility: A stance that recognizes that culture is an important part of human behavior, that people live within many different cultures, and that we will never understand other cultures as well as the people who live within them. It also requires that we be self-reflective about our own cultural experiences and interested in and open to how other people understand their own cultural identities.

Cultural relativism: A position that calls for suspending judgment of other people’s cultural values and practices in order to understand them in their own cultural context through the eyes of their own members, avoiding judging one culture by the standards of another culture.

Culture: A system of knowledge, beliefs, values, language, symbols, patterns of behavior, material objects, and institutions that are created, learned, shared, and contested by a group of people.

Daily hassles: Common occurrences that are taxing; used to measure stress.

Decision-making theory: A theory that sees organizational decision makers as constrained and limited in their capacity for rational decision making.

Deductive reasoning: A method of reasoning that lays out general, abstract propositions

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used to generate specific hypotheses to test in unique situations.

Deep ecology: A theory and a social movement that emphasizes the total interconnectedness of all elements of the natural and physical world and the inseparability of human well-being and the well-being of planet Earth; it argues for the intrinsic value of all life forms.

Defense mechanisms: Unconscious, automatic responses that enable a person to minimize perceived threats or keep them out of awareness entirely.

Density: Ratio of persons per unit area of a space.

Determinism: A belief that persons are passive products of their circumstances, external forces, or internal urges.

Developmental perspective: An approach that focuses on how human behavior changes and stays the same across stages of the life cycle.

Diabetes mellitus: A disease of the endocrine system resulting from insulin deficiency or resistance to insulin’s effects.

Differential emotions theory: A theory asserting that emotions originate in our neurophysiology and that our personalities are organized around affective biases.

Differentiation of self: In family systems theory, the process of learning to differentiate between thoughts and feeling and to follow one’s own beliefs rather than making decisions based on reactivity to the cues of others or the need to win approval.

Dimension: A feature that can be focused on separately but that cannot be understood without considering its embeddedness with other features.

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Diversity: Patterns of group differences.

Ecocentric: Perspective that the ecosphere and everything on earth has its own intrinsic worth and should be valued and cared for, including Earth (Gaia) itself; recognition that humans are only one part of the interconnected web of life.

Ecocritical theories: Theories that call attention to the ways human behavior degrades and destroys the natural world, the unequal burden of environmental degradation on different groups, and ethical obligations humans have to nonhuman elements of the natural environment.

Ecofeminism: A feminist approach to environmental ethics; sees the oppression of women and the domination of nature as interconnected.

Economic institution: The social institution with primary responsibility for regulating the production, distribution, and consumption of goods and services.

Ecotherapy: Exposure to nature and the outdoors as a component of psychotherapy.

Educational institution: The social institution responsible for passing along formal knowledge from one generation to the next.

Efficacy expectation: In cognitive social learning theory, the expectation that one can personally accomplish a goal.

Ego: A mental structure of personality responsible for negotiating between internal needs of the individual and the outside world.

Ego psychology: A theory of human behavior and clinical practice that views activities

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of the ego as the primary determinants of behavior.

Elites: The most powerful members of a society.

Emotion: A feeling state characterized by one’s appraisal of a stimulus, changes in bodily sensations, and expressive gestures.

Emotional intelligence: A person’s ability to process information about emotions accurately and effectively and consequently to regulate emotions in an optimal manner.

Emotional labor: A form of emotion regulation wherein workers are expected to engage, suppress, or evoke emotions as part of their job.

Emotion-focused coping: Coping efforts in which a person attempts to change either the way a stressful situation is attended to (by vigilance or avoidance) or the meaning of what is happening. Most effective when situations are not readily controllable by action.

Empirical research: A careful, purposeful, and systematic observation of events with the intent to note and record them in terms of their attributes, to look for patterns in those events, and to make one’s methods and observations public.

Empowerment theories: Theories that focus on processes by which individuals and collectivities can recognize patterns of inequality and injustice and take action to increase their own power.

Enculturation: The process of learning culture.

Endocrine system: A body system involved in growth, metabolism, development, learning, and memory. Made up of glands that secrete hormones into

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the blood system.

Environmental justice: The situation that occurs when the burden of environmental hazards or degradation is shared equally across all demographic groups or communities, and there is equal inclusion in decision-making processes about environmental policies and action steps

Ethnic identity: That part of personal identity that derives from one’s sense of being a part of an ethnic group.

Ethnicity: A sense of cultural, historical, and sometimes ancestral connection to a group of people that is considered to be distinct from people outside the group.

Ethnocentrism: The belief that one’s own cultural way of life is normal, natural, and even superior to other cultural ways of life; other cultures are judged by the standards of one’s own culture.

Evidence-based design: Architectural design that reflects findings on physiological and health-outcome measures on the health benefits of specific design features.

Exchange and choice perspective: A category of behavioral science theory that shares the common focus on the processes whereby individual and collective actors seek and exchange resources and the choices made in pursuit of those resources.

Exchange and choice perspective on families: A way of studying families that assumes that family relationships are based on the exchange of resources valued by the participants—that family members act to maximize those outcomes they most value.

Faith: As defined in Fowler’s theory of faith development, a generic feature of the human search for meaning that provides a centering orientation

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from which to live one’s life. May or may not be based in religious expression.

Faith stages: Distinct levels of faith development, each with particular characteristics, emerging strengths, and potential dangers. Fowler identifies seven faith stages in his theory of faith development.

Family: A social group of two or more persons, characterized by ongoing interdependence with long-term commitments that stem from blood, law, or affection.

Family and kinship institution: The social institution primarily responsible for the regulation of procreation; for the initial socialization of new members of society; and for the economic, emotional, and physical care of its members.

Family ecomap: Visual representation of how a family is connected to other individuals and social systems; uses circles, lines, and arrows to show family relationships and the strength and directional flow of energy and resources to and from the family.

Family economic stress model: A model of family stress suggesting that economic hardship leads to economic pressure, which leads to parent distress, which leads to disrupted family relationships, which leads to child and adolescent adjustment problems.

Family investment model: Theoretical model proposing that families with greater economic resources can afford to make large investments in the development of their children.

Family of origin: The family into which we were born and in which we were raised, when the two are the same.

Family resilience perspective: An approach to family that seeks to identify and strengthen family

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processes that allow families to bear up under and rebound from distressing life experiences.

Family stress, coping, and resilience perspective: A perspective on families that incorporates research on individual stress and coping and the risk and resilience framework to understand how families cope with stress.

Family systems perspective: A way of understanding families that focuses on the family as a social system, with patterns of interaction and relationships, and on changes in these patterns over time.

Family timeline: A visual representation of important dates and events in a family’s life over time.

Feedback mechanisms: Processes that use the conditions of one component to regulate the functions of another or by which outputs of the system are fed back as inputs in a circular manner.

Feminist perspective on families: A perspective proposing that families should not be studied as whole systems, with the lens on the family level, but rather as patterns of dominance, subjugation, and oppression, particularly as those patterns are tied to gender.

Feminist theories: Theories that focus on male domination of the major social institutions and present a vision of a just world based on gender equity.

First force therapies: Therapies based on dynamic theories of human behavior, with the prime concern being solving instinctual conflicts by developing insights.

Formal organization: A collectivity of people, with a high degree of formality of structure, working together to meet a goal or goals.

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Formed group: A group formed for a specific purpose, such as a group for substance abusers, a therapy group for women with eating disorders, or a self- help group for gamblers.

Fourth force therapies: Therapies that specifically target the spiritual dimension, focusing on helping the person let go of ego attachments and transcend the self through various spiritually based practices.

Framing contests: Competition among factions of a social movement to control the definition of the problem, goals, and strategies for the movement.

Gemeinschaft: A community in which relationships are personal and traditional.

Gender: A cultural creation, composed of the behavioral expectations that each culture assigns to people of different sexes.

General adaptation syndrome: The physical process of coping with a stressor through the stages of alarm (awareness of the threat), resistance (efforts to restore homeostasis), and exhaustion (the termination of coping efforts because of the body’s inability to sustain the state of disequilibrium).

Genogram: A visual representation of the multigenerational family system, using squares, circles, and relationship lines.

Geographic information system (GIS): Computer-based system for mapping the spatial distribution of a variety of social data.

Gesellschaft: A community in which relationships are impersonal and contractual.

Gini index: An index that measures the extent to which the distribution of income within a country deviates from a perfectly equal distribution; scores

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range from 0 (perfect equality) to 100 (perfect inequality).

Globalization: The process by which the world’s people are becoming more interconnected economically, politically, environmentally, and culturally.

Government and political institution: The social institution responsible for how decisions are made and enforced for the society as a whole.

Group cohesiveness: A tendency for a group to stick together and be unified in the pursuit of its objectives and the satisfaction of members’ emotional needs.

Group dynamics: The patterns of interaction that emerge in groups, including group leadership, roles, and communication networks.

Group work: A recognized social work method that involves teaching and practicing social work with groups.

Hawthorne effect: Tendency of participants in an experimental study to perform in particular ways simply because they know they are being studied.

Health care institution: The social institution with primary responsibility for promoting the general health of a society.

Hegemony: The ability of a dominant group to obtain consent and agreement to cultural values and norms without the use or threat of force.

Heterogeneity: Individual-level variations; differences among individuals.

Hierarchy of needs: Abraham Maslow’s humanistic theory suggesting that higher needs cannot emerge until lower needs have been satisfied; the hierarchy

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runs from physiological needs at the bottom, to safety needs, belongingness and love needs, and esteem needs, with self- actualization needs at the top.

High blood pressure (hypertension): Blood pressure greater than 140/90; the leading cause of stroke and a major risk factor for heart attack and kidney failure.

Homeostasis: Equilibrium; a positive, steady state of biological, psychological, or social functioning.

Horizontal linkage: Interaction within a community.

Human agency: The capacity of individuals to act independently and to make their own free choices.

Human immunodeficiency virus (HIV): The virus that causes acquired immunodeficiency syndrome (AIDS).

Human relations theory: A theory that focuses on the role of human relationships in organizational efficiency and effectiveness.

Humanistic perspective: An approach that sees human behavior as based on freedom of action of the individual and focuses on the human search for meaning.

Hybrid organization: An organization that combines political advocacy and service provision in its core identity.

Hypotheses: Tentative statements to be explored and tested.

Ideology (cultural): A set of shared beliefs that explains the social world and guides people’s actions, especially in relation to economic and political theory and policy.

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Ideology (personal): A particular body of ideas or outlook; a person’s specific worldview.

Immune system: Organs and cells that interact and work together to defend the body against disease.

Information processing theory: A sensory theory of cognition that sees information as flowing from the external world through the senses to the nervous system, where it is coded.

Institutional theory of organizations: A perspective that focuses on how formal organizations are embedded in society and its major institutions and shaped by them.

Interactional/interpretive perspective on organizations: A perspective that sees formal organizations as social constructions of reality, providing members with a sense of connection and reflecting the worldviews of the creators.

Interdisciplinary team: A special type of task group composed of professionals representing a variety of disciplines; it may also include consumers or clients.

Interpretist perspective: Ways of understanding human behavior that share the assumption that reality is based on people’s definition of it.

Intersectionality feminist theory: A feminist theory suggesting that no single category is sufficient to understand social oppression and that categories such as gender, race, and class intersect to produce different experiences for women of various races and classes.

Intersectionality theory: A pluralist theory of social conflict that recognizes numerous vectors of oppression and privilege, including but not limited to gender, class, race, global location, sexual orientation, and age; recognizes that individuals often hold cross-cutting and overlapping memberships in different status groups.

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Iron cage of rationality: Max Weber’s term for the dehumanizing potential of bureaucracies.

Language: The system of words or signs that people use to express thoughts and feelings to each other.

Leadership: A process of influencing a group to achieve a common goal.

Learned helplessness: In cognitive social learning theory, a situation in which a person’s prior experience with environmental forces has led to low self- efficacy and efficacy expectation.

Learning organization theory: A theory of formal organizations developed on the premise that rational planning is not sufficient for an organization to survive in a rapidly changing environment such as the one in which we live and that formal organizations must become complex systems capable of constant learning.

Levels of consciousness: From Wilber’s integral theory, overall stages of awareness and being; moving from the prepersonal to the personal and transpersonal phases, each with multiple levels of development.

Life course developmental perspective on families: A perspective that focuses on families as multigenerational systems moving through time, composed of people who have a shared history and a shared future

Linear time: Time based on past, present, and future.

Lone-parent families: Families composed of one parent and at least one child residing in the same household, headed by either a divorced or unmarried parent.

Lymphocytes: White blood cells.

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Management by objectives: An approach to organizational leadership that involves both short- range and long-range planning of organizational objectives and the structures and processes for meeting those objectives

Managing diversity model: An approach to formal organizations that focuses on the need to maximize the potential advantages, and minimize the potential disadvantages, of diversity in organizational membership.

Mass media institution: In a democratic society, the social institution responsible for managing the flow of information, images, and ideas.

Material culture: Includes physical objects, resources, and spaces that people use to define their culture; examples include homes, religious places of worship, work spaces, tools, products, and technologies.

Materialist perspective (culture): A theoretical perspective on culture that places primary emphasis on the role of the environment, technology, and economy in creating, maintaining, and changing culture.

Mentalist perspective (culture): A theoretical perspective on culture that sees humans creating, maintaining, and changing culture based on their beliefs, values, language, and symbolic representations.

Mobilizing structures: Existing informal networks and formal organizations that serve as the collective building blocks for social movements.

Mobilizing structures (MS) perspective: An approach to social movements that suggests that they develop out of existing networks and formal organizations.

Mood: A feeling disposition that, in contrast to an emotion, is more chronic, less intense, and less tied to a specific situation.

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Multiculturalism: The process of managing ethnic diversity whereby minority groups and new immigrants and their children enculturate to the mainstream culture while also retaining their ethnic culture.

Multidetermined behavior: A view that human behavior is developed as a result of many causes.

Multidimensional: Having several identifiable dimensions.

Multilevel family practice model: A way of viewing a family that focuses on stress from and resources provided (or not provided) by patterns and institutions within larger social systems, including the neighborhood, local community, state, nation, and global socioeconomic system.

Multiple intelligences: The eight distinct biopsychosocial potentials, as identified by Howard Gardner, with which people process information that can be activated in cultural settings to solve problems or create products of value in the culture.

Multiple psychological senses of community (MPSOC): The idea that individuals participate in multiple communities and consequently have multiple senses of community.

Musculoskeletal system: Muscles that are attached to bone and cross a joint. Their contraction and relaxation are the basis for voluntary movements.

Mutual aid group: A formed group of persons who use the support, encouragement, and feedback from other persons in the group to work on certain problems they have in common.

Narrative theory: A theory proposing that all of us are engaged in an ongoing process of constructing a life story.

Natural environment:

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That part of the environment made up of all living and nonliving things naturally occurring.

Natural group: A group that occurs naturally, without external initiative, such as a group of peers or coworkers.

Neocolonialism: The practice of dominant and powerful nations going beyond their boundaries, using international financial institutions such as the World Bank and the International Monetary Fund to exert influence over impoverished nations and to impose their culture, laws, and language on the occupied nations using financial incentives (loans) and disincentives.

Neoliberal philosophy: A philosophy that governments should keep their hands off the economic institution.

Nervous system: The biological system that provides the structure and processes for multiway communication of sensory, perceptual, and autonomically generated information throughout the body.

Network: A set of relationships and ties among a set of actors.

Network model: A social movement theory in the mobilizing structures perspective that focuses on the role of grassroots settings in the development and maintenance of social movements.

Networked individualism: A way of thinking about community in which individuals operate in large, personalized, complex networks.

Neuron: Nerve cell that is the basic working unit of the nervous system. Composed of a cell body, dendrites (receptive extensions), and an axon.

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Neuroplasticity: The ability of the brain to change its structure and patterns of activity in significant ways throughout life.

Neurotransmitters: Messenger molecules that transfer chemical and electrical messages from one neuron to another.

Nonhierarchical organization: An organization run by consensus, with few rules, characterized by informality.

Nonnormative stressors: Unexpected stressful events that can quickly drain a family’s resources.

Nonspecific immunity: Immunity that includes physical barriers to infection, inflammation, and phagocytosis. Does not include antibodies or cell-mediated immunity.

Norm: Culturally defined standard or rule of conduct.

Normative stressors: The stressors families face as a result of typical family life cycle transitions.

Objective reality: The belief that phenomena exist and have influence, whether or not we are aware of them.

Ongoing group: A natural or formed group that is set up without a time limit and meets until the group is disbanded.

Open group: A natural or formed group that includes any person who would like to become a member; a natural or formed group that accepts persons who meet the group’s criteria after the group has begun and throughout its existence.

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Operant conditioning theory: A theory in the behavioral perspective that sees behavior as the result of reinforcement.

Organizational culture model: An approach to formal organizations that sees them as cultures with shared experiences and shared meanings.

Organizational humanism: An approach to formal organizations that assumes organizations can maximize efficiency and effectiveness while also promoting individual happiness and well-being.

Organizations as multiple oppressions: A theory of organizations that views them as social constructions that exclude and discriminate against some categories of people.

Outsourcing: In the economic institution, the relocation of goods and services production from one place to another as a strategy for cost reduction.

Performance expectations: The expectations group members have of other group members in terms of how they will act or behave in the group or how well they will perform a task.

Personal community: Networks of social interaction composed of friends, relatives, neighbors, workmates, and so on.

Personal network: Those from the social network who provide a person with his or her most essential support resources.

Personal space: The physical distance we choose to maintain in interpersonal relationships.

Person-in-environment (PIE) classification system: A classification system developed for the purpose of social work assessment. Assessment is based on four factors: social functioning

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problems, environmental problems, mental health problems, and physical health problems.

Phenomenal self: An individual’s subjectively felt and interpreted experience of “who I am.”

Place attachment: A process in which individuals and groups form bonds with places.

Place identity: A process in which the meaning of a place merges with one’s self- identity.

Political economy model: A model of formal organizations that focuses on the organization’s dependence on its environments for political and economic resources and, more specifically, on the influence of political and economic factors on the internal workings of the organization.

Political process (PP) perspective: An approach to social movements that suggests they develop when windows of political opportunity are open.

Positive psychology: An approach to psychology that focuses on people’s strengths and virtues and promotes optimal functioning of individuals and communities.

Positivist perspective: The perspective on which modern science is based. Assumes objective reality: that findings of one study should be applicable to other groups, that complex phenomena can be studied by reducing them to some component part, and that scientific methods are value- free.

Postconventional morality: In Kohlberg’s theory of moral development, a stage in which moral decisions are based on moral principles that transcend those of one’s own society.

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Postpositivism: A philosophical position that recognizes the complexity of reality and the limitations of human observers; proposes that scientists can never develop more than a partial understanding of human behavior.

Post-traumatic stress disorder (PTSD): A set of symptoms experienced by some trauma survivors that includes reliving the traumatic event, avoidance of stimuli related to the event, and hyperarousal.

Practice orientation (culture): A way of thinking about culture that recognizes the relationships and mutual influence among structures of society and culture, the impact of history, and the impact of human agency.

Preconscious: Mental activity that is outside of awareness but can be brought into awareness with prompting.

Preconventional morality: In Kohlberg’s theory of moral development, a stage in which moral decisions are made based on avoiding punishment and receiving rewards.

Primary emotions: Emotions that developed as specific reactions and signals with survival value for the human species. They serve to mobilize an individual, focus attention, and signal one’s state of mind to others; examples include anger, fear, sadness, joy, and anticipation.

Primary territory: A territory that evokes feelings of ownership, that we control on a relatively permanent basis, and that is vital to our daily lives.

Privacy: Selective control of access to the self or to one’s group.

Privatization: Shifting the administration of programs from government to nongovernment organizations.

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Privilege: Unearned advantage enjoyed by members of some social categories.

Proactive social movement: A social movement with the goal of changing traditional social arrangements.

Problem-focused coping: Coping efforts in which the person attempts to change a stress situation by acting on the environment. Most effective when situations are controllable by action.

Process-oriented leader: A leader who identifies and manages group relationships.

Professional social movement organizations: Organizations staffed by leaders and activists who make a career out of reform causes.

Programs: In behavior settings theories, the consistent, prescribed patterns of behavior developed and maintained in particular behavior settings.

Proposition: An assertion about a concept or about the relationship between concepts.

Psychoanalytic theory: A theory of human behavior and clinical intervention that assumes the primacy of internal drives and unconscious mental activity in determining human behavior.

Psychodynamic perspective: An approach that focuses on how internal processes motivate human behavior.

Psychoeducational group: A formed group focused on providing information and support concerning a particular problem area or issue; such groups usually meet over a short period of time.

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Psychology: The study of the mind and mental processes.

Public territory: A territory open to anyone, to which we generally make no attempt to control access.

Qualitative methods of research: Research methods that use flexible methods of data collection, seek holistic understanding, present findings in words rather than numbers, and attempt to account for the influence of the research setting and process on the findings.

Quantitative methods of research: Research methods, based on the tenets of modern science, that use quantifiable measures of concepts, standardize the collection of data, attend only to preselected variables, and use statistical methods to look for patterns and associations.

Race: A system of classification that uses certain physical characteristics to divide the human population into supposedly discrete groups.

Racism: The belief that race accounts for differences in human character or ability and that a particular race is superior to others, justifying access to power, privilege, resources, and opportunities on the basis of race.

Radical antithesis: Philosophy that equality is the natural, divine order and that inequality is based on abuse of privilege and should be minimized.

Rational perspective on organizations: A perspective that sees formal organizations as goal-directed, purposefully designed machines that maximize efficiency and effectiveness.

Reactive social movement: A social movement with the goal of defending traditional values and social arrangements.

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Reciprocity: A norm that receiving resources in social exchange requires giving resources of relatively equal value, proposed by social exchange theory.

Relational community: A community based on voluntary association rather than geography.

Relational coping: Coping that takes into account actions that maximize the survival of others as well as oneself.

Relational theory: A theory proposing that the basic human tendency is relationships with others and that our personalities are formed through ongoing interactions with others.

Religion: A systematic set of beliefs, practices, and traditions experienced within a particular social institution over time.

Religious institution: The social institution with primary responsibility for answering questions about the meaning and purpose of life.

Resource mobilization theory: A social movement theory in the mobilizing structures perspective that focuses on the role of formal organizations in the development and maintenance of social movements.

Role: A set of usual behaviors of persons occupying a particular social status or position.

Role strain: Problems experienced in the performance of specific roles. Used by sociologists to measure stress.

Satisfice: In organizational theory, to seek satisfactory rather than perfect solutions and to discontinue the search for alternative solutions when

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a satisfactory solution is available.

Schema: An internalized representation of the world, including systematic patterns of thought, action, and problem solving.

Science: A set of logical, systematic, documented methods for answering questions about the world.

Scientific management: A set of principles developed by Frederick Taylor to maximize the internal efficiency of formal organizations; it is focused on finding the “one best way” to perform every organizational task.

Second force therapies: Therapies based on behavioral theories; they focus on learned habits and seek to remove symptoms through various processes of direct learning.

Secondary emotions: Emotions that are socially acquired. They evolved as humans developed more sophisticated means of learning, controlling, and managing emotions to promote flexible cohesion in social groups. Examples include envy, jealousy, anxiety, guilt, shame, relief, hope, depression, pride, love, gratitude, and compassion.

Secondary territory: A territory less important to us than primary territories, control of which does not seem essential.

Self: An essence of who we are that is more or less enduring.

Self-categorization theory: A theory of small groups proposing that in the process of social identity development, we come to divide the world into in-groups (those to which we belong) and out-groups (those to which we do not belong) and to be biased toward in-groups.

Self-efficacy:

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A sense of personal competence.

Self-help group: A formed group, which may or may not be professionally led, composed of persons who share a common life situation.

Sense of community: A feeling of belonging and mutual commitment.

Settlement house movement: A social movement, brought to the United States from England in the late 1800s, that turned attention to the environmental hazards of industrialization and focused on research, service, and social reform.

Small group: Two or more people who interact with each other because of shared interests, goals, experiences, or needs.

Social action model: A model of community social work practice that emphasizes social reform and the challenge of structural inequalities.

Social capital: Connections among individuals that provide potential sources of a number of types of resources.

Social class: A particular position in a societal structure of inequality.

Social constructionist perspective: An approach that focuses on how people learn, through their interactions with each other, to classify the world and their place in it.

Social entrepreneurial organization: An organization formed by a social entrepreneur who recognizes a social problem and uses ideas from business entrepreneurs to organize, create, and manage a new venture to bring about social change related to that problem.

Social exchange theory: A theory in the exchange and choice perspective that sees human

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behavior as based on the desire to maximize benefits and minimize costs in social interactions.

Social identity theory: A stage theory of socialization that articulates the process by which we come to identify with some social groups and develop a sense of difference from other social groups.

Social institutions: Patterned ways of organizing social relations in a particular sector of social life.

Social movement organizations (SMOs): Formal organizations through which social movement activities are coordinated.

Social movement service organizations (SMSOs): A type of social agency that has the explicit goal of social change and accomplishes this goal through the delivery of services.

Social movements: Consciously organized and sustained attempts by ordinary people working outside of established institutions to change some aspect of society

Social network: The people with whom a person routinely interacts; the patterns of interaction that result from exchanging resources with others.

Social network theory: A developing theory in the exchange and choice perspective that focuses on the pattern of ties that link persons and collectivities.

Social planning model: A model of community social work based on the premise that the complexities of modern social problems require expert planners schooled in a rational planning model; also referred to as a top-down approach.

Social reform: Efforts to create more just social institutions.

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Social structure: A set of interrelated social institutions developed by humans to provide stability to society and order to individual lives.

Social support: The interpersonal interactions and relationships that provide people with assistance or feelings of attachment to others they perceive as caring.

Social welfare institution: The social institution in modern industrial societies that is concerned with allocating goods, services, and opportunities to enhance social functioning of individuals and contribute to the social health of the society.

Specific immunity: Immunity that involves cells (lymphocytes) that not only respond to an infection but also develop a memory of that infection and allow the body to defend against it rapidly during subsequent exposure.

Spiritual bypassing: Use of spiritual beliefs or practices to avoid dealing in any significant depth with unresolved issues and related emotional and behavioral problems; includes attempts to prematurely transcend the ego.

Spirituality: A search for purpose, meaning, and connection among oneself, other people, the universe, and the ultimate reality that can be experienced within either a religious or nonreligious framework.

Staffing: In behavior settings theories, the participants in a particular behavior setting.

State: A personality characteristic that changes over time, depending on the social or stress context.

States of consciousness: From Wilber’s integral theory, an understanding of experience that includes both ordinary (waking, sleeping, and dreaming) and

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nonordinary experiences (peak experiences, religious experiences, altered states, and meditative or contemplative states).

Status: A specific social position.

Status characteristics: In status characteristics and expectation states theory, any characteristics evaluated in the broader society to be associated with competence.

Status characteristics and expectation states theory: A theory of basic group processes assuming that the influence and participation of group members during initial interactions are related to their status and to expectations others hold about their ability to help the group accomplish tasks.

Stimulation theories: Theories that focus on the physical environment as a source of sensory information necessary for human well-being.

Strain theory: An approach to social movements that sees them as developing in response to some form of societal strain.

Stress: Any biological, psychological, or social event in which environmental demands or internal demands, or both, tax or exceed the adaptive resources of the individual.

Stress pileup: When a series of crises over time depletes a family’s resources and exposes the family to increasing risk of very negative outcomes.

Subculture: A group of people in a given culture who accept much of the dominant culture but distinguish themselves by one or more culturally significant characteristics.

Subjective reality: The belief that reality is created by personal perception and does not

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exist outside that perception; the same as the interpretist perspective.

Symbol: An artifact (such as a flag) or verbal (language) or nonverbal (standing for the national anthem) behavior that comes to stand for something else; a way of expressing meaning.

Symbolic interaction perspective on families: An application of symbolic interaction theory to families that understands family life as a system of meaning created through interaction.

Symbolic interactionism: A theory stressing that we develop a sense of meaning in the world through interaction with our physical and social environments and interpretation of symbols.

Synapse: In the nervous system, the gap between an axon and a dendrite; the site at which chemical and electrical communication occurs.

Systems perspective: An approach that sees human behavior as the outcome of reciprocal interactions of persons operating within linked social systems.

Systems perspective on organizations: A perspective that focuses on formal organizations in constant interaction with multiple environments.

Task group: A group formed to accomplish a specific goal or objective.

Task-oriented leader: A leader who facilitates problem solving within the context of the group.

Technology: The tools, machines, instruments, and devices developed and used by humans to enhance their lives.

Territorial community:

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A community based on geography.

Territoriality: A pattern of behavior of a group or individual that involves marking or personalizing a territory to signify ownership and engaging in behaviors to protect it from invasion.

Testes: Male gonads, primarily responsible for producing sperm (mature germ cells that fertilize the female egg) and secreting male hormones called androgens.

Theory: An interrelated set of concepts and propositions, organized into a deductive system that explains relationships among aspects of our world.

Theory of gendered organizations: Theory of formal organizations that proposes that women are disadvantaged in workplaces because male dominance is embedded in organizational structure and processes.

Therapy group: A formed group that uses an intensive group format to promote growth in its members and to assist its members in resolving emotional and behavioral problems.

Third force therapies: Therapies rooted in experiential/humanistic/existential theories that focus on helping a person deal with existential despair and that seek the actualization of the person’s potential through techniques grounded in immediate experiencing.

Time-limited group: A natural or formed group whose members or leader establish a certain length of time that they will meet as a group.

Time orientation: The extent to which individuals and collectivities are invested in three temporal zones: past, present, and future.

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Trait: A stable personality characteristic.

Transition points: Time when families face a transition in family life stage or in family composition.

Transnational corporation (TNC): A very large company that carries on production and distribution activities in many nations.

Transnational social movement organizations (TSMOs): Social movement organizations that operate in more than one nation- state.

Transpersonal approach: An approach to human behavior that includes levels of consciousness or spiritual development that move beyond rational-individuated- personal personhood to a sense of self that transcends the mind/body ego—a self-identity also referred to as transegoic.

Traumatic stress: Stress associated with events that involve actual or threatened severe injury or death of oneself or significant others.

Ultimate environment: Conceptualizations of the highest level of reality, understood differently by persons at various levels of spiritual development or consciousness.

Unconscious: Mental activities of which one is not aware but that influence behavior.

Uterus: Also called the womb; serves as the pear-shaped home for the fetus for the 9 months from implantation to birth.

Values: Beliefs about what is important or unimportant, desirable or undesirable, and right or wrong.

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Ventricles: The two lower, thick-walled chambers of the heart.

Vertical linkage: Interaction with systems external to the community.

Voluntarism: The belief that persons are free and active agents in the creation of their behaviors.

Worldcentric: Identification beyond the “me” (egocentric) or the “us” (ethnocentric) to identification and concern for “all of us” (worldcentric), or the entire global human family; a moral stance characteristic of higher levels of spiritual development.

Xenophobia: Fear and hatred of strangers or foreigners or of anything that is strange or foreign.

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References

23andMe. (2017). The latest science. Results you can trust. Retrieved from www.23andme.com/genetic-science/

350.org. (2018). About 350.org. Retrieved from https://350.org/about/

Abajobir, A., Kisely, S., Williams, G., Strathearn, L., & Najman, J. (2017). Height deficit in early adulthood following substantiated childhood maltreatment: A birth cohort study. Child Abuse & Neglect, 64, 71–78.

Abma, J., & Martinez, G. (2006). Childlessness among older women in the United States: Trends and profiles. Journal of Marriage and Family, 68, 1045–1056.

Abrams, D., Hogg, M., Hinkle, S., & Otten, S. (2005). The social identity perspective on small groups. In M. Poole & A. Hollingshead (Eds.), Theories of small groups: Interdisciplinary perspectives (pp. 99–137). Thousand Oaks, CA: Sage.

Acker, J. (1990). Hierarchies, jobs, bodies: A theory of gendered organizations. Gender & Society, 4, 139–158.

Acker, J. (2006). Inequality regimes—gender, class, and race in organizations. Gender & Society, 20, 441–464.

Acker, J. (2012). Gendered organizations and intersectionality: Problems and possibilities. Equality, Diversity and Inclusion: An International Journal, 31(3), 214–224.

Adams, B., & Trost, J. (2005). Handbook of world families. Thousand Oaks, CA: Sage.

954

http://www.23andme.com/genetic-science/

https://350.org/about/

Addams, J. (1910). Twenty years at Hull House. New York: MacMillan.

Adler, N., & Stewart, J. (2010a). Preface to the biology of disadvantage: Socioenomomic status and health. Annals of the New York Academy of Sciences, 1186, 1–4.

Adler, N., & Stewart, J. (2010b). Health disparities across the lifespan: Meaning, methods, and mechanisms. Annals of the New York Academy of Sciences, 1186, 5–23.

Afshar, P., Foroughan, M., Vedadhir, A., & Tabatabaei, G. (2017). The effects of place attachment on social well-being in older adults. Educational Gerontology, 43(1), 45–51.

Aguilar, M. A. (2001). Catholicism. In M. Van Hook, B. Hugen, & M. Aguilar (Eds.), Spirituality within religious traditions in social work practice (pp. 120–145). Pacific Grove, CA: Brooks/Cole.

Ahmed, T., Hoyle, R., Shaffer, P., Connelly, K., Crandall, D., & Kapadia, A. (2017). Understanding the physical safety, security, and privacy concerns of people with visual impairments. IEEE Internet Computing, 21(3), 56–63.

Ahmed-Mohamed, K. (2011). Social work practice and contextual systemic intervention: Improbability of communication between social work and sociology. Journal of Social Work Practice, 25(1), 5–15.

Ahrons, C. (2016). Divorce: An unscheduled family transition. In M. McGoldrick, N. Preto, & B. Carter (Eds.), The expanding family life cycle: Individual, family, and social perspectives (5th ed., pp. 376–393). Boston: Pearson.

Ainsworth, M. S., Blehar, M. C., & Waters, E. (1978). Patterns of attachment: A psychological study of the strange situation. Oxford, UK:

955

Erlbaum.

Akesson, B., Burns, V., & Hordyk, S. (2017). The place of place in social work: Rethinking the person-in-environment model in social work education and practice. Journal of Social Work Education, 53(3), 372–383.

Al-Bishawi, M. Ghadban, S., & Jørgensen, K. (2017). Women’s behavior in public spaces and the influence of privacy as a cultural value: The case of Nablus, Palestine. Urban Studies, 54(7), 1559–1577.

Aldwin, C. M., & Wenner, E. E. (2009). Stress, coping, and development: An integrative perspective (2nd ed.). New York: Guilford Press.

Alinsky, S. (1971). Rules for radicals. New York: Vintage.

Allen, K., & Henderson, A. (2017). Family theories: Foundations and applications. Walden, MA: Wiley.

Allen, K., Lloyd, S., & Few, A. (2009). Reclaiming feminist theory, method, and praxis for family studies. In S. Lloyd, A. Few, & K. Allen (Eds.), Handbook of feminist family studies (pp. 3–17). Thousand Oaks, CA: Sage.

Almaas, A. H. (1995). Luminous night’s journey. Berkeley, CA: Diamond Books.

Almaas, A. H. (1996). The point of existence. Berkeley, CA: Diamond Books.

Alperovitz, G. (2005). America beyond capitalism: Reclaiming our wealth, our liberty, and our democracy. Hoboken, NJ: Wiley.

956

Altman, I. (1975). The environment and social behavior: Privacy, personal space, territory, and crowding. Monterey, CA: Brooks/Cole.

Amaoka, T., Laga, H., Yoshi, M., & Nakajima, M. (2011). Personal space- based simulation of non-verbal communications. Entertainment Computing, 2, 245–261.

Amato, P. (2005). The impact of family formation change on the cognitive, social, and emotional well-being of the next generation. The Future of Children, 15(2), 75–96.

Amato, P. (2010). Research on divorce: Continuing trends and new developments. Journal of Marriage and Family, 72(3), 650–666.

Amato, P., & Anthony, C. (2014). Estimating the effects of parental divorce and death with fixed effects models. Journal of Marriage and Family, 76(2), 370–386.

Amaya-Jackson, L. (2016). The Adverse Childhood Experiences Study and beyond. Journal of the American Academy of Child and Adolescent Psychiatry, 55(Suppl.), 67.

Amenta, E., Caren, N., & Stobaugh, J. (2012). Political reform and the historical trajectories of U.S. social movements in the twentieth century. Social Forces, 90(4), 1073–1100.

American Academy of Child and Adolescent Psychiatry. (2015). Adopted children. Retrieved from www.aacap.org/AACAP/Families_and_youth/Facts_for_Families/FFF- Guide/The-Adopted-Child-015.aspx

American Diabetes Association. (2013). The cost of diabetes. Retrieved from www.diabetes.org/advocate/resources/cost-of-diabetes.html

957

http://www.aacap.org/AACAP/Families_and_youth/Facts_for_Families/FFF-Guide/The-Adopted-Child-015.aspx

http://www.diabetes.org/advocate/resources/cost-of-diabetes.html

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

American Psychological Association. (2013). Gun violence research: History of the federal funding freeze. Retrieved from www.apa.org/science/about/psa/2013/02/gun-violence.aspx

Amodio, D. (2014). The neuroscience of prejudice and stereotyping. Nature, 15, 670–682.

Amole, D. (2005). Coping strategies for living in student residential facilities in Nigeria. Environment & Behavior, 37(2), 201–219.

Anandarajah, G., & Hight, E. (2001). Spirituality and medical practice: Using the HOPE questions as a practical tool for spiritual assessment. American Family Physician, 63(1), 81–99.

Anastasiou, D., & Kauffman, J. M. (2013). The social model of disability: Dichotomy between impairment and disability. Journal of Medicine & Philosophy, 38(4), 441–459.

Anderson, C. (2012). The diversity, strengths, and challenges of single- parent households. In F. Walsh (Ed.), Normal family processes: Growing diversity and complexity (4th ed., pp. 128–148). New York: Guildford.

Anderson, H. (2009). A spirituality for family living. In F. Walsh (Ed.), Spiritual resources in family therapy (2nd ed., pp. 194–211). New York: Guilford Press.

Anderson, P. (2008). The powerful bond between people and pets: Our boundless connections to companion animals. Westport, CT: Praeger.

958

http://www.apa.org/science/about/psa/2013/02/gun-violence.aspx

Andric, M., & Hasson, U. (2015). Global features of functional brain networks change with contextual disorder. NeuroImage, 117, 103–113.

Antoinette, M., & WinklerPrins, M. (2010). Cultural ecology. In B. Warf (Ed.), Encyclopedia of geography (pp. 632–634). Thousand Oaks, CA: Sage.

Aranda, M. P. (2008). Relationship between religious involvement and psychological well-being: A social justice perspective. Health & Social Work, 33(1), 9–21.

Argyris, C. (1999). On organizational learning. Cambridge, MA: Blackwell.

Argyris, C., & Schön, D. (1978). Organizational learning: A theory of action perspective. Reading, MA: Addison-Wesley.

Argyris, C., & Schön, D. (1996). Organizational learning II: Theory, method, and practice. Reading, MA: Addison-Wesley.

Asher, J., Michopoulos, V., Reding, K. M., Wilson, M. E., & Toufexis, D. (2013). Social stress and the polymorphic region of the serotonin reuptake transporter gene modify oestradiol-induced changes on central monoamine concentrations in female rhesus monkeys. Journal of Neuroendocrinology, 25(4), 321–328.

Ashford, J., LeCroy, C., & Williams, L. (2018). Human behavior in the social environment: A multidimensional perspective (6th ed.). Boston: Cengage Learning.

Ashkanani, H. R. (2009). The relationship between religiosity and subjective well-being: A case of Kuwaiti car accident victims. Traumatology, 15(1), 23–28.

959

Assagioli, R. (1965). Psychosynthesis: A manual of principles and techniques. New York: Viking.

Assagioli, R. (1973). The act of will. New York: Penguin.

Assagioli, R. (1989). Self-realization and psychological disturbances. In S. Grof & C. Grof (Eds.), Spiritual emergency: When personal transformation becomes a crisis (pp. 27–48). Los Angeles: Jeremy P. Tarcher.

Associated Press. (2014, November 21). Texas oks most new controversial history textbooks amid outcry. Retrieved from www.foxnews.com/us/2014/11/21/texas-oks-most-new-controversial- history-textbooks-amid-outcry.html

Aveling, E., Martin, G., Herbert, G., & Armstrong, N. (2017). Optimising the community-based approach to healthcare improvement: Comparative case studies of the clinical community model in practice. Social Science & Medicine, 173, 96–103.

Averill, J. R. (2012). The future of social constructionism: Introduction to a special section of Emotion Review. Emotion Review, 4(3), 215–220.

Baard, P. (2015). Managing climate change: A view from deep ecology. Ethics & the Environment, 20(1), 23–44.

Baer, E., Feraco, A., Tuysuzoglu Sagalowsky, S., Williams, D. Litman, H., & Vinci, R. (2017). Pediatric resident burnout and attitudes toward patients. Pediatrics, 139(3): e2016–e2163.

Baffy, G., & Loscalzo, J. (2014). Complexity and network dynamics in physiological adaptation: An integrated view. Physiology & Behavior, 131, 49–56.

960

http://www.foxnews.com/us/2014/11/21/texas-oks-most-new-controversial-history-textbooks-amid-outcry.html

Baker, M., Das, D., Venugopal, K., & Howden-Chapman, P. (2008). Tuberculosis associated with household crowding in a developed country. Journal of Epidemiology and Community Health, 62(8), 715–721.

Baldwin, C. (2013). Narrative social work: Theory and application. Chicago: Policy Press.

Ballantine, J., Roberts, K., & Korgen, K. (2018). Our social world: Introduction to sociology (6th ed.). Thousand Oaks, CA: Sage.

Balsam, K., Beauchaine, T., Rothblum, E., & Solomon, S. (2008). Three- year follow-up of same-sex couples who had civil unions in Vermont, same-sex couples not in civil unions, and heterosexual married couples. Developmental Psychology, 44(1), 102–116.

Bandura, A. (1977a). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191–215.

Bandura, A. (1977b). Social learning theory. Englewood Cliffs, NJ: Prentice Hall.

Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.

Bandura, A. (2001). Social cognitive theory: An agentic perspective. Annual Review of Psychology, 52, 1–26.

Bandura, A. (2002). Social cognitive theory in cultural context. Applied Psychology: An International Review, 51(2), 269–290.

Banerjee, M. M., & Canda, E. R. (2009). Spirituality as a strength of African-American women affected by welfare reform. Social Thought,

961

28(3), 239–262.

Banerjee, M. M., & Canda, E. R. (2012). Comparing Rawlsian justice and the capabilities approach to justice from a spiritually sensitive social work perspective. Journal of Religion & Spirituality in Social Work: Social Thought, 31, 1–2, 9–31.

Banik, S., Gupta, A., Habib, M., & Mousumi, R. (2013). Determination of active personal space based on emotion when interacting with a service robot. International Journal of Advanced Robotic Systems, 10, 1–7.

Barak, A., & Grohol, J. (2011). Current and future trends in Internet- supported mental health interventions. Journal of Technology in Human Services, 29(3), 155–196.

Barker, C., & Jane, E. (2016). Cultural studies: Theory and practice (5th ed.). Thousand Oaks, CA: Sage.

Barker, R. G. (1968). Ecological psychology: Concepts and methods for studying the environment of human behavior. Palo Alto, CA: Stanford University Press.

Barnes, P. M., Bloom, B., & Nahin, R. (2008, December 10). Complementary and alternative medicine use among adults and children: United States, 2007. National Health Statistics Report #12, 1–23. Retrieved from www.ncbi.nlm.nih.gov/pubmed/19361005

Barnes, R. (2017, July 19). Supreme court allows Trump refugee ban but backs broader exemptions for relatives. Washington Post. Retrieved from www.washingtonpost.com/politics/courts_law/supreme-court- allows-trump-travel-ban-enforcement-but-says-it-must-allow-broader- exemptions-for-relatives/2017/07/19/6945e01e-6bf8-11e7-96ab- 5f38140b38cc_story.html?utm_term=.d1e9004b0a28

962

http://www.ncbi.nlm.nih.gov/pubmed/19361005

http://www.washingtonpost.com/politics/courts_law/supreme-court-allows-trump-travel-ban-enforcement-but-says-it-must-allow-broader-exemptions-for-relatives/2017/07/19/6945e01e-6bf8-11e7-96ab-5f38140b38cc_story.html?utm_term=.d1e9004b0a28

Barnoff, L., & Moffatt, K. (2007). Contradictory tensions in anti- oppression practice in feminist social services. Affilia, 22(1), 56–70.

Barret, R., & Barzan, R. (1996). Spiritual experiences of gay men and lesbians. Counseling and Values, 41, 4–15.

Barton, B. (2010). “Abomination”—Life as a Bible belt gay. Journal of Homosexuality, 57, 465–484.

Barton, J., & Pretty, J. (2010). What is the best dose of nature and green exercise for improving mental health? A multi-study analysis. Environmental Science and Technology, 44, 3947–3955.

Barton, P., & Coley, R. (2010). The Black-White achievement gap: When progress stopped. Princeton, NJ: Educational Testing Service.

Bas, G. (2016). The effect of multiple intelligences theory based education on academic achievement: A meta-analytic review. Educational Sciences: Theory and Practice, 16, 1833–1864.

Baskin, C. (2006). Aboriginal world views as challenges and possibilities in social work education. Critical Social Work, 7(2). Retrieved from www1.uwindsor.ca/criticalsocialwork/aboriginal-world-views-as- challenges-and-possibilities-in-social-work-education

Basow, S., & Minieri, A. (2010). “You owe me.” Effects of date cost, who pays, participant gender and rape myth beliefs on perception of rape. Journal of Interpersonal Violence, 26, 479–497.

Batsche, C., & Reader, S. (2012). Using GIS to enhance programs serving emancipated youth leaving foster care: Evaluation and Program Planning, 35, 25–33.

963

http://www1.uwindsor.ca/criticalsocialwork/aboriginal-world-views-as-challenges-and-possibilities-in-social-work-education

Baum, F. (1999). The role of social capital in health promotion. Australian perspectives. Health Promotion Journal of Australia, 9(3), 171–178.

Baxter, L., & Braithwaite, D. (2006). Introduction: Metatheory and theory in family communication research. In D. Braithwaite & L. Baxter (Eds.), Engaging theories in family communication: Multiple perspectives (pp. 1–15). Thousand Oaks, CA: Sage.

Baynton, D. (2016). Disability and the justification of inequality. In P. Rothenberg (Ed.), Race, class, and gender in the United States: An integrated study (10th ed., pp. 81–90). New York: Worth.

BBC News. (2006, June 22). The popularity of “time” unveiled. Retrieved from http://news.bbc.co.uk/2/hi/5104778.stm

Bearak, M., & Cameron, D. (2016, June 16). Here are the 10 countries where homosexuality may be punished by death. Washington Post. Retrieved from www.washingtonpost.com/news/worldviews/wp/2016/06/13/here-are- the-10-countries-where-homosexuality-may-be-punished-by-death-2/? utm_term=.719e9d88dc81

Beard, V., & Sarmiento, C. (2010). Ties that bind: Transnational community-based planning in Southern California and Oaxaca. International Development Planning Review, 32(3–4), 207–224.

Beauchemin, K., & Hays, P. (1998). Dying in the dark: Sunshine, gender, and outcomes in myocardial infarction. Journal of the Royal Society of Medicine, 91, 352–354.

Beck, A. T. (2008). The evolution of the cognitive model of depression and its neurobiological correlates. American Journal of Psychiatry, 165, 969–977.

964

http://news.bbc.co.uk/2/hi/5104778.stm

http://www.washingtonpost.com/news/worldviews/wp/2016/06/13/here-are-the-10-countries-where-homosexuality-may-be-punished-by-death-2/?utm_term=.719e9d88dc81

Beck, E., & Eichler, M. (2000). Consensus organizing: A practice model for community building. Journal of Community Practice, 8(1), 87–102.

Beck, U. (1992). Risk society: Towards a new modernity. Thousand Oaks, CA: Sage.

Beck, U. (2007). World at risk. Cambridge, UK: Polity Press.

Becker, H. (1957). Current sacred–secular theory and its development. In H. Becker & A. Boskoff (Eds.), Modern sociological theory in continuity and change (pp. 137–185). New York: Dryden.

Beckett, A., & Campbell, T. (2015). The social model of disability as an oppositional device. Disability & Society, 30(2), 270–283.

Beel-Bates, C., Ingersoll-Dayton, B., & Nelson, E. (2007). Deference as a form of reciprocity among residents in assisted living. Research on Aging, 29(6), 626–643.

Beitel, M., Genova, M., Schuman-Olivier, Z., Arnold, R., Avants, S. K., & Margolin, A. (2007). Reflections by inner-city drug users on a Buddhist- based spirituality-focused therapy: A qualitative study. American Journal of Orthopsychiatry, 77(1), 1–9.

Bekteshi, V., & Kayser, K. (2013). When a mother has cancer: Pathways to relational growth for mothers and daughters coping with cancer. Psycho-Oncology, 22(10), 2379–2385.

Belanger, K., Copeland, S., & Cheung, M. (2009). The role of faith in adoption: Achieving positive adoption outcomes for African American children. Child Welfare, 87(2), 99–123.

Belcher, J. R., Fandetti, D., & Cole, D. (2004). Is Christian religious

965

conservatism compatible with the liberal social welfare state? Social Work, 49(2), 269–276.

Bell, K. (2012). Towards a post-conventional philosophical base for social work. British Journal of Social Work, 42, 408–423.

Bell, L. (2009). Mindful psychotherapy. Journal of Spirituality in Mental Health, 11(1–2), 126–144.

Bell-Toliver, L., & Wilkerson, P. (2011). The use of spirituality and kinship as contributors to successful therapy outcomes with African American families. Journal of Religion & Spirituality in Social Work, 30(1), 48–70.

Belzung, C., & Wigmore, P. (Eds.). (2013). Neurogenesis and neural plasticity. Berlin Heidelberg: Springer-Verlag.

Benagiano, G., & Mori, M. (2009). The origins of human sexuality: Procreation or recreation? Ethics, Bioscience and Life, 4(1), 50–59.

Benavides, L. E. (2012). A phenomenological study of spirituality as a protective factor for adolescents exposed to domestic violence. Journal of Social Service Research, 38(2), 165–174.

Ben-David, V. (2011). Social constructions of reality and narratives of parental incapability in the process of adjudicating the adoption of minors in Israel. Child and Family Social Work, 16, 402–411.

Bender, C. (2010). The new metaphysicals: Spirituality and the American religious imagination. Chicago: University of Chicago Press.

Benedetti, F., Colombo, C., Barbini, B., Campori, E., & Smeraldi, E. (2001). Morning sunlight reduces length of hospitalization in bipolar

966

depression. Journal of Affective Disorders, 62(3), 221–223.

Beningfield, J. (2006). The frightened land: Land, landscape and politics in South Africa in the twentieth century. New York: Routledge.

Benne, K. D, & Sheats, P. (1948). Functional roles of group members. Journal of Social Issues, 4(2), 41–49.

Bennett, S., Sheridan, M. J., & Richardson, F. (2014). Caregiving as ministry: Perceptions of African Americans providing care for elders. Families in Society: The Journal of Contemporary Social Services, 95(1), 51–58.

Bennett, W. L. (2004). Communicating global activism: Strength and vulnerabilities of networked politics. In W. van de Donk, B. Loader, P. Nixon, & D. Rucht (Eds.), Cyberprotest: New media, citizens and social movements (pp. 109–126). London: Routledge.

Bentley, K. J., & Walsh, J. (2014). The social worker and psychotropic medication: Toward effective collaboration with mental health clients, families, and providers (4th ed.). Pacific Grove, CA: Brooks/Cole.

Berger, P. L. (1969). The sacred canopy: Elements of a sociological theory of religion. Garden City, NY: Doubleday.

Berger, P. L., & Luckmann, T. (1966). The social construction of reality. Garden City, NY: Doubleday.

Bergman, K., Rubio, R., Green, R., & Padrón, E. (2010). Gay men who become fathers via surrogacy: The transition to parenthood. Journal of GLBT Family Studies, 6, 111–141.

Berman, M., Kross, E., Krpan, K., Askren, M., Burson, A., Deldin, P., . . .

967

Jonides, J. (2012). Interacting with nature improves cognition and affect for individuals with depression. Journal of Affective Disorder, 140, 300–305.

Bernardo, F., & Palma-Oliveira, J. (2016). Urban neighborhoods and intergroup relations: The importance of place identity. Journal of Environmental Psychology, 45, 239–251.

Berry, M. E. (2009). The sacred universe: Earth, spirituality, and religion in the 21st century. New York: Columbia University Press.

Bertalanffy, L. V. (1969). General systems theory. New York: George Braziller.

Berzoff, J. (2011). Why we need a biopsychosocial perspective with vulnerable, oppressed, and at-risk clients. Smith College Studies in Social Work, 81, 132–166.

Berzoff, J. (2016). Relational and intersubjective theories. In J. Berzoff, L. M. Flanagan, & P. Hertz (Eds.). Inside out and outside in: Psychodynamic clinical theory and psychopathology in contemporary multicultural contexts (4th ed., pp. 249–268). Lanham, MD: Rowman & Littlefield.

Berzoff, J., Flanagan, L., & Hertz, P. (2016). Inside out and outside in: Psychodynamic clinical theory and psychopathology in contemporary multicultural contexts (4th ed.). Lanham, MD: Rowman & Littlefield.

Besthorn, F. H. (2001). Transpersonal psychology and deep ecology: Exploring linkages and applications for social work. In E. R. Canda & E. D. Smith (Eds.), Transpersonal perspectives on spirituality in social work (pp. 23–44). Binghamton, NY: Haworth Press.

Besthorn, F. H. (2012). Deep ecology’s contributions to social work: A

968

ten-year retrospective. International Journal of Social Welfare, 21, 248–259.

Besthorn, F. H. (2013). Radical equalitarian ecological justice: A social work call to action. In M. Gray, J. Coates, & T. Hetherington (Eds.), Environmental social work (pp. 31–45). New York: Routledge.

Beute, F., & de Kort, Y.A. W. (2014). Natural resistance: Exposure to nature and self-regulation, mood, and physiology after ego-depletion. Journal of Environmental Psychology, 40, 167–178.

Bialik, K., & Matsa, K. (2017). Key trends in social and digital news media. Washington, DC: Pew Research Center. Retrieved from www.pewresearch.org/fact-tank/2017/10/04/key-trends-in-social-and- digital-news-media/

Bianchi, A. (2010). Status characteristics/expectation states theory. In J. Levin & Michael Hogg (Eds.), Encyclopedia of group processes and intergroup relations (pp. 845–848). Thousand Oaks, CA: Sage.

Bianchi, S., Sayer, L., Milkie, M., & Robinson, J. (2012). Housework: Who did, does or will do it, and how much does it matter? Social Forces, 91(1), 55–63.

Biorck, G. (1977). The essence of the clinician’s art. Acta Medica Scandinavica, 201(3), 145–147.

Black, P. J., Woodworth, M., Tremblay, M., & Carpenter, T. (2012). A review of trauma-informed treatment for adolescents. Canadian Psychology, 53(3), 192–203.

Blackman, L, & Venn, C. (2010). Affect. Body & Society, 16(1), 7–28.

969

http://www.pewresearch.org/fact-tank/2017/10/04/key-trends-in-social-and-digital-news-media/

Blanchard, A. (2004). Virtual behavior settings: An application of behavior setting theories to virtual communities. Journal of Computer- Mediated Communication, 9(2). doi:10.1111/j.1083- 6101.2004.tb00285.x

Blasi, J., Freeman, R., & Kruse, D. (2013). The citizen’s share. New Haven, CT: Yale University Press.

Blau, P. (1964). Exchange and power in social life. New York: Wiley.

Bloom, J., Sianoja, M., Korpela, K., Tuomisto, M., Lilja, A., Geurts, S., & Kinnunen, U. (2017). Effects of park walks and relaxation exercises during lunch breaks on recovery from job stress: Two randomized controlled trials. Journal of Environmental Psychology, 51, 14–30.

Blumer, H. (1998). Symbolic interactionism: Perspective and method. Berkeley: University of California Press.

Boase, J. (2008). Personal networks and the personal communication system: Using multiple media to connect. Information, Communication & Society, 11(4), 490–508.

Boase, J., Horrigan, J., Wellman, B., & Rainie, L. (2006). The strength of Internet ties: The Internet and email aid users in maintaining their social networks and provide pathways to help when people face big decisions. Washington, DC: Pew Internet & American Life Project. Retrieved from www.pewinternet.org/2006/01/25/the-strength-of-internet-ties/

Bocquier, P., Madise, N., & Zulu, E. (2011). Is there an urban advantage in child survival in sub-saharan Africa? Evidence from 18 countries in the 1990s. Demography, 48, 531–558.

Boddie, S. C., & Cnaan, R. A. (Eds.). (2006). Faith-based social services: Measures, assessments, and effectiveness. Binghamton, NY: Haworth

970

http://www.pewinternet.org/2006/01/25/the-strength-of-internet-ties/

Press.

Boddie, S. C., Hong, P. Y. P., Im, H., & Chung, S. (2011). Korean- American churches as partners in community development. Social Work & Christianity, 38(4), 395–416.

BodyLogicMD. (n.d.). What is testosterone? Isn’t it a male hormone? Retrieved from www.bodylogicmd.com/hormones-for- women/testosterone

Bogovic, A., Mihanovic, M., Jokic-Begic, N., & Svagelj, A. (2014). Personal space of male war veterans with posttraumatic stress disorder. Environment and Behavior, 46(8), 929–945.

Bolman, F., & Deal, T. (2017). Reframing organizations (6th ed.). Hoboken, NJ: Jossey-Bass.

Bonduriansky, R. (2012). Rethinking heredity, again. Trends in Ecology & Evolution, 27(6), 330–336.

Booth, R., & O’Brien, P. J. (2008). An holistic approach for counsellors: Embracing multiple intelligences. International Journal of Advising and Counselling, 30, 79–92.

Borczyskowski, A., Vinnerljung, B., & Hjern, A. (2013). Alcohol and drug abuse among young adults who grew up in substitute care—Findings from a Swedish national cohort study. Children and Youth Services Review, 35, 1954–1961.

Borgatti, S., & Halgin, D. (2011). On network theory. Organization Science, 22(5), 1168–1181.

Bornstein, A. (2009). N30 + 10: Global civil society, a decade after the

971

http://www.bodylogicmd.com/hormones-for-women/testosterone

Battle of Seattle. Dialectical Anthropology, 33, 97–108.

Boroditsky, L., Fuhrman, O., & McCormick, K. (2011). Do English and Mandarin speakers think about time differently? Cognition, 118, 123–129.

Borysenko, J. (1996). A woman’s book of life: The biology, psychology, and spirituality of the life cycle. New York: Riverhead Books.

Bos, H., van Balen, F., & van den Boom, D. (2007). Child adjustment and parenting in planned lesbian-parent families. American Journal of Orthopsychiatry, 77, 38–48.

Bosk, E., Alst, D., & Van Scoyoc, A. (2017). A chronic problem: Competing paradigms for substance abuse in child welfare policy and practice and the need for new approaches. British Journal of Social work, 47, 1669–1685.

Boswell, J. (1994). Same-sex unions in premodern Europe. New York: Random House.

Bottoms, B. L., Nielsen, M., Murray, R., & Filipas, H. (2003). Religion- related child physical abuse: Characteristics and psychological outcomes. Journal of Aggression, Maltreatment & Trauma, 8(1/2), 87–114.

Boufleur, N., Antoniazzi, C. T. D., Pase, C. S., Benvegn, D. M., Dias, V. T., Segat, H. J., . . . Bürger, M. E. (2013). Neonatal handling prevents anxiety-like symptoms in rats exposed to chronic mild stress: Behavioral and oxidative parameters. Stress: The International Journal on the Biology of Stress, 16(3), 321–330.

Bourdieu, P. (1977). Outline of a theory of practice. New York: Cambridge University Press.

972

Bowen, M. (1978). Family therapy in clinical practice. New York: Aronson.

Bowland, S., Biswas, B., Kyriakakis, S., & Edmond, T. (2011). Transcending the negative: Spiritual struggles and resilience in older female trauma survivors. Journal of Religion, Spirituality & Aging, 23(4), 318–337.

Bowler, D., Buyung-Ali, L., Knight, T., & Pullin, S. (2010). A systematic review of evidence for the added benefits of health and exposure to natural environments. BMC Public Health, 10, 456.

Boyes-Watson, C. (2005). Seeds of change: Using peacemaking circles to build a village for every child. Child Welfare, 82(2), 191–208.

Bozard, R. L., & Sanders, C. J. (2011). Helping Christian lesbian, gay, and bisexual clients recover religion as a source of strength: Developing a model for assessment and integration of religious identity in counseling. Journal of LGBT Issues in Counseling, 5(1), 47–74.

Brabender, V., & Fallon, A. (2009). Group development in practice: Guidance for clinicians and researchers on stages and dynamics of change. Washington, DC: American Psychological Association.

Brackett, W. J., Ertle, W., & Pritchett, J. W. (2016). Lower-extremity amputations. Medscape. Retrieved from https://emedicine.medscape.com/article/1232102-overview

Bradley, R., & Corwyn, R. (2002). Socioeconomic status and child development. Annual Review of Psychology, 53, 371–399.

Brandon, D. (1976). Zen in the art of helping. New York: Delta/Seymour Lawrence.

973

https://emedicine.medscape.com/article/1232102-overview

Brantley, J., Doucette, D., & Lindell, A. (2008). Mindfulness, meditation, and health. In A. L. Strozier & J. E. Carpenter (Eds.), Introduction to alternative and complementary therapies (pp. 9–29). New York: Haworth Press.

Braude, A. (1997). Women’s history is American religious history. In T. A. Tweed (Ed.), Retelling U.S. religious history (pp. 87–107). Berkeley: University of California Press.

Brautigam, D. (2009). The dragon’s gift: The real story of China in Africa. Oxford, UK: Oxford University Press.

Brave Heart, M. Y. H. (2001). Clinical interventions with American Indians. In R. Fong & S. Furuto (Eds.), Cultural competent social work practice: Practice skills, interventions, and evaluation (pp. 285–298). New York: Longman.

Brawley, E. (2006). Design innovations for aging and Alzheimer’s. Hoboken, NJ: Wiley.

Brawley, E. (2009). Enriching lighting design. NeuroRehabilitation, 25, 189–199.

Breedlove, M., & Watson, N. (2018). Biological psychology: An introduction to behavioral, cognitive, and clinical neuroscience (7th ed.). Sunderland, MA: Sinauer Associates.

Breitman, B. E. (1995). Social and spiritual reconstruction of self within a feminist Jewish community. Woman and Therapy: A Feminist Quarterly, 16(2/3), 73–82.

Brennan, T. (2004). The transmission of affect. Ithaca, NY: Cornell University Press.

974

Brent, J. (1997). Community without unity. In P. Hoggett (Ed.), Contested communities: Experiences, struggles, policies (pp. 68–83). Bristol, UK: Policy Press.

Britton, D., & Logan, L. (2008). Gendered organizations: Progress and prospects. Sociology Compass, 2(1), 107–121.

Brodsky, A. (2009). Multiple psychological sense of community in Afghan context: Exploring commitment and sacrifice in an underground resistance community. American Journal of Community Psychology, 44, 176–187.

Bronfenbrenner, U. (2005). Making human beings human: Bioecological perspective on human development. Thousand Oaks, CA: Sage.

Bronfenbrenner, U., & Morris, P. (2006). The bioecological model of human development. In W. Damon & R. Lerner (Eds.), Handbook of child psychology: Vol. 1. Theoretical models of human development (6th ed., pp. 793–828). New York: John Wiley.

Brown, B., Rutherford, P., & Crawford, P. (2015). The role of noise in clinical environments with particular reference to mental health care: A narrative review. International Journal of Nursing Studies, 52, 1514–1524.

Brown, D., Tang, X., & Hollman, R. (2014). The structure of social exchange in self-help support groups: Development of a measure. American Journal of Community Psychology, 53, 83–95.

Brown, D. R., Carney, J. S., Parrish, M. S., & Klem, J. L. (2013). Assessing spirituality: The relationship between spirituality and mental health. Journal of Spirituality in Mental Health, 15(2), 108–122.

Brown, G. (2009). NICU noise and the preterm infant. Neonatal Network,

975

28(3), 165–173.

Brown, G., Lawrence, T., & Robinson, S. (2005). Territoriality in organizations. Academy of Management Review, 30(3), 577–594.

Brown, G., & Zhu, H. (2016). “My workplace, not yours”: The impact of psychological ownership and territoriality in organizations. Journal of Environmental Psychology, 48, 54–64.

Brown, L., Shepherd, M., Wituk, S., & Meissen, G. (2007). How settings change people: Applying behavior setting theory to consumer-run organizations. Journal of Community Psychology, 35(3), 399–416.

Brown, N. (2011). Psychoeducational groups: Process and practice (3rd ed.). New York: Routledge.

Brown, S., Manning, W., & Payne, K. (2017). Relationship quality among cohabiting versus married couples. Journal of Family Issues, 38(12), 1730–1753.

Brown, T., & Sumner, K. (2013). The work-family interface among school psychologists and related school personnel: A test of role conflict and expansionist theories. Journal of Applied Social Psychology, 43, 1771–1776.

Brueggemann, W. (2013). History and context for community practice in North America. In M. Weil, M. Reisch, & M. Ohmer (Eds.), The handbook of community practice (2nd ed., pp. 27–46). Thousand Oaks, CA: Sage.

Bryan, B. (2018, January 16). The number of Americans without health insurance jumped by 3.2 million in 2017—and Congress to blame. Business Insider. Retrieved from http://nordic.businessinsider.com/gallup-health-insurance-uninsured-

976

http://nordic.businessinsider.com/gallup-health-insurance-uninsured-survey-shows-trump-congress-impact-2018-1/

survey-shows-trump-congress-impact-2018-1/

Buck, P. (2001). Worked to the bone: Race, class, power, and privilege in Kentucky. New York: Monthly Review Press.

Buckingham, S. (2015). Ecofeminism. In J. Wright (Ed.), Encyclopedia of the social and behavioural sciences (2nd ed., Vol. 6, pp. 845–850). New York: Elsevier.

Bucko, R. A., & Iron Cloud, S. (2008). Lakota health and healing. Southern Medical Journal, 101(6), 596–598.

Budman, S. H., Soldz, S., Demby, A., Davis, M., & Merry, J. (1993). What is cohesiveness? An empirical examination. Small Group Research, 24, 199–216.

Buechler, S. (2011). Understanding social movements: Theories from the classical era to the present. Boulder, CO: Paradigm.

Bullis, R. K. (1996). Spirituality in social work practice. Washington, DC: Taylor & Francis.

Bunic, S. (2013). Libraries and the homeless: Experiences, challenges and opportunities — socio-economic background of homelessness in Croatia. Library Review, 62 1/2), 34–42.

Burgess, S. (2011). Queer theory. In G. Kurian (Ed.), The encyclopedia of political science. doi:10.4135/9781609712434.n1309

Burke, M. T., Chauvin, J. C., & Miranti, J. G. (2005). Religious and spiritual issues in counseling: Applications across diverse populations. New York: Brunner/Routledge.

977

Burston, D., & Frie, R. (2006). Psychotherapy as a human science. Pittsburgh, PA: Duquesne University Press.

Burtless, G. (2012). Life expectancy and rising income inequality: Why the connection matters for fixing entitlements. Retrieved from www.brookings.edu/opinions/life-expectancy-and-rising-income- inequality-why-the-connection-matters-for-fixing-entitlements/

Bush, K., Bohon, S., & Kim, H. (2010). Adaptation among immigrant families: Resources and barriers. In S. Price, C. Price, & P. McKenry (Eds.), Families and change: Coping with stressful events and transitions (4th ed., pp. 285–310). Thousand Oaks, CA: Sage.

Byoung-Suk, K., Ulrich, R., Walker, V., & Tassinary, L. (2008). Anger and stress: The role of landscape posters in an office setting. Environment & Behavior, 40(3), 355–381.

Cacioppo, J. T., Cacioppo, S., Capitanio, J. P., & Cole, S. W. (2015). The neuroendocrinology of social isolation. Annual Review of Psychology, 66(1), 733–767.

Cady, S. H., & Valentine, J. (1999). Team innovation and perceptions of consideration: What difference does diversity make? Small Group Research, 30(6), 730–750.

Cairns, D. B. (2005). The journey to resiliency: An integrative framework for treatment for victims and survivors of family violence. Social Work & Christianity, 32(4), 305–320.

Cameron, D., & Berkowitz, B. (2016, June 14). The state of gay rights around the world. Washington Post. Retrieved from www.washingtonpost.com/graphics/world/gay-rights/

Cameron, M. (2014). This is common factors. Clinical Social Work

978

http://www.brookings.edu/opinions/life-expectancy-and-rising-income-inequality-why-the-connection-matters-for-fixing-entitlements/

http://www.washingtonpost.com/graphics/world/gay-rights/

Journal, 42, 151–160.

Campbell, C. (2014). Community mobilization in the 21st century: Updating our theory of social change? Journal of Health Psychology, 19(1), 46–59.

Campbell, C. L., McCoy, S., Hoffman, N., & O’Neil, P. (2014). Decreasing role strain for caregivers of veterans with dependence in performing activities of daily living. Health & Social Work, 39(1), 55–62.

Campbell, D. (1997). The Mozart effect: Tapping the power of music to heal the body, strengthen the mind, and unlock the creative spirit. New York: Harper Trade.

Campos, B., & Kim, H. (2017). Incorporating the cultural diversity of family and close relationships into the study of health. American Psychologist, 72(6), 543–554.

Canda, E. R. (1983). General implications of shamanism for clinical social work. International Social Work, 26(4), 14–22.

Canda, E. R. (1988). Conceptualizing spirituality for social work: Insights from diverse perspectives. Social Thought, 14(1), 30–46.

Canda, E. R. (1997). Spirituality. Encyclopedia of social work: 1997 supplement (19th ed.). Washington, DC: NASW Press.

Canda, E. R. (2005). The future of spirituality in social work: The farther reaches of human nature. Advances in Social Work, 6(1), 97–108.

Canda, E. R., & Furman, L. D. (1999). Spiritual diversity in social work practice: The heart of helping. New York: Free Press.

979

Canda, E. R., & Furman, L. D. (2010). Spiritual diversity in social work practice: The heart of helping (2nd ed.). New York: Oxford University Press.

Canda, E. R., Nakashima, M., & Furman, L. D. (2004). Ethical considerations about spirituality in social work: Insights from a national qualitative study. Families in Society: The Journal of Contemporary Social Services, 85(1), 27–35.

Canda, E. R., & Phaobtong, T. (1992). Buddhism as a support system for Southeast Asian refugees. Social Work, 37, 61–67.

Canda, E. R., Shin, S., & Canda, H. (1993). Traditional philosophies of human services in Korea and contemporary social work implications. Social Development Issues, 15(3), 84–104.

Canda, E. R., & Yellow Bird, M. J. (1996). Cross-tradition borrowing of spiritual practices in social work settings. Society for Spirituality and Social Work Newsletter, 3(1), 1–7.

Cannon, W. B. (1924). Bodily changes in pain, hunger, fear, and rage. New York: Appleton.

Cao, X., Mokhtarian, P., & Handy, S. (2009). Examining the impacts of residential self-selection on travel behavior: A focus on empirical findings. Transport Reviews, 29(3), 359–395.

Caplan, G., & Caplan, R. B. (2000). The future of primary prevention. Journal of Primary Prevention, 21(2), 131–136.

Cappicci, A., Chadha, J., Bi Lin, M., & Snyder, F. (2012). Using critical race theory to analyze how Disney constructs diversity: A construction for Baccalaureate human behavior in the social environment curriculum. Journal of Teaching in Social Work, 32(1), 46–61.

980

Cardoso, C., Ellenbogen, M., Serravalle, L., & Linnen, A. M. (2013). Stress-induced negative mood moderates the relation between oxytocin administration and trust: Evidence for the tend-and-befriend response to stress? Psychoneuroendocrinology, 38(11), 2800–2804.

Carlson, J., Nguyen, H., & Reinardy, J. (2016). Social justice and the capabilities approach: Seeking a global blueprint for the EPAS. Journal of Social Work Education, 52(3), 269–282.

Carlton-LaNey, I. B. (1999). African American social work pioneers’ response to need. Social Work, 44(4), 311–321.

Carnes, R., & Craig, S. (1998). Sacred circles: A guide to creating your own women’s spirituality group. San Francisco: HarperSanFrancisco.

Carnoy, M., & Rothstein, R. (2013). What do international tests really show about U.S. student performance? Washington, DC: Economic Policy Institute. Retrieved from www.epi.org/publication/us-student- performance-testing/

Caron, S. L. (2011). Sex around the world: Cross-cultural perspectives on human sexuality (4th ed.). Upper Saddle River, NJ: Pearson/Prentice Hall.

Carron, A. V., & Brawley, L. R. (2000). Cohesion: Conceptual and measurement issues. Small Group Research, 31(1), 89–106.

Carter, M. J., & Fuller, C. (2016). Symbols, meaning, and action: The past, present, and future of symbolic interactionism. Current Sociology, 64, 931–961.

Carter, R. (2009). The human brain book. London: Dorling Kindersley.

981

http://www.epi.org/publication/us-student-performance-testing/

Case, R. (2017). Eco-social work and community resilience: Insights from water activism in Canada. Journal of Social Work, 17(4), 391–412.

Casey, R., Goudie, R., & Reeve, K. (2008). Homeless women in public spaces: Strategies of resistance. Housing Studies, 23(6), 899–916.

Casey, T., & Maldonado, L. (2012). Worst off—single-parent families in the United States: A cross-national comparison of single parenthood in the U.S. and sixteen other high-income countries. New York: Legal Momentum: The Women’s Legal Defense and Education Fund. Retrieved from www.legalmomentum.org/sites/default/files/reports/worst-off-single- parent.pdf

Castells, M. (2012). Networks of outrage and hope. Boston: Polity.

Castañeda, C., Hopkins, L., & Peters, M. (2013). Ableism. In M. Adams, W. Blumenfeld, C. Castañeda, H. Hackman, M. Peters, & X. Zúñiga (Eds.), Readings for diversity and social justice (3rd ed., pp. 461–468). New York: Routledge.

Castex, G. M. (1994). Providing services to Hispanic/Latino populations: Profiles in diversity. Social Work, 39(3), 288–296.

Catalano, S. (2012). Intimate partner violence, 1993–2010. Washington, DC: U.S. Department of Justice. Retrieved from www.bjs.gov/content/pub/pdf/ipv9310.pdf

Cattich, J., & Knudson-Martin, C. (2009). Spirituality and relationship: A holistic analysis of how couples cope with diabetes. Journal of Marital & Family Therapy, 35(1), 111–124.

CDC Foundation. (2015). Heart disease and stroke cost America nearly $1 billion a day in medical costs, lost productivity. Atlanta, GA: CDC

982

http://www.legalmomentum.org/sites/default/files/reports/worst-off-single-parent.pdf

http://www.bjs.gov/content/pub/pdf/ipv9310.pdf

Foundation. Retrieved from www.cdcfoundation.org/pr/2015/heart- disease-and-stroke-cost-america-nearly-1-billion-day-medical-costs- lost-productivity

Center for Health Design. (2008). A practitioner’s guide to evidence-based design. Concord, CA: Author.

Centers for Disease Control and Prevention. (2013). CDC health disparities and inequalities report—United States, 2013. Morbidity and Mortality Weekly Report, 62(Suppl. 3), 1–187.

Centers for Disease Control and Prevention. (2017a). HIV in the United States: At a glance. Retrieved from www.cdc.gov/hiv/statistics/overview/ataglance.html

Centers for Disease Control and Prevention. (2017b). Evaluating genomic tests. Retrieved from www.cdc.gov/genomics/gtesting/index.htm

Centers for Disease Control and Prevention. (2017c). National data on intimate partner violence, sexual violence, and stalking. National Center for Injury Prevention and Control. Retrieved from www.cdc.gov/violenceprevention/pdf/NISVS-Fact-Sheet-2014.pdf

Central Intelligence Agency. (2016). The world factbook: Country comparison: Distribution of family income: Gini index. Retrieved from www.cia.gov/library/publications/the-world- factbook/rankorder/2172rank.html

Central Intelligence Agency. (2017a). The world factbook: Country comparison GDP per capita. Retrieved from www.cia.gov/library/publications/the-world- factbook/rankorder/2004rank.html

Central Intelligence Agency. (2017b). The world factbook: Country

983

http://www.cdcfoundation.org/pr/2015/heart-disease-and-stroke-cost-america-nearly-1-billion-day-medical-costs-lost-productivity

http://www.cdc.gov/hiv/statistics/overview/ataglance.html

http://www.cdc.gov/genomics/gtesting/index.htm

http://www.cdc.gov/violenceprevention/pdf/NISVS-Fact-Sheet-2014.pdf

http://www.cia.gov/library/publications/the-world-factbook/rankorder/2172rank.html

http://www.cia.gov/library/publications/the-world-factbook/rankorder/2004rank.html

comparison: Life expectancy at birth. Retrieved from www.cia.gov/library/publications/the-world- factbook/rankorder/2102rank.html

Cervigni, F., Suzuki, Y., Ishii, T., & Hata, A. (2008). Spatial accessibility to pediatric services. Journal of Community Health, 33, 444–448.

Chamiec-Chase, R. (2009). Developing a scale to measure social workers’ integration of spirituality in the workplace. Journal of Religion & Spirituality in Social Work, 28(3), 284–305.

Chan, T., Birkelund, G., Aas, A., & Wiborg, O. (2010). Social status in Norway. European Sociological Review, 27(4), 451–468.

Chan, Y., Lam, G., & Cheng, H. (2009). Community capacity building as a strategy of family violence prevention in a problem-stricken community: A theoretical formulation. Journal of Family Violence, 24, 559–568.

Charmaraman, L., & Grossman, J. M. (2010). Importance of race and ethnicity: An exploration of Asian, Black, Latino and multiracial adolescent identity. Cultural Diversity and Ethnic Minority Psychology, 16(2), 144–152.

Charon, J. (1998). Symbolic interactionism: An introduction, an interpretation, and integration (6th ed.). Englewood Cliffs, NJ: Prentice Hall.

Chaskin, R. (2013). Theories of community. In M. Weil, M. Reisch, & M. Ohmer (Eds.), The handbook of community practice (2nd ed., pp. 105–121). Thousand Oaks, CA: Sage.

Chaturvedi, S., Zyphur, M., Arvey, R., Avolio, B., & Larsson, G. (2012). The heritability of emergent leadership: Age and gender as moderating

984

http://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html

factors. The Leadership Quarterly, 23, 219–232.

Chaves, C., Lopez-Gomez, I., Hervas, G., & Vazquez, C. (2017). A comparative study on the efficacy of a positive psychology intervention and a cognitive behavioral therapy for clinical depression. Cognitive Theory Research, 41, 417–433.

Chavis, A. M. (2012). Social learning theory and behavioral therapy: Considering human behaviors within the social and cultural context of individuals and families. Journal of Human Behavior in the Social Environment, 22, 54–64.

Cheadle, J., Amato, P., & King, V. (2010). Patterns of non-resident father contact. Demography, 47(1), 205–225.

Cheng, J., & Monroe, M. (2012). Connection to nature: Children’s affective attitude toward nature. Environment and Behavior, 44(1), 31–49.

Cheng, S., & Powell, B. (2015). Measurement, methods, and divergent patterns: Reassessing the effects of same-sex parents. Social Science Research, 52, 615–626.

Cheng, Y. (2016). Critical geographies of education beyond “value”: Moral sentiments, caring, and a politics for acting differently. Antipode, 48(4), 919–936.

Chesney, B. K., & Chesler, M. A. (1993). Activism through self-help group membership: Reported life changes of parents of children with cancer. Small Group Research, 24, 258–273.

Chibucos, T., & Leite, R. (2005). Readings in family theory. Thousand Oaks, CA: Sage.

985

Child, J., & Starcher, S. (2016). Fuzzy Facebook privacy boundaries: Exploring mediated lurking, vague-booking, and Facebook privacy management. Computers in Human Behavior, 54, 483–490.

Child Trends. (2016). Fertility and birth rates. Retrieved from www.childtrends.org/wp-content/uploads/2016/10/79_Birth_Rate.pdf

Child Welfare Information Gateway. (2017, March). Child maltreatment 2015: Summary of key findings. Retrieved from www.childwelfare.gov/pubPDFs/canstats.pdf

Children’s Bureau. (2017, March). Foster care statistics 2016. Retrieved from www.childwelfare.gov/pubPDFs/foster.pdf

Choi, G., & Tirrito, T. (1999). The Korean church as a social service provider for older adults. Arete, 23(2), 69–83.

Choi, J., Beltran, L., & Kim, H. (2012). Impacts of indoor daylight environments on patient average length of stay (ALOS) in a healthcare facility. Building and Environment, 50, 65–75.

Chong, J., Fortier, Y., & Morris, T. L. (2009). Cultural practices and spiritual development for women in a Native American alcohol and drug treatment program. Journal of Ethnicity in Substance Abuse, 8(3), 261–282.

Chung, D. K. (2001). Confucianism. In M. V. Hook, B. Hugen, & M. Aguilar (Eds.), Spirituality within religious traditions in social work practice (pp. 73–97). Pacific Grove, CA: Brooks/Cole.

Chung, G., Tucker, M., & Takeuchi, D. (2008). Wives’ relative income production and household male dominance: Examining violence among Asian American enduring couples. Family Relations, 57, 227–238.

986

http://www.childtrends.org/wp-content/uploads/2016/10/79_Birth_Rate.pdf

http://www.childwelfare.gov/pubPDFs/canstats.pdf

http://www.childwelfare.gov/pubPDFs/foster.pdf

Chung, J. E. (2014). Social networking in online support groups for health: How online social networking benefits patients. Journal of Health Communication, 19, 639–659.

Ciabattari, T. (2017). Sociology of families: Change, continuity, and diversity. Thousand Oaks, CA: Sage.

Clammer, J. (2009). Sociology and beyond: Towards a deep sociology. Asian Journal of Social Science, 37(3), 332–346.

Clark, C. C. (2002). Health promotion in communities: Holistic and wellness approaches. New York: Springer.

Clark, J. L. (2007). Listening for meaning: A research-based model for attending to spirituality, culture and worldview in social work practice. Critical Social Work, 7(1). Retrieved from www1.uwindsor.ca/criticalsocialwork/listening-for-meaning-a-research- based-model-for-attending-to-spirituality-culture-and-worldview-in-

Clemens, E. (1996). Organizational form as frame: Collective identity and political strategy in the American labor movement, 1880–1920. In D. McAdam, J. McCarthy, & M. Zald (Eds.), Comparative perspectives on social movements (pp. 205–226). New York: Cambridge University Press.

Cleveland Clinic. (2014). Pulse and heart rate. Retrieved from https://my.clevelandclinic.org/health/diagnostics/17402-pulse--heart- rate?view=print

Coates, J. (2003). Ecology and social work: Toward a new paradigm. Halifax, NS: Fernwood.

Coates, J. (2007). From ecology to spirituality and social justice. In J. Coates, J. R. Graham, B. Swartzentruber, & B. Ouelette (Eds.),

987

http://www1.uwindsor.ca/criticalsocialwork/listening-for-meaning-a-research-based-model-for-attending-to-spirituality-culture-and-worldview-in-

https://my.clevelandclinic.org/health/diagnostics/17402-pulse--heart-rate?view=print

Spirituality and social work: Selected Canadian readings (pp. 213–227). Toronto, ON: Canadian Scholars’ Press.

Cockerham, W. (2012). Current direction in medical sociology. In G. Ritzer (Ed.), The Blackwell encyclopedia of sociology (pp. 385–401). Malden, MA: Blackwell.

Cohen, E. J., Quarta, E., Bravi, R., Granato, A., & Minciacchi, D. (2017). Neural plasticity and network remodeling: From concepts to pathology. Neuroscience, 344, 326–345.

Coholic, D. (2011). Exploring how young people living in foster care discuss spiritually sensitive themes in a holistic arts-based group program. Journal of Religion & Spirituality in Social Work, 30(3), 193–211.

Colby, I. C., Dulmus, C. N., & Sowers, K. M. (2012). Social work and social policy: Advancing the principles of economic and social justice. Somerset, NJ: Wiley.

Coleman, J. (1990). Foundations of social theory. Cambridge, MA: Belknap Press.

Coles, R. (1990). The spiritual life of children. Boston: Houghton Mifflin.

Collado, S., Evans, G., & Sorrel, M. (2017). The role of parents and best friends in children’s pro-environmentalism: Differences according to age and gender. Journal of Environmental Psychology, 54, 27–37.

Collado, S., Staats, H., & Corraliza, J. (2013). Experiencing nature in children’s summer camps: Affective, cognitive and behavioral consequences. Journal of Environmental Psychology, 33, 37–44.

988

Collins, G. (2009). When everything changed: The amazing journey of American women from 1960 to the present. New York: Little, Brown.

Collins, P. H. (1990). Black feminist thought: Knowledge, consciousness, and the politics of empowerment. Boston: Unwin Hyman.

Collins, P. H. (2000). It’s all in the family: Intersections of gender, race, and nation. In U. Narayan & S. Harding (Eds.), Decentering the center: Philosophy for a multicultural, postcolonial, and feminist world (pp. 156–176). Bloomington: Indiana University Press.

Collins, P. H. (2010). The new politics of community. American Sociological Review, 75(1), 7–30.

Collins, P. H. (2012). Looking back, moving ahead: Scholarship in service to social justice. Gender & Society, 26, 14–22.

Collins, R. (2004). Interaction ritual chains. Princeton, NJ: Princeton University Press.

Conger, R., & Conger, K. (2008). Understanding the processes through which economic hardship influences families and children. In D. R Crane & T. Heaton (Eds.), Handbook of families & poverty (pp. 64–81). Thousand Oaks, CA: Sage.

Conger, R., & Donnellan, M. (2007). An interactionist perspective on the socioeconomic context of human development. Annual Review of Psychology, 58, 175–199.

Connolly, M. (2006). Fifteen years of Family Group Conferencing: Coordinators talk about their experiences in Aotearoa New Zealand. British Journal of Social Work, 36(4), 523–540.

989

Conrad, D., & Kellar-Guenther, Y. (2006). Compassion fatigue, burnout, and compassion satisfaction among Colorado child protection workers. Child Abuse & Neglect, 30, 1071–1080.

Conrad, P. (2007). The medicalization of society: On the transformation of human conditions into treatable disorders. Baltimore: Johns Hopkins University Press.

Cook, K. (Ed.). (1987). Social exchange theory. Newbury Park, CA: Sage.

Cooley, C. (1902). Human nature and the social order. New York: Scribner’s.

Cooper, A., Seibert, G., May, R., Fitzgerald, M., & Fincham, F. (2017). School burnout and intimate partner violence: The role of self-control. Personality and Individual Differences, 112, 18–25.

Copen, C., Daniels, K., & Mosher, W. (2013). First premarital cohabitation in the United States: 2006–2010 National Survey of Family Growth. National Health Statistics Reports. No. 64. U.S. Department of Health and Human Services. Centers for Disease Control and Prevention. National Center for Health Statistics.

Copen, C., Daniels, K., Vespa, J., & Mosher, W. (2012). First marriages in the United States: Data from the 2006–2010 National Survey of Family Growth (National Health Statistics Reports, number 49). Washington, DC: National Center for Health Statistics.

Cooperrider, D., & Srivastva, S. (1990). Appreciative management and leadership: The power of positive thought and action in organizations. San Francisco: Jossey-Bass.

Cooperrider, D., Whitney, D., & Stavros, J. (2008). Appreciative inquiry handbook: For leaders of change. San Francisco: Berrett-Koehler.

990

Corbett, J. M. (1997). Religion in America (3rd ed.). Upper Saddle River, NJ: Prentice Hall.

Corcoran, J., & Walsh, J. (2016). Clinical assessment and diagnosis in social work practice (3rd ed.). New York: Oxford University Press.

Cortright, B. (1997). Psychotherapy and spirit: Theory and practice in transpersonal psychotherapy. Albany, NY: SUNY Press.

Coser, L. (1956). The functions of conflict. New York: Free Press.

Costa, M. (2012). Territorial behavior in public settings. Environment and Behavior, 44(5), 713–721.

Costas, O. E. (1991). Hispanic theology in North America. In L. M. Getz & R. O. Costa (Eds.), Strategies for solidarity: Liberation theologies in tension (pp. 63–74). Minneapolis, MN: Fortress Press.

Coulombe, S., Jutras, S., Labbé, D., & Jutras, D. (2016). Residential experience of people with disabilities: A positive psychology perspective. Journal of Environmental Psychology, 46, 42–54.

Coulton, C., Jennings, M. Z., & Chan, T. (2013). How big is my neighborhood? Individual and contextual effects on perceptions of neighborhood scale. American Journal of Community Psychology, 51, 140–150.

Council on Social Work Education. (2015). Educational policy and accreditation standards. Alexandria, VA: Author.

Cousins, L. (2013). Deservingness, children in poverty, and collective well being. Children and Youth Services Review, 35, 1252–1259.

991

Cousins, L. (2015). Culture. In E. Hutchison (Ed.), Dimensions of human behavior: Person and environment (5th ed.). Thousand Oaks, CA: Sage.

Cowley, A. S. (1993). Transpersonal social work: A theory for the 1990s. Social Work, 38, 527–534.

Cowley, A. S. (1996). Transpersonal social work. In F. J. Turner (Ed.), Social work treatment: Interlocking theoretical approaches (4th ed., pp. 663–698). New York: Free Press.

Cowley, A. S. (1999). Transpersonal theory and social work practice with couples and families. Journal of Family Social Work, 3(20), 5–21.

Cowley, A. S., & Derezotes, D. (1994). Transpersonal psychology and social work education. Journal of Social Work Education, 30, 32–39.

Cox, D., & Pawar, M. (2013). International social work: Issues, strategies, and programs (2nd ed.). Thousand Oaks, CA: Sage.

Cox, T., Jr. (1993). Cultural diversity in organizations: Theory, research, and practice. San Francisco: Berrett-Koehler.

Cox, T., Jr. (2001). Creating a multicultural organization: A strategy for capturing the power of diversity. San Francisco: Jossey-Bass.

Coyhis, D., & Simonelli, R. (2005). Rebuilding Native American communities. Child Welfare, 84(2), 323–336.

Coyle, J., Nochajski, T., Maguin, E., Safyer, A., DeWit, D., & Macdonald, S. (2009). An exploratory study of the nature of family resilience in families affected by parental alcohol abuse. Journal of Family Issues, 30(12), 1606–1623.

992

Coyne, R. (2014). Group work leadership: An introduction for helpers. Thousand Oaks, CA: Sage.

Cozolino, L. (2014). The neuroscience of human relationships (2nd ed.). New York: W. W. Norton.

Crabbe, J. (Ed.). (2012). From soul to self. Hoboken, NJ: Taylor and Francis.

Crabtree, S. A., Husain, F., & Spalek, B. (2008). Islam and social work: Debating values, transforming practice. Bristol, UK: Policy Press.

Craig, S., Frankford, R., Allan, K., Williams, C., Schwrtz, C., Yaworski, A., . . . Malek-Saniee S. (2016). Self-reported psychosocial needs in integrated primary health care: A role for social work in interdisciplinary teams. Social Work in Health Care, 55(1), 41–60.

Criminal Defense Lawyer. (2017). Sodomy laws. Retrieved from www.criminaldefenselawyer.com/resources/sodomy-laws.htm

Cronley, C. (2010). Unraveling the social construction of homelessness. Journal of Human Behavior in the Social Environment, 20(2), 319–333.

Crook, W. (2001). Trickle-down bureaucracy: Does the organization affect client responses to programs? Administration in Social Work, 26(1), 37–59.

Cross, W., Parham, T., & Black, E. (1991). The stages of Black identity development: Nigrescence models. In R. Jones (Ed.), Black psychology (3rd ed., pp. 319–338). Berkeley, CA: Cobb & Henry.

Croteau, D., & Hoynes, W. (2014). Media society: Industries, images, and audiences (5th ed.). Thousand Oaks, CA: Sage.

993

http://www.criminaldefenselawyer.com/resources/sodomy-laws.htm

Cuba, L., & Hummon, D. (1993). A place to call home: Identification with dwelling, community, and region. Sociological Quarterly, 34(1), 111–131.

Cummings, S. (2008). Treating older persons with severe mental illness in the community: Impact of an interdisciplinary geriatric mental health team. Journal of Gerontological Social Work, 52(1), 17–31.

Cunha, M., & Silva, N. (2015). Hospital noise and patients’ wellbeing. Procedia: Social and Behavioral Sciences, 171, 246–251.

Czarniawska, B. (2007). Has organization theory a tomorrow? Organization Studies, 28, 27–29.

Dakin, E. (2014). Protection as care: Moral reasoning and moral orientation among ethnically and socioeconomically diverse older women. Journal of Aging Studies, 28, 44–56.

Dalenberg, C. J. (2014). On building a science of common factors in trauma therapy. Journal of Trauma and Dissociation, 15(4), 373–383.

David, D., Miclea, M., & Opre, A. (2004). Information processing approach to the human mind: Basics and beyond. Journal of Clinical Psychology, 60(4), 353–368.

Davidson, R. J., & Begley, S. (2012). The emotional life of your brain. New York: Plume.

Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F., . . . Sheridan, J. F.(2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65(4), 564–570.

994

Davies, M. F., & Kanaki, E. (2006). Interpersonal characteristics associated with different team roles in workgroups. Journal of Managerial Psychology, 21(7), 638–650. doi:10.1108/02683940610690187

Davies, S. (2006). Challenging gender norms: Five genders among the Bugis in Indonesia. Belmont, CA: Wadsworth.

Davis, G. (2015). Celebrating organization theory: The after-party. Journal of Management Studies, 52(2). doi:10.1111/joms.12094

Davis, G., McAdam, D., Scott, W. R., & Zald, M. (2005). New York: Cambridge University Press.

Davis, G., & Preves, S. (2017). Intersex and the social construction of sex. Contexts, 16(1), 80.

Davis, L. E. (1984). Essential components of group work with Black Americans. Social Work with Groups, 7(3), 97–109.

Davis, L. E. (1995). The crisis of diversity. In M. D. Feit, J. H. Famey, J. S. Wodarski, & A. R. Mann (Eds.), Capturing the power of diversity (pp. 47–57). New York: Haworth.

Davis, L. E., Strube, M., & Cheng, L. (1995). Too many Blacks, too many Whites: Is there a racial balance? Basic and Applied Social Psychology, 17(1 & 2), 119–135.

Davis, M. (2006). Planet of slums. London: Verso.

Dawson, E., Grant, B., Chou, S. P., & Stinson, F. (2007). The impact of partner alcohol problems on women’s physical and mental health. Journal of Studies on Alcohol and Drugs, 68(1), 66–75.

995

Day, M. (2012). Interdisciplinary hospice team processes and multidimensional pain: A qualitative study. Journal of Social Work in End-of-Life & Palliative Care, 8(1), 53–76.

Day, P., & Schuler, D. (2004). Community practice in the network society: Local action/global interaction. New York: Routledge.

De Carvalho, R. V. C., Seidl-de-Moura, M. L., Martins, G. D. F., & Vieira, M. L. (2014). Culture and developmental trajectories: A discussion on contemporary theoretical models. Early Child Development and Care, 184(11), 1599–1614.

Dean, R. G. (2001). The myth of cross-cultural competence. Families in Society, 82(6), 623–630.

DeFilippis, J., Fisher, R., & Shragge, E. (2009). What’s left in the community? Oppositional politics in contemporary practice. Community Development Journal, 44(1), 38–52.

Delgado, M. (1988). Groups in Puerto Rican spiritism: Implications for clinicians. In C. Jacobs & D. D. Bowles (Eds.), Ethnicity and race: Critical concepts in social work (pp. 34–37). Silver Spring, MD: NASW Press.

Delgado, M., & Staples, L. (2013). Youth-led organizing, community engagement, and opportunity creation. In M. Weil, M. Reisch, & M. Ohmer (Eds.), The handbook of community practice (2nd ed., pp. 547–565). Thousand Oaks, CA: Sage.

Delgado, R. (2017). Critical race theory: An introduction. New York: New York University Press.

Dell’Amore, C. (2012, February 29). Women can make new eggs after all, stem-cell study hints finding may one day help delay menopause,

996

improve fertility. National Geographic News. Retrieved from https://news.nationalgeographic.com/news/2012/02/120229-women- health-ovaries-eggs-reproduction-science/

della Porta, D., & Diani, M. (2006). Social movements: An introduction (2nd ed.). Malden, MA: Blackwell.

della Porta, D., Kriesi, H., & Rucht, D. (2009). Social movements in a globalizing world. New York: Palgrave Macmillan.

DeLucia-Waack, J., Kalodner, C., & Riva, M. (2014). Handbook of group counselling and psychotherapy (2nd ed.). Thousand Oaks, CA: Sage.

Demo, D., & Fine, M. (2010). Beyond the average divorce. Thousand Oaks, CA: Sage.

DeNavas-Walt, C., Proctor, B., & Hill Lee, C. (2006). Income, poverty, and health insurance coverage in the United States: 2005. Washington, DC: U.S. Census Bureau.

DeNavas-Walt, C., Proctor, B., & Smith, J. (2013). Income, poverty, and health insurance coverage in the United States: 2012. Washington, DC: U.S. Census Bureau.

Denby, R., Gomez, E., & Alford, K. (2016). Promoting well-being through relationship building: The role of smartphone technology in foster care. Journal of Technology in Human Services, 34(2), 183–208.

DePoy, E., & Gilson, S. F. (2004). Rethinking disability: Principles for professional and social change. Belmont, CA: Wadsworth.

DePoy, E., & Gilson, S. F. (2007). The human experience: Description, explanation, and judgment. New York: Rowman & Littlefield.

997

https://news.nationalgeographic.com/news/2012/02/120229-women-health-ovaries-eggs-reproduction-science/

DePoy, E., & Gilson, S. F. (2011). Studying disability: Multiple theories and responses. Thousand Oaks, CA: Sage.

DePoy, E., & Gilson, S. F. (2012). Human behavior theory and applications: A critical thinking approach. Thousand Oakes, CA: Sage.

DePoy, E., & Gilson, S. (2014). Branding and designing disability. Abingdon/Oxon, UK: Routledge.

Desilver, D. (2015). Job categories where union membership has fallen off most. Pew Research Center. Retrieved from www.pewresearch.org/fact- tank/2015/04/27/union-membership/

Desilver, D. (2017). U.S. trails most development countries in voter turnout. Pew Research Center. Retrieved from www.pewresearch.org/fact-tank/2017/05/15/u-s-voter-turnout-trails- most-developed-countries/

Dijkstra, S., Creemers, H., Asscher, J., Dekovic, M., & Stams, G. (2016). The effectiveness of family group conferencing in youth care: A meta- analysis. Child Abuse & Neglect, 62, 100–110.

DiMaggio, P. J., & Powell, W. W. (1983). The iron cage revisited: Institutional isomorphis and collective rationality in organizational fields. American Sociological Review, 48, 147–160.

DiPrete, T., Gelman, A., McCormick, T., Teitler, J., & Zheng, T. (2011). Segregation in social networks based on acquaintanceship and trust. American Journal of Sociology, 116(4), 1234–1283.

Disabled People’s International. (2017). About us. Retrieved from www.usicd.org/index.cfm/DPI

998

http://www.pewresearch.org/fact-tank/2015/04/27/union-membership/

http://www.pewresearch.org/fact-tank/2017/05/15/u-s-voter-turnout-trails-most-developed-countries/

http://www.usicd.org/index.cfm/DPI

Diwan, S., Jonnalagadda, S. S., & Balaswamy, S. (2004). Resources predicting positive and negative affect during the experience of stress: A study of older Asian Indian immigrants in the United States. The Gerontologist, 44(5), 605–614.

Dixon, J., Dogan, R., & Sanderson, A. (2005). Community and communitarianism: A philosophical investigation. Community Development Journal, 40(1), 4–16.

Dodge, A. (2016). Digitizing rape culture: Online sexual violence and the power of the digital photograph. Crime Media Culture, 12(1), 65–82.

Dominelli, L. (2012). Green social work: From environmental crises to environmental justice. Cambridge, UK: Polity Press.

Donigian, J., & Malnati, R. (2005). Systemic group therapy: A triadic model. Belmont, CA: Wadsworth.

Donleavey, G. A. (2008). No man’s land: Exploring the space between Gilligan and Kohlberg. Journal of Business Ethics, 80, 807–822.

Doyle, E. A. (2015). Autoimmune conditions associated with type 1 diabetes. Pediatric Nursing, 41(2), 89–91.

Drake, R. E., Mueser, K. T., Brunette, M. F., & McHugo, G. J. (2004). A review of treatments for people with severe mental illnesses and co- occurring substance use disorders. Psychiatric Rehabilitation Journal, 27(4), 360.

Drescher, K. D., Burgoyne, M., Casas, E., Lovato, L., Curran, E., Pivar, I., & Foy, D. W. (2009). Issues of grief, loss, honor, and remembrance: Spirituality and work with military personnel and their families. In S. M. Freeman, B. A. Moore, & A. Freeman (Eds.), Living and surviving in harm’s way: A psychological treatment handbook for pre- and post-

999

deployment of military personnel (pp. 437–466). New York: Routledge.

Drucker, P. (1954). The practice of management. New York: Harper.

Duba, J. D., & Watts, R. E. (2009). Therapy with religious couples. Journal of Clinical Psychology, 65(2), 210–223.

Dudziak, S., & Profitt, N. (2012). Group work and social justice: Designing pedagogy for social change. Social Work with Groups, 35, 235–252.

Dunbar-Ortiz, R. (2014). An indigenous peoples’ history of the United States. Boston: Beacon Press.

Duntley-Matos, R., Arteaga, V., Garcia, A., Arellano, R., Garza, R., & Ortega, R. (2017). “We always say: And then came the Water . . .”: Flint’s emergent Latinx capacity building journey during the government-induced lead crisis. Journal of Community Practice, 25(3–4), 365–390.

Duran, E., & Duran, B. (1995). Native American postcolonial psychology. Albany: State University of New York Press.

Duvall-Early, K., & Benedict, J. (1992). The relationship between privacy and different components of job satisfaction. Environment and Behavior, 24, 670–679.

Dworkis, D., Taylor, L, Peak, D., & Bearnot, B. (2017). Geospatial analysis of emergency department visits for targeting community-based responses to the opioid epidemic. PLOS One. Retrieved from https://dash.harvard.edu/bitstream/handle/1/32630702/5376332.pdf? sequence=1.

1000

https://dash.harvard.edu/bitstream/handle/1/32630702/5376332.pdf?sequence=1

Dybicz, P. (2011). Anything goes? Science and social constructions in competing discourses. Journal of Sociology & Social Welfare, 38(3), 101–122.

Dylan, A., & Coates, J. (2012). The spirituality of justice: Bringing together the eco and the social. Journal of Religion & Spirituality in Social Work, 31(1–2), 128–149.

Eacott, M., & Easton, A. (2012). Remembering the past and thinking about the future: Is it really about time? Learning and Motivation, 43, 200–208.

Earle, A., Mokomane, Z., & Heymann, J. (2011). International perspectives on work-family policies: Lessons from the world’s most competitive economies. The Future of Children, 21(2), 191–200.

Eberhard, J. (2008). Brain landscape: The coexistence of neuroscience and architecture. New York: Oxford University Press.

Eckerd, A., & Keeler, A. (2012). Going green together? Brownfield remediation and environmental justice. Policy Science, 45, 293–314.

Edin, K., Kefalas, M., & Reed, J. (2004). A peek inside the black box: What marriage means for poor unmarried parents. Journal of Marriage and the Family, 66, 1007–1014.

Edin, K., & Kissane, R. (2010). Poverty and the American family: A decade in review. Journal of Marriage and Family, 72, 460–479.

Edin, K., & Reed, J. (2005). Why don’t they just get married? Barriers to marriage among the disadvantaged. The Future of Children, 15(5), 117–137.

1001

Edwards, C., & Harold, G. (2014). DeafSpace and the principles of universal design. Disability and Rehabilitation, 36(16), 1350–1359.

Edwards, G. (2014). Social movements and protest. New York: Cambridge University Press.

Eggerston, L. (2012). Hospital noise: Increasingly, it hinders communication and puts patients at risk. Canadian Nurse, 108(4), 28–31.

Eheart, B., Hopping, D., Power, M., Mitchell, E., & Racine, D. (2009). Generations of Hope Communities: An intergenerational neighborhood model of support and service. Children and Youth Services Review, 31, 47–52.

Elder, G. H., Jr. (1974). Children of the Great Depression: Social change in life experience. Chicago: University of Chicago Press.

Elder, G. H., Jr. (1998). The life course as developmental theory. Child Development, 69(1), 1–12.

Elder, G. H., Jr., & Giele, J. (Eds.). (2009). The craft of life course research. New York: Guilford Press.

Elkins, D. N. (2016). Attachment theory and social relationships research: The power of human connection and social interaction. Washington, DC: American Psychological Association.

Ellison, J. W., & Plaskow, J. (Eds.). (2007). Heterosexism in contemporary world religion: Problem and prospect. Cleveland, OH: Pilgrim Press.

Ellison, N., Steinfield, C., & Lampe, C. (2007). The benefits of Facebook

1002

“friends”: Social capital and college students’ use of online social network sites. Journal of Computer-Mediated Communication, 12, 1143–1168.

Ellsworth, P. C. (1991). Some implications of cognitive appraisal theories of emotion. In K. T. Strongman (Ed.), International review of studies on emotion (pp. 143–161). New York: Wiley.

Ellwardt, L., van Tilburg, T., Aartsen, M., Wittek, R., & Steverink, N. (2015). Personal networks and mortality risk in older adults: A twenty- one-year longitudinal study. PLoS One, 10(3), 1–13.

Elwell, L., Grogan, S., & Coulson, N. (2010). Adolescents living with cancer: The role of computer-mediated support groups. Journal of Health Psychology, 16(2), 236–248.

Engel, R., & Schutt, R. (2017). The practice of research in social work (4th ed.). Thousand Oaks, CA: Sage.

Engels, F. (1892). The condition of the working class in England in 1844 (F. K. Wischnewtzky, Trans.). London: Sonnenschein.

Engels, F. (1970). The origins of the family, private property and the state. New York: International. (Original work published 1884)

Ensari, N., Riggio, R., Christian, J., & Carslaw, G. (2011). Who emerges as leader: Meta-analyses of individual differences as predictors of leadership emergence. Personality and Individual Differences, 51, 532–536.

Epp, C. Maynard-Moody, S., & Haider-Markel, D. (2014). Pulled over: How police stops define race and citizenship. Chicago: University of Chicago Press.

1003

Erikson, E. (1963). Childhood and society (2nd ed.). New York: Norton.

Erikson, E. (1968). Identity: Youth and crisis. New York: Norton.

Ernst, J. (2000). Mapping child maltreatment: Looking at neighborhoods in a suburban county. Child Welfare, 79, 555–572.

Esbjörn-Hargens, S. (Ed.). (2010). Integral theory in action: Applied, theoretical, and constructive perspectives on the AQAL model. Albany, NY: SUNY Press.

Esperidiao-Antonio, V., Majeski-Colombo, M., Toledo-Monteverde, D., Moraes-Martins, G., Fernandes, J. J., Bauchiglioni de Assis, M., . . . Siqueira-Batista, R. (2017). Neurobiology of emotions: An update. International Review of Psychiatry, 29(3), 293–307.

European Commission: Employment, Social Affairs & Inclusion. (2017). Social protection committee annual report 2017. Retrieved from https://publications.europa.eu/en/publication-detail/- /publication/9ebf0bf6-c439-11e7-9b01-01aa75ed71a1/language-en

Evans, A., & Coccoma, P. (2014). Trauma-informed care: How neuroscience influences practice. New York: Routledge/Taylor and Francis Group.

Evans, C. J., Boustead, R. S., & Owens, C. (2008). Expressions of spirituality in parents with at-risk children. Families in Society: The Journal of Contemporary Social Services, 89(2), 245–252.

Evans, G., Lepore, S., & Allen, K. (2000). Cross-cultural differences in tolerance for crowding: Fact or fiction? Journal of Personality and Social Psychology, 79(2), 204–210.

1004

https://publications.europa.eu/en/publication-detail/-/publication/9ebf0bf6-c439-11e7-9b01-01aa75ed71a1/language-en

Evans, G., & Saegert, S. (2000). Residential crowding in the context of inner city poverty. In S. Wapner, J. Demick, T. Yamamoto, & H. Minami (Eds.), Theoretical perspectives in environment–behavior research: Underlying assumptions, research problems, and methodologies (pp. 247–267). New York: Kluwer Academic.

Ewing, R., Meakins, G., Hamidi, S., & Nelson, A. (2014). Relationships between urban sprawl and physical activity, obesity, and morbidity— Update and refinement. Health & Place, 26, 118–126.

Faculty of Public Health. (2010). Great outdoors: How our natural health service uses green space to improve well-being. London: Faculty of Public Health. Retrieved from www.champspublichealth.com/writedir/9ee3FPH%20green%20space%20briefing.pdf

Fadiman, A. (1998). The spirit catches you and you fall down: A Hmong child, her American doctors, and the collision of two cultures. New York: Farrar, Straus and Giroux.

Fairbrother, M., & Martin, I. (2013). Does inequality erode social trust? Results from multilevel models of U.S. states and counties. Social Science Research, 42, 347–360.

Falicov, C. (2016). Migration and the life cycle. In M. McGoldrick, N. Garcia-Preto, & B. Carter (Eds.), The expanding family life cycle: Individual, family, and social perspectives (5th ed., pp. 222–239). Boston: Pearson.

Families USA. (2018). A 50-state look at Medicaid expansion. Retrieved from http://familiesusa.org/product/50-state-look-medicaid-expansion

Fan, Y., & Song, Y. (2009). Is sprawl associated with a widening urban- suburban mortality gap? Journal of Urban Health: Bulletin of the New York Academy of Medicine, 86(5), 708–728.

1005

http://www.champspublichealth.com/writedir/9ee3FPH%20green%20space%20briefing.pdf

http://familiesusa.org/product/50-state-look-medicaid-expansion

Fandos, N. (2017, April 29). Climate march draws thousands of protesters alarmed by Trump’s environmental agenda. New York Times. Retrieved from www.nytimes.com/2017/04/29/us/politics/peoples-climate-march- trump.html

Farmer, R. (2009). Neuroscience and social work practice: The missing link. Thousand Oaks, CA: Sage.

Farrell, M. (2009, September 19). ACORN scandal: How much federal funding does it get? The Christian Science Monitor. Retrieved from www.csmonitor.com/USA/2009/0919/p02s13-usgn.html

Fatima, S., & Tahir, S. (2013). Comparison of coping strategies used by adolescents on state and trait anxiety. FWU Journal of Social Sciences, 7(2), 165–174.

Faver, C. A., & Trachte, B. L. (2005). Religion and spirituality at the border: A survey of Mexican-American social work students. Social Thought, 24(4), 3–18.

Feldman, R. (1990). Settlement-identity: Psychological bonds with home places in a mobile society. Environment and Behavior, 22(2), 183–229.

Feldman, R. (2017). The neurobiology of human attachments. Trends in Cognitive Sciences, 21(2), 80–99.

Felitti, V. J., Anda, F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., . . . Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Child Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245–258.

Felsten, G. (2009). Where to take a study break on college campus: An attention restoration theory perspective. Journal of Environmental

1006

http://www.nytimes.com/2017/04/29/us/politics/peoples-climate-march-trump.html

http://www.csmonitor.com/USA/2009/0919/p02s13-usgn.html

Psychology, 29, 160–176.

Ferdman, R. (2014, September 25). The pay gap between CEOs and workers is much worse than you realize. Washington Post. Retrieved from www.washingtonpost.com/news/wonk/wp/2014/09/25/the-pay- gap-between-ceos-and-workers-is-much-worse-than-you-realize/? utm_term=.e1e61c1fb16f

Ferguson, K. M., Wu, Q., Dryrness, G., & Spruijt-Metz, D. (2007). Perceptions of faith and outcomes in faith-based programs for homeless youth: A grounded theory approach. Journal of Social Service Research, 33(4), 25–43.

Ferree, M. M., & Martin, P. Y. (1995). Feminist organizations: Harvest of the new women’s movement. Philadelphia: Temple University Press.

Fillary, J., Chaplin, H., Jones, G., Thompson, A., Holme, A., & Wilson, P. (2015). Noise at night in hospital general wards: A mapping of literature. British Journal of Nursing, 24(10), 536–540.

Finger, W., & Arnold, E. M. (2002). Mind–body interventions: Applications for social work practice. Social Work in Health Care, 35(4), 57–78.

Finkelhor, D., Ormrod, R., Turner, H., & Hamby, S. (2005). The victimization of children and youth: A comprehensive national survey. Child Maltreatment, 10, 5–25.

Firestein, S. (2012). Ignorance: How it drives science. New York: Oxford University Press.

Fischer, D. (1989). Albion’s seed: Four British folkways in America. New York: Oxford University Press.

1007

http://www.washingtonpost.com/news/wonk/wp/2014/09/25/the-pay-gap-between-ceos-and-workers-is-much-worse-than-you-realize/?utm_term=.e1e61c1fb16f

Fischer, J., Lyness, K., & Engler, R. (2010). Families coping with alcohol and substance abuse. In S. Price, C. Price, & P. McKenry (Eds.), Families & change: Coping with stressful events and transitions (4th ed., pp. 141–162). Thousand Oaks, CA: Sage.

Fisher, R. (2005). History, context, and emerging issues for community practice. In M. Weil (Ed.), The handbook of community practice (pp. 34–58). Thousand Oaks, CA: Sage.

Fisher, R., & Karger, H. (1997). Social work and community in a private world. New York: Longman.

Fisher, R., & Shragge, E. (2000). Challenging community organizing: Facing the 21st century. Journal of Community Practice, 8(3), 1–19.

Fisher, S., & Ridley, M. (2013). Culture, genes, and the human revolution. Science, 340(6135), 929–930.

Fitzgerald, J. (1997). Reclaiming the whole: Self, spirit, and society. Disability and Rehabilitation, 19(10), 407–413.

Fitzgerald, K., & Rodgers, D. (2000). Radical social movement organizations: A theoretical model. Sociological Quarterly, 41(4), 573–592.

Flacks, R. (2004). Knowledge for what? Thoughts on the state of social movement studies. In J. Goodwin & J. Jasper (Eds.), Rethinking social movements: Structure, meaning, and emotion (pp. 135–153). Lanham, MD: Rowman & Littlefield.

Flake, E., Davis, B., Johnson, P., & Middleton, L. (2009). The psychosocial effects of deployment on military children. Journal of Developmental & Behavioral Pediatrics, 30(4), 271–278.

1008

Flanagan, L. (2016a). Object relations theory. In J. Berzoff, L. Flanagan, & P. Hertz (Eds.), Inside out and outside in: Psychodynamic clinical theory and psychopathology in contemporary multicultural contexts (4th ed., pp. 123–165). Lanham, MD: Rowman & Littlefield.

Flanagan, L. (2016b). The theory of self psychology. In J. Berzoff, L. Flanagan, & P. Hertz (Eds.), Inside out and outside in: Psychodynamic clinical theory and psychopathology in contemporary multicultural contexts (4th ed., pp. 166–195). Lanham, MD: Rowman & Littlefield.

Fletcher, G. J. O., Simpson, J. A., Campbell, L., & Overall, N. C. (2015). Pair-bonding, romantic love, and evolution: The curious case of homo sapiens. Perspectives on Psychological Science, 10(1), 20–36.

Flores, P., & Porges, S. (2017). Group psychotherapy as a neural exercise: Bridging polyvagal theory and attachment theory. Psychotherapy, 67(2), 202–222.

Follett, M. P. (1918). The new state: Group organization, the solution of popular government. London: Longman, Green.

Follett, M. P. (1924). Creative experience. New York: Longman, Green.

Forsyth, D. (2011). The nature and significance of groups: In R. Coyne (Ed.), The Oxford handbook of group counseling (pp. 19–35). New York: Oxford University Press.

Foucault, M. (1969). The archaeology of knowledge and the discourse on language. New York: Harper Colophon.

Fowler, J. F. (1981). Stages of faith: The psychology of human development and the quest for meaning. San Francisco: Harper.

1009

Fowler, J. F. (1995). Stages of faith: The psychology of human development and the quest for meaning. New York: HarperCollins.

Fowler, J. F. (1996). Faithful change: The personal and public challenges of postmodern life. Nashville, TN: Abingdon Press.

Fox, S. (2011). Americans living with disability and their technology profile. Washington, DC: Pew Research Center.

Francescato, D., & Tomai, M. (2001). Community psychology: Should there be a European perspective? Journal of Community & Applied Social Psychology, 11, 371–380.

Francis, A. (2013). Saving normal. New York: HarperCollins.

Frank, A. (1967). Capitalism and development in Latin America. New York: Monthly Review Press.

Frankl, V. E. (1988). The will to meaning: Foundations and applications of logotherapy. New York: Meridian.

Franklin, A. (2007). Posthumanism. In G. Ritzer (Ed.), The Blackwell encyclopedia of sociology (pp. 3548–3550). Oxford, UK: Blackwell.

Fraser, C., McIntyre, A., & Manby, M. (2009). Exploring the impact of parental drug/alcohol problems on children and parents in a Midlands county in 2005/06. British Journal of Social Work, 39, 846–866.

Freedberg, S. (2007). Re-examining empathy: A relational-feminist point of view. Social Work, 52(3), 251–259.

Freedom House. (2017). Freedom of the press: 2017: Press freedom’s dark horizon. Retrieved from https://freedomhouse.org/report/freedom-

1010

https://freedomhouse.org/report/freedom-press/freedom-press-2017

press/freedom-press-2017

Freeman, D. R. (2006). Spirituality in violent and substance abusing African American men: An untapped resource in healing. Social Thought, 25(1), 3–22.

Freeman, E., & Couchonnal, G. (2006). Narrative and culturally based approaches in practice with families. Families in Society: The Journal of Contemporary Social Services, 87(2), 198–208.

Freeman, J. (1995). From seed to harvest: Transformations of feminist organizations and scholarship. In M. Ferree & P. Martin (Eds.), Feminist organizations: Harvest of the new women’s movement (pp. 397–408). Philadelphia: Temple University Press.

Fremeaux, I. (2005). New labour’s appropriation of the concept of community: A critique. Community Development Journal, 40(3), 265–274.

Freud, S. (1928). The future of an illusion. London: Hogarth Press and Institute of Psychoanalysis.

Freud, S. (1953). Three essays on the theory of sexuality. In J. Strachey (Ed. & Trans.), The standard edition of the complete psychological works of Sigmund Freud (Vol. 7, pp. 135–245). London: Hogarth Press. (Original work published 1905)

Freud, S. (1978). The interpretation of dreams (A. A. Brill, Trans.). New York: Modern Library. (Original work published 1899)

Freudenberger, H. (1974). Staff burnout. Journal of Social Issues, 30, 159–165.

1011

Frey, L., & Sunwolf. (2005). The symbolic-interpretive perspective of group life. In M. Poole & A. Hollingshead (Eds.), Theories of small groups: Interdisciplinary perspectives (pp. 185–239). Thousand Oaks, CA: Sage.

Friend, D., Bradley, R., Thatcher, R., & Gottman, J. (2011). Typologies of intimate partner violence: Evaluation of a screening instrument for differentiation. Journal of Family Violence, 26, 551–563.

Fuchs, C. (2017). Social media: A critical introduction (2nd ed.). Thousand Oaks, CA: Sage.

Fukuyama, M. A., & Sevig, T. D. (1999). Integrating spirituality into multicultural counseling. Thousand Oaks, CA: Sage.

Furman, L. E., & Chandy, J. M. (1994). Religion and spirituality: A long- neglected cultural component of rural social work practice. Human Services in the Rural Environment, 17(3/4), 21–26.

Gaard, G. (2011). Ecofeminism revisited: Rejecting essentialism and re- placing species in a material feminist environmentalism. Feminist Formations, 23(2), 26–53.

Gaertner, L., Sedikides, C., Luke, M., O’Mara, E. M., Iuzzini, J., Jackson, L. E., . . . Wu, Q. (2012). A motivational hierarchy within: Primacy of the individual self, relational self, or collective self? Journal of Experimental Social Psychology, 48(5), 997–1013.

Galatzer-Levy, I. R., Ankri, Y., Freedman, S., Israeli-Shalev, Y., Roitman, P., Gilad, M., . . . Shalev, A. Y. (2013). Early PTSD symptom trajectories: Persistence, recovery, and response to treatment: Results from the Jerusalem Trauma Outreach and Prevention Study (J-TOPS). PLoS One, 8(8), 1–9.

1012

Gale, J. (2009). Meditation and relational connectedness: Practices for couples and families. In F. Walsh (Ed.), Spiritual resources in family therapy (2nd ed., pp. 247–266). New York: Guilford Press.

Gallagher, L. (2013). The end of the suburbs: Where the American dream is moving. New York: Penguin.

Gallup, G. H. (2002). Americans feel need to believe. Retrieved from http://news.gallup.com/poll/5617/Americans-Feel-Need-Believe.aspx

Gallup, G. H., & Lindsay, D. M. (1999). Surveying the religious landscape: Trends in U.S. beliefs. Harrisburg, PA: Morehouse.

Gallup News. (2017). Religion. Retrieved from http://news.gallup.com/poll/1690/religion.aspx

Galotti, K. M. (1989). Gender differences in self-reported moral reasoning: A review and new evidence. Journal of Youth and Adolescence, 18, 475–488.

Gamble, D. (2013). Participatory methods in community practice. In M. Weil, M. Reisch, & M. Ohmer (Eds.), The handbook of community practice (2nd ed., pp. 327–343). Thousand Oaks, CA: Sage.

Gamson, W., & Meyer, D. (1996). Framing political opportunity. In D. McAdam, J. McCarthy, & M. Zald (Eds.), Comparative perspectives on social movements (pp. 273–290). New York: Cambridge University Press.

Gana, K., & Jakubowska, S. (2016). Relationships between infertility- related stress and emotional distress and marital satisfaction. Journal of Health Psychology, 21(6), 1043–1054.

1013

http://news.gallup.com/poll/5617/Americans-Feel-Need-Believe.aspx

http://news.gallup.com/poll/1690/religion.aspx

Gannett, L. (2008). The Human Genome Project. Stanford encyclopedia of philosophy. Retrieved from http://plato.stanford.edu/entries/human- genome/

Garden, F., & Jalaludin, B. (2009). Impact of urban sprawl on overweight, obesity, and physical activity in Sydney, Australia. Journal of Urban Health, 86(1), 19–30.

Gardiner, H. (2018). Lives across cultures: Cross-cultural human development (6th ed.). New York: Pearson.

Gardner, H. (1999). Intelligence reframed: Multiple intelligences for the 21st century. New York: Basic Books.

Gardner, H. (2006). Multiple intelligences: New horizons. New York: Basic Books.

Gardner, H. (2008). Multiple intelligence: New horizons. New York: Basic Books.

Garland, D. R., Myers D. M., & Wolfer, T. A. (2008). Social work with religious volunteers: Activating and sustaining community involvement. Social Work, 53(3), 255–265.

Garland, J., Jones, H., & Kolodny, R. (1976). A model for stages of development in social work groups. In S. Bernstein (Ed.), Explorations in group work (pp. 17–71). Boston: Milford.

Garner, R., & Zald, M. (2012). Now we are almost fifty! Reflections on a theory of the transformation of social movement organizations. Social Forces, 91(1), 3–11.

Garrett, K. (2005). Use of groups in school social work: Group work and

1014

http://plato.stanford.edu/entries/human-genome/

group processes. Social Work with Groups, 27(2–3), 75–92.

Garrow, E., & Hasenfeld, Y. (2010). Theoretical approaches to human service organizations. In Y. Hasenfeld (Ed.), Human services as complex organizations (2nd ed., pp. 33–57). Thousand Oaks, CA: Sage.

Gates, G. (2013). LGBT parenting in the United States. Los Angeles: The Williams Institute. Retrieved from http://williamsinstitute.law.ucla.edu/wp-content/uploads/LGBT- Parenting.pdf

Gatumba Refugees Survivors Foundation. (2018). Heinous massacres against Congolese Tutsi (Banyamulenge) on August 13, 2004 at Gatumba Refugee Camp in Burundi. Retrieved from www.gatumbasurvivors.org/massacre/

Geertz, C. (1973). The interpretation of cultures. New York: Basic Books.

Geller, M. (2005). The psychoanalytic perspective. In S. Wheelan (Ed.), The handbook of group research and practice (pp. 87–105). Thousand Oaks, CA: Sage.

Gelles, R. (2010). Violence, abuse, and neglect in families and intimate relationships. In S. Price, C. Price, & P. McKenry (Eds.), Families and change: Coping with stressful events and transitions (4th ed., pp. 119–139). Thousand Oaks, CA: Sage.

Generations United. (2016). Raising the children of the opioid epidemic. Retrieved from https://dl2.pushbulletusercontent.com/qdCNUO2JMMZKzKRjyIlwbgjMtf39xkKa/16- Report-SOGF-Final.pdf

George, L. (1993). Sociological perspectives on life transitions. Annual Review of Sociology, 19, 353–373.

1015

http://williamsinstitute.law.ucla.edu/wp-content/uploads/LGBT-Parenting.pdf

http://www.gatumbasurvivors.org/massacre/

https://dl2.pushbulletusercontent.com/qdCNUO2JMMZKzKRjyIlwbgjMtf39xkKa/16-Report-SOGF-Final.pdf

Gerdes, K., & Segal, E. (2011). Importance of empathy for social work practice: Integrating new science. Social Work, 56(2), 141–148.

Gergen, K. (1985). The social constructionist movement in modern psychology. American Psychologist, 40, 266–275.

Germain, C. (1981). The physical environment and social work practice. In A. N. Maluccio (Ed.), Promoting competence in clients (pp. 103–124). New York: Free Press.

Germain, C., & Gitterman, A. (1996). The life model of social work practice (2nd ed.). New York: Columbia University Press.

Ghavami, N., Fingerhut, A., Peplau, L. A., Grant, S. K., & Wittig, M. A. (2011). Testing a model of minority identity achievement, identity affirmation, and psychological well-being among ethnic minority and sexual minority individuals. Cultural Diversity & Ethnic Minority Psychology, 17(1), 79–88.

Giang, T., Karpyn, A., Laurison, H., Hillier, A., & Perry, D. (2008). Pennsylvania’s Fresh Food Financing Initiative. Journal of Public Health Management and Practice, 14, 272–279.

Gibbs, J. C., Basinger, K. S., Grime, R. L., & Snarey, J. R. (2007). Moral judgement development across cultures: Revisiting Kohlberg’s universality claims. Developmental Review, 27, 443–500.

Gibbs, N. (2009, October 14). What women want now. Time. Retrieved from http://content.time.com/time/specials/packages/article/0,28804,1930277_1930145_1930309,00.html

Gibson-Davis, C., Edin, K., & McLanahan, S. (2005). High hopes but even higher expectations: The retreat from marriage among low-income couples. Journal of Marriage and Family, 65(5), 1301–1312.

1016

http://content.time.com/time/specials/packages/article/0,28804,1930277_1930145_1930309,00.html

Giddens, A. (1979). Central problems in social theory: Action, structure, and contradiction in social analysis. Berkeley: University of California Press.

Giddens, A. (2000). Runaway world: How globalization is reshaping our lives. New York: Routledge.

Gifford, R. (2009). Personal space. In H. Reis & S. Sprecher (Eds.), Encyclopedia of human relationships (pp. 1227–1228). Thousand Oaks, CA: Sage.

Gifford, R. (2014). Environmental psychology: Principles and practice (5th ed.). Colville, WA: Optimal Books.

Gilbert, L., Brown, C., & Mistry, R. (2017). Latino immigrant parents’ financial stress, depression, and academic involvement predicting child academic success. Psychology, in the Schools 54, 1202–1215.

Gill, S. (2010). Developing a learning culture in nonprofit organizations. Thousand Oaks, CA: Sage.

Gillieatt, S., Fernandes, C., Fielding, A., Hendrick, A., Martin, R., & Matthews, S. (2015). Social network analysis and social work inquiry. Australian Social Work, 68(3), 338–351.

Gilligan, C. (1982). In a different voice. Cambridge, MA: Harvard University Press.

Gilligan, C. (1988). Remapping the moral domain: New images of self in relationship. In C. Gilligan, J. V. Ward, & J. M. Taylor (Eds.), Mapping the moral domain (pp. 3–20). Cambridge, MA: Harvard University Press.

1017

Gil-Rivas, V., Kilmer, R., Larson, J., & Armstrong, L. (2017). Facilitating successful reintegration: Attending to the needs of military families. American Journal of Orthopsychiatry, 87(2), 176–184.

Gintis, H. (2011). Gene-culture coevolution and the nature of human sociality. Philosophical Transactions of Royal Society BR. Society B, 366, 878–888.

Gitterman, A. (2009). The life model. In A. R. Roberts (Ed.), Social workers’ desk reference (2nd ed., pp. 231–235). New York: Oxford University Press.

Gitterman, A., & Germain, C. (2008). The life model of social work practice: Advances in theory and practice (3rd ed.). New York: Columbia University Press.

Gitterman, A., & Shulman, L. (Eds.). (2005). Mutual aid groups, vulnerable and resilient populations and the life cycle (3rd ed.). New York: Columbia University Press.

Gleason, P., Clark, M., Clark Tuttle, C., Dwoyer, E., & Silberberg, M. (2010). The evaluation of charter school impacts. Washington, DC: U.S. Department of Education. Retrieved from http://files.eric.ed.gov/fulltext/ED510573.pdf

Go, J. (2013). For a postcolonial sociology. Theory and Society 42(1), 25–55.

Godoy, S., Sadwick, R., & Baca, K. (2016). Shedding light on sex trafficking. Retrieved from http://innovation.luskin.ucla.edu/sites/default/files/Luskin%20HT%20Report.pdf

Godsall, R., Jurkovic, G., Emshoff, J., Anderson, L., & Stanwyck, D. (2004). Why some kids do well in bad situations: Relation of parental

1018

http://files.eric.ed.gov/fulltext/ED510573.pdf

http://innovation.luskin.ucla.edu/sites/default/files/Luskin%20HT%20Report.pdf

alcohol misuse and parentification to children’s self-concept. Substance Use & Misuse, 39(5), 789–809.

Godwyn, M., & Gittell, J. (2012). Introduction. In M. Godwyn & J. Gittell (Eds.), Sociology of organizations: Structures and relationships (pp. xi–xxiv). Thousand Oaks, CA: Sage.

Goehler, H., Kowald, A., Turewicz, M., Stephan, C., Meyer, H. E., Lueking, A., . . . Saft, C. (2012). F08 The autoimmune profile of Huntington’s disease patients: A pilot study. The Journal of Neurology Neurosurgery & Psychiatry, 83(Suppl. 1), A23.

Goering, S. (2015). Rethinking disability: The social model of disability and chronic illness. Current Reviews in Musculoskeletal Medicine , 8, 134–138.

Goffman, E. (1959). Presentation of self in everyday life. Garden City, NY: Archer.

Goldenberg, S. (2011, November 7). Thousands protest at the White House against Keystone XL pipeline. The Guardian. Retrieved from www.theguardian.com/environment/2011/nov/07/keystone-xl-pipeline- protest-white-house

Goldman, J. (1996). Healing sounds: The power of harmonics. Rockport, MA: Element Books.

Goldstein, D. (1996). Ego psychology theory. In F. Turner (Ed.), Social work treatment (4th ed., pp. 191–217). New York: Free Press.

Goldstein, E. G. (1995). Ego psychology and social work practice (2nd ed.). New York: Free Press.

1019

http://www.theguardian.com/environment/2011/nov/07/keystone-xl-pipeline-protest-white-house

Goldstein, E. G. (2001). Object relations theory and self psychology in social work practice. New York: Free Press.

Goldstein, E. G. (2009). The relationship between social work and psychoanalysis: The future impact of social workers. Clinical Social Work Journal, 37(1), 7–13.

Goleman, D. (2005). Emotional intelligence (10th anniv. ed.). New York: Bantam.

Golembiewski, R. T. (1994). Is organizational membership bad for your health? Phases of burnout as covariants of mental and physical well- being. In A. Farazmand (Ed.), Modern organizations: Administrative theory in contemporary society (pp. 211–227). Westport, CT: Praeger.

Gonzales, A. (2016). The contemporary US digital divide: From initial access to technology maintenance. Information, Communication & Society, 19(2), 234–248.

Goodwin, J., & Jasper, J. (2015). The social movements reader: Cases and concepts (3rd ed.). Malden, MA: Wiley Blackwell.

Gotham, K. (2013). Contrasts of carnival: Mardi Gras between the modern and the postmodern. In P. Kivisto (Ed.), Illuminating social life: Classical and contemporary theory revisited (6th ed., pp. 319–344). Thousand Oaks, CA: Sage.

Gotta, G., Green, R., Rothblum, E., Solomon, S., Balsam, K., & Schwartz, P. (2011). Heterosexual, lesbian, and gay male relationships: A comparison of couples in 1975 and 2000. Family Process, 50(3), 353–376.

Gottlieb, B. H., & Bergen, A. E. (2010). Social support concepts and measures. Journal of Psychosomatic Research, 69(5), 511–520.

1020

Gould, D. (2009). Moving politics: Emotion and ACT UP’s fight against AIDS. Chicago: University of Chicago Press.

Government of Canada. (2016). Labour organizations in Canada 2015. Retrieved from www.canada.ca/en/employment-social- development/services/collective-bargaining-data/reports/union- coverage.html

Graber, D., & Dunaway, J. (2018). Mass media and American politics (10th ed.). Thousand Oaks, CA: Sage.

Granovetter, M. (1973). The strength of weak ties. American Journal of Sociology, 78, 1360–1380.

Grant, J. (2015). New urbanism. In J. Wright (Ed.), International encyclopedia of the social and behavioural sciences (2nd ed., Vol. 16, pp. 809–814). Oxford, UK: Elsevier.

Gray, M., Coates, B., & Yellow Bird, M. (Eds.). (2010). Indigenous social work around the world: Towards culturally relevant education and practice. Surrey, UK: Ashgate.

Gray, M., Coates, J., & Hetherington, T. (2013). Environmental social work. New York: Routledge.

Greeff, A. P., & Fillis, A. J. (2009). Resiliency in poor single-parent families. Families in Society: The Journal of Contemporary Social Services, 90(3), 279–285.

Green, G., & Haines, A. (2012). Asset building and community development (3rd ed.). Thousand Oaks, CA: Sage.

Green, R. (2012). Gay and lesbian family life: Risk, resilience, and rising

1021

http://www.canada.ca/en/employment-social-development/services/collective-bargaining-data/reports/union-coverage.html

expectations. In F. Walsh (Ed.), Normal family processes: Growing diversity and complexity (4th ed., pp. 172–193). New York: Guildford.

Greenbaum, S. (2016). Debunking the pathology of poverty. In P. Rothenberg (Ed.), Race, class, and gender in the United States: An integrated study (10th ed., pp. 78–80). New York: Worth.

Greenberg, L. S. (2011). Emotion-focused therapy. Washington, DC: American Psychological Association.

Greenberg, L. S. (2012). Emotions, the great captains of our lives: Their role in the process of change in psychotherapy. American Psychologist, 67(8), 697–707.

Greene, G., & Lee, M. Y. (2011). Solution-oriented social work practice: An integrative approach to working with client strengths. New York: Oxford University Press.

Greene, R. R., & Cohen, H. L. (2005). Social work with older adults and their families: Changing practice paradigms. Families in Society, 86(3), 367–373.

Greene, S., Anderson, E., Forgatch, M., Degarmo, D., & Hetherington, E. M. (2012). Risk and resilience after divorce. In F. Walsh (Ed.), Normal family processes: Growing diversity and complexity (4th ed., pp. 102–127). New York: Guildford.

Greenfield, P. (2014). Sociodemographic differences within countries produce variable cultural values. Journal of Cross-Cultural Psychology, 45(1), 37–41.

Greenwald, H. (2008). Organizations: Management without control. Thousand Oaks, CA: Sage.

1022

Greenwood, A., & Gatersleben, B. (2016). Let’s go outside! Environmental restoration amongst adolescents and the impact of friends and phones. Journal of Environment Psychology, 48, 131–139.

Griffin, B., Eibner, C., Bird, C., Jewell, A., Margolis, K., & Shih, R. (2013). The relationship between urban sprawl and coronary heart disease in women. Health & Place, 20, 51–61.

Griswold, W. (2013). Cultures and societies in a changing world (4th ed.). Thousand Oaks, CA: Sage.

Grof, S. (2003). Physical manifestations of emotional disorders: Observations from the study of non-ordinary states of consciousness. In K. Taylor (Ed.), Exploring holotropic breathwork: Selected articles from a decade of The Inner Door. Santa Cruz, CA: Hanford Mead.

Grof, S., & Bennett, H. Z. (1992). The holotropic mind: The three levels of human consciousness and how they shape our lives. New York: HarperCollins.

Grossman, P., Niemann, I., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: A meta- analysis. Journal of Psychosomatic Research, 57(1), 35–43.

Gudmunson, C., Beutler, I., Israelsen, C., McCoy, J., & Hill, E. (2007). Linking financial strain to marital instability: Examining the roles of emotional distress and marital interaction. Journal of Family and Economic Issues, 28(3), 357–376.

Guerts, T., Poortman, A., & van Tilburg, T. (2012). Older parents providing child care for adult children: Does it pay off? Journal of Marriage and Family, 74, 239–250.

Guest, K. (2017). Cultural anthropology: A toolkit for a global age (2nd

1023

ed.). New York: Norton.

Guo, C., & Saxton, G. (2014). Tweeting social change: How social media are changing non-profit advocacy. Nonprofit and Volunteer Sector Quarterly, 43(1), 57–79.

Gusterson, H. (1997). Studying up revisited. Political and Legal Anthropology Review, 20(1), 114–119.

Gutierrez, L. (1990). Working with women of color: An empowerment perspective. Social Work, 35(2), 149–153.

Gutierrez, L. (1994). Beyond coping: An empowerment perspective on stressful life events. Journal of Sociology and Social Welfare, 21(3), 201–219.

Gutman, L., McLoyd, V., & Tokoyawa, T. (2005). Financial strain, neighborhood stress, parenting behaviors, and adolescent adjustment in urban African American families. Journal of Research on Adolescence, 15(4), 425–449.

Guy, M., Newman, M., Mastracci, S., & Maynard-Moody, S. (2010). Emotional labor in the human service organization. In Y. Hasenfeld (Ed.), Human services as complex organizations (2nd ed., pp. 291–309). Thousand Oaks, CA: Sage.

Haan, N. (1991). Moral development and action from a social constructivist perspective. In W. Kurtines & J. Gewirtz (Eds.), Handbook of moral behavior and development: Theory (Vol. 1, pp. 251–273). Hillsdale, NJ: Erlbaum.

Habermas, J. (1984). The theory of communicative action: Vol. 1. Reason and the rationalization of society. Boston: Beacon Press.

1024

Habermas, J. (1987). The theory of communicative action: Vol. 2. Lifeworld and system: A critique of functionalist reason (T. McCarthy, Trans.). Boston: Beacon Press. (Original work published 1981)

Habi, C., Renner, A-T., Bobek, J., & Laschkoing, A. (2016). Study on big data in public health, telemedicine, and health care. Final report. Luxembourg: Publications Office of the European Union. Retrieved from https://ec.europa.eu/health/sites/health/files/ehealth/docs/bigdata_report_en.pdf

Haddad, Y. Y. (1997). Make room for the Muslims? In W. H. Conser Jr. & S. B. Twiss (Eds.), Religious diversity and American religious history: Studies in traditions and cultures (pp. 218–261). Athens: University of Georgia Press.

Haig, A. J. (2013). Disability policy must espouse medical as well as social rehabilitation. Social Inclusion, 1(2), 136–138.

Haig-Brown, C. (1988). Resistance and renewal: Surviving the Indian residential school. Vancouver, BC, Canada: Tillacum Library.

Hall, E. (1966). The hidden dimension. New York: Doubleday.

Hall, L. (2016). Counseling military families (2nd ed.). New York: Routledge.

Hallam, C., & Zanella, B. (2017). Online self-disclosure: The privacy paradox explained as a temporally discounted balance between concerns and rewards. Computers in Human Behavior, 68, 217–227.

Halloran, L. (2015, April 24). Survey shows striking increase in Americans who know and support transgender people. Human Rights Campaign. Retrieved from www.hrc.org/blog/survey-shows-striking- increase-in-americans-who-know-and-support-transgender

1025

https://ec.europa.eu/health/sites/health/files/ehealth/docs/bigdata_report_en.pdf

http://www.hrc.org/blog/survey-shows-striking-increase-in-americans-who-know-and-support-transgender

Hames, A. M., & Godwin, M. C. (2008). The “out of control” balloon: Using spirituality as a coping resource. In C. F. Sori & L. L. Hecker (Eds.), The therapist’s notebook: More homework, handouts, and activities for use in psychotherapy (pp. 171–176). New York: Routledge/Taylor & Francis.

Hampton, K., Sessions, L., Her, E. J., & Rainie, L. (2009, November 4). Social isolation and new technology. Washington, DC: Pew Internet & American Life Project. Retrieved from www.pewinternet.org/2009/11/04/social-isolation-and-new-technology/

Hampton, K., & Wellman, B. (2003). Neighboring in Netville: How the Internet supports community and social capital in a wired suburb. City & Community, 2(4), 277–311.

Hansen, D., Larson, R., & Dworkin, J. (2003). What adolescents learn in organized youth activities: A survey of self-reported developmental experiences. Journal of Research on Adolescence, 13(1), 25–55.

Hansen, J. E., & Lambert, S. M. (2011). Grief and loss of religion: The experiences of four rural lesbians. Journal of Lesbian Studies, 15, 187–196.

Hanson, K., Saul, D., Vanderploeg, J., Painter, M., & Adnopoz, J. (2015). Family-based recovery: An innovative in-home substance abuse treatment model for families with young children. Child Welfare, 94(4), 161–183.

Hanson, R. (2017). Mass communication (6th ed.). Thousand Oaks, CA: Sage.

Haraway, D. (2008). When species meet. Minneapolis: University of Minnesota Press.

1026

http://www.pewinternet.org/2009/11/04/social-isolation-and-new-technology/

Hardie, E. A. (2005). Stress-coping congruence: A tripartite conceptual framework for exploring the health consequences of effective and ineffective coping. Journal of Applied Psychology: Social Section, 1(2), 26–33.

Hare-Mustin, R. T. (2017). Those were the best of times, and then. . . . Women & Therapy, 40(3/4), 346–357.

Hareven, T. K. (2000). Families, history, and social change: Life-course and cross-cultural perspectives. Boulder, CO: Westview Press.

Harris, A. (2015). Critical race theory. In International Encyclopedia of the Social & Behavioral Sciences (2nd ed., Vol. 5). doi:10.1016/B978-0-08- 097086-8.86019-5

Harrison, R., & Thomas, M. (2009). Identity in online communities: Social networking sites and language learning. International Journal of Emerging Technologies & Society, 7(2), 109–124.

Hart, J. (1970). The development of client-centered therapy. In J. T. Hart & T. M. Tomlinson (Eds.), New directions in client-centered therapy (pp. 3–22). Boston: Houghton Mifflin.

Hartman, A., & Laird, J. (1983). Family-centered social work practice. New York: Free Press.

Harvard Pluralism Project. (2005). Native American religious and cultural freedom: An introductory essay. Retrieved from http://pluralism.org/research-report/native-american-religious-and- cultural-freedom-an-introductory-essay-2005/

Hasenfeld, Y. (2010a). Introduction. In Y. Hasenfeld (Ed.), Human services as complex organizations (2nd ed., pp. 1–5). Thousand Oaks, CA: Sage.

1027

http://pluralism.org/research-report/native-american-religious-and-cultural-freedom-an-introductory-essay-2005/

Hasenfeld, Y. (2010b). The attributes of human service organizations. In Y. Hasenfeld (Ed.), Human services as complex organizations (2nd ed., pp. 9–32). Thousand Oaks, CA: Sage.

Haslam, A. (2014). Making good theory practical: Five lessons for an applied social identity approach to challenges of organizational, health, and clinical psychology. British Journal of Social Psychology, 53(1), 1–20.

Haslam, S. A., & Reicher, S. (2015). Self-categorization theory. In J. Wright (Ed.), International encyclopedia of the social and behavioural sciences (2nd ed., Vol. 21, pp. 455–459). Oxford, UK: Elsevier.

Hastings, M. (1998). Theoretical perspectives on social movements. New Zealand Sociology, 13(2), 208–238.

Hauser, M., Cushman, F., Young, L., Mikhail, J., & Jin, R. K. (2007). A dissociation between moral judgments and justifications. Mind & Language, 22(1), 1–21.

Havigerová, J., Haviger, J., & Truhlářová, Z. (2013). Teacher’s subjective definition of family. Procedia: Social and Behavioral Sciences, 106, 2507–2515.

Haviland, W., Prins, H., Walrath, D., & McBride, B. (2017). Anthropology: The human challenge (15th ed.). Boston: Cengage Learning.

Havnen, K., Breivik, K., Stormark, K., & Jakobsen, R. (2011). Why do children placed out-of-home because of parental substance abuse have less mental health problems than children placed for other reasons? Children and Youth Services Review, 33, 2010–2017.

Hay, D., & Nye, R. (2006). The spirit of the child (Rev. ed.). London:

1028

Jessica Kingsley.

Hay, D., Nye, R., & Murphy, R. (1996). Thinking about childhood spirituality: Review of research and current directions. In L. J. Francis, W. K. Kay, & W. S. Campbell (Eds.), Research in religious education (pp. 47–71). Macon, GA: Smyth & Helwys.

Hayward, R., Miller, S., & Shaw, T. (2013). Social work education on the environment in contemporary curricula in the USA. In M. Gray, J. Coates, & T. Hetherington (Eds.), Environmental social work (pp. 246–259). New York: Routledge.

Healey, J., & Stepnick, A. (2017). Diversity and society: Race, ethnicity, and gender (5th ed.). Thousand Oaks, CA: Sage.

Hearn, J., & Parkin, W. (1993). Organizations, multiple oppressions and postmodernism. In J. Hassard & M. Parker (Eds.), Postmodernism and organizations (pp. 148–162). Newbury Park, CA: Sage.

Hedberg, P., Brulin, C., & Alex, L. (2009). Experiences of purpose in life when becoming and being a very old woman. Journal of Women & Aging, 21(2), 125–137.

Hederman, R., & Rector, R. (1999). Income inequality: How census data misrepresent income distribution. Retrieved from www.heritage.org/poverty-and-inequality/report/income-inequality- how-census-data-misrepresent-income-distribution

Heffernan, M. E., Fraley, R. C., Vicary, A. M., & Brumbaugh, C. C. (2012). Attachment features and functions in adult romantic relationships. Journal of Social and Personal Relationships, 29(5), 671–693.

Hegtvedt, K. A. (1994). Justice. In M. Foshci & E. J. Lawler (Eds.), Group

1029

http://www.heritage.org/poverty-and-inequality/report/income-inequality-how-census-data-misrepresent-income-distribution

processes: Sociological analyses (pp. 177–204). Chicago: Nelson-Hall.

Heid, A., Pruchno, R., Cartwright, F., & Wilson-Genderson, M. (2017). Exposure to Hurricane Sandy, neighbourhood collective efficacy, and post-traumatic symptoms in older adults. Aging & Mental Health, 21(7), 742–750.

Heller, K. (1989). The return to community. American Journal of Community Psychology, 17(1), 1–14.

Helmy, J. (2016). The 2020 U.S. census’ new ethnic category for Middle Easterners and North Africans. International and Comparative Law Review, 23(2). Retrieved from http://international-and-comparative- law-review.law.miami.edu/2020-u-s-census-ethnic-category-middle- easterners-north-africans/

Henderson, L. (2000). The knowledge and use of alternative therapeutic techniques by social work practitioners: A descriptive study. Social Work in Health Care, 30(3), 55–71.

Henrich, J., Heine, S., & Norenzayan, A. (2010). The weirdest people in the world? Behavioral and Brain Sciences, 33(2–3), 61–83.

Hepworth, D. H., Rooney, R. H., Rooney, G. D., & Strom-Gottfried, K. (2017). Direct social work practice: Theory and skills (10th ed.). Boston: Cengage.

Hetherington, E., & Kelly, J. (2002). For better or for worse: Divorce reconsidered. New York: W. W. Norton.

Hetherington, T., & Boddy, J. (2013). Ecosocial work with marginalized populations: Time for action on climate change. In M. Gray, J. Coates, & T. Hetherington (Eds.), Environmental social work (pp. 46–61). New York: Routledge.

1030

http://international-and-comparative-law-review.law.miami.edu/2020-u-s-census-ethnic-category-middle-easterners-north-africans/

Heuveline, P., & Timberlake, J. (2004). The role of cohabitation in family formation: The United States in comparative perspective. Journal of Marriage and Family, 66, 1214–1230.

Heymann, J., Earle, A., & Hayes, J. (2007). The work, family, and equity index. How does the United States measure up? Boston: Project on Global Working Families, Harvard School of Public Health. Retrieved from https://www.worldpolicycenter.org/sites/default/files/Work%20Family%20and%20Equity%20Index- How%20does%20the%20US%20measure%20up-Jan%202007.pdf

Hickson, J., & Phelps, A. (1998). Women’s spirituality: A proposed practice model. In D. S. Becvar (Ed.), The family, spirituality, and social work (pp. 43–57). Binghamton, NY: Haworth Press.

Hill, A. J., & Donaldson, L. P. (2012). We shall overcome: Promoting an agenda for integrating spirituality and community practice. Journal of Religion & Spirituality in Social Work: Social Thought, 31(1–2), 67–84.

Hill, J., & LaVela, S. (2015). Noise levels in patient rooms and at nursing stations at three VA medical centers. Health Environments Research & Design Journal, 9(1), 54–63.

Hill, R. (1949). Families under stress. Westport, CT: Greenwood.

Hill, R. (1958). Generic features of families under stress. Social Casework, 49, 139–150.

Hillery, G. (1955). Definitions of community: Areas of agreement. Rural Sociology, 20, 111–123.

Hillier, A. (2007). Why social work needs mapping. Journal of Social Work Education, 43(2), 205–221.

1031

https://www.worldpolicycenter.org/sites/default/files/Work%20Family%20and%20Equity%20Index-How%20does%20the%20US%20measure%20up-Jan%202007.pdf

Hillier, A., Cole, B., Smith, T., Williams, J., Grier, S., Yancey, A., & McCarthy, W. J. (2009). Clustering of unhealthy advertisements around child-serving institutions: A three-city study. Health and Place, 15, 935–945.

Hillier, A., & Culhane, D. (2013). GIS applications and administrative data to support community change. In M. Weil, M. Reisch, & M. Ohmer (Eds.), The handbook of community practice (2nd ed., pp. 827–844). Thousand Oaks, CA: Sage.

Hitchcock, J. A. (2006). Net crimes and misdemeanors: Outmaneuvering web spammers, stalkers, and con artists (2nd ed.). Medford, NJ: Information Today.

Ho, K. (2009). Liquidated: An ethnography of Wall Street. Durham, NC: Duke University Press.

Ho, M., Rasheed, J., & Rasheed, M. (2004). Family therapy with ethnic minorities (2nd ed.). Thousand Oaks, CA: Sage.

Hodge, D. R. (2002). Does social work oppress evangelical Christians? A new class analysis of society and social work. Social Work, 47, 401–414.

Hodge, D. R. (2004). Working with Hindu clients in a spiritually sensitive manner. Social Work, 49(1), 27–38.

Hodge, D. R. (2005). Developing a spiritual assessment toolbox: A discussion of the strengths and limitation of five different assessment methods. Health & Social Work, 30(4), 314–323.

Hodkinson, P. (2017). Media culture and society (2nd ed.). Thousand Oaks, CA: Sage.

1032

Hofstede, G. (1996). An American in Paris: The influence of nationality on organization theories. Organization Studies, 17(13), 525–537.

Hofstede, G. (2001). Culture’s consequences: Comparing values, behaviors, institutions and organizations across nations (2nd ed.). Thousand Oaks, CA: Sage.

Hofstede, G. (2010). Cultures and organizations: Software of the mind (3rd ed.). Boston: McGraw-Hill.

Hofstede, G., Deusen, C., Mueller, C., & Charles, T. (2002). What goals do business leaders pursue? A study in fifteen countries. Journal of International Business Studies, 33(4), 785–803.

Hoge, E., Bui, E., Luana, M., Metcalf, C., Morris, L., Robinaugh, D., . . . Simon, N. M. (2013). Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: Effects on anxiety and stress reactivity. Journal of Clinical Psychiatry, 74(8), 786–792.

Hogg, M. (2005). The social identity perspective. In S. Wheelan (Ed.), The handbook of group research and practice (pp. 133–157). Thousand Oaks, CA: Sage.

Hollinghurst, S., Kessler, D., Peters, T., & Gunnell, D. (2005). Opportunity cost of antidepressant prescribing in England: Analysis of routine data. British Medical Journal, 330(7948), 999–1000.

Hollingsworth, L., Allen-Meares, P., Shanks, T., & Gant, L. (2009). Using the miracle question in community engagement and planning. Families in Society, 90(3), 332–335.

Holm, J., & Bowker, J. (Eds.). (1994). Women in religion. New York: Pinter.

1033

Holt, A. (2016). Adolescent-to-parent abuse as a form of “domestic violence”: A conceptual review. Trauma, Violence, & Abuse, 17(5), 490–499.

Holt, D., Boeke, E., Coombs, G., DeCross, S., Cassidy, B., Stufflebeam, S., . . . Tootellb, R. (2015). Abnormalities in personal space and parietal-frontal function in schizophrenia. NeuroImage: Clinical, 9, 233–243.

Holt, D., Cassidy, B., Yue, X., Rauch, S., Boeke, E. Nasr, S., . . . Garth Coombs, I. (2014). Neural correlates of personal space intrusion. Journal of Neuroscience, 34(12), 4123–4134.

Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on Psychological Science, 10(2), 227–237.

Holtzworth-Munroe, A., & Stuart, G. (1994). Typologies of male batterers: Three subtypes and the differences among them. Psychological Bulletin, 116(3), 476–497.

Homans, G. (1958). Social behavior as exchange. American Journal of Sociology, 63, 597–606.

Hopkins, R. (2008). The transition handbook: From oil dependency to local resilience. White River Junction, VT: Chelsea Green.

Hotho, J., & Saka-Helmhout, A. (2017). In and between societies: Reconnecting comparative institutionalism and organization theory. Organization Studies, 38(5), 647–666.

House, R., Hanges, P., Javidan, M., Dorfman, P., & Gupta, V. (Eds.). (2004). Culture, leadership, and organizations: The GLOBE study of 62

1034

societies. Thousand Oaks, CA: Sage.

Houston, J. B., Pfefferbaum, B., Sherman, M., Meison, A., Jeon-Slaughter, H., Brand, M., & Yana Jarman, D. O. (2009). Children of deployed National Guard troops: Perceptions of parental deployment to Operation Iraqi Freedom. Psychiatric Annals, 39(8), 805–811.

Hsu, S. H., Grow, J., Marlatt, A., Galanter, M., & Kaskutas, L. A. (Eds.). (2008). Research on Alcoholics Anonymous and spirituality in addiction recovery. New York: Springer Science.

Huang, C., & Han, K. (2012). Child support enforcement in the United States: Has policy made a difference? Children and Youth Services Review, 34, 622–627.

Huang, P., Smock, P., Manning, W., & Bergstrom-Lynch, C. (2011). He says, she says: Gender and cohabitation. Journal of Family Issues, 32(7), 876–905.

Huber, M. S., Egeren, L., Pierce, S., & Foster-Fishman, P. (2009). GIS applications for community-based research and action: Mapping change in a community-building initiative. Journal of Prevention & Intervention in the Community, 27, 5–20.

Hugen, B., & Venema, R. (2009). The difference of faith: The influence of faith in human service programs. Journal of Religion & Spirituality in Social Work: Social Thought, 28(4), 405–429.

Hughes, B. (2009). Disability activisms: Social model stalwarts and biological citizens. Disability & Society, 24(6), 677–688.

Hughes, S., Williams, B., Molina, L., Bayles, C., Bryant, L., Harris, J., . . . Watkins, K. (2005). Characteristics of physical activity programs for older adults: Results of a multisite survey. Gerontologist, 45(5),

1035

667–675.

Huisman. E. R. C. M, Morales, E., van Hoof, J., & Kort, H. S. M. (2012). Healing environment: A review of the impact of physical environmental factors on users. Building and Environment, 58, 70–80.

Human Rights Watch. (2017). Democratic Republic of Congo. Retrieved from www.hrw.org/world-report/2017/country-chapters/democratic- republic-congo

Hunler, O. S., & Gencoz, T. (2005). The effect of religiousness on marital satisfaction: Testing the mediator role of marital problem solving between religiousness and marital satisfaction relationship. Contemporary Family Therapy, 27(1), 123–136.

Hunsaker, P. L., & Hunsaker, J. S. (2008). Virtual teams: A leader’s guide. Team Performance Management: An International Journal, 14(1/2), 86–101.

Hunter, A., & Riger, S. (1986). The meaning of community in community mental health. Journal of Community Psychology, 14, 55–71.

Hurdle, D. E. (2002). Hawaiian traditional healing: Culturally based interventions for social work practice. Social Work, 47(2), 183–192.

Hurst, J. (2007). Disability and spirituality in social work practice. Journal of Social Work in Disability & Rehabilitation, 6(1/2), 179–194.

Husain, S. A. (2012). Trauma, resiliency and recovery in children: Lessons from the field. Psychiatria Danubina, 24(Suppl. 3), 277–284.

Hutchison, E. (1987). Use of authority in direct social work practice with mandated clients. Social Service Review, 61(4), 581–598.

1036

http://www.hrw.org/world-report/2017/country-chapters/democratic-republic-congo

Hutchison, E. (2007). Community violence. In E. Hutchison, H. Matto, M. Harrigan, L. Charlesworth, & P. Viggiani (Eds.), Challenges of living: A multidimensional model for social workers (pp. 71–104). Thousand Oaks, CA: Sage.

Hutchison, E. (2012). Spirituality, religion, and progressive social movements: Resources and motivation for social change. Journal of Religion & Spirituality in Social Work: Social Thought, 31, 105–127.

Hutchison, E. (2014). Adult criminal justice system. In H. Matto, J. Strolin-Goltzman, & M. Ballan (Eds.), Neuro-science for social work (pp. 355–378). New York: Springer.

Hutchison, E., & Charlesworth, L. (2000). Securing the welfare of children: Policies past, present, and future. Families in Society, 81(6), 576–586.

Hutchison, E., Charlesworth, L., Matto, H., Harrigan, M., & Viggiani, P. (2007). Elements of knowing and doing in social work. In E. Hutchison, H. Matto, M. Harrigan, L. Charlesworth, & P. Viggiani (Eds.), Challenges of living: A multidimensional working model for social workers (pp. 13–33). Thousand Oaks, CA: Sage.

Hyde, C. (2000). The hybrid nonprofit: An examination of feminist social movement organizations. Journal of Community Practice, 8(4), 45–67.

Iachini, T., Coello, Y., Frassinetti, F., Senese, V., Galante, F., & Ruggiero, G. (2016). Peripersonal and interpersonal space in virtual and real environments: Effects of gender and age. Journal of Environmental Psychology, 45, 154–164.

Iannello, K. (1992). Decisions without hierarchy: Feminist interventions in organization theory and practice. New York: Routledge.

1037

Ibrahim, F. (2010). Social justice and cultural responsiveness: Innovative teaching strategies for groupwork. Journal for Specialists in Group Work, 35(3), 271–280.

Imber-Black, E. (2012). The value of rituals in family life. In F. Walsh (Ed.), Normal family processes (4th ed., pp. 483–497). New York: Guilford Press.

Imrie, R. (2012). Universalism, universal design and equitable access to the built environment. Disability and Rehabilitation, 34(10), 873–882.

Indigenous Environmental Network. (2010, August). IENnews August 2010. Retrieved from www.mynewsletterbuilder.com/email/newsletter/1410458347

Inglis, D. (2016). Introduction: Culture/sociology/sociology of culture/cultural sociology. In D. Inglis & A. Almila (Eds.), The Sage handbook of cultural sociology (pp. 1–7). Thousand Oaks, CA: Sage.

Internet World Stats. (2017a). Internet usage statistics. Retrieved from www.internetworldstats.com/stats.htm

Internet World Stats. (2017b). Internet world users by language. Retrieved from https://internetworldstats.com/stats7.htm

Iruka, I., LaForett, D., & Odom, E. (2012). Examining the validity of the family investment and stress models and relationship to children’s school readiness across five cultural groups. Journal of Family Psychology, 26(3), 359–370.

Iverson, K., King, M., Cunningham, K., & Resick, P. (2015). Rape survivors’ trauma-related beliefs before and after cognitive processing therapy: Associations with PTSD and depression symptoms. Behavior Research and Therapy, 66, 49–55.

1038

http://www.mynewsletterbuilder.com/email/newsletter/1410458347

http://www.internetworldstats.com/stats.htm

https://internetworldstats.com/stats7.htm

Ivins, M. (1999, October 21). Way to go, college students! Creators Syndicate, Inc. Retrieved from www.creators.com/read/molly- ivins/10/99/molly-ivins-october-21-1999-10-21-94c7af1d

Iyendo, T. (2016). Exploring the effect of sound and music on health in hospital settings: A narrative review. International Journal of Nursing Studies, 63, 82–100.

Jackson, M. A. (2002). Christian womanist spirituality: Implications for social work practice. Social Thought, 21(1), 63–76.

James, R., & Gilliland, B. (2013). Crisis intervention strategies (7th ed.). Belmont, CA: Brooks/Cole.

James, W. (1890). Principles of psychology. New York: Holt.

James, W. (2014). All rural places are not created equal: Revisiting the rural mortality penalty in the United States. American Journal of Public Health, 104(11), 2122–2129.

Jansson, B., Heidemann, G., McCroskey, J., & Fertig, R. (2013). Eight models of policy practice: Local, state, national, and international arenas. In M. Weil, M. Reisch, & M. Ohmer (Eds.), The handbook of community practice (2nd ed., pp. 403–420). Thousand Oaks, CA: Sage.

Janutaitė, Š., Vosyliūtė, V., Vizgirdaitė, J., & Taras, V. (2015). Cross- cultural virtual group work: Cooperation vs. collaboration (case of project “X-Culture”). Social Sciences, 88(2), 66–88. doi:10.5755/j01.ss.88.2.1273

Jasinski, J., Blumenstein, L., & Morgan, R. (2014). Testing Johnson’s typology: Is there gender symmetry in intimate terrorism? Violence and Victims, 29(1), 73–88.

1039

http://www.creators.com/read/molly-ivins/10/99/molly-ivins-october-21-1999-10-21-94c7af1d

Jaskyte, K. (2012). Exploring potential for technology innovation in nonprofit organizations. Journal of Technology in Human Services, 30, 118–127.

Jasper, J. (2014). Protest: A cultural introduction to social movements. Malden, MA: Polity Press.

Jeffers, E. (2013). Banking deregulation and the financial crisis in the US and France. Comparative Economic Studies, 55, 479–500.

Jenkins, W. (2008). Ecologies of grace: Environmental ethics and Christian theology. Oxford, UK: Oxford University Press.

Jenson, J., & Fraser, M. (2016). Social policy for children and families: A risk and resilience perspective (3rd ed.). Thousand Oaks, CA: Sage.

Jiang, S. (2014). Therapeutic landscapes and healing gardens: A review of Chinese literature in relation to the studies in Western countries. Frontiers of Architectural Research, 3, 141–153.

Jobin-Leeds, G. (2016). When we fight we win! Twenty-first-century social movement and the activists that are transforming our world. New York: The New Press.

Johansson, U., & Woodilla, J. (2008). Designers dancing within hierarchies: The importance of non-hierarchical power for design integration and implementation. The Design Journal, 11(2), 95–118.

Johnson, M. (Ed.). (1992). People with disabilities explain it all for you. Louisville, KY: Advocado Press.

Johnson, M. (1995). Patriarchal terrorism and common couple violence: Two forms of violence against women. Journal of Marriage and the

1040

Family, 57(2), 283–294.

Johnson, M. (2008). A typology of domestic violence: Intimate terrorism, violent resistance, and situational couple violence. Boston: Northeastern University Press.

Johnson, M., Caughlin, J., & Huston, T. (1999). The tripartite nature of marital commitment: Personal, moral, and structural reasons to stay married. Journal of Marriage and the Family, 61, 160–177.

Johnson, S. K. (1997). Does spirituality have a place in rural social work? Social Work and Christianity, 24(1), 58–66.

Johnstone, B., Yoon, D. P., Rupright, J., & Reid-Arndt, S. (2009). Relationships among spiritual beliefs, religious practices, congregational support and health for individuals with traumatic brain injury. Brain Injury, 23(5), 411–419.

Joint Center for Housing Studies of Harvard University. (2017). The state of the nation’s housing 2017. Retrieved from http://jchs.harvard.edu/sites/jchs.harvard.edu/files/harvard_jchs_state_of_the_nations_housing_2017_0.pdf

Joint Economic Committee United States Congress. (2016). Gender pay inequality. Retrieved from www.jec.senate.gov/public/_cache/files/0779dc2f-4a4e-4386-b847- 9ae919735acc/gender-pay-inequality----us-congress-joint-economic- committee.pdf

Jones, A., & Meier, A. (2011). Growing www.parentsofsuicide: A case study of an online support community. Social Work with Groups, 34, 101–120.

Jones, R. P., & Cox, D. (2017). America’s changing religious identity: Findings from the 2016 American Values Atlas. Washington, DC:

1041

http://jchs.harvard.edu/sites/jchs.harvard.edu/files/harvard_jchs_state_of_the_nations_housing_2017_0.pdf

http://www.jec.senate.gov/public/_cache/files/0779dc2f-4a4e-4386-b847-9ae919735acc/gender-pay-inequality----us-congress-joint-economic-committee.pdf

Public Religion Research Institute.

Jones, T. (2005). Mediating intragroup and intergroup conflict. In S. Wheelan (Ed.), The handbook of group research and practice (pp. 463–483). Thousand Oaks, CA: Sage.

Jorgensen, G. (2006). Kohlberg and Gilligan: Duet or duel? Journal of Moral Education, 35(2), 179–196.

Jorgensen, H., & Applebaum, E. (2014). Expanding federal family and medical leave coverage: Who benefits from changes in eligibility requirements? Washington, DC: Center for Economic and Policy Research.

Joseph, A. (2006). The impact of light on outcomes in healthcare settings. Issue Paper # 2. Concord, CA: The Center for Health Design.

Joseph, A., & Ulrich, R. (2007). Sound control for improved outcomes in healthcare settings (Report No. 4). Concord, CA: The Center for Health Design.

Joye, Y. (2007). Architectural lessons from environmental psychology: The case of biophilic architecture. Review of General Psychology, 11(4), 305–328.

Judd, R. G., & Johnston, L. B. (2012). Ethical consequences of using social network sites for students in professional social work programs. Journal of Social Work Values & Ethics, 9(1), 5–12.

Julien-Chinn, F., Cotter. K., Piel, M., Geiger, J., & Lietz, C. (2017). Examining risk, strengths, and functioning of foster families: Implications for strengths-based practice. Journal of Family Social Work, 20(4), 306–321.

1042

Jung, C. (1933). Modern man in search of a soul. New York: Harcourt, Brace & World.

Jung, C. (1969). The archetypes and the collective unconscious (R. F. C. Hull, Trans.). Princeton, NJ: Princeton University Press. (Original work published 1959)

Kahn, J., & Pearlin, L. (2006). Financial strain over the life course and health among older adults. Journal of Health & Social Behavior, 47(1), 17–31.

Kahneman, D. (2011). Thinking fast and slow. New York: Farrar, Straus and Giroux.

Kahneman, D., & Tversky, A. (1982). The psychology of preferences. Scientific American, 246, 160–173.

Kahneman, D., & Tversky, A. (1984). Choices, values, and frames. American Psychologist, 39, 341–350.

Kaiser Family Foundation. (2017a). Percent of adults with cardiovascular disease, 2013–2016. Retrieved from www.kff.org/other/state- indicator/percent-of-adults-with-cardiovascular-disease/? activeTab=graph&currentTimeframe=0&startTimeframe=3&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

Kaiser Family Foundation. (2017b). Key facts about the uninsured population. Retrieved from www.kff.org/uninsured/fact-sheet/key-facts- about-the-uninsured-population/

Kaiser Family Foundation. (2018). State health insurance marketplace types, 2018. Retrieved from www.kff.org/health-reform/state- indicator/state-health-insurance-marketplace-types/? currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

1043

http://www.kff.org/other/state-indicator/percent-of-adults-with-cardiovascular-disease/?activeTab=graph&currentTimeframe=0&startTimeframe=3&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

http://www.kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/

http://www.kff.org/health-reform/state-indicator/state-health-insurance-marketplace-types/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

Kaitz, M., Bar-Haim, Y., Lehrer, M., & Grossman, E. (2004). Adult attachment style and interpersonal distance. Attachment & Human Development, 6(3), 285–304.

Kalkhoff, W., & Barnum, C. (2000). The effects of status-organizing and social identity processes on patterns of social influence. Social Psychology Quarterly, 63, 95–115.

Kamitsis, I., & Simmonds, J. (2017). Using resource of nature in the counselling room: Qualitative research into ecotherapy practice. International Journal for the Advancement of Counselling, 39, 229–248.

Kanel, K. (2015). A guide to crisis intervention (5th ed.). Stamford, CT: Cengage.

Kapit, W., Macey, R. I., & Meisami, E. (2000). The physiology coloring book (2nd ed.). Cambridge, MA: HarperCollins.

Kaplan, S., & Berman, M. (2010). Directed attention as a common resource for executive functioning and self-regulation. Perspectives on Psychological Science, 6(1), 43.

Kapoulitsas, M., & Corcoran, T. (2015). Compassion fatigue and resilience: A qualitative analysis of social work practice. Qualitative Social Work, 14(1), 86–101.

Karenga, M. (1995). Making the past meaningful: Kwanzaa and the concept of Sankofa. Reflections: Narratives of Professional Helping, 1(4), 36–46.

Karger, H., & Stoesz, D. (2018). American social welfare policy: A pluralist approach (8th ed.). Boston: Pearson.

1044

Karls, J. M., & O’Keefe, M. (2008). Person-in-environment system manual (2nd ed.). Washington, DC: NASW Press.

Karmanov, D., & Hamel, R. (2008). Assessing the restorative potential of contemporary urban environment(s): Beyond the nature versus urban dichotomy. Landscape and Urban Planning, 86, 115–125.

Karpowitz, C., Mendelberg, T., & Shaker, L. (2012). Gender inequality in deliberative participation. American Political Science Review, 106(3), 533–547.

Karraker, M. (2013). Global families (2nd ed.). Thousand Oaks, CA: Sage.

Kasee, C. R. (1995). Identity, recovery, and religious imperialism: Native American women and the new age. Women and Therapy: A Feminist Quarterly, 16(2/3), 83–93.

Kastberg, D., Chan, J., Murray, G., & Gonzales, P. (2016). Performance of U.S. 15-year-old students in science, reading, and mathematics literacy in an international context. National Center for Education Statistics. Retrieved from https://nces.ed.gov/pubs2017/2017048.pdf

Kay, A. (2006). Social capital, the social economy and community development. Community Development Journal, 41(2), 160–173.

Kaya, N., & Burgess, B. (2007). Territoriality: Seat preferences in different types of classroom arrangements. Environment & Behavior, 39(6), 859–876.

Kaya, N., & Weber, M. (2003). Territorial behavior in residence halls: A cross-cultural study. Environment and Behavior, 35(3), 400–414.

Keane, C. (1991). Socioenvironmental determinants of community

1045

https://nces.ed.gov/pubs2017/2017048.pdf

formation. Environment and Behavior, 23(1), 27–46.

Kearney, A. (2006). Residential development patterns and neighborhood satisfaction: Impacts of density and nearby nature. Environment and Behavior, 38(1), 112–139.

Keefe, T. (1996). Meditation and social work treatment. In F. J. Turner (Ed.), Social work treatment: Interlocking theoretical approaches (4th ed., pp. 434–460). New York: Free Press.

Kelleher, A. (2013). Not just a place to sleep: Homeless perspectives on librarians in central Michigan. Library Review, 62(1/2), 19–33.

Kelley, H., & Thibaut, H. (1978). Interpersonal relations: A theory of interdependence. New York: Wiley.

Kennedy, D., & Adolphs, R. (2014). Violations of personal space by individuals with autism spectrum disorder. PLos One, 9(8): E103369

Kent, S. (1991). Partitioning space: Cross-cultural factors influencing domestic spatial segmentation. Environment and Behavior, 23, 438–473.

Keutzer, C. (1982). Physics and consciousness. Journal of Humanistic Psychology, 22, 74–90.

Khng, J., Woo, I., & Fan, G. (2016). Experimental group work for cancer patients shaped by experiences of participants during group intervention. Future Oncology, 12(24), 2817–2822.

Khosravi, P., Rezvani, A., & Wiewiora, A. (2016). The impact of technology on older adults’ social isolation. Computers in Human Behavior, 63, 594–603.

1046

Kidd, S. M. (1996). The dance of the dissident daughter: A woman’s journey from Christian tradition to the sacred feminine. New York: HarperCollins.

Kids Count Data Center. (2017). Children in single-parent families by race. Annie E. Casey Foundation. Retrieved from http://datacenter.kidscount.org/data/tables/107-children-in-single- parent-families- by#detailed/1/any/false/869,36,868,867/10,11,9,12,1,185,13/432,431

Kihlström, A. (2012). Luhmann’s system theory in social work: Criticism and reflections. Journal of Social Work, 12(3), 287–299.

Kim, H. (2011). Job conditions, unmet expectations, and burnout in public child welfare workers: How different from other social workers? Children and Youth Services Review, 33, 358–367.

Kim, H., Ji, J., & Kao, D. (2011). Burnout and physical health among social workers: A three-year longitudinal study. Social Work, 56(3), 258–268.

Kim, S., & Hou, Y. (2016). Intergenerational transmission of tridimensional cultural orientations in Chinese American families: The role of bicultural socialization. Journal of Youth and Adolescence, 45, 1452–1465.

Kim, S. M., Han, D. H., Trksak, G. H., & Lee, Y. S. (2014). Gender differences in adolescent coping behaviors and suicidal ideation: Findings from a sample of 73,238 adolescents. Anxiety, Stress, & Coping, 4, 439–454.

Kim, T., Jeong, G., Baek, H., Kim, G., Sundaram, T., Kang, H., & Song, J. K. (2010). Human brain activation in response to visual stimulation with rural and urban scenery pictures: A functional magnetic resonance imaging study. Science of the Total Environment, 408, 2600–2607.

1047

http://datacenter.kidscount.org/data/tables/107-children-in-single-parent-families-by#detailed/1/any/false/869,36,868,867/10,11,9,12,1,185,13/432,431

Kimani-Murage, E. W., Fotso, J. C., Egondi, T., Abuya, B., Elungata, P., Ziraba, A. K., & Madise, N. (2014). Trends in childhood mortality in Kenya: The urban advantage has seemingly been wiped out. Health & Place, 29, 95–103.

Kimmel, M. S. (2016). The gendered society (6th ed.). New York: Oxford University Press.

King, V., Boyd, L., & Thorsen, M. (2015). Adolescents’ perceptions of family belonging in stepfamilies. Journal of Marriage and Family, 77, 761–774.

Kinkade, K. (1973). A Walden Two experiment: The first five years of Twin Oaks Community. New York: Morrow.

Kirk, G., & Okazawa-Rey, M. (2013). Identities and social locations: Who am I? Who are my people? In M. Adams, W. Blumenfeld, C. Castañeda, H. Hackman, M. Peters, & X. Zúñiga (Eds.), Readings for diversity and social justice (3rd ed., pp. 9–15). New York: Routledge.

Kish, D. (2015). How I use sonar to navigate the world. TED2015. Retrieved from www.ted.com/talks/daniel_kish_how_i_use_sonar_to_navigate_the_world

Kitchen, A., & Brook, J. (2005). Social work at the heart of the medical team. Social Work in Health Care, 40(4), 1–18.

Kivel, P. (1991). Men, spirituality, and violence. Creation Spirituality, 7(4), 12–14, 50.

Kjellgren, A., & Buhrkall, H. (2010). A comparison of the restorative effect of a natural environment with that of a simulated natural environment. Journal of Environmental Psychology, 30, 464–472.

1048

http://www.ted.com/talks/daniel_kish_how_i_use_sonar_to_navigate_the_world

Kleim, J. A. (2011). Neural plasticity and neurorehabilitation: Teaching the new brain old tricks. Journal of Communication Disorders, 44(5), 521–528.

Klein, F., Sepekoff, B., & Wolf, T. (1985). Sexual orientation: A multi- variable dynamic process. Journal of Homosexuality, 11, 35–39.

Klein, N. (2014). This changes everything. Toronto, ON: Knopf.

Klein, R. (2002). The dawn of human culture. New York: Wiley.

Knodel, J., Kespichayawattana, J., Saengtienchai, C., & Wiwatwanich, S. (2010). How left behind are rural parents of migrant children? Evidence from Thailand. Ageing and Society, 30(5), 811–841.

Knudson-Martin, C. (2012). Changing gender norms in families and society: Toward equality amid complexities. In F. Walsh (Ed.), Normal family processes (4th ed., pp. 324–346). New York: Guilford Press.

Koenig, H. G. (2001). Religion and mental health II: Religion, mental health, and related behaviors. International Journal of Psychiatry in Medicine, 31(10), 97–109.

Koenig, H. G. (2005). Faith and mental health: Religious sources for healing. Philadelphia: Templeton Foundation Press.

Koenig, H. G., King, D. E., & Carson, V. B. (2012). Handbook of religion and health (2nd ed.). New York: Oxford University Press.

Kogler Hill, S. (2013). Team leadership. In P. Northouse (Ed.), Leadership: Theory and practice (6th ed., pp. 287–318). Thousand Oaks, CA: Sage.

1049

Kohlberg, L. (1969). Stages in the development of moral thought and action. New York: Holt, Rinehart and Winston.

Kohli, M., & Albertini, M. (2009). Childlessness and intergenerational transfers: What is at stake? Ageing & Society, 29, 1171–1183.

Kondrat, M. E. (1999). Who is the “self” in self-aware: Professional self- awareness from a critical theory perspective. Social Service Review, 73(4), 451–477.

Kondrat, M. E. (2008). Person-in-environment. In T. Mizrahi & L. Davis (Eds.), Encyclopedia of social work (20th ed., Vol. 3, pp. 349–354). New York: NASW Press/Oxford University Press.

Kosmin, B., & Keysar, A. (2009). American Religious Identification Survey (ARIS 2008). Retrieved from http://commons.trincoll.edu/aris/files/2011/08/ARIS_Report_2008.pdf

Koss, M., & Figueredo, A. (2004). Change in cognitive mediators of rape’s impact on psychosocial health across 2 years of recovery. Journal of Counseling and Clinical Psychology, 72(6), 1063–1072.

Kossek, E., Lobel, S., & Brown, J. (2006). Human resource strategies to manage workforce diversity: Examining “the business case.” In A. Konrad & J. Pringle (Eds.), Handbook of workplace diversity (Vol. 1, pp. 53–74). Thousand Oaks, CA: Sage.

Kottler, J., & Englar-Carlson, M. (2015). Learning group leadership: An experiential approach (3rd ed.). Thousand Oaks, CA: Sage.

Kraeger, D., Felson, R., Warner, C., & Wenger, M. (2013). Women’s education, marital violence, and divorce: A social exchange perspective. Journal of Marriage and Family, 75, 565–581.

1050

http://commons.trincoll.edu/aris/files/2011/08/ARIS_Report_2008.pdf

Kramer, D. N., & Landolt, M. A. (2010). Characteristics and efficacy of early psychological intervention with children and adolescents after single trauma: A meta-analysis. European Journal of Psychotraumatology, 1, 1–24.

Krause, M., & Montenegro, C. (2017). Community as a multifaceted concept. In M. Bond, I. Serrano-Garcia, C. Keys, & M. Shinn (Eds.), APA handbook of community psychology: Theoretical foundations, core concepts, and emerging challenges (pp. 275–294). Washington, DC: American Psychological Association.

Kravetz, D. (2004). Tales from the trenches: Politics and practice in feminist service organizations. Lanham, MD: University Press of America.

Kriesi, H. (1996). The organizational structure of new social movements in a political context. In D. McAdam, J. McCarthy, & M. Zald (Eds.), Comparative perspectives on social movements (pp. 152–184). New York: Cambridge University Press.

Krill, D. F. (1996). Existential social work. In F. J. Turner (Ed.), Social work treatment (4th ed., pp. 250–281). New York: Free Press.

Krill, D. F. (2017). Existential social work. In F. J. Turner (Ed.), Social work treatment: Interlocking theoretical approaches (6th ed., pp. 166–190). New York: Oxford University Press.

Kroeber, A., & Kluckhohn, C. (1952). Culture: A critical review of concepts and definitions. Cambridge, MA: Peabody Museum.

Kroll, B. (2004). Living with an elephant: Growing up with parental substance misuse. Child and Family Social Work, 9, 129–140.

Kropf, N., & Malone, D. M. (2004). Interdisciplinary practice in

1051

developmental disabilities. Journal of Social Work in Disability & Rehabilitation, 3(1), 21–36.

Kulick, D., & Rydstrom, J. (2015). Loneliness and its opposite: Sex, disability, and the ethics of engagement. Durham, NC: Duke University Press.

Kupritz, V. (2003). Accommodating privacy to facilitate new ways of working. Journal of Architectural and Planning Research, 20(2), 122–135.

Kurdek, L. (2006). Differences between partners from heterosexual, gay, and lesbian cohabiting couples. Journal of Marriage and Family, 68, 509–528.

Kurian, G. T. (2011). Misogyny. In The encyclopedia of political science (p. 1046). Washington, DC: CQ Press. doi: 10.4135/9781608712434.n1001

Kurlanski, S., & Ibay, A. (2012). Seasonal affective disorder. American Family Physician, 86(1), 1037–1041.

Kurtz, L. (2016). Gods in the global village: The world’s religions in sociological perspective (4th ed.). Thousand Oaks, CA: Sage.

Kurtz, L., & Kurtz, M. (2016). Religion and social conflict. In L. Kurtz, Gods in the global village: The world’s religions in sociological perspective (4th ed., pp. 290–332). Thousand Oaks, CA: Sage.

Kurtz, S. (2002). Workplace justice: Organizing multi-identity movements. Minneapolis: University of Minnesota Press.

Kuther, T. (2017). Lifespan development: Lives in context. Thousand

1052

Oaks, CA: Sage.

Kurzweil, R. (2012). How to create a mind: The secret of human thought revealed. New York: Viking.

Kvarfordt, C. L. (2010). Spiritual abuse and neglect of youth: Reconceptualizing what is known through an investigation of practitioners’ experiences. Journal of Religion & Spirituality in Social Work: Social Thought, 29(2), 143–164.

Kvarfordt, C. L., & Sheridan, M. J. (2007). The role of religion and spirituality in working with children and adolescents: Results of a national survey. Social Thought, 26(3), 1–23.

Kylén, M., Schmidt, S., Iwarsson, S., Haak, M., & Ekström, H. (2017). Perceived home is associated with psychological well-being in a cohort aged 67–70 years. Journal of Environmental Psychology, 51, 239–247.

Kythreotis, A. (2012). Progress in global climate change politics? Reasserting national state territoriality in a post-political world. Progress in Human Geography, 36(4), 457–474.

Lachs, M., & Pillemer, K. (2015). Elder abuse. New England Journal of Medicine, 373(20), 1947–1956.

LaDue, R. A. (1994). Coyote returns: Twenty sweats does not an Indian expert make. Women & Therapy, 15(1), 93–111.

Laird, J. (1998). Theorizing culture: Narrative ideas and practice principles. In M. McGoldrick (Ed.), Revisioning family therapy (pp. 20–36). New York: Guilford Press.

Lajoie, D. H., & Shapiro, S. I. (1992). Definitions of transpersonal

1053

psychology: The first twenty-three years. Journal of Transpersonal Psychology, 4, 79–98.

Lakey, B., Vander Molen, R. J., Fles, E., & Andrews, J. (2016). Ordinary social interaction and the main effect between perceived support and affect. Journal of Personality, 84(5), 671–684.

Lakoff, G. (2011). How Occupy Wall Street’s moral vision can beat the disastrous conservative world view. AlterNet. Retrieved from https://img.alternet.org/story/152800/lakoff%3A_how_occupy_wall_street%27s_moral_vision_can_beat_the_disastrous_conservative_worldview

Laland, K., Odling-Smee, J., & Miles, S. (2010). How culture shaped the human genome: Bringing genetics and human sciences together. Nature Reviews: Genetics, 11, 137–148.

Lalayants, M., & Epstein, I. (2005). Evaluating multidisciplinary child abuse and neglect teams: A research agenda. Child Welfare, 84(4), 433–458.

Landry, B. (2000). Black working wives: Pioneers of the American family revolution. Berkeley: University of California Press.

Lane, C. (2007). Shyness: How normal behavior became a sickness. New Haven, CT: Yale University Press.

Lane, K. L., Wehby, J., Menzies, H. M., Doukas, G. L., Munton, S. M., & Gregg, R. M. (2003). Social skills instruction for students at risk for antisocial behavior. The effects of small-group instruction. Behavioral Disorders, 28(3), 229–248.

Lankton, N., McKnight, D. H., & Tripp, J. (2017). Facebook privacy management strategies: A cluster analysis of user privacy behaviors. Computers in Human Behavior, 76, 149–163.

1054

https://img.alternet.org/story/152800/lakoff%3A_how_occupy_wall_street%27s_moral_vision_can_beat_the_disastrous_conservative_worldview

Lantz, J., & Walsh, J. (2007). Short-term existential intervention in clinical practice. Chicago: Lyceum.

LaRocque, S. E. (2017). Group work education in social work: A review of the literature reveals possible solutions. Journal of Social Work Education, 53(2), 276–285.

Larsson, G., Berglund, A. K., & Ohlsson, A. (2016). Daily hassles, their antecedents and outcomes among professional first responders: A systematic literature review. Scandinavian Journal of Psychology, 57, 359–367.

Latour, B. (2007). Reassembling the social: An introduction to actor network theory. Oxford, UK: Oxford University Press.

Lau, W., Chan, C., Li, J., & Au, T. (2010). Effectiveness of group cognitive-behavioral treatment for childhood anxiety in community clinics. Behavior Research and Therapy, 28, 1067–1077.

Laumann, E., Leitsch, S., & Waite, L. (2008). Elder mistreatment in the United Sates: Prevalence estimate from a nationally representative study. Journals of Gerontology Series B, Psychological Sciences and Social Sciences, 63(4), S248–S254.

Lawrence, C., & Andrews, K. (2004). The influence of perceived prison crowding on male inmates’ perception of aggressive events. Aggressive Behavior, 30(4), 273–283.

Layton, L. (2016). Editor’s introduction to the special section: Feminism and psychoanalysis: Conversations across generations. Psychoanalysis, Culture, and Society, 21(3), 221–222.

Layton, R. (2006). Structuralism and semiotics. In C. Tilley, W. Keane, S. Kücher, M. Rowlands, & P. Spyer (Eds.), Handbook of material culture

1055

(pp. 29–42). Thousand Oaks, CA: Sage.

Lazarus, R. S. (2006). Emotions and interpersonal relationships: Toward a person-centered conceptualization of emotions. Journal of Personality, 74(1), 9–46.

Lazarus, R. S. (2007). Stress and emotion: A new synthesis. In A. Monat, R. S. Lazarus, & G. Reevy (Eds.), The Praeger handbook on stress and coping (Vol. 1, pp. 33–51). Westport, CT: Praeger/Greenwood.

Leaf, J., Leaf, J., Milne, C., Taubman, M., Oppenheim-Leaf, M., Torres, N., . . . Yoder, P. (2017). An evaluation of a behaviourally based social skills group for individuals diagnosed with autism spectrum disorder. Journal of Autism Developmental Disorder, 47, 243–259.

Le Brocque, R. M., Hendrikz, J., & Kenardy, J. A. (2010). The course of posttraumatic stress in children: Examination of recovery trajectories following traumatic injury. Journal of Pediatric Psychology, 35(6), 637–645.

Lee, B., & Campbell, K. (1999). Neighbor networks of Black and White Americans. In B. Wellman (Ed.), Networks in the global village (pp. 119–146). Boulder, CO: Westview Press.

Lee, J. A., & Hudson, R. E. (2017). Empowerment approach to social work treatment. In F. J. Turner (Ed.), Social work treatment: Interlocking theoretical approaches (6th ed., pp. 142–165). New York: Oxford University Press.

Lee, K. H. (2011). The role of spiritual experience, forgiveness, and religious support on the general well-being of older adults. Journal of Religion, Spirituality & Aging, 23(3), 206–223.

Lee, M. Y., Ng, S., Leung, P. P. Y., & Chan, C. L. W. (2009). Integrative

1056

body–mind–spirit social work: An empirically based approach to assessment and treatment. New York: Oxford University Press.

Lee, Y. (2010). Office layout affecting privacy, interaction, and acoustic quality in LEED-certified buildings. Building and Environment, 45, 1594–1600.

Leeder, E. (2004). The family in global perspective: A gendered journey. Thousand Oaks, CA: Sage.

LegalMatch. (2014). What are cousin marriage laws? Retrieved from www.legalmatch.com/law-library/article/cousin-marriage-laws.html

LeMahieu, P. G., Nordstrum, L. E., & Gale, D. (2017). Positive deviance: Learning from positive anomalies. Quality Assurance in Education: An International Perspective, 25(1), 109–124.

Lemma, A. (2010). The power of relationship: A study of key working as an intervention with traumatised young people. Journal of Social Work Practice, 24(4), 409–427.

Lengermann, P., & Niebrugge, G. (2018). Contemporary feminist theory. In G. Ritzer & J. Stepnisky (Ed.), Modern sociological theory (8th ed., pp. 290–332). Thousand Oaks, CA: Sage.

Lenski, G. (1966). Power and privilege. New York: McGraw-Hill.

Leonard, K., & Eiden, R. (2007). Marital and family processes in the context of alcohol use and alcohol disorders. Annual Review of Clinical Psychology, 3, 285–310.

Leung, P. P. Y., & Chan, C. L. W. (2010). Utilizing Eastern spirituality in clinical practice: A qualitative study of Chinese women with breast

1057

http://www.legalmatch.com/law-library/article/cousin-marriage-laws.html

cancer. Smith College Studies in Social Work, 80(2–3), 159–183.

Leung, P. P. Y., Chan, C. L. W., Ng, S. M., & Lee, M. Y. (2009). Towards body-mind-spirit integration: East meets West in clinical social work practice. Clinical Social Work Journal, 37(4), 303–311.

Levi, D. (2014). Group dynamics for teams (4th ed.). Thousand Oaks, CA: Sage.

Levine, S. (1999). Children’s cognition as the foundation of spirituality. International Journal of Children’s Spirituality, 4(2), 121–140.

Levinson, D. (1996). The seasons of a woman’s life. New York: Knopf.

Levitt, H., & Ippolito, M. (2014). Being transgender: Navigating minority stressors and developing authentic self-presentation. Psychology of Women Quarterly, 38(1), 46–64.

Levy, D. L., & Lo, J. R. (2013). Transgender, transsexual, and gender queer individuals with a Christian upbringing: The process of resolving conflict between gender identity and faith. Journal of Religion & Spirituality in Social Work: Social Thought, 32(1), 60–83.

Lewandowski, C. A., & Canda, E. R. (1995). A typological model for the assessment of religious groups. Social Thought, 18(1), 17–38.

Lewicka, M. (2011). Place attachment: How far have we come in the last 40 years? Journal of Environmental Psychology, 31, 207–230.

Lewis, M. (2010). The big short: Inside the doomsday machine. New York: Norton.

Lewis, O. (1959). Five families: Mexican case studies in the culture of

1058

poverty. New York: Basic Books.

Lewis, O. (1966). La vida: A Puerto Rican family in the culture of poverty — San Juan and New York. New York: Random House.

Lewis, S. Passmore, J., & Cantore, S. (2016). Appreciative inquiry for change management: Using AI to facilitate organizational development (2nd ed.). Philadelphia: Kogan Page.

Li, J., Karakowsky, L., & Siegel, J. (1999). The effects of proportional representation on intragroup behavior in mixed-race decision-making groups. Small Group Research, 30(3), 259–279.

Li, W., Hodgetts, D., & Sonn, C. (2014). Multiple sense of community among older Chinese migrants to New Zealand. Journal of Community & Applied Social Psychology, 24, 26–36.

Lichter, D., Turner, R., & Sassler, S. (2010). National estimates of the rise of serial cohabitation. Social Science Research, 39, 754–765.

Lid, I. (2014). Universal design and disability: An interdisciplinary perspective. Disability and Rehabilitation, 36(16), 1344–1349.

Lieberman, M. (2013). Social: Why our brains are wired to connect. New York: Crown.

Lightfoot, C., Lalonde, C., & Chandler, M. (Eds.). (2004). Changing conceptions of psychological life. Mahwah, NJ: Erlbaum.

Lighthouse, A., Bailey, S. K., & Voros, P. (2015). Collaborative music therapy via remote video technology to reduce a veteran’s symptoms of severe, chronic PTSD. Arts & Health, 7(2), 123–136.

1059

Limb, G. E., & Hodge, D. R. (2008). Developing spiritual competency with Native Americans: Promoting wellness through balance and harmony. Families in Society: The Journal of Contemporary Social Services, 89(4), 615–622.

Lindgren, S. (2017). Digital media and society. Thousand Oaks, CA: Sage.

Lindsey, E. W., Kurtz, P. D., Jarvis, S., Williams, N. R., & Nackerud, L. (2000). How runaway and homeless youth navigate troubled waters: Personal strengths and resources. Clinical and Adolescent Social Work Journal, 17(2), 115–140.

Linver, M., Brooks-Gunn, J., & Kohen, D. (2002). Family processes as pathways from income to young children’s development. Developmental Psychology, 38, 719–734.

Litka, M. (2015, May 13). A closer look at America’s rapidly growing religious “nones.” Pew Research Center. Retrieved from www.pewresearch.org/fact-tank/2015/05/13/a-closer-look-at-americas- rapidly-growing-religious-nones/

Litton, E., Carnegie, V., Elliott, R., & Webb, S. (2016). The efficacy of earplugs as a sleep hygiene strategy for reducing delirium in the ICU: A systematic review and meta-analysis. Critical Care Medicine, 44(5), 992–999.

Livingston, G. (2013, July 2). The rise of single fathers. Retrieved from www.pewsocialtrends.org/2013/07/02/the-rise-of-single-fathers/

Livingston, G. (2016). Among 41 nations, U.S. is the outlier when it comes to paid parental leave. Pew Research Center. Retrieved from www.pewresearch.org/fact-tank/2016/09/26/u-s-lacks-mandated-paid- parental-leave/

1060

http://www.pewresearch.org/fact-tank/2015/05/13/a-closer-look-at-americas-rapidly-growing-religious-nones/

http://www.pewsocialtrends.org/2013/07/02/the-rise-of-single-fathers/

http://www.pewresearch.org/fact-tank/2016/09/26/u-s-lacks-mandated-paid-parental-leave/

Livingston, G. (2018). Is U.S. fertility at an all-time low? It depends. Pew Research Center. Retrieved from www.pewresearch.org/fact- tank/2018/01/18/is-u-s-fertility-at-an-all-time-low-it-depends/

Lizano, E., & Mor Barak, M. (2012). Workplace demands and resources as antecedents of job burnout among public child welfare workers: A longitudinal study. Children and Youth Services Review, 34, 1769–1776.

Logan, S. L. (1997). Meditation as a tool that links the personal and the professional. Reflections: Narratives of Professional Helping, 3(1), 38–44.

Logan, S. L. (Ed.). (2001). The Black family: Strengths, self-help, and positive change (2nd ed.). Boulder, CO: Westview Press.

Long, G. (2013, April). Differences between union and non-union compensation, 2001–2011. Monthly Labor Review, 16–23.

Loomis, E. (2013). The global water crisis: Privatization and neocolonialism in film. Radical History Review, 116, 189–195.

Lopez, R., & Hynes, P. (2006). Obesity, physical activity, and the urban environment: Public health research needs. Environmental Health: A Global Access Science Source, 5(1), 25. doi:10.1186/1476-069x-5-25

López-Mosquera, N., & Sánchez, M. (2013). Direct and indirect effects of received benefits and place attachment in willingness to pay and loyalty in suburban natural areas. Journal of Environmental Psychology, 34, 27–35.

Lopoo, L., & London, A. (2016). Household crowding during childhood and long-term education outcomes. Demography, 53, 699–721.

1061

http://www.pewresearch.org/fact-tank/2018/01/18/is-u-s-fertility-at-an-all-time-low-it-depends/

Lorber, J. (2016). “Night to his day”: The social construction of gender. In P. Rothenberg (Ed.), Race, class, and gender in the United States: An integrated study (10th ed.). New York: Macmillan.

Lough, E., Flynn, E., & Riby, D. (2016). Personal space regulation in Williams syndrome: The effect of familiarity. J Autism Dev Disord, 46, 3207–3215.

Lovaglia, M. J. (1995). Power and status: Exchange, attribution, and expectation states. Small Group Research, 26, 400–426.

Lovaglia, M. J., Mannix, E., Samuelson, C., Sell, J., & Wilson, R. (2005). Conflict, power, and status in groups. In M. Poole & A. Hollingshead (Eds.), Theories of small groups: Interdisciplinary perspectives (pp. 63–97). Thousand Oaks, CA: Sage.

Lovett, I., Levitz, J., & McWhirter, C. (2017, September 20). How Antifa violence splits the left. Wall Street Journal. Retrieved from www.wsj.com/articles/how-antifa-violence-has-split-the-left- 1505833640

Low, P., Lee, D., & Chan, A. (2007). An exploratory study of Chinese older people’s perceptions of privacy in residential care homes. Journal of Advanced Nursing, 57(6), 605–613.

Low, S., & Altman, I. (1992). Place attachment: A conceptual inquiry. In I. Altman & S. Low (Eds.), Place attachment (pp. 1–12). New York: Plenum.

Lowenberg, F. M. (1988). Religion and social work practice in contemporary American society. New York: Columbia University Press.

Lowenstein, A., Katz, R., & Gur-Yaish, N. (2007). Reciprocity in parent- child exchange and life satisfaction among the elderly: A cross-national

1062

http://www.wsj.com/articles/how-antifa-violence-has-split-the-left-1505833640

perspective. Journal of Social Issues, 63(4), 865–883.

Lownsdale, S. (1997). Faith development across the lifespan: Fowler’s integrative work. Journal of Psychology and Theology, 25, 49–63.

Lowry, B., Cao, J., & Everard, A. (2011). Privacy concerns versus desire for interpersonal awareness in driving the use of self-disclosure technologies: The case of instant messaging in two cultures. Journal of Management Information Systems, 27(4), 163–200.

Lu, W., & Hampton, K. N. (2017). Beyond the power of networks: Differentiating network structure from social media affordances for perceived social support. New Media & Society, 19(6), 861–879.

Luhby, T. (2017, December 17). Will Obamacare survive the tax bill? CNN. Retrieved from http://money.cnn.com/2017/12/15/news/economy/obamacare- individual-mandate-tax/index.html

Luhmann, N. (2011). Introduction to systems theory. New York: Polity Press.

Lum, D. (2011). Culturally competent practice: A framework for understanding diverse groups and justice issues (4th ed.). Belmont, CA: Thomson.

Luthans, F. (2003). Positive organizational behavior (POB): Implications for leadership and HR development and motivation. In R. Steers, L. Porter, & G. Bigley (Eds.), Motivation and leadership at work (pp. 178–195). New York: McGraw-Hill.

Lutz, A., Dunne, J. D., & Davidson, R. J. (2007). Meditation and the neuroscience of consciousness. In P. Zelazo, M. Moscovitch, & E. Thompson (Eds.), The Cambridge handbook of consciousness (pp.

1063

http://money.cnn.com/2017/12/15/news/economy/obamacare-individual-mandate-tax/index.html

499–552). Cambridge, UK: Cambridge University Press.

Lyon, L. (1987). The community in urban society. Philadelphia: Temple University Press.

Lyotard, J. (1984). The postmodern condition. Minneapolis: University of Minnesota Press.

Ma, J., & Grogan-Kaylor, A. (2017). Longitudinal associations of neighbourhood collective efficacy and maternal corporal punishment with behavior problems in early childhood. Developmental Psychology, 53(6), 1027–1041.

MacArthur Network on Mind–Body Interactions. (2001). Vital connections: Science of mind–body interactions: A report on the interdisciplinary conference held at NIH, March 26–28, 2001. Chicago: Author.

Mackay, G., & Neill, J. (2010). The effect of “green exercise” on state anxiety and the roles of exercise duration, intensity, and greenness: A quasi-experimental study. Psychology of Sport and Exercise, 22, 238–245.

MacKinlay, E. (Ed.). (2006). Aging, spirituality and palliative care. Binghamton, NY: Haworth Press.

MacNair, R., Fowler, L., & Harris, J. (2000). The diversity functions of organizations that confront oppression: The evolution of three social movements. Journal of Community Practice, 7(2), 71–88.

MacKrill, T., & Hesse, M. (2011). The adult children of alcoholics trauma inventory. Substance Use & Misuse, 46, 1099–1104.

1064

Mader, S., & Windelspecht, M. (2012). Human biology (12th ed.). New York: McGraw-Hill.

Madigan, S., Moran, G., & Pederson, D. R. (2006). Unresolved states of mind, disorganized attachment relationships, and disrupted interactions of adolescent mothers and their infants. Developmental Psychology, 42(2), 293–304.

Magai, C., Consedine, N. S., Krivoshekova, Y. S., Kudadjie-Gyamfi, E., & McPherson, R. (2006). Emotion experience and expression across the adult life span: Insights from a multimodal assessment study. Psychology & Aging, 21(2), 303–317.

Magen, R., & Mangiardi, E. (2005). Groups and individual change. In S. Wheelan (Ed.), The handbook of group research and practice (pp. 351–361). Thousand Oaks, CA: Sage.

Mahoney, D., & Markel, B. (2016). An integrative approach to conceptualizing and treating complex trauma. Psychoanalytic Social Work, 23(1), 1–22.

Maidenberg, M. P., & Golick, T. (2001). Developing or enhancing interdisciplinary programs: A model for teaching collaboration. Professional Development: The International Journal of Continuing Social Work, 4(2), 15–24.

Maier, S., & Seligman, M. (2016). Learned helplessness at fifty: Insights from neuroscience. Psychological Review, 123(4), 349–367.

Majeed, G. (2013). Ethnicity and ethnic conflict in Pakistan. Journal of Political Studies, 1(2), 51–63.

Mak, W., Cheung, R., & Law, L. (2009). Sense of community in Hong Kong: Relations with community-level characteristics and residents’

1065

well-being. American Journal of Community Psychology, 44, 80–92.

Malanga, S. (2003, Winter). How the “living wage” sneaks socialism into cities. City Journal. Retrieved from www.city- journal.org/html/how-“living-wage”-sneaks-socialism-cities-12397.html

Malti, T., Gasser, L., & Buchmann, M. (2009). Aggressive and prosocial children’s emotion attributions and moral reasoning. Aggressive Behavior, 35(1), 90–102.

Mandayam, G., & Joosten, D. (2016). Understanding client communities spatially for developing effective interventions: Application of geographic information systems (GIS) technology for program planning in health and human services agencies. Journal of Technology in Human Services, 34(2), 171–182.

Mandolesi, L., Gelfo, F., Serra, L., Montuori, S., Polverino, A., Curcio, G., & Sorrentino, G. (2017). Environmental factors promoting neural plasticity: Insights from animal and human studies. Neural Plasticity, 1–10.

Mann, C. (2011). 1493: Discovering the new world Columbus created. New York: Knopf.

Mann, J. J., Oquendo, M. A., Watson, K. T., Boldrini, M., Malone, K. M., Ellis, S. P., . . . Currier D. (2014). Anxiety in major depression and cerebrospinal fluid free gamma-aminobutyric acid. Depression & Anxiety, 31(10), 814–821.

Mann, S. (2011). Pioneers of U.S. ecofeminism and environmental justice. Feminist Formations, 23(2), 1–25.

Mannarini, T., Taló, C., Mezzi, M., & Procentese, F. (2018). Multiple senses of community and acculturation strategies among migrants.

1066

http://www.city-journal.org/html/how-%E2%80%9Cliving-wage%E2%80%9D-sneaks-socialism-cities-12397.html

Journal of Community Psychology, 46, 7–22.

Manning, L. K. (2010). An exploration of paganism: Aging women embracing the divine feminine. Journal of Religion, Spirituality & Aging, 22(3), 196–210.

Manning, W., & Cohen, J. (2012). Premarital cohabitation and marital dissolution: An examination of recent marriages. Journal of Marriage and Family, 74, 247–260.

Manning, W., Fettro, M., & Lamidi, E. (2014). Child well-being in same- sex parent families: Review of research prepared for American Sociological Association amicus brief. Population Research and Policy Review, 33, 485–502.

Manning, W. D., & Sykes, J. B. (2015). Twenty-five years of change in cohabitation in the U.S., 1987–2013. National Center for Family and Marriage Research. Retrieved from www.bgsu.edu/content/dam/BGSU/college-of-arts-and- sciences/NCFMR/documents/FP/FP-15-01-twenty-five-yrs-cohab- us.pdf

Manyena, S. (2006). The concept of resilience revisited. Disaster, 30(5), 433–450.

Manzanera-Ruiz, R., & Lizárraga, C. (2017). Women’s social movements and social development: Opportunities for social work in Tanzania. International Social Work, 60(1), 219–233.

Mapp, S. (2014). Human rights and social justice in a global perspective: An introduction to international social work (2nd ed.). New York: Oxford University Press.

March, J., & Simon, H. (1958). Organizations. New York: Wiley.

1067

http://www.bgsu.edu/content/dam/BGSU/college-of-arts-and-sciences/NCFMR/documents/FP/FP-15-01-twenty-five-yrs-cohab-us.pdf

Marino, R., Weinman, M. L., & Soudelier, K. (2001). Social work intervention and failure to thrive in infants and children. Health and Social Work, 26(2), 90–97.

Markovitzky, G., & Mosek, A. (2005). The role of symbolic resources in coping with immigration. Journal of Ethnic & Cultural Diversity in Social Work, 14(1/2), 145–158.

Marks, G., & McAdam, D. (2009). On the relationship of political opportunities to the form of collective action: The case of the European Union. In D. della Porta, H. Kriesi, & D. Rucht (Eds.), Social movements in a globalising world (pp. 97–111). New York: Palgrave Macmillan.

Markus, H. R., & Kitayama, S. (2003). Models of agency: Sociocultural diversity in the construction of action. In G. Berman & J. Berman (Eds.), Cross-cultural differences in perspectives on the self (pp. 2–57). Lincoln: University of Nebraska Press.

Markus, H. R., & Kitayama, S. (2010). Culture and selves: A cycle of mutual constitution. Perspectives on Psychological Science, 5(4), 420–430.

Marsh, V. R. (2005). Story sharing, voice fatigue, and moving forward after divorce: When women resist being defined by their tragedies. Reflections: Narratives of Professional Helping, 11(1), 86–91.

Marti, I., Etzion, D., & Leca, B. (2008). Theoretical approaches for studying corporations, democracy, and the public good. Journal of Management Inquiry, 17, 148–151.

Martin, E. P., & Martin, J. M. (2002). Spirituality and the Black helping tradition in social work. Washington, DC: NASW Press.

1068

Martin, J., Gladstone, T., Diehl, A., & Beardslee, W. (2016). Development and evaluation of a web-based clinician training program for a family- focused depression preventive intervention. Journal of Technology in Human Services, 34(3), 267–284.

Martin, J., & Sherman, M. (2010). The impact of military duty and military life on individuals and families. In S. Price, C. Price, & P. McKendry (Eds.), Families and change: Coping with stressful events and transitions (4th ed., pp. 381–397). Thousand Oaks, CA: Sage.

Martin, J. G. (1993). Why women need a feminist spirituality. Women’s Studies Quarterly, 1, 106–120.

Martin, M., Conger, R., Schofield, T., Dogan, S., Widamina, K., & Neppl, T. (2010). Evaluation of the interactionist model of socioeconomic status and problem behavior. Development and Psychopathology, 22, 695–709.

Martinez-Brawley, E. (2000). Close to home: Human services and the small community. Washington, DC: NASW Press.

Martins, A., Ramalho, N., & Morin, E. (2010). A comprehensive meta- analysis of the relationship between emotional intelligence and health. Personality & Individual Differences, 49(6), 554–564.

Marx, G., & McAdam, D. (1994). Collective behavior and social movements: Process and structure. Englewood Cliffs, NJ: Prentice Hall.

Marx, J. (2012). American social policy in the 1960’s and 1970’s: The Social Welfare History Project. Retrieved from https://socialwelfare.library.vcu.edu/eras/american-social-policy-in-the- 60s-and-70s/

Marx, K. (1967). Capital: A critique of political economy (S. Moore & E.

1069

https://socialwelfare.library.vcu.edu/eras/american-social-policy-in-the-60s-and-70s/

Aveling, Trans; Vol. 1). New York: International. (Original work published 1887)

Masci, J. D., & Lipka, M. (2016). Americans may be getting less religious, but feelings of spirituality are on the rise. Retrieved from www.pewresearch.org/fact-tank/2016/01/21/americans-spirituality/

Maslach, C. (1976). Burned-out. Human Behavior, 9, 16–22.

Maslach, C., & Jackson, S. (1981). Maslach Burnout Inventory: Research edition. Palo Alto, CA: Consulting Psychologists Press.

Maslach, C., Schaufeli, W., & Leiter, M. (2001). Job burnout. Annual Review of Psychology, 52, 397–422.

Maslow, A. (1954). Motivation and personality. New York: Harper.

Maslow, A. (1962). Toward a psychology of being. New York: Van Nostrand.

Maslow, A. (1971). Farther reaches of human nature. New York: Viking.

Mason, E., Williams, A., & Elliott, K. (2017, June 29). The dramatic rise in state efforts to limit LGBT rights. Washington Post. Retrieved from www.washingtonpost.com/graphics/national/lgbt-legislation/? utm_term=.722fb76102d8

Mathambo, V., & Gibbs, A. (2009). Extended family childcare arrangements in a context of AIDS: Collapse or adaptation? AIDS Care, 21, 22–27.

Matheson, L. (1996). Valuing spirituality among Native American populations. Counseling and Values, 41, 51–58.

1070

http://www.pewresearch.org/fact-tank/2016/01/21/americans-spirituality/

http://www.washingtonpost.com/graphics/national/lgbt-legislation/?utm_term=.722fb76102d8

Matthews, D. A., McCullough, M. E., Larson, D. B., Koenig, H. G., Swyers, J. P., & Milano, M. G. (1998). Religious commitment and health status: A review of the research and implications for family medicine. Archives of Family Medicine, 7(2), 118–124.

Matto, H., Berry-Edwards, J., Hutchison, E. D., Bryant, S. A., & Waldbillig, A. (2006). An exploratory study on multiple intelligences and social work education. Journal of Social Work Education, 42(2), 405–416.

Maxwell, L. (2003). Home and school density effects on elementary school children: The role of spatial density. Environment and Behavior, 35(4), 566–578.

May, A., Duivenvoorden, H., Korstjens, I., van Weert, E., Hoekstra- Weebers, J., van den Borne, B., . . . Ros, W. J. (2008). The effects of group cohesion on rehabilitation outcome in cancer survivors. Psycho- Oncology, 17, 917–925.

Maynard, M., & Taylor, C. (1996). A comparative analysis of Japanese and U.S. attitudes toward direct marketing. Journal of Direct Marketing, 10(1), 34–44.

Mayo, E. (1933). The human problems of an industrial civilization. New York: MacMillan.

Mayo, K. R. (2009). Creativity, spirituality, and mental health: Exploring connections. Surrey, UK: Ashgate.

McAdam, D. (1996a). Conceptual origins, current problems, future directions. In D. McAdam, J. McCarthy, & M. Zald (Eds.), Comparative perspectives on social movements (pp. 23–40). New York: Cambridge University Press.

1071

McAdam, D. (1996b). The framing function of movement tactics: Strategic dramaturgy in the American civil rights movement. In D. McAdam, J. McCarthy, & M. Zald (Eds.), Comparative perspectives on social movements (pp. 338–355). New York: Cambridge University Press.

McAdam, D., McCarthy, J., & Zald, M. (1996). Introduction: Opportunities, mobilizing structures, and framing processes: Toward a synthetic, comparative perspective on social movements. In D. McAdam, J. McCarthy, & M. Zald (Eds.), Comparative perspectives on social movements (pp. 1–20). New York: Cambridge University Press.

McAvoy, M. (1999). The profession of ignorance: With constant reference to Socrates. Lanham, MD: University Press of America.

McBee, L., Westreich, L., & Likourezos, A. (2004). A psychoeducational relaxation group for pain and stress management in the nursing home. Journal of Social Work in Long-Term Care, 3(1), 15–28.

McCarroll, J., Ursano, R., Fan, Z., & Newby, J. (2004). Patterns of mutual and nonmutual spouse abuse in the U.S. Army (1998–2002). Violence and Victims, 19(4), 453–468.

McCarthy, R., Rabenhorst, M., Thomsen, C., Milner, J., Travis, W., Copeland, C., & Foster, R. (2015). Child maltreatment among civilian parents before, during, and after deployment in United States Air Force families. Psychology of Violence, 5, 26–34.

McCrea, K. T., Guthrie, D., & Bulanda, J. J. (2016). When traumatic stressors are not past, but now: Psychosocial treatment to develop resilience with children and youth enduring concurrent, complex trauma. Journal of Child and Adolescent Trauma, 9, 5–16.

McCubbin, H. I., & Figley, C. R. (1983). Stress and the family: Vol. 1. Coping with normative transitions. New York: Brunner/Mazel.

1072

McCubbin, H. I., & Patterson, J. M. (1983). The family stress process: The double ABCX model of adjustment and adaptation. In H. I. McCubbin, M. B. Sussman, & J. M. Patterson (Eds.), Social stress and the family: Advances and developments in family stress theory and research (pp. 7–37). New York: Haworth.

McDermott, M. L. (1997). Voting cues in low-information elections: Candidate gender as a social information variable in contemporary United States elections. American Journal of Political Science, 41(1), 270–283.

McFarlane, J., Fredland, N., Symes, L., Zhou, W., Jouriles, E., Dutton, M., & Greeley, C. (2017). The intergenerational impact of intimate partner violence against mothers on child function over four years. Journal of Family Violence, 32, 645–655.

McFarlane, J., Nava, A., Gilroy, H., & Maddoux, J. (2016). Child brides, forced marriage, and partner violence in America: Tip of iceberg revealed. Obstetrics & Gynecology, 127(4), 706–713.

McGeeney, A. (2016). With nature in mind: The ecotherapy manual for mental health professionals. Philadelphia: Jessica Kingsley.

McGinty, A. (2014). Emotional geographies of veiling: The meanings of the hijab for five Palestinian American Muslim women. Gender, Place & Culture: A Journal of Feminist Geography, 21(6), 683–700.

McGoldrick, M., & Ashton, D. (2012). Culture: A challenge to concepts of normality. In F. Walsh (Ed.), Normal family processes: Growing diversity and complexity (4th ed., pp. 249–272). New York: Guilford Press.

McGoldrick, M., Garcia-Preto, N., & Carter, B. (2016). The expanded family life cycle: Individual, family, and social perspectives (4th ed.). Boston: Pearson.

1073

McGregor, D. (1960). The human side of enterprise. New York: McGraw- Hill.

McIntosh, D., Poulin, M., Silver, R., & Holman, E. A. (2011). The distinct roles of spirituality and religiosity in physical and mental health after collective trauma: A national longitudinal study of responses to the 9/11 attacks. Journal of Behavioral Medicine, 34, 497–507.

McIntosh, P. (2016). White privilege: Unpacking the invisible knapsack. In P. Rothenberg (Ed.), Race, class, and gender in the United States (10th ed., pp. 176–180). New York: Worth.

McKee-Ryan, F., Song, Z., Wanberg, C., & Kinicki, A. (2005). Psychological and physical well-being during unemployment: A meta- analytic study. Journal of Applied Psychology, 90(1), 53–76.

McKenzie, F. (2011). Understanding and managing the therapeutic relationship. Chicago: Lyceum.

McLeod, P., & Kettner-Polley, R. (2005). Psychodynamic perspectives on small groups. In M. Poole & A. Hollingshead (Eds.), Theories of small groups: Interdisciplinary perspectives (pp. 63–97). Thousand Oaks, CA: Sage.

McMichael, P. (2017). Development and social change: A global perspective (6th ed.). Thousand Oaks, CA: Sage.

McMillan, D. (1996). Sense of community. Journal of Community Psychology, 24, 315–325.

McMillan, D., & Chavis, D. (1986). Sense of community: A definition and theory. Journal of Community Psychology, 14, 6–23.

1074

McMullen, J., & Warnick, B. (2016). Should we require every new venture to be a hybrid organization? Journal of Management Studies, 53(4). doi:10.1111/joms.12150

McPherson, M., Smith-Lovin, L., & Brashears, M. (2006). Social isolation in America: Changes in core discussion networks over two decades. American Sociological Review, 71(3), 353–375.

Mead, G. E., Hsieh, C.-F., Lee, R., Kutlubaev, M. A., Claxton, A., Hankey, G. J., & Hackett, M. L. (2013). Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery. São Paulo Medical Journal, 131(3), 208–209.

Mead, G. H. (1934). Mind, self, and society. Chicago: University of Chicago Press.

Mead, G. H. (1959). The philosophy of the present. LaSalle, IL: Open Court.

Meadows, S., Tanielian, T., Karney, B., Schell, T., Griffin, B., Jaycox, L., . . . Vaughan, C. (2017). The deployment of life study: Longitudinal analysis of military families across the deployment cycle. Rand Health Quarterly, 6(2). Retrieved from www.rand.org/pubs/periodicals/health- quarterly/issues/v6/n2/07.html

Mederos, R., & Perilla, J. (2003). Community connections: Men, gender, and violence. Retrieved from http://menengage.org/wp- content/uploads/2014/06/Community_connection_- _Men_boys_and_gender.pdf

Meisenhelder, J. B., & Marcum, J. P. (2009). Terrorism, post-traumatic stress, coping strategies, and spiritual outcomes. Journal of Religion and Health, 48(1), 46–57.

1075

http://www.rand.org/pubs/periodicals/health-quarterly/issues/v6/n2/07.html

http://menengage.org/wp-content/uploads/2014/06/Community_connection_-_Men_boys_and_gender.pdf

Melchert, T. (2013). Beyond theoretical orientations: The emergence of a unified scientific framework in professional psychology. Professional Psychology: Research and Practice, 44(1), 11–19.

Melton, J. G. (1993). Encyclopedia of American religion. Detroit, MI: Gale Research.

Melunsky, N., Crellin, N., Dudzinski, E., Orrell, M., Wenbron, J., Poland, F., . . . Charlesworth, G. (2015). The experience of family carers attending a joint reminiscence group with people with dementia. Dementiak, 14(6), 842–859.

Memmi, D. (2006). The nature of virtual communities. AI & Society: Journal of Knowledge, Culture and Communication, 20, 288–300.

Menezes, P., Scazufca, M., Rodrigues, L., & Mann, A. (2000). Household crowding and compliance with outpatient treatment in patients with non-affective functional psychoses. Social Psychiatry and Psychiatric Epidemiology, 35(3), 116–120.

Merai, R., Siegel, C., Rakotz, M., Basch, P., Wright, J., Wong, B., . . . Thorpe, P. (2016). CDC grand rounds: A public health approach to detect and control hypertension. Morbidity and Mortality Weekly Report, 65(45), 1261–1264.

Mercadante, L. (2014). Belief without borders: Inside the minds of the spiritual but not religious. New York: Oxford University Press.

Merriam-Webster. (2017a, November.). Taxonomy. Retrieved from www.merriam-webster.com/dictionary/taxonomy

Merriam-Webster. (2017b, February). We just added more than 1,000 new words to the dictionary. Retrieved from www.merriam- webster.com/words-at-play/new-words-in-the-dictionary-feb-2017

1076

http://www.merriam-webster.com/dictionary/taxonomy

http://www.merriam-webster.com/words-at-play/new-words-in-the-dictionary-feb-2017

Meuleman, R., Kraaykamp, G., & Verbakel, E. (2017). Do female colleagues and supervisors influence family role attitudes? A three-level test of exposure explanations among employed men and women in 27 European countries. Journal of Marriage and Family, 79, 277–293.

Meyer, C. (1993). Assessment in social work practice. New York: Columbia University Press.

Meyer, D. (2004). Tending the vineyard: Cultivating political process research. In J. Goodwin & J. Jasper (Eds.), Rethinking social movements: Structure, meaning, and emotion (pp. 47–59). Lanham, MD: Rowman & Littlefield.

Meyer, H. (2010). Culture and disability: Advancing comparative research. Comparative Sociology, 9, 157–164.

Meyer, J., & Rowan, B. (1977). Institutional organizations: Formal structure as myth and ceremony. American Journal of Sociology, 83, 340–363.

Meyer, M. (2010). Social movement service organizations: The challenges and consequences of combining service provision and political advocacy. In Y. Hasenfeld (Ed.), Human services as complex organizations (2nd ed., pp. 533–550). Thousand Oaks, CA: Sage.

Michels, R. (1959). Political parties: A sociological study of the oligarchical tendencies of modern democracy (Eden & Cedar Paul, Trans.). New York: Dover. (Original work published 1911)

Middleton, K., & Craig, C. D. (2012). A systematic literature review of PTSD among female veterans from 1990 to 2010. Social Work in Mental Health, 10(3), 233–252.

Migration Policy Centre. European University Institute. (2016). Syrian

1077

refugees: A snapshot of the crisis in the Middle East and Europe. Retrieved from syrianrefugees.eu.

Mihailidis, P., & Viotty, S. (2017). Spreadable spectacle in digital culture: Civic expression, fake news, and the role of media literacies in “post- fact” society. American Behavioral Sciences, 6(4), 441–454.

Mikulas, W. L. (2002). The integrative helper: Convergence of Eastern and Western traditions. Pacific Grove, CA: Brooks/Cole Thomson Learning.

Miles, M. (1995). Disability in an Eastern religious context: Historical perspectives. Disability and Society, 10, 49–69.

Minkoff, D. (2010). The emergence of hybrid organizational forms: Combining identity-based provision and political action. In Y. Hasenfeld (Ed.), Human services as complex organizations (2nd ed., pp. 117–138). Thousand Oaks, CA: Sage.

Minnig, S. (2016). Thinking clearly about the earliest symptoms of HD and which brain regions control them. Retrieved from https://en.hdbuzz.net/216

Miran-Khan, C. (2017). Working with stepfamilies. Australian & New Zealand Journal of Family Therapy, 38, 329–341.

Mishel, L., & Davis, A. (2015). Top CEOS make 300 times more than typical workers. Economic Policy Institute. Retrieved from www.epi.org/publication/top-ceos-make-300-times-more-than-workers- pay-growth-surpasses-market-gains-and-the-rest-of-the-0-1-percent/

Mistry, R., Lowe, D., Renner, A., & Chien, N. (2008). Expanding the family economic stress model: Insights from a mixed-methods approach. Journal of Marriage and Family, 70(1), 196–209.

1078

https://syrianrefugees.eu

https://en.hdbuzz.net/216

http://www.epi.org/publication/top-ceos-make-300-times-more-than-workers-pay-growth-surpasses-market-gains-and-the-rest-of-the-0-1-percent/

Mitchell, A., Simmons, K., Matsa, K., & Silver, L. (2018). Publics globally want unbiased news coverage, but are divided on whether their news media deliver. Pew Research Center. Retrieved from www.pewglobal.org/2018/01/11/publics-globally-want-unbiased-news- coverage-but-are-divided-on-whether-their-news-media-deliver/

Mitchell, K., Dick, A., DiMartino, D., Smith, B., Niles, B., Koenen, K., & Street A. (2014). A pilot study of randomized controlled trial of yoga as an intervention to PTSD symptoms in women. Journal of Traumatic Stress, 27, 121–128.

Mizrahi, T., & Abramson, J. S. (2000). Collaboration between social workers and physicians: Perspectives on a shared case. Social Work in Health Care, 31(3), 1–24.

Mizrahi, T., Rosenthal, B., & Ivery, J. (2013). Coalitions, collaborations, and partnerships: Interorganizational approaches to social change. In M. Weil, M. Reisch, & M. Ohmer (Eds.), The handbook of community practice (2nd ed., pp. 383–402). Thousand Oaks, CA: Sage.

Mmatli, T. (2008). Political activism as a social work strategy in Africa. International Social Work, 51(3), 297–310.

Mobility Technologies. (2017). AFARI stylized mobility aid. Retrieved from http://mobility-tech.com

Mohai, P., & Saha, R. (2007). Racial inequality in the distribution of hazardous waste: A national-level reassessment. Social Problems, 54(3), 343–370.

Monette, D., Sullivan, T., DeJong, C., & Hilton, T. (2014). Applied social research: A tool for the human services (9th ed.). Belmont, CA: Brooks/Cole.

1079

http://www.pewglobal.org/2018/01/11/publics-globally-want-unbiased-news-coverage-but-are-divided-on-whether-their-news-media-deliver/

http://mobility-tech.com

Moody, H., & Sasser, J. (2015). Aging: Concepts and controversies (8th ed.). Thousand Oaks, CA: Sage.

Moore, D., & Coyhis, D. (2010). The multicultural Wellbreity peer recovery support program: Two decades of community-based recovery. Alcoholism Treatment Quarterly, 28(3), 273–292.

Mor Barak, M. (2014). Managing diversity: Toward a globally inclusive workplace (3rd ed.). Thousand Oaks, CA: Sage.

Mor Barak, M., & Travis, D. (2010). Diversity and organizational performance. In Y. Hasenfeld (Ed.), Human services as complex organizations (2nd ed., pp. 341–378). Thousand Oaks, CA: Sage.

Morgaine, K., & Capous-Desyllas, M. (2015). Anti-oppressive social work practice: Putting theory into action. Thousand Oaks, CA: Sage.

Morgan, G. (2006). Images of organizations (Updated ed.). Thousand Oaks, CA: Sage.

Morgan, P. (2010). Towards a developmental theory of place attachment. Journal of Environmental Psychology, 30, 11–22.

Morreale, D. (Ed.). (1998). The complete guide to Buddhist America. Boston: Shambhala.

Morris, A. (2004). Reflections on social movement theory: Criticisms and proposals. In J. Goodwin & J. Jasper (Eds.), Rethinking social movements (pp. 233–246). Lanham, MD: Rowman & Littlefield.

Morris, P. M. (2002). The capabilities perspective: A framework for social justice. Families in Society, 83(4), 365–373.

1080

Mosbacher, D., Reid, F., & Rhue, S. (1996). All god’s children. [Videorecording]. Retrieved from Woman Vision, www.womanvision.org.

Moynihan, D. P. (1965). The Negro family: The case for national action. Washington, DC: Office of Policy Planning and Research, U.S. Department of Labor.

Mueller, P. C., Plevak, D. J., & Rummans, T. A. (2001). Religious involvement, spirituality, and medicine: Implications for clinical practice. Mayo Clinical Proceedings, 76(12), 1225–1235.

Mulligan, K., & Scherer, K. R. (2012). Toward a working definition of emotion. Emotion Review, 4(4), 345–357.

Mulroy, E., Nelson, K., & Gour, D. (2005). Community building and family-centered service collaboratives. In M. Weil (Ed.), The handbook of community practice (pp. 460–474). Thousand Oaks, CA: Sage.

Murphy, M. J. (2004). Cognitive and constructivist psychotherapies: Theory, research, and practice. New York: Springer.

Murr, R. (2013). “I became proud of being gay and proud of being Christian”: The spiritual journeys of queer Christian women. Journal of Religion & Spirituality in Social Work: Social Thought, 32(4), 349–372.

Musick, K., & Bumpass, L. (2012). Reexamining the case for marriage: Union formation and changes in well-being. Journal of Marriage and Family, 74, 1–18.

Mustaine, E. (2015). History of social control and deviance. In J. Wright (Ed.), International encyclopedia of the social and behavioral sciences (pp. 235–241). Oxford, UK: Elsevier.

1081

http://www.womanvision.org

Myers, S., & Anderson, C. (2008). The fundamentals of small group communication. Thousand Oaks, CA: Sage.

Nagai, C. (2007). Culturally based spiritual phenomena: Eastern and Western theories and practices. Psychoanalytic Social Work, 14(1), 1–22.

Nakagawa, F., Miners, A., Smith, C., Simmons, R., Lodwick, R., Cambiano, V., . . . Phillips, A. (2015). Projected lifetime healthcare costs associated with HIV infection. PloS One, 10(4), e0125018. doi:10.1371/journal.pone.0125018

Naidoo, R., & Adamowicz, W. (2006). Modeling opportunity costs of conservation in transitional landscapes. Conservation Biology, 20(2), 490–500.

NASW, ASWB, CSWE, & CSWA. (2017). Standards for technology in social work practice. Washington, DC: National Association of Social Workers.

NASW Virginia. (2003, February). The social worker as part of an interdisciplinary team. NASW Virginia Chapter News, 3(1), 8.

National Association of Social Workers. (2017). Code of ethics of the National Association of Social Workers. Washington, DC: Author.

National Center for Chronic Disease Prevention and Health Promotion. Division for Heart Disease and Stroke Prevention. (2016). High blood pressure fact sheet. Retrieved from www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_bloodpressure.htm

National Center for Chronic Disease Prevention and Health Promotion. Division of Diabetes Translation. (2017). National diabetes statistics report. Estimates of diabetes and its burden in the United States. Atlanta,

1082

http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_bloodpressure.htm

GA: U.S. Department of Health & Human Services. Retrieved from www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics- report.pdf

National Center for Complementary and Alternative Medicine. (2016). Complementary, alternative, or integrative health: What’s in a name? Retrieved from https://nccih.nih.gov/health/integrative-health

National Conference of State Legislatures. (2017). Substance abuse and child welfare resources. Retrieved from www.ncsl.org/research/human- services/substance-abuse-and-child-welfare-resources.aspx

National Human Genome Research Institute. (2013). All about the Human Genome Project (HGP). Retrieved from www.Genome.gov/10001772

National Institutes of Health. (2013). Human Genome Project. Retrieved from https://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=45

National Institutes of Health. (2017). Preconception counselling and care for women of childbearing age living with HIV. Retrieved from https://aidsinfo.nih.gov/guidelines/html/3/perinatal/153/reproductive- options-for-hiv-concordant-and-serodiscordant-couples

National Network of Libraries of Medicine. (2013). Health literacy. Retrieved from https://nnlm.gov/priorities/topics/health-literacy

National Religious Partnership for the Environment. (2018). About. Retrieved from www.nrpe.org/about.html

National Sexual Violence Resource Center. (2015). Statistics about sexual violence. Retrieved from www.nsvrc.org/sites/default/files/publications_nsvrc_factsheet_media- packet_statistics-about-sexual-violence_0.pdf

1083

http://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf

https://nccih.nih.gov/health/integrative-health

http://www.ncsl.org/research/human-services/substance-abuse-and-child-welfare-resources.aspx

http://www.Genome.gov/10001772

https://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=45

https://aidsinfo.nih.gov/guidelines/html/3/perinatal/153/reproductive-options-for-hiv-concordant-and-serodiscordant-couples

https://nnlm.gov/priorities/topics/health-literacy

http://www.nrpe.org/about.html

http://www.nsvrc.org/sites/default/files/publications_nsvrc_factsheet_media-packet_statistics-about-sexual-violence_0.pdf

Navarro, V., Muntaner, C., Borrell, C., Benach, J., Quiroga, A., Rodriguez-Sanz, M., . . . Isabel Pasarín, M. (2006). Politics and health outcomes. Lancet, 368(9540), 1033–1037.

Neal, Z. (2017). Taking stock of the diversity and sense of community debate. American Journal of Community Psychology, 59, 255–260.

Neal, Z., & Neal, J. (2014). The (in)compatibility of diversity and sense of community. American Journal of Community Psychology, 53, 1–12.

Nee, V., & Opper, S. (2010). Political capital in a market economy. Social Forces, 88(5), 2105–2132.

Neff, K. D., & Helwig, C. C. (2002). A constructionist approach to understanding the development of reasoning about rights and authority in cultural contexts. Cognitive Development, 17, 1429–1450.

Neger, E., & Prinz, R. (2015). Interventions to address parenting and parental substance abuse: Conceptual and methodological considerations. Clinical Psychology Review, 39, 71–82.

Nelson-Becker, H. B. (2006). Voices of resilience: Older adults in hospice care. Journal of Social Work in End-of-Life & Palliative Care, 2(3), 87–106.

Neppl, T., Senia, J., & Donnellan, M. B. (2016). Effects of economic hardship: Testing the family stress model over time. Journal of Family Psychology, 30(1), 12–21.

Nesmith, A., & Smyth, N. (2015). Environmental justice and social work education: Social workers’ professional perspectives. Social Work Education, 34(5), 484–501.

1084

Netting, F. E., O’Connor, M. K., & Singletary, J. (2007). Finding homes for their dreams: Strategies founders and program initiators use to position and sustain faith-based programs. Families in Society: The Journal of Contemporary Social Services, 88(1), 19–29.

Netting, F. E., Kettner, P., McMurtry, S., & Thomas, M. S. (2017). Social work macro practice (6th ed.). Boston: Pearson.

Newhard, M. (2012). Appreciative inquiry. In W. Rothwell (Ed.), The encyclopedia of human resource management: Short entries (pp. 42–49). New York: John Wiley & Sons.

Newman, D. (2017). Sociology: Exploring the architecture of everyday life: Brief Edition (5th ed.). Thousand Oaks, CA: Sage.

Newransky, C., Kayser, K., & Lombe, M. (2014). The development of self-efficacy beliefs of widowed and abandoned women through microcredit self-help groups: The case of rural South India. Journal of Social Service Research, 40, 201–214.

Nicholson, J., D’Esposito, F., Lucas, N., & Westrupp, E. (2014). Raising children in single-parent families. In A. Abela & J. Walker (Eds.), Contemporary issues in family studies: Global perspectives on partnerships, parenting and support in a changing world (pp. 166–188). Malden, MA: Wiley.

Nicotera, N. (2005). The child’s view of neighborhood: Assessing a neglected element in direct social work practice. Journal of Human Behavior in the Social Environment, 11(3/4), 105–133.

Niemann, S. (2005). Persons with disabilities. In M. T. Burke, J. C. Chauvin, & J. G. Miranti (Eds.), Religious and spiritual issues in counseling: Applications across diverse populations (pp. 105–133). New York: Brunner-Routledge.

1085

Noack, R. (2015, April 1). Sweden is about to add a gender-neutral pronoun to its official dictionary. Washington Post. Retrieved from www.washingtonpost.com/news/worldviews/wp/2015/04/01/sweden-is- about-to-add-a-gender-neutral-pronoun-to-its-official-dictionary/? utm_term=.27440195b90e

Noble, C. (2015). Social protest movements and social work practice. International Encyclopedia of the Social and Behavioral Sciences (2nd ed., Vol. 22, pp. 518–524). doi:10.1016/B978-0-08-097086-8.28085-9

Nobles, W. W. (1980). African philosophy: Foundations for Black psychology. In R. L. Jones (Ed.), Black psychology (2nd ed., pp. 23–36). New York: Harper & Row.

Noddings, N. (2002). Starting at home: Caring and social policy. Berkeley: University of California Press.

Noddings, N. (2005). Educating citizens for global awareness. New York: Teachers College Press.

Noonan, D. (2016). Busting blood clots. Scientific American, 315(4), 26–27.

Norcross, J. C., & Wampold, B. E. (2011). Evidence-based therapy relationships: Research conclusions and clinical practices. Psychotherapy, 48(1), 98–102.

Nordberg, J. (2014). The underground girls of Kabul: In search of a hidden resistance in Afghanistan. New York: Crown Group.

Northen, H. (1988). Social work with groups (3rd ed.). New York: Columbia University Press.

1086

http://www.washingtonpost.com/news/worldviews/wp/2015/04/01/sweden-is-about-to-add-a-gender-neutral-pronoun-to-its-official-dictionary/?utm_term=.27440195b90e

Northouse, P. (2013). Leadership: Theory and practice (6th ed.). Thousand Oaks, CA: Sage.

Northouse, P. (2018). Introduction to leadership: Concepts and practice (4th ed.). Thousand Oaks, CA: Sage.

Norton, C. (2009). Ecopsychology and social work: Creating an interdisciplinary framework for redefining person-in-environment. Ecopsychology, 1(3), 138–145.

Novak, G., Fan, T., O’Dowd, B. F., & George, S. R. (2013). Striatal development involves a switch in gene expression networks, followed by a myelination event: Implications for neuropsychiatric disease. Synapse, 67(4), 179–188.

Novelli, D., Drury, J., & Reicher, S. (2010). Come together: Two studies concerning the impact of group relations on “personal space.” British Journal of Social Psychology, 49, 223–236.

Nowell, B., Berkowitz, S., Deacon, Z., & Foster-Fishman, P. (2006). Revealing the cues within community places: Stories of identity, history, and possibility. American Journal of Community Psychology, 37(1/2), 29–46.

Nussbaum, M. (2001). Women and human development: The capabilities approach. New York: Cambridge University Press.

Nussbaum, M. (2011). Creating capabilities: The human development approach. Cambridge, MA: The Belknap Press of the Harvard University Press.

Oberschall, A. (1992). Social movements: Ideologies, interests, and identities. New Brunswick, NJ: Transaction.

1087

O’Brien, M., & Laland, K. (2012). Genes, culture, and agriculture: An example of human niche construction. Current Anthropology, 53(4), 434–470.

O’Brien, P. (1992). Social work and spirituality: Clarifying the concept for practice. Spirituality and Social Work Journal, 3(1), 2–5.

Obst, P., & Tham, N. (2009). Helping the soul: The relationship between connectivity and well-being within a church community. Journal of Community Psychology, 37(3), 342–361.

Obst, P., & White, K. (2004). Revisiting the Sense of Community Index: A confirmatory factor analysis. Journal of Community Psychology, 32(6), 691–705.

Obst, P., Zinkiewicz, L., & Smith, S. (2002a). Sense of community in science fiction fandom: Part 1. Understanding sense of community in an international community of interest. Journal of Community Psychology, 30(1), 87–103.

Obst, P., Zinkiewicz, L., & Smith, S. (2002b). Sense of community in science fiction fandom: Part 2. Comparing neighborhood and interest group sense of community. Journal of Community Psychology, 30(1), 105–117.

Ochshorn, J., & Cole, E. (Eds.). (1995). Women’s spirituality, women’s lives. Binghamton, NY: Haworth Press.

O’Connor, M., & Netting, E. (2009). Organization practice: A guide to understanding human service organizations (2nd ed.). Hoboken, NJ: Wiley.

OECD Family Database. (2016). Cohabitation rate and prevalence of other forms of partnership. Retrieved from www.oecd.org/els/family/SF_3-3-

1088

http://www.oecd.org/els/family/SF_3-3-Cohabitation-forms-partnership.pdf

Cohabitation-forms-partnership.pdf

Office of the Deputy Assistant Secretary of Defense. (2014). 2014 demographics: Profile of the military community. Retrieved from http://download.militaryonesource.mil/12038/MOS/Reports/2014- Demographics-Report.pdf

Ohmer, M., & Brooks, F. (2013). The practice of community organizing: Comparing and contrasting conflict and consensus approaches. In M. Weil, M. Reisch, & M. Ohmer (Eds.), The handbook of community practice (2nd ed., pp. 233–248). Thousand Oaks, CA: Sage.

Oliver, D., & Peck, M. (2006). Inside the interdisciplinary team: Experiences of hospice social workers. Journal of Social Work in End- of-Life & Palliative Care, 2(3), 7–21.

Olshever, A. (2011). Integration of groupwork theory and hospice interdisciplinary team practice: A review of the literature. Groupwork, 21(3), 22–61.

Ombelet, W. (2014). Is global access to infertility care realistic? The Walking Egg Project. Reproductive BioMedicine Online, 28, 267–272.

Oppenheimer, D., & Kelso, E. (2015). Information processing as a paradigm for decision making. Annual Review of Psychology, 66, 277–294.

Oransky, I. (2012). Are we over-medicalized? TEDMED2012. Retrieved from www.ted.com/talks/ivan_oransky_are_we_over_medicalized

Orbuch, T., & Brown, E. (2006). Divorce in the context of being African American. In M. Fine & J. Harvey (Eds.), Handbook of divorce and relationship dissolution (pp. 481–498). Mahwah, NJ: Erlbaum.

1089

http://download.militaryonesource.mil/12038/MOS/Reports/2014-Demographics-Report.pdf

http://www.ted.com/talks/ivan_oransky_are_we_over_medicalized

Organisation for Economic Co-operation and Development. (2016a). Education at a glance 2016: OECD indicators. OECD Publishing. Retrieved from www.oecd-ilibrary.org/education/education-at-a-glance- 2016/indicator-a1-to-what-level-have-adults-studied_eag-2016-7-en

Organisation for Economic Co-operation and Development. (2016b). Dataset: Social expenditure—Aggregated data. Retrieved from www.oecd.org/fr/social/depenses.htm

Organisation for Economic Co-operation and Development. (2017). Health at a glance 2017: OECD indicators. Paris: OECD Publishing. doi:10.1787/health_glance-2017-en

Orleck, A. (n.d.). The problem of citizenship in American history. Retrieved from www.flowofhistory.org/the-problem-of-citizenship-in- american-history/

Ortner, S. B. (1989). High religion: A cultural and political history of Sherpa Buddhism. Princeton, NJ: Princeton University Press.

Ortner, S. B. (1996). Making gender: The politics and erotics of culture. Boston: Beacon Press.

Ortner, S. B. (2006). Anthropology and social theory: Culture, power, and the acting subject. Durham, NC: Duke University Press.

Oswalt, S., Evans, S., & Drott, A. (2016). Beyond alphabet soup: Helping college health professionals understand sexual fluidity. Journal of American College Health, 64(6), 502–508.

Ozdemir, A. (2008). Shopping malls: Measuring interpersonal distance under changing conditions and cultures. Field Methods, 20(3), 226–248.

1090

http://www.oecd-ilibrary.org/education/education-at-a-glance-2016/indicator-a1-to-what-level-have-adults-studied_eag-2016-7-en

http://www.oecd.org/fr/social/depenses.htm

http://www.flowofhistory.org/the-problem-of-citizenship-in-american-history/

Ozorak, E. W. (1996). The power, but not the glory: How women empower themselves through religion. Journal for the Scientific Study of Religion, 35(1), 17–29.

Pack, M. J. (2013). Critical incident stress management: A review of the literature with implications for social work. International Social Work, 56(5), 608–627.

Padden, D., & Agazio, J. (2013). Caring for military families across the deployment cycle. Journal of Emergency Nursing, 39(6), 562–569.

Padilla, Y., & Sherraden, M. (2005). Communities and social policy issues: Persistent poverty, economic inclusion, and asset building. In M. Weil (Ed.), The handbook of community practice (pp. 103–116). Thousand Oaks, CA: Sage.

Pals, D. L. (1996). Seven theories of religion. New York: Oxford University Press.

Pandya, S. (2016). Hospital social work and spirituality: Views of medical social workers. Social Work in Public Health, 31(7), 700–710.

Papell, D., & Prodan, R. (2012). The statistical behavior of GDP after financial crises and severe recessions. The B.E. Journal of Macroeconomics, 12(3). doi:org/10.1515/1935-1690.101

Pargament, K. I. (1997). The psychology of religious coping: Theory, research, practice. New York: Guilford Press.

Pargament, K. I. (2008). The sacred character of community life. American Journal of Community Psychology, 41(1–2), 22–34.

Pargament, K. I., Koenig, H. G., & Perez, L. M. (2000). The many

1091

methods of religious coping: Development and initial validation of the RCOPE. Journal of Clinical Psychology, 56, 519–543.

Parham, P. (2009). The immune system (3rd ed.). New York: Garland Science, Taylor & Francis.

Paris, P. J. (1995). The spirituality of African peoples: The search for a common moral discourse. Minneapolis, MN: Fortress Press.

Parish, S. L., Magana, S., & Cassiman, S. A. (2008). It’s just that much harder: Multi-layered hardship experiences of low-income mothers with disabilities. AFFILIA: Journal of Women and Social Work, 23(1), 51–65.

Park, J. (2015). Introversion and human-contaminant disgust sensitivity predict personal space. Personality and Individual Differences, 82, 185–187.

Park, R. (1936). Human ecology. American Journal of Sociology, 17, 1–15.

Park, Y., & Bonk, C. (2007). Synchronous learning experiences: Distance and residential learners’ perspectives in a blended graduate course. Journal of Interactive Online Learning, 6(3), 245–264.

Parkinson, B., Fischer, A. H., & Manstead, A. S. R. (2005). Emotion in social relations: Cultural, group, and interpersonal processes. New York: Psychology Press.

Parliament of the World’s Religions. (2018). About us. Retrieved from https://parliamentofreligions.org/about/mission

Parreñas, R. (2008). The force of domesticity: Filipina migrants and

1092

https://parliamentofreligions.org/about/mission

globalization. New York: New York University Press.

Parrillo, V. (2009). Diversity in America (3rd ed.). Thousand Oaks, CA: Pine Forge Press.

Pasley, K., & Garneau, C. (2012). Remarriage and stepfamily life. In F. Walsh (Ed.), Normal family processes (4th ed., pp. 149–171). New York: Guilford Press.

Passini, S. (2010). Moral reasoning in a multicultural society: Moral inclusion and moral exclusion. Journal for the Theory of Social Behavior, 40(4), 435–451.

Patterson, C., Riskind, R., & Tornello, S. (2014). Sexual orientation, marriage and parenthood: A global perspective. In A. Abela & J. Walker (Eds.), Contemporary issues in family studies: Global perspectives on partnerships, parenting and support in a changing world (pp. 189–202). New York: Wiley & Sons.

Paulino, A. (1995). Spiritism, Santeria, brujeria, and voodooism: A comparative view of indigenous healing systems. Journal of Teaching in Social Work, 12(1/2), 105–124.

Paulus, P., & Baum, A. (2010). Crowding. In J. Levine & M. Hogg (Eds.), The encyclopedia of group processes and intergroup relations (pp. 167–169). Thousand Oaks, CA: Sage.

Payne, K. (2017). The broken ladder: How inequality affects the way we think, live, and die. New York: Viking.

Pearson, J. (1996). Discovering the self through drama and movement: The Sesame approach. London: Jessica Kingsley.

1093

Pellow, D., & Brulle, R. (2015). Environmental justice. In J. Goodwin & J. Jasper (Eds.), The social movements reader: Cases and concepts (3rd ed., pp. 391–397). Malden, MA: Wiley Blackwell.

Pemberton, D. (2015, January 28). Statistical definition of “family” unchanged since 1930. Census blogs. Retrieved from www.census.gov/newsroom/blogs/random- samplings/2015/01/statistical-definition-of-family-unchanged-since- 1930.html

Peplau, L., & Fingerhut, A. (2007). The close relationships of lesbians and gay men. Annual Review of Psychology, 58, 373–408.

Perkins, D., King, W., & Varner, R. (2012). Social waste facilities in South Carolina: Issues of racial, economic, and environmental justice. Environmental Justice, 5(1), 47–53.

Perkins, T. (2012). Women’s pathways into activism: Rethinking the women’s environmental justice narrative in California’s San Joaquin Valley. Organization & Environment, 25(1), 76–94.

Perry, B. G. F. (1998). The relationship between faith and well-being. Journal of Religion and Health, 37(2), 125–136.

Pesta, J. (2014). Across the tracks: A case study of a rural transnational community (Doctoral dissertation). Retrieved from ProQuest.

Peteet, J., Lu, F., & Narrow, W. (2011). Religious and spiritual issues in psychiatric diagnosis: A research agenda for DSM-V. Washington, DC: American Psychiatric Publishing.

Peters, S. (2014). Disability culture. Encyclopaedia Britannica. Retrieved from www.britannica.com/topic/disability-culture

1094

http://www.census.gov/newsroom/blogs/random-samplings/2015/01/statistical-definition-of-family-unchanged-since-1930.html

http://www.britannica.com/topic/disability-culture

Peterson, U., Demerouti, E., Bergstrom, G., Samuelsson, M., Asberg, M., & Nygren, A. (2008). Burnout and physical and mental health among Swedish healthcare workers. Journal of Advanced Nursing, 62, 84–95.

Pew Forum on Religion & Public Life. (2008). U.S. religious landscape survey: Religious affiliation—diverse and dynamic. Washington, DC: Author.

Pew Research Center. (2009). Views of religious similarities and differences: Muslims widely seen as facing discrimination. Retrieved from www.people-press.org/files/legacy-pdf/542.pdf

Pew Research Center. (2011, January 13). A portrait of stepfamilies. Retrieved from www.pewsocialtrends.org/2011/01/13/a-portrait-of- stepfamilies/

Pew Research Center. (2015a). America’s changing religious landscape. Retrieved from www.pewforum.org/files/2015/05/RLS-08-26-full- report.pdf

Pew Research Center. (2015b). U.S. public becoming less religious. Retrieved from http://assets.pewresearch.org/wp- content/uploads/sites/11/2015/11/201.11.03_RLS_II_full_report.pdf

Pew Research Center. (2016). Vast majority of Americans know someone who is gay, fewer know someone who is transgender. Retrieved from www.pewforum.org/2016/09/28/5-vast-majority-of-americans-know- someone-who-is-gay-fewer-know-someone-who-is-transgender/

Pew Research Center. (2018). Social media fact sheet. Retrieved from www.pewinternet.org/fact-sheet/social-media

Pew Research Center Religion & Public Life. (2012). “Nones” on the rise. Retrieved from www.pewforum.org/files/2012/10/NonesOnTheRise-

1095

http://www.people-press.org/files/legacy-pdf/542.pdf

http://www.pewsocialtrends.org/2011/01/13/a-portrait-of-stepfamilies/

http://www.pewforum.org/files/2015/05/RLS-08-26-full-report.pdf

http://assets.pewresearch.org/wp-content/uploads/sites/11/2015/11/201.11.03_RLS_II_full_report.pdf

http://www.pewforum.org/2016/09/28/5-vast-majority-of-americans-know-someone-who-is-gay-fewer-know-someone-who-is-transgender/

http://www.pewinternet.org/fact-sheet/social-media

http://www.pewforum.org/files/2012/10/NonesOnTheRise-full.pdf

full.pdf

Pew Research Center Religion & Public Life. (2017a). The changing global religious landscape. Retrieved from www.pewforum.org/2017/04/05/the-changing-global-religious- landscape/

Pew Research Center Religion & Public Life. (2017b). Gay marriage around the world. Retrieved from www.pewforum.org/2017/08/08/gay- marriage-around-the-world-2013/

Pew Research Social & Demographic Trends. (2013). On pay gap, millennial women near parity—for now. Retrieved from www.pewsocialtrends.org/2013/12/11/on-pay-gap-millennial-women- near-parity-for-now/

Pfeffer, J. (1982). Organizations and organization theory. Boston: Pitman.

PFLAG. (2018). About PFLAG. Retrieved from www.pflag.org/about

Phalkey, R. K., & Louis, V. R. (2016). Two hot to handle: How do we manage the simultaneous impacts of climate change and natural disasters on human health? The European Physical Journal Special Topics, 225, 443–457.

Pharr, S. (1988). Homophobia: A weapon of sexism. Inverness, CA: Chardon Press.

Philip, D., & Reisch, M. (2015). Rethinking social work’s interpretation of “environmental justice”: From local to global. Social Work Education, 34(5), 471–483.

Phillips, M. (2016). Embodied care and planet earth: Ecofeminism,

1096

http://www.pewforum.org/2017/04/05/the-changing-global-religious-landscape/

http://www.pewforum.org/2017/08/08/gay-marriage-around-the-world-2013/

http://www.pewsocialtrends.org/2013/12/11/on-pay-gap-millennial-women-near-parity-for-now/

http://www.pflag.org/about

maternalism and postmaternalism. Australian Feminist Studies, 31(90), 468–485.

Pickering, J., Kintrea, K., & Bannister, J. (2012). Invisible walls and visible youth: Territoriality among young people in British cities. Urban Studies, 49(5), 945–960.

Pinker, S. (2011). The better angels of our nature: Why violence has declined. New York: Viking.

Polaris. (2018). The facts. Retrieved from http://polarisproject.org/human- trafficking/facts

Polletta, F. (2004). Culture is not just in your head. In J. Goodwin & J. Jasper (Eds.), Rethinking social movements (pp. 97–110). Lanham, MD: Rowman & Littlefield.

Pons, F., Laroche, M., & Mourali, M. (2006). Consumer reactions to crowded retail settings: Cross-cultural differences between North America and Middle East. Psychology & Marketing, 23(7), 555–572.

Popple, P. (1992). Social work: Social function and moral purpose. In P. Reid & P. Popple (Eds.), The moral purposes of social work: The character and intentions of a profession (pp. 141–154). Chicago: Nelson-Hall.

Popple, P., & Leighninger, L. (2011). Social work, social welfare, and American society (8th ed.). Boston: Pearson.

Porges, S. (2001). The polyvagal theory: Phylogenetic substrates of a social nervous system. International Journal of Psychophysiology, 42, 123–146.

1097

http://polarisproject.org/human-trafficking/facts

Potter, T. (2005, Fall). Bringing foster care management into the 21st century with GIS. ArcNews Online. Retrieved from www.esri.com/news/arcnews/fall05articles/bringing-foster.html

Powell, B., Bolzendahl, C. Geist, C., & Steelman, L. (2015). Changing counts, counting change: Americans’ movement toward a more inclusive definition of family. In B. Risman & V. Rutter (Eds.), Families as they really are (2nd ed., pp. 84–95). New York: Norton.

Praglin, L. (2004). Spirituality, religion, and social work: An effort towards interdisciplinary conversation. Social Thought, 23, 67–84.

Prezza, M., & Costantini, S. (1998). Sense of community and life satisfaction: Investigation in three different territorial contexts. Journal of Community and Applied Social Psychology, 8(3), 181–194.

Price, S., Price, C., & McKenry, P. (2010). Families and change: Coping with stressful events and transitions (4th ed.). Thousand Oaks, CA: Sage.

Prickett, K., Martin-Storey, A., & Crosnoe, R. (2015). A research not on time with children in different- and same-sex two-parent families. Demography, 52, 905–918.

Proescholdbell, R., Roosa, M., & Nemeroff, C. (2006). Component measures of psychological sense of community among gay men. Journal of Community Psychology, 34(1), 9–24.

Puchalski, C., Blatt, B., Kogan, M., & Butler, A. (2014). Spirituality and health: The development of a field. Academic Medicine, 89(1), 10–16.

Puchalski, C., & Romer, A. L. (2000). Taking a spiritual history allows clinicians to understand patients more fully. Journal of Palliative Medicine, 3(1), 129–137.

1098

http://www.esri.com/news/arcnews/fall05articles/bringing-foster.html

Putnam, R. (1993). Making democracy work. Princeton, NJ: Princeton University Press.

Putnam, R. (2000). Bowling alone: The collapse and revival of American community. New York: Simon & Schuster.

Putnam, R. (2007). E Pluribus Unum: Diversity and community in the twenty-first century. Scandinavian Political Studies, 30, 137–174.

Pyles, L. (2017). Decolonising disaster social work: Environment justice and community participation. British Journal of Social Work, 47, 630–647.

Raanaas, R., Evensen, K., Rich, D., Sjostrom, G., & Patil, G. (2011). Benefits of indoor plants on attention capacity in an office setting. Journal of Environmental Psychology, 31, 99–105.

Rahim, Z. (2015). The influence of culture and religion on visual privacy. Social and Behavioral Sciences, 170, 537–544.

Raines, J. (1997). Co-constructing the spiritual tree. Society for Social Work and Social Work Newsletter, 4(1), 3, 8.

Rainie, J., & Wellman, B. (2014). Networked: The new social operating system. Boston: Massachusetts Institute of Technology.

RAINN. (2017). Scope of the problem: Statistics. Retrieved from www.rainn.org/statistics/scope-problem

Rajaei, A. R., Khoynezhad, G. R., Javanmard, J., & Abdollahpour, M. (2016). The relation between positive psychological states and coping styles. Journal of Fundamentals of Mental Health, 18(1), 57–63.

1099

http://www.rainn.org/statistics/scope-problem

Ramirez, R. (1985). Hispanic spirituality. Social Thought, 11(3), 6–13.

Rampage, C., Eovaldi, M., Ma, C., Foy, C., Samuels, G., & Bloom, L. (2012). Adoptive families. In F. Walsh (Ed.), Normal family processes: Growing diversity and complexity (4th ed., pp. 222–246). New York: Guilford Press.

Rapoport, J., Jacobs, P., & Jonsson, E. (2009). Cost containment and efficiency in national health systems. Hoboken, NJ: Wiley-Blackwell.

Rashed, M. A., & Bingham, R. (2014). Can psychiatry distinguish social deviance from mental disorder? Philosophy, Psychiatry, & Psychology, 21(3), 243–255.

Rassia, S., & Pardalos, P. (Eds.). (2012). Sustainable environmental design in architecture: Impacts on health. New York: Springer ebooks.

Ravitch, D. (2010). The death and life of the great American school system: How testing and choice are undermining education (Revised and expanded). New York: Basic Books.

Ravitch, D. (2013). Reign of error: The hoax of the privatization movement and the danger to America’s public schools. New York: Knopf.

Rawls, J. (1971). A theory of justice. Cambridge, MA: Harvard University Press.

Rawls, J. (2001). Justice as fairness: A restatement. Cambridge, MA: The Belknap Press of Harvard University.

Ray, O. (2004). How the mind hurts and heals the body. American Psychologist, 59(1), 29–40.

1100

Razurel, C., Kaiser, B., Sellenet, C., & Epiney, M. (2013). Relation between perceived stress, social support, and coping strategies and material well-being: A review of the literature. Women & Health, 53(1), 74–99.

Reamer, F. (1992). Social work and the public good: Calling or career? In P. Reid & P. Popple (Eds.), The moral purposes of social work: The character and intentions of a profession (pp. 11–33). Chicago: Nelson- Hall.

Reardon, S. (2011). The widening academic achievement gap between the rich and the poor: New evidence and possible explanations. In G. Duncan & R. Murname (Eds.), Whither opportunity? Rising inequality, schools, and children’s life chances (pp. 91–116). New York: Russell Sage Foundation.

Rector, R., Johnson, K., & Fagan, P. (2008). Increasing marriage would dramatically reduce child poverty. In D. R. Crane & T. Heaton (Eds.), Handbook of families and poverty (pp. 457–470). Thousand Oaks, CA: Sage.

Redfield, R. (1947). The folk society. American Journal of Sociology, 52, 293–308.

Redman, D. (2008). Stressful life experiences and the roles of spirituality among people with a history of substance abuse and incarceration. Social Thought, 27(1–2), 47–67.

Redzic, S. (2015). Youth gender differences in moral reasoning on gender morality in the light of theories by Kohlberg and Gilligan. Teme, 39(4), 1083–1103.

Reese, D. J. (2011). Interdisciplinary perceptions of the social work role in hospice: Building upon the class Kulys and Davis study. Journal of Social Work in End-of-Life & Palliative Care, 7(4), 383–406.

1101

Reese, D. J., & Kaplan, M. S. (2000). Spirituality, social support, and worry about health: Relationships in a sample of HIV+ women. Social Thought, 19(4), 37–52.

Reese, D. J., & Raymer, M. (2004). Relationships between social work services and hospice outcomes: Results of the National Hospice Social Work Survey. Social Work, 49(3), 415–422.

Regnerus, M. (2012). How different are the adult children of parents who have same-sex relationships? Findings from the New Family Structures Study. Social Science Research, 41, 752–770.

Regoeczi, W. (2008). Crowding in context: An examination of the differential responses of men and women to high-density living environments. Journal of Health and Social Behavior, 49(3), 254–268.

Reinhardt, U., Hussey, P., & Anderson, G. (2002). Cross-national comparisons of health systems using OECD data, 1999. Health Affairs, 21(3), 169–181.

Reinhardt, U., Hussey, P., & Anderson, G. (2004). U.S. health care spending in an international context. Health Affairs, 23(3), 10–25.

Reinsmith-Jones, K., Kibbe, S., Crayton, T., & Campbell, E. (2015). Use of Second Life in social work. Journal of Social Work Education, 51, 90–108.

Reisch, M. (2008). Social movements. In T. Mizrahi & L. Davis (Eds.), Encyclopedia of social work (20th ed., Vol. 4, pp. 52–56). New York: NASW Press and Oxford University Press.

Reisch, M. (2013). Radical community organizing. In M. Weil, M. Reisch, & M. Ohmer (Eds.), The handbook of community practice (2nd ed., pp. 361–381). Thousand Oaks, CA: Sage.

1102

Reisch, M., Ife, J., & Weil, M. (2013). Social justice, human rights, values, and community practice. In M. Weil, M. Reisch, & M. Ohmer (Eds.), The handbook of community practice (2nd ed., pp. 73–103). Thousand Oaks, CA: Sage.

Reisch, M., & Jani, J. (2012). The new politics of social work practice: Understanding the context to promote change. British Journal of Social Work, 42, 1132–1150.

Reitzes, D., Crimmins, T., Yarbrough, J., & Parker, J. (2015). Home or office? The homeless and Atlanta’s downtown park. Sociological Focus, 48(1), 28–48.

Renner, L., & Boel-Studt, S. (2017). Physical family violence and externalizing and internalizing behaviors among children and adolescents. American Journal of Orthopsychiatry, 87(4), 474–486.

Repke, L., & Benet-Martinez, V. (2017). Conceptualizing the dynamics between bicultural identification and personal social networks. Frontiers in Psychology, 8, 469. doi:10.3389/psyg.2017.00469

Reporters Without Borders. (2017). Press Freedom Index 2017. Retrieved from https://rsf.org/en/ranking

Ressler, L. E., & Hodge, D. R. (2003). Silenced voices: Social work and the oppression of conservative narratives. Social Thought, 22, 125–142.

Reuther, R. (1983). Sexism and God-talk: Toward a feminist theology. Boston: Beacon Press.

Richards, M., Lewis, G., Sanderson, R., Deane, K., & Quimby, D. (2016). Introduction to special issue: Resilience-based approaches to trauma intervention for children and adolescents. Journal of Child & Adolescent Trauma, 9(1), 1–4.

1103

https://rsf.org/en/ranking

Richards-Schuster, K., & Aldana, A. (2013). Learning to speak out about racism: Youth’s insights on participation in an intergroup dialogues program. Social Work with Groups, 36(4), 332–348.

Richerson, P., Boyd, R., & Henrich, J. (2010). Gene-culture coevolution in the age of genomics. Proceedings of the National Academy of Sciences of the United States of America, 107(Suppl. 2), 8985–8992.

Richmond, M. (1917). Social diagnosis. New York: Russell Sage Foundation.

Riera, C. (2005). Social policy and community development in multicultural contexts. Community Development Journal, 40(4), 433–438.

Rine, C., Morales, J., Vanyukevych, A., Durand, E., & Schroeder, K. (2012). Using GIS mapping to assess foster care: A picture is worth a thousand words. Journal of Family Social work, 14(5), 375–388.

Ripley, A. (2013). The smartest kids in the world: And how they got that way. New York: Simon & Schuster.

Ritzer, G. (2013). Introduction to sociology. Thousand Oaks, CA: Sage.

Ritzer, G. (2016). Essentials of sociology (2nd ed.). Thousand Oaks, CA: Sage.

Ritzer, G. (2015). Prosumer capitalism. Sociological Quarterly, 56(4), 413–445.

Ritzer, G. (2018). The McDonaldization of society (9th ed.). Thousand Oaks, CA: Sage.

1104

Robbins, S., Chatterjee, P., & Canda, E. (2012). Contemporary human behavior theory: A critical perspective for social work (3rd ed.). Boston: Allyn & Bacon.

Roberson, W. W. (2004). Life and livelihood: A handbook for spirituality at work. Harrison, PA: Morehouse.

Roberts, K., & Yamane, D. (2016). Religion in sociological perspective (6th ed.). Thousand Oaks, CA: Sage.

Robertson, R. (1992). Globalization. London: Sage.

Robinson, T. R. (2010). Genetics for dummies (Kindle Locations 2036– 2039). Hoboken, NJ: Wiley. Kindle Edition.

Robinson, W. I. (2007). Theories of globalization. In G. Ritzer (Ed.), The Blackwell companion to globalization (pp. 125–143). Oxford, UK: Blackwell.

Roehlkepartain, E. C., King, P. E., Wagener, L., & Benson, P. L. (2006). Spiritual development in childhood and adolescence. Thousand Oaks, CA: Sage.

Rogers, C. R. (1951). Client-centered therapy. Boston: Houghton Mifflin.

Rogers, C. R. (1986). Carl Rogers on the development of the person- centered approach. Person-Centered Reviews, 1(3), 257–259.

Rogers, R. K. (2009). Community collaboration: Practices of effective collaboration as reported by three urban faith-based social service programs. Social Work & Christianity, 36(3), 326–345.

Rogers-Sirin, L., & Gupta, T. (2012). Cultural identity and mental health:

1105

Different trajectories among Asian and Latino youth. Journal of Counseling Psychology, 59(4), 555–566.

Rollero, C., & Piccoli, N. (2010). Place attachment, identification and environment perception: An empirical study. Journal of Environmental Psychology, 30, 198–205.

Romanucci-Ross, L., De Vos, G. A., & Tsude, T. (Eds.). (2006). Ethnic identity: Problems and prospects for the twenty-first century. Lanham, MD: AltaMira Press.

Ronen, T., & Freeman, A. (Eds.). (2007). Cognitive behavior therapy in clinical social work practice. New York: Springer.

Roof, W. C. (1999). Spiritual marketplace: Baby boomers and the remaking of American religion. Princeton, NJ: Princeton University Press.

Rose, S. (1992). Case management and social work practice. White Plains, NY: Longman.

Rose, S. (1994). Defining empowerment: A value-based approach. In S. P. Robbins (Ed.), Melding the personal and the political: Advocacy and empowerment in clinical and community practice. Proceedings of the Eighth Annual Social Work Futures Conference, may 13–14, 1993 (pp. 17–24). Houston, TX: University of Houston Graduate School of Social Work.

Rosenfeld, L. B., & Richman, J. M. (2003). Social support and educational outcomes for students in out-of-home care. Children & Schools, 25(2), 69–86.

Rosenwald, M., Smith, M., Bagnoli, M., Ricceli, D., Ryan, S., Salcedo, L., & Seeland, D. (2013). Relighting the campfire: Rediscovering activity-

1106

based group work. Social Work with Groups, 36(4), 321–331.

Roser, M., & Ortiz-Ospina, E. (2018). Global extreme poverty. Published online at OurWorldInData.org. Retrieved from https://ourworldindata.org/extreme-poverty

Ross, J. (2015, October 20). Think the United States is anti-immigration? It has nothing on Europe. Washington Post. Retrieved from www.washingtonpost.com/news/the-fix/wp/2015/10/20/when-it-comes- to-anti-immigrant-sentiment-the-u-s-has-nothing-on-europe/? utm_term=.c7e1434d3f1b

Ross, L., & Coleman, M. (2000). Urban community action planning inspires teenagers to transform their community and their identity. Journal of Community Practice, 7(2), 29–45.

Rostow, W. (1990). The stages of economic growth: A non-communist manifesto. Cambridge, UK: Cambridge University Press.

Rothenberg, P. (2006). Preface. In P. Rothenberg (Ed.), Beyond borders: Thinking critically about global issues (pp. xv–xvii). New York: W. H. Freeman.

Rothenberg, P. (Ed.). (2016). Race, class, and gender in the United States: An integrated study (10th ed.). New York: Worth.

Rothschild-Whitt, J., & Whitt, J. (1986). The cooperative workplace. Cambridge, UK: Cambridge University Press.

Rothstein, R. (2011). Fact-challenged policy. Economic Policy Institute. Retrieved from www.epi.org/publication/fact-challenged_policy/

Rudacille, D. (2005). The riddle of gender: Science, activism, and

1107

https://ourworldindata.org/extreme-poverty

http://www.washingtonpost.com/news/the-fix/wp/2015/10/20/when-it-comes-to-anti-immigrant-sentiment-the-u-s-has-nothing-on-europe/?utm_term=.c7e1434d3f1b

http://www.epi.org/publication/fact-challenged_policy/

transgender rights. New York: Pantheon.

Runge, S. (2016, November 30). Standing Rock water protectors: A breakdown of the North Dakota access pipeline conflict and how you can help. Inquisti. Retrieved from www.yahoo.com/news/standing-rock- water-protectors-breakdown-181337885.html

Rusbult, C. (1980). Commitment and satisfaction in romantic associations: A test of the investment model. Journal of Experimental Social Psychology, 16, 172–186.

Rusbult, C. (1983). A longitudinal test of the investment model: The development (and deterioration) of satisfaction and commitment in heterosexual involvement. Journal of Personality and Social Psychology, 45, 101–177.

Russel, R. (1998). Spirituality and religion in graduate social work education. Social Thought, 18(2), 15–29.

Russell, A. (2011). Extra-national information flows, social media, and the 2011 Egyptian uprising. International Journal of Communication, 5, 1375–1405.

Rychtarik, R., McGillicuddy, N., & Barrick, C. (2013). Reaching women under stress from a partner’s drinking problem: Assessing interest in online help. Journal of Technology in Human Services, 31(3), 185–196.

Sachdeva, S., Singh, P., & Medin, D. (2011). Culture and the quest for universal principles in moral reasoning. International Journal of Psychology, 46(3), 161–176.

Saegert, S., & Carpiano, R. (2017). Social support and social capital: A theoretical synthesis using community psychology and community sociology approaches. In M. Bond, I. Serrano-Garcia, C. Keys, & M.

1108

http://www.yahoo.com/news/standing-rock-water-protectors-breakdown-181337885.html

Shinn (Eds.), APA handbook of community psychology: Theoretical foundations, core concepts, and emerging challenges (pp. 295–314). Washington, DC: American Psychological Association.

Saez, E. (2012). Striking it richer: The evolution of top incomes in the United States (Updated with 2009 and 2010 estimates). Retrieved from https://eml.berkeley.edu/~saez/saez-UStop_incomes-2015.pdf

Sager, J., & Weil, M. (2013). Larger-scale social planning. In M. Weil, M. Reisch, & M. Ohmer (Eds.), The handbook of community practice (2nd ed., pp. 299–325). Thousand Oaks, CA: Sage.

Sahgal, N., & Smith, G. (2009). A religious portrait of African-Americans. Pew Research Center’s Forum on Religion & Public Life. Retrieved from www.pewforum.org/2009/01/30/a-religious-portrait-of-african- americans/

Saleebey, D. (2012). The strengths perspective in social work practice (6th ed.). Upper Saddle River, NJ: Pearson.

Sameroff, A. (2010). A unified theory of development: A dialectic integration of nature and nurture. Child Development, 81(1), 6–22.

Sampson, R. (2003). The neighborhood context of well-being. Perspectives in Biology and Medicine, 46(3), S53–S65.

Sampson, R., Morenoff, J., & Earls, F. (1999). Beyond social capital: Spatial dynamics of collective efficacy for children. Science, 277, 918–924.

Sangalang, C. C., & Vang, C. (2016). Intergenerational trauma in refugee families: A systematic review. Journal of Immigrant Minority Health, 19, 745–754.

1109

https://eml.berkeley.edu/~saez/saez-UStop_incomes-2015.pdf

http://www.pewforum.org/2009/01/30/a-religious-portrait-of-african-americans/

Santiago, A. M., & Smith, R. (2018). Engaging youth in community work. Journal of Community Practice, 26(1), 1–4.

Sapolsky, R. (2017). Behave: The biology of humans at our best and worst. New York: Penguin.

Sarafino, E. P., & Smith, T. W. (2010). Health psychology: Biopsychosocial interactions (7th ed.). New York: John Wiley & Sons.

Sarason, S. (1974). The psychological sense of community: Prospects for a community psychology. San Francisco: Jossey-Bass.

Sargent, L. D., & Sue-Chan, C. (2001). Does diversity affect group efficacy? The intervening role of cohesion and task independence. Small Group Research, 32(4), 426–450.

Satir, V. (1983). Conjoint family therapy (3rd ed.). Palo Alto, CA: Science and Behavior Books.

Scannell, L., & Gifford, R. (2010a). Defining place attachment: A tripartite organizing framework. Journal of Environmental Psychology, 30, 1–10.

Scannell, L., & Gifford, R. (2010b). The relations between natural and civic place attachment and pro-environmental behavior. Journal of Environmental Psychology, 30, 289–297.

Scannell, L., & Gifford, R. (2013). Personality relevant climate change: The role of place attachment and local versus global message framing in engagement. Environment and Behavior, 45(1), 60–85.

Scannell, L., & Gifford, R. (2016). Place attachment enhances on psychological need satisfaction. Environment & Behavior, 49(4), 359–389.

1110

Scannell, L., & Gifford, R. (2017). The experienced psychological benefits of place attachment. Journal of Environmental Psychology, 51, 256–269.

Scannell, P. (2007). Media and communication. London: Sage.

Schacter, S., & Singer, J. E. (1962). Cognitive, social, and physiological determinants of emotional states. Psychological Review, 69, 379–399.

Schamess, G., & Shilkrit, R. (2016). Ego psychology. In J. Berzoff, L. M. Flanaagan, & P. Hertz (Eds.), Inside out and outside in: Psychodynamic clinical theory and psychopathology in contemporary multicultural contexts (4th ed., pp. 64–99). Lanham, MD: Rowman & Littlefield.

Schaufeli, W. (2017). Burnout: A short socio-cultural history. In S. Neckel, A. Schaffner, & G. Wagner (Eds.), Burnout, fatigue, exhaustion (pp. 105–127). Cham, Switzerland: Palgrave Macmillan.

Schaufeli, W., & Enzmann, D. (1998). The burnout companion to study and practice: A critical analysis. London: Taylor & Francis.

Schaufeli, W., Leiter, M., & Maslach, C. (2009). Burnout: 35 years of research and practice. Career Development International, 14(3), 204–220.

Schein, E. (1992). Organizational culture and leadership (2nd ed.). San Francisco: Jossey-Bass.

Schienle, A., Wabmegger, A., Leitner, M., & Leutgeb, V. (2017). Neuronal correlates of personal space intrusion in violent offenders. Brain Imaging and Behavior, 11, 454–460.

Schienle, A., Wabnegger, A., Schöngassner, F., & Leutgeb, V. (2015).

1111

Effects of personal space intrustion in affective contexts: An fMRI investigation with women suffering from borderline personality disorder. Social Cognitive and Affective Neuroscience, 10(10), 1424–1428.

Schiller, J., Lucas, J., & Peregoy, J. (2012). Summary health statistics for U.S. adults: National Health Interview Survey, 2011. Vital and Health Statistics, 10(256). Hyattsville, MD: U.S. Department of Health and Human Services: Centers for Disease Control and Prevention.

Schneider, J., & Cook, K. (1995). Status inconsistency and gender: Combining revisited. Small Group Research, 26, 372–399.

Schoech, D. (2013). Community practice in the digital age. In M. Weil, M. Reisch, & M. Ohmer (Eds.), The handbook of community practice (2nd ed., pp. 809–826). Thousand Oaks, CA: Sage.

Schoech, D. (2014). Human services technology, 1980+: Retrospective and perspective. Journal of Technology in Human Servicers, 32, 240–253.

Schore, A. N. (2002). Dysregulation of the right brain: A fundamental mechanism of traumatic attachment and the psychopathogenesis of post- traumatic stress disorder. Australian and New Zealand Journal of Psychiatry, 36, 9–30.

Schore, A. N. (2017). All our sons: The developmental neurobiology and neuroendocrinology of boys at risk. Infant Mental Health Journal, 38(1), 15–52.

Schutz, A. (1967). The phenomenology of the social world (G. Walsh & F. Lehnert, Trans.). Evanston, IL: Northwestern University Press. (Original work published 1932)

1112

Schvaneveldt, P., & Hubler, D. (2012). Mate selection in Bolivia: A comparison of rural and urban practices and preferences. Journal of Comparative Family Studies, 43(6), 837–855.

Schwalbe, M. (2006). Afterword: The costs of American privilege. In P. Rothenberg (Ed.), Beyond borders: Thinking critically about global issues (pp. 603–605). New York: Worth.

Schweinhart, L., Barnett, S., & Belfield, C. (2005). Lifetime effects: The High/Scope Perry Preschool Study through age 40. Ypsilanti, MI: High/Scope Press.

Scott, M. (2005). A powerful theory and a paradox: Ecological psychologists after Barker. Environment and Behavior, 37(3), 295–329.

Scott, W. R. (2014). Institutions and organizations: Ideas, interests, and identities (4th ed.). Thousand Oaks, CA: Sage.

Seabrook, J., & Avison, W. (2012). Socioeconomic status and cumulate disadvantage processes across the life course: Implications for health outcomes. Canadian Review of Sociology, 49(1), 50–68.

Segerstrom, S. C., & Miller, G. E. (2004). Psychological stress and the human immune system: A meta-analytic study of 30 years of inquiry. Psychological Bulletin, 130(4), 601–630.

Seidman, E. (2012). An emerging action science of social settings. American Journal of Community Psychology, 50, 1–16.

Seligman, M. (1998). Learned optimism: How to change your mind and your life (2nd ed.). New York: Pocket Books.

Seligman, M. (2002). Authentic happiness: Using the new positive

1113

psychology to realize your potential for lasting fulfillment. New York: Free Press.

Seliske, L., Pickett, W., & Janssen, I. (2012). Urban sprawl and its relationship with active transportation, physical activity and obesity in Canadian youth. Health Reports, 23(2), 1–9.

Selye, H. (1991). History and present status of the stress concept. In A. Monat & R. S. Lazarus (Eds.), Stress and coping: An anthology (3rd ed., pp. 21–35). New York: Columbia University Press.

Semega, J., Fontenot, K., & Kollar, M. (2017). Income and poverty in the United States: 2016. Washington, DC: U.S. Census Bureau, Current Population Reports, P60–259. U.S. Government Printing Office.

Sen, A. (1992). Inequality reexamined. Cambridge, MA: Harvard University Press.

Sen, A. (1999). Development as freedom. New York: Anchor Books.

Sen, A. (2009). The idea of justice. Cambridge, MA: The Belknap Press of Harvard University.

Senge, P. (1990). The fifth discipline. New York: Doubleday.

Sernau, S. (2014). Social inequality in a global age (4th ed.). Thousand Oaks, CA: Sage.

Sernau, S. (2017). Social inequality in a global age (5th ed.). Thousand Oaks, CA: Sage.

Shaheen, R. (2010). I’m protective of this yard: Long-term homeless persons’ construction of home place and workplace in a historical public

1114

space. Social & Cultural Geography, 11(6), 539–558.

Shaw, B., Sivakumar, G., Balinas, T., Chipman, R., & Krahn, D. (2013). Testing the feasibility of mobile audio-based recovery material as an adjunct to intensive outpatients treatment for veterans with substance abuse disorders. Journal of Technology in Human Services, 31(4), 321–336.

Shear, M., & Davis, J. (2017, September 5). Trump moves to end DACA and calls on Congress to act. New York Times. Retrieved from www.nytimes.com/2017/09/05/us/politics/trump-daca-dreamers- immigration.html

Shek, D. (2003). Economic stress, psychological well-being and problem behavior in Chinese adolescents with economic disadvantage. Journal of Youth and Adolescence, 32(4), 259–266.

Shensa, A., Sidani, J., Lin, L., Bowman, N. D., & Primak, B. (2016). Social media use and perceived emotional support among U.S. young adults. Journal of Community Health, 41(3), 541–549.

Shepard, B. (2005). Play, creativity, and the new community organizing. Journal of Progressive Human Services, 16(2), 47–69.

Shepard, B. (2013). Community gardens, community organizing, and environmental activism. In M. Gray, J. Coates, & T. Hetherington (Eds.), Environmental social work (pp. 121–134). New York: Routledge.

Shepherd, H. (2014). Culture and cognition: A process account of culture. Sociological Forum, 29(4), 1007–1011.

Sheridan, M. J. (1995). Honoring angels in my path: Spiritually sensitive group work with persons who are incarcerated. Reflections: Narratives

1115

http://www.nytimes.com/2017/09/05/us/politics/trump-daca-dreamers-immigration.html

of Professional Helping, 1(4), 5–16.

Sheridan, M. J. (2002). Spiritual and religious issues in practice. In A. R. Roberts & G. J. Greene (Eds.), Social workers’ desk reference (pp. 567–571). New York: Oxford University Press.

Sheridan, M. J. (2004). Predictors of use of spiritually-derived interventions in social work practice: A survey of practitioners. Journal of Spirituality and Religion in Social Work: Social Thought, 23(4), 5–25.

Sheridan, M. J. (2009). Ethical issues in the use of spiritually-based interventions in social work practice: What are we doing and why? Social Thought, 28(1/2), 99–126.

Sheridan, M. J. (2013). Elders caring for elders: The role of religious involvement and spiritual rewards on caregiver stress, resources, and health. Journal of Religion & Spirituality in Social Work: Social Thought, 32, 397–421.

Sheridan, M. J. (Ed.). (2014). Connecting spirituality and social justice: Conceptualizations and applications for macro social work practice. London: Routledge.

Sheridan, M. J. (2017). Addressing spiritual bypassing: Issues and guidelines for spiritually sensitive practice. In B. Crisp (Ed.), Routledge handbook of religion, spirituality, and social work (pp. 358–368). London: Routledge.

Sheridan, M. J., & Amato-von Hemert, K. (1999). The role of religion and spirituality in social work education and practice: A survey of student views and experiences. Journal of Social Work Education, 35(1), 125–141.

1116

Sheridan, M. J., Bullis, R. K., Adcock, C. R., Berlin, S. D., & Miller, P. C. (1992). Practitioners’ personal and professional attitudes and behaviors toward religion and spirituality: Issues for social work education and practice. Journal of Social Work Education, 28(2), 190–203.

Sheridan, M. J., Wilmer, C., & Atcheson, L. (1994). Inclusion of content on religion and spirituality in the social work curriculum: A study of faculty views. Journal of Social Work Education, 30, 363–376.

Sherif, A., Sabry, H., Wagdy, A., Mashaly, I., & Arafa, R. (2016). Shaping the slats of hospital patient room window blinds for daylighting and external view under desert clear skies. Solar Energy, 133, 1–13.

Sherry, A., Adelman, A., Whilde, M. R., & Quick, D. (2010). Competing selves: Negotiating the intersection of spiritual and sexual identities. Professional Psychology: Research and Practice, 41(2), 112–119.

Shetterly, M. (2016). Hidden figures: The American dream and untold story of the Black women mathematicians who helped win the space race. New York: William Morrow.

Shilkret, R., & Shilkret, C. (2016). Attachment theory. In J. Berzoff, L. M. Flanagan, & P. Hertz (Eds.). Inside out and outside in: Psychodynamic clinical theory and psychopathology in contemporary multicultural contexts (4th ed., pp. 196–219). Lanham, MD: Rowman & Littlefield.

Shonkoff, J., Boyce, W. T., & McEwen, B. S. (2009). Neuroscience, molecular biology, and the childhood roots of health disparities. Journal of the American Medical Association, 301(21), 2252–2260.

Shonkoff, J., Garner, A., & The Committee on Psychosocial Aspects of Child and Family Health. (2012). The lifelong effects of early childhood adversity and toxic stress. American Academy of Pediatrics, 129(1), e232–e246.

1117

Shore, R., & Shore, B. (2009). Increasing the percentage of children living in two-parent families. Baltimore: The Annie E. Casey Foundation. Retrieved from https://files.eric.ed.gov/fulltext/ED507783.pdf

Shortell, S. (2016). Applying organization theory to understanding the adoption and implementation of accountable care organizations: Commentary. Medical Care Research and Review, 73(6), 694–702.

Shu, L., & Li, Y. (2007). How far is enough? A measure of information privacy in terms of interpersonal distance. Environment & Behavior, 39(3), 317–331.

Sidel, R. (2006). Unsung heroines: Single mothers and the American dream. Berkeley: University of California Press.

Simaika, J., & Samways, M. (2010). Biophilia as a universal ethic for conserving biodiversity. Conservation Biology, 24(3), 903–906.

Simon, H. (1957). Administrative behavior (2nd ed.). New York: Macmillan.

Simons, L., Wickrama, K., Lee, T., Landers-Potts, M., Cutrona, C., & Conger, R. (2016). Testing family stress and family investment explanations for conduct problems among African American adolescents. Journal of Marriage and Family, 78, 498–515.

Sinetar, M. (2011). Do what you love, the money will follow: Discovering your right livelihood. New York: Random House.

Singh, R. (2001). Hinduism. In M. V. Hook, B. Hugen, & M. Aguilar (Eds.), Spirituality within religious traditions in social work practice (pp. 34–52). Pacific Grove, CA: Brooks/Cole.

1118

https://files.eric.ed.gov/fulltext/ED507783.pdf

Sinha, S., & Mukherjee, N. (1996). The effect of perceived cooperation on personal space requirements. Journal of Social Psychology, 136, 655–657.

Sinha, S., & Nayyar, P. (2000). Crowding effects of density and personal space requirements among older people: The impact of self-control and social support. Journal of Social Psychology, 140(6), 721–726.

Siporin, M. (1986). Contribution of religious values to social work and the law. Social Thought, 12(4), 35–50.

Siu, K. (2013). Accessible park environments and facilities for the visually impaired. Facilities, 31(13/14), 590–609.

Skelton, R., & Miller, V. (2016). The environmental justice movement. Retrieved from www.nrdc.org/stories/environmental-justice-movement

Skinner, B. F. (1948). Walden Two. New York: MacMillan.

Skocpol, T. (2003). Diminished democracy: From membership to management in American civil life. New York: Cambridge University Press.

Skocpol, T., & Williamson, V. (2012). The Tea Party and the remaking of Republican conservatism. New York: Oxford University Press.

Skolnick, A. (1997, May/June). Family values: The sequel. American Prospect, 32, 86–94.

Skye, W. (2002). E.L.D.E.R.S. gathering for Native American youth: Continuing Native American traditions and curbing substance abuse in Native American youth. Journal of Sociology and Social Welfare, 24(1), 117–135.

1119

http://www.nrdc.org/stories/environmental-justice-movement

Slater, S., Ewing, R., Powell, L., Chaloupka, F., Johnston, L., & O’Malley, P. (2010). The association between community physical activity settings and youth physical activity, obesity, and body mass index. Journal of Adolescent Health, 47(5), 496–503.

Slee, N. M. (1996). Further on from Fowler: Post-Fowler faith development research. In L. J. Francis, W. K. Kay, & W. S. Campbell (Eds.), Research in religious education (pp. 73–96). Leominster, UK: Gracewing.

Slopen, N., McLaughlin, K. A., & Shonkoff, J. P. (2014). Interventions to improve cortisol regulation in children: A systematic review. Pediatrics, 133, 312–326.

Small, M., Harding, D., & Lamont, M. (2010). Reconsidering culture and poverty. ANNALS, AAPSS, 629, 6–27.

Smedley, A. (2011). Race in North America (4th ed.). Boulder, CO: Westview.

Smith, C., & Denton, M. L. (2005). Soul searching: The religious and spiritual lives of American teenagers. New York: Oxford University Press.

Smith, D. (2005). Institutional ethnography: A sociology of people. Oxford, UK: AltaMira.

Smith, E. D. (1995). Addressing the psychospiritual distress of death as reality: A transpersonal approach. Social Work, 40, 402–413.

Smith, G. (1996). Ties, nets and an elastic bund: Community in the postmodern city. Community Development Journal, 31(3), 250–259.

1120

Smith, K., & Faig, K. (2014). The role of flexibility in personal space preferences. Journal of Neuroscience, 30, 10135–10136.

Smith, K., & Teasley, M. (2009). Social work research on faith-based programs: A movement towards evidence-based practice. Journal of Religion & Spirituality in Social Work: Social Thought, 28, 306–327.

Smith, N. R. (2006). Workplace spirituality: A complete guide for business leaders. Lynn, MA: Axial Age.

Smith, R., Fortin, A., Dwamena, F., & Frankel, R. (2013). An evidence- based patient-centered method makes the biopsychosocial model scientific. Patient Education and Counseling, 91, 265–270.

Smith, S., & Hamon, R. (2017). Exploring family theories (4th ed.). New York: Oxford University Press.

Snipp, C. M. (1998). The first Americans: American Indians. In M. L. Andersen & P. H. Collins (Eds.), Race, class, and gender: An anthology (pp. 357–364). Belmont, CA: Wadsworth.

Snyder, C., Lopez, S., & Pedrotti, J. (2011). Positive psychology: The scientific and practical explorations of human strengths (2nd ed.). Thousand Oaks, CA: Sage.

Snyder, C., Lopez, S., Pedrotti, J., & McKnight, P. (2011). Eastern and Western perspectives on positive psychology. In C. Snyder, S. Lopez, & J. Pedrotti, Positive psychology: The scientific and practical explorations of human strengths (2nd ed., pp. 19–35). Thousand Oaks, CA: Sage.

Snyder, M. (2014). Self-fulfilling stereotypes. In P. S. Rothenberg (Ed.), Race, class, and gender in the United States (9th ed.). New York: Worth.

1121

Social Welfare History Archives. (1952). Who should teach what in human growth and behavior. University of Minnesota Libraries. Box 31 Folder 2.

Society for Neuroscience. (2012). Brain facts: A primer on the brain and nervous system. Washington, DC: Author. Retrieved from www.brainfacts.org/book.

Soclof, A. (2015, January 16). How to keep your cool when kids make you angry. The Jewish News Weekly of Northern California, 119(3), 29.

Sohr-Preston, S., Scaramella, L., Martin, M., Neppl, T., Ontai, L., & Conger, R. (2013). Parental socioeconomic status, communication, and children’s vocabulary development A third-generation test of the family investment model. Child Development, 84(3), 1046–1062.

Soilemezi, D., Drahota, A., Crossland, J., Stores, R., & Costall, A. (2017). Exploring the meaning of home for family caregivers of people with dementia. Journal of Environmental Psychology, 51, 70–81.

Solantaus, T., Leinonen, J., & Punamaki, R. (2004). Children’s mental health in times of economic recession: Replication and extension of the family economic stress model in Finland. Developmental Psychology, 40(3), 412–429.

Sollod, R., Wilson, J., & Monte, C. (2009). Beneath the mask: An introduction to theories of personality (8th ed.). Hoboken, NJ: Wiley.

Solomon, B. (1976). Black empowerment: Social work in oppressed communities. New York: Columbia University Press.

Solomon, B. (1987). Empowerment: Social work in oppressed communities. Journal of Social Work Practice, 2(4), 79–91.

1122

http://www.brainfacts.org/book

Sommers-Flanagan, J. (2015). Evidence-based relationship practice: Enhancing counselor competence. Journal of Mental Health Counseling, 37(2), 95–108.

Sompayrac, L. M. (2012). How the immune system works. Hoboken, NJ: Wiley & Sons.

Soulsby, A., & Clark, E. (2007). Organization theory and the post-socialist transformation: Contributions to organizational knowledge. Human Relations, 60(10), 1419–1442.

Southern Poverty Law Center. (2017). LGBT rights. Retrieved from www.splcenter.org/issues/lgbt-rights

Southerners on New Ground. (2018). About Southerners on New Ground. Retrieved from http://southernersonnewground.org/about/

Specht, H., & Courtney, M. E. (1994). Unfaithful angels: How social work has abandoned its mission. New York: Free Press.

Speed, S. (2015, January 21). “Pro-American” history textbooks hurt native Americans. Huffington Post. Retrieved from www.huffingtonpost.com/shannon-speed/proamerican-history- textb_b_6199070.html

Speybroeck, N., Konings, P., Lynch, J., Harper, S., Berkvens, D., Lorant, V., . . . Hosseinpoor, A. R. (2010). Decomposing socioeconomic health inequalities. International Journal of Public Health, 55(4), 347–351.

Spiegel, D., & Classen, C. (2000). Group therapy for cancer patients: A research-based handbook of psychosocial care. New York: Basic Books.

Staggenborg, S. (2016). Social movements (2nd ed.). New York: Oxford

1123

http://www.splcenter.org/issues/lgbt-rights

http://southernersonnewground.org/about/

http://www.huffingtonpost.com/shannon-speed/proamerican-history-textb_b_6199070.html

University Press.

Stanbridge, K., & Kenney, J. S. (2009). Emotions and the campaign for victims’ rights in Canada. Canadian Journal of Criminology & Criminal Justice, 51(4), 473–509.

Stanhope, V., & Straussner, S. L. A. (2017). Social work and integrated health care: From policy to practice and back. Oxford, UK: Oxford University Press.

Starhawk. (1979). The spiral dance: A rebirth of the ancient religion of the great Goddess. San Francisco: Harper & Row.

Statistic Brain. (2017). Adoption statistics. Retrieved from www.statisticbrain.com/adoption-statistics/

The Statistics Portal. (2017). Number of monthly active Facebook users worldwide as of 4th quarter 2017. Retrieved from www.statista.com/statistics/264810/number-of-monthly-active- facebook-users-worldwide/

The Statistics Portal. (2018). Average time spent with major media per day in the United States as of September 2017 (in minutes). Retrieved from www.statista.com/statistics/276683/media-use-in-the-us/

Stein, L. (2009). Social movement web use in theory and practice: A content analysis of US movement websites. New Media & Society, 11(5), 749–771.

Steinbeis, N., Engert, V., Linz, R., & Singer, T. (2015). The effects of stress and affiliation on social decision-making: Investigating the tend- and-befriend pattern. Psychoneuroendocrinology, 62, 138–148.

1124

http://www.statisticbrain.com/adoption-statistics/

http://www.statista.com/statistics/264810/number-of-monthly-active-facebook-users-worldwide/

http://www.statista.com/statistics/276683/media-use-in-the-us/

Steinberg, D. M. (2014). A mutual-aid model for social work with groups (3rd ed.). New York: Routledge.

Steinert, H. (2003). Culture industry. Cambridge, UK: Polity.

Sternberg, E. (2009). Healing spaces: The science of place and well-being. Cambridge, MA: Belknap Press.

Stevens, R., & Brown, B. (2011). Walkable new urban LEED- Neighborhood-Development (LEED-ND) community design and children’s physical activity: Selection, environmental, or catalyst effects? International Journal of Behavioral Nutrition and Physical Activity, 8(1), 139–148.

Stewart, C., Koeske, G., & Pringle, J. L. (2007). Religiosity as a predictor of successful post-treatment abstinence for African-American clients. Journal of Social Work Practice in the Addictions, 7(4), 75–92.

Stiglitz, J. (2012). The price of inequality: How today’s divided society endangers our future. New York: W. W. Norton.

Stokols, D., & Montero, M. (2002). Toward an environmental psychology of the Internet. In R. Bechtel & A. Churchman (Eds.), Handbook of environmental psychology (pp. 661–675). New York: Wiley.

Stoler, A. (2010). Carnal knowledge and imperial power: Race and the intimate in colonial rule (Rev. ed.). Berkeley: University of California Press.

Stoltenberg, S. (Ed.). (2014). Genes and the motivation to use substances. New York: Springer.

Stone, D. (2012). Policy paradox: The art of political decision making (3rd

1125

ed.). New York: Norton.

Storolow, R. D. (2013). Intersubjective-systems theory: A phenomenological-contextualist psychoanalytic perspective. Psychoanalytic Dialogues, 23, 383–389.

Stotzer, R. (2009). Violence against transgender people: A review of United States data. Aggression and Violent Behavior, 14, 170–179.

Streib, H. (2005). Faith development research revisited: Accounting for diversity in structure, content, and narrativity of faith. International Journal for the Psychology of Religion, 15, 99–121.

Streifel, C., & Servaty-Seib, H. L. (2009). Recovering from alcohol and other drug dependency: Loss and spirituality in a 12-step context. Alcoholism Treatment Quarterly, 27(2), 184–198.

Strier, R. (2013). Responding to the global economic crisis: Inclusive social work practice. Social Work, 58(4), 344–353.

Strohschein, L. (2005). Parental divorce and child mental health trajectories. Journal of Marriage and Family, 67(5), 1286–1300.

Stuart, R. (1989). Social learning theory: A vanishing or expanding presence? Psychology: A Journal of Human Behavior, 26, 35–50.

Studdert, D., & Walkerdine, V. (2016). Being in community: Re-visioning sociology. The Sociological Review, 64, 613–621.

Stykes, B., & Guzzo, K. (2015). Remarriage and stepfamilies (FP-15-10). National Center for Family & Marriage Research. Retrieved from www.bgsu.edu/content/dam/BGSU/college-of-arts-and- sciences/NCFMR/documents/FP/stykes-guzzo-remarriage-stepfamilies-

1126

http://www.bgsu.edu/content/dam/BGSU/college-of-arts-and-sciences/NCFMR/documents/FP/stykes-guzzo-remarriage-stepfamilies-fp-15-10.pdf

fp-15-10.pdf

Substance Abuse and Mental Health Services Administration. (2012). Results from the 2011 National Survey on Drug Use and Health: Summary of national findings. NSDUH series H-44, HHS publication no. (SMA) 12–4713. Rockville, MD: Author.

Sue, D. R., Rasheed, M. N., & Rasheed, J. M. (2016). Multicultural social work practice: A competence-based approach to diversity and justice (2nd ed.). Hoboken, NJ: John Wiley & Sons.

Super, J. T., & Jacobson, L. (2011). Religious abuse: Implications for counseling lesbian, gay, bisexual, and transgender individuals. Journal of LGBT Issues in Counseling, 5, 180–196.

Supiano, K. P., & Berry, P. H. (2013). Developing interdisciplinary skills and professional confidence in palliative care social work students. Journal of Social Work Education, 49, 387–396.

Suter, E., Daas, K., & Bergen, K. (2008). Negotiating lesbian family identity via symbols and rituals. Journal of Family Issues, 29(1), 26–47.

Sutphin, S. (2010). Social exchange theory and the division of household labor in same-sex couples. Marriage & Family Review, 46(3), 191–206.

Swatos, W. H. (2005). Globalization theory and religious fundamentalism. In P. Kivisto (Ed.), Illuminating social life: Classical and contemporary theory revisited (3rd ed., pp. 319–339). Thousand Oaks, CA: Pine Forge Press.

Sweifach, J. (2015). Has group work education lost its social group work essence? A content analysis of MSW course syllabi in search of mutual aid and group conflict content. Journal of Teaching in Social Work, 35(3), 279–295.

1127

Świątczak, B. (2012). Immune system, immune self: Introduction. Avant: Journal of Philosophical-Interdisciplinary Vanguard, 3(1), 12–18.

Swift, D. C. (1998). Religion and the American experience. Armonk, NY: M. E. Sharpe.

Swinton, J. (2012). From inclusion to belonging: A practical theology of community, disability, and humanness. Journal of Religion, Disability & Health, 16(2), 172–190.

Sword, R., Sword, R., Brunskill, S., & Zimbardo, P. (2014). Time perspective therapy: A new time-based metaphor therapy for PTSD. Journal of Loss and Trauma, 19(3), 197–201.

Sykes, B. (2015). Generation X and millennials: Attitudes about having and raising children in cohabiting unions. (National Center for Family & Marriage Research FP-15-13). Retrieved from www.bgsu.edu/ncfmr/resources/data/family-profiles/sykes-gen-x- millennials-fp-15-13.html

Szabo, Y. Z., Warnecke, A. J., Newton, T. L., & Valentine, J. C. (2017). Rumination and posttraumatic stress symptoms in trauma-exposed adults: A systematic review and meta-analysis. Anxiety, Stress, and Coping, 30(4), 396–414.

Szondy, D. (2015). Breakthrough bionic leg prosthesis controlled by subconscious thoughts. Retrieved from https://newatlas.com/ossur-first- mind-controlled-bionic-leg-prosthesis/37614/

Tan, P. P. (2006). Spirituality and religious beliefs among South-East Asians. Reflections: Narratives of Professional Helping, 12(3), 44–47.

Tanielian, T., & Jaycox, L. (Eds.). (2008). Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to

1128

http://www.bgsu.edu/ncfmr/resources/data/family-profiles/sykes-gen-x-millennials-fp-15-13.html

https://newatlas.com/ossur-first-mind-controlled-bionic-leg-prosthesis/37614/

assist recovery. Santa Monica, CA: RAND Corporation.

Tarrow, S. (1994). Power in movement: Social movements, collective action, and politics. New York: Cambridge University Press.

Tarrow, S. (1998). Power in movement: Social movements and contentious politics (2nd ed.). New York: Cambridge University Press.

Tarrow, S. (2006). The new transnational activism. New York: Cambridge University Press.

Tarrow, S. (2011). Why Occupy Wall Street is not the Tea Party of the left. Foreign Affairs, Snapshot. Retrieved from www.foreignaffairs.com/articles/136401/sidney-tarrow/why-occupy- wall-street-is-not-the-tea-party-of-the-left

Tausch, C., Marks, L. D., Brown, J. S., Cherry, K. E., Frias, T., McWilliams, Z., . . . Sasser, D. D. (2011). Religion and coping with trauma: Qualitative examples from Hurricanes Katrina and Rita. Journal of Religion, Spirituality & Aging, 23(3), 236–253.

Taylor, A., & Kuo, F. (2009). Children with attention deficits concentrate better after walk in the park. Journal of Epidemiology and Community, 56, 913–918.

Taylor, F. W. (1911). Principles of scientific management. New York: Harper & Row.

Taylor, P., & Cohn, D. (2012). A milestone en route to a majority minority nation. Pew Research Center. Retrieved from www.pewsocialtrends.org/2012/11/07/a-milestone-en-route-to-a- majority-minority-nation

1129

http://www.foreignaffairs.com/articles/136401/sidney-tarrow/why-occupy-wall-street-is-not-the-tea-party-of-the-left

http://www.pewsocialtrends.org/2012/11/07/a-milestone-en-route-to-a-majority-minority-nation

Taylor, R. B. (1988). Human territorial functioning: An empirical, evolutionary perspective on individual and small group territorial cognitions, behaviors, and consequences. Cambridge, UK: Cambridge University Press.

Taylor, R. J., Chatters, L. M., & Levin, J. (2004). Religion in the lives of African-Americans: Social, psychological, and health perspectives. Thousand Oaks, CA: Sage.

Taylor, V. (1999). Gender and social movements: Gender processes in women’s self-help movements. Gender & Society, 13(1), 8–33.

Teeple, G. (2000). Globalization and the decline of social reform: Into the twenty-first century. Aurora, ON: Garamond Press.

Teixeira, S., & Krings, A. (2015). Sustainable social work: An environmental justice framework for social work education. Social work Education, 34(5), 513–527.

Terkel, S. (1980). C. P. Ellis. In American dreams: Lost and found (pp. 200–211). New York: New Press.

Terkel, S. (2003). Hope dies last: Keeping the faith in difficult times. New York: The New Press.

Teshome, E., Zenebe, M., Metaferia, H., & Biadgilign, S. (2012). The role of self-help voluntary associations for women empowerment and social capital: The experience of women’s Iddirs (burial societies) in Ethiopia. Journal of Community Health, 37, 706–714.

Tesoriero, F. (2006). Strengthening communities through women’s self- help groups in South India. Community Development Journal, 41(3), 321–333.

1130

Tett, G. (2010). Fool’s gold: The inside story of J.P. Morgan and how Wall Street greed corrupted its bold dream and created a financial catastrophe. New York: Free Press.

Thibaut, J. W., & Kelley, H. H. (1959). The social psychology of groups. New York: Wiley.

Thomas, E., Wingert, P., Conant, E., & Register, S. (2010, March 5). Why we can’t get rid of bad teachers. Newsweek, 155(11), 24–27.

Thomas, M. L. (2009). Faith collaboration: A qualitative analysis of faith- based social service programs in organizational relationships. Administration in Social Work, 33(1), 40–60.

Thompson, N. (2002). Social movements, social justice and social work. , 711–722.

Thompson Coon, J., Boddy, K., Stein, K., Whear, R., Barton, J., & Depledge, M. (2011). Does participating in physical activity in outdoor natural environments have a greater effect on physical and mental wellbeing than physical activity indoors? A systematic review. Environmental Science & Technology, 45, 1761–1772.

Thyer, B. A. (2005). The misfortunes of behavioral social work: Misprized, misread, and misconstrued. In S. A. Kirk (Ed.), Mental disorders in the social environment: Critical perspectives (pp. 330–343). New York: Columbia University Press.

Tilley, C., Keane, W., Küchler, S., Rowlands, M., & Spyer, P. (2013). Handbook of material culture. Thousand Oaks, CA: Sage.

Tilly, C., & Wood, L. (2013). Social movements 1768–2012. Boulder, CO: Paradigm.

1131

Tilton, J. (2009). Youth uprising: Gritty youth leadership development and communal transformation. In L. Nybell, J. Shook, & J. Finn (Eds.), Childhood, youth, and social work in transformation: Implications for policy and practice (pp. 385–400). New York: Columbia University Press.

Timberlake, E. M., & Cook, K. O. (1984). Social work and the Vietnamese refugee. Social Work, 29(2), 108–114.

Tinajero, C., Martinez-Lopez, Z., Rodriguez, M., Guisande, M., & Paramo, M. F. (2015). Gender and socioeconomic status differences in university students’ perception of social support. European Journal of Psychology of Education, 30(2), 227–244.

Tindall, D. (2004). Social movement participation over time: An ego- network approach to micro-mobilization. Sociological Focus, 37, 163–184.

Tisi, G., Franzini, A., Messina, G., Savino, M., & Gambini, O. (2014). Vagus nerve stimulation therapy in treatment-resistant depression: A series report. Psychiatry and Clinical Neurosciences, 68, 606–611.

Titone, A. M. (1991). Spirituality and psychotherapy in social work practice. Spirituality and Social Work Communicator, 2(1), 7–9.

Tomai, M., Veronica, R., Mebane, M., D’Acunti, A., Benedetti, M., & Francescato, D. (2010). Virtual communities in schools as tools to promote social capital with high school students. Computers & Education, 54, 265–274.

Tomic, W., & Tomic, E. (2008). Existential fulfillment and burnout among principals and teachers. Journal of Beliefs & Values: Studies in Religion & Education, 29(1), 11–27.

1132

Tonnies, F. (1963). Community and society (C. P. Loomis, Ed.). New York: Harper & Row. (Original work published 1887)

Toosi, N., Sommers, S., & Ambady, N. (2012). Getting a word in group- wise: Effects of racial diversity on gender dynamics. Journal of Experimental Social Psychology, 48, 1150–1155.

Toseland, R. W., & Larkin, H. (2010). Developing and leading telephone groups. Social Work with Groups, 34(1), 21–34.

Toseland, R. W., & Rivas, R. F. (2017). An introduction to group work practice (8th ed.). Essex, UK: Pearson.

Townley, G., Kloos, B., Green, E., & Franco, M. (2011). Reconcilable differences? Human diversity, cultural relativity, and sense of community. American Journal of Community Psychology, 47, 69–85.

Townley, G., & Kloos, B. (2011). Examining the psychological sense of community for individuals with serious mental illness residing in supported housing environments. Community Mental Health Journal, 47, 436–446.

Tracy, E., & Martin, T. (2007). Children’s roles in the social networks of women in substance abuse treatment. Journal of Substance Abuse Treatment, 32, 81–88.

Troiden, R. (1989). The formation of homosexual identities. Journal of Homosexuality, 17, 43–73.

Tsai, K., & Fuligni, A. (2012). Change in ethnic identity across the college transition. Developmental Psychology, 48(1), 56–64.

Tucker, A. R. (2009). Adventure-based group therapy to promote social

1133

skills in adolescents. Social Work with Groups, 32(4), 315–329.

Tucker, M. (2011). Standing on the shoulders of giants: An American agenda for education reform. Washington, DC: National Center on Education and the Economy.

Tuckman, B., & Jensen, M. (1977). Stages of small group development revisited. Group and Organizational Studies, 2, 419–427.

Tufekci, Z. (2017). Twitter and Tear Gas: The power and fragility of networked protest. New Haven, CT: Yale University Press.

Turnbull, B., Graham, M., & Taket, A. (2016). Social exclusion of Australian childless women in their reproductive years. Social Inclusion, 4(1), 102–115.

Turkle, S. (2011). Alone together: Why we expect more from technology and less from each other. New York: Basic Books.

Turkle, S. (2015). Reclaiming conversation: The power of talk in a digital age. New York: Penguin.

Turner, R. P., Lukoff, D., Barnhouse, R. T., & Lu, F. G. (1995). Religious or spiritual problem: A culturally sensitive diagnostic category in the DSM–IV. Journal of Nervous and Mental Disease, 183, 435–444.

Tweed, T. T. (1997). Asian religions in the United States. In W. H. Conser Jr. & S. B. Twiss (Eds.), Religious diversity and American religious history: Studies in traditions and cultures (pp. 189–217). Athens: University of Georgia Press.

Tyagi, A., & Cohen, M. (2016). Yoga and heart rate variability: A comprehensive review of the literature. International Journal of Yoga,

1134

9(2), 97–113.

Tylor, E. B. (1871). Primitive culture (2 vols.). London: Murray.

Uchino, B. N. (2009). Understanding the links between social support and physical health: A life-span perspective with emphasis on the separability of perceived and received support. Perspectives on Psychological Science, 4(3), 236–255.

Uhlenbruck, K., Meyer, K., & Hitt, M. (2003). Organizational transformation in transition economies: Resource based and organizational learning perspectives. Journal of Management Studies, 40, 257–282.

UK Parliament. (2017). Churchill and the commons chamber. Retrieved from www.parliament.uk/about/living- heritage/building/palace/architecture/palacestructure/churchill/

Ulrich, R. (1984). View through a window may influence recovery from surgery. Science, 224, 420–421.

Ulrich, R. (2006). Evidence-based health-care architecture. Lancet, 368, 538–539.

Ulrich, R., Simons, R., Losito, B., Fiorito, E., Miles, M., & Zelson, M. (1991). Stress recovery during exposure to natural and urban environments. Journal of Environmental Psychology, 11, 201–230.

Ulrich, R., & Zimring, C. (2005). The role of the physical environment in the hospital of the 21st century: A once-in-a-lifetime opportunity. Retrieved from www.healthdesign.org/chd/research/role-physical- environment-hospital-21st-century

1135

http://www.parliament.uk/about/living-heritage/building/palace/architecture/palacestructure/churchill/

http://www.healthdesign.org/chd/research/role-physical-environment-hospital-21st-century

Ulset, V., Vitaro, F., Brendgen, M., Bekkhus, M., & Borge, A. (2017). Time spent outdoors during preschool: Links with children’s cognitive and behavioural development. Journal of Environmental Psychology, 52, 60–80.

UNESCO. (2015). Education 2030: Incheon declaration and framework for action. Paris: Author. Retrieved from http://unesdoc.unesco.org/images/0024/002456/245656e.pdf

UNESCO. (2016). Global education monitoring report summary. Paris: Author. Retrieved from http://unesdoc.unesco.org/images/0024/002457/245752e.pdf

UNICEF. (2012). Measuring child poverty. Florence, Italy: UNICEF Innocenti Research Center. Retrieved from www.unicef- irc.org/publications/pdf/rc10_eng.pdf

The Union of the Physically Impaired Against Segregation and the Disability Alliance. (1976). Fundamental principles of disability. Retrieved from http://disability-studies.leeds.ac.uk/files/library/UPIAS- fundamental-principles.pdf

United Nations. (1948). The universal declaration of human rights. Retrieved from www.un.org/en/documents/udhr

United Nations Department of Economic and Social Affairs. (2014). World urbanization prospects: The 2014 revision, highlights. New York: Author.

United Nations Department of Economic and Social Affairs. (2016). Good practices of accessible urban development. Retrieved from www.un.org/development/desa/undesavoice/more-from- undesa/2016/11/29730.html

1136

http://unesdoc.unesco.org/images/0024/002456/245656e.pdf

http://unesdoc.unesco.org/images/0024/002457/245752e.pdf

http://www.unicef-irc.org/publications/pdf/rc10_eng.pdf

http://disability-studies.leeds.ac.uk/files/library/UPIAS-fundamental-principles.pdf

http://www.un.org/en/documents/udhr

http://www.un.org/development/desa/undesavoice/more-from-undesa/2016/11/29730.html

United Nations Development Programme. (2016). Human development report 2016. New York: Author. Retrieved from http://hdr.undp.org/sites/default/files/2016_human_development_report.pdf

United Nations Division for Social Policy and Development Disability. (2017). Convention on the rights of persons with disabilities. Retrieved from www.un.org/development/desa/disabilities/convention-on-the- rights-of-persons-with-disabilities.html

United Nations Human Rights. (2014). Human rights and climate change. Office of High Commissioner for Human Rights. Retrieved from www.ohchr.org/EN/Issues/HRAndClimateChange/Pages/HRClimateChangeIndex.aspx

United Nations Human Rights. (2017). Intersex fact sheet. Retrieved from www.ohchr.org/Documents/issues/Discrimination/LGBT/FactSheets/UNFE_FactSheet_Intersex_EN.pdf

Urbina, I. (2010, March 23). Acorn to shut all offices by April 1. New York Times, p. A17.

U.S. Bureau of Labor Statistics. (2014). Women in the labor force: A databook. Retrieved from www.bls.gov/opub/reports/womens- databook/archive/women-in-the-labor-force-a-databook-2014.pdf

U.S. Bureau of Labor Statistics. (2017a). Union members – 2016. Retrieved from www.bls.gov/news.release/pdf/union2.pdf

U.S. Bureau of Labor Statistics. (2017b). Employment characteristics of families – 2016. Retrieved from www.bls.gov/news.release/pdf/famee.pdf

U.S. Census Bureau. (2010). Statistical abstract of the United States. Washington, DC: Government Printing Office.

1137

http://hdr.undp.org/sites/default/files/2016_human_development_report.pdf

http://www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities.html

http://www.ohchr.org/EN/Issues/HRAndClimateChange/Pages/HRClimateChangeIndex.aspx

http://www.ohchr.org/Documents/issues/Discrimination/LGBT/FactSheets/UNFE_FactSheet_Intersex_EN.pdf

http://www.bls.gov/opub/reports/womens-databook/archive/women-in-the-labor-force-a-databook-2014.pdf

http://www.bls.gov/news.release/pdf/union2.pdf

http://www.bls.gov/news.release/pdf/famee.pdf

U.S. Census Bureau. (2012). Statistical abstract of the United States, 2012. Retrieved from www.census.gov/library/publications/2011/compendia/stattab/131ed.html

U.S. Census Bureau. (2013). Asians fastest-growing race or ethnic group in 2012. Retrieved from www.census.gov/newsroom/press=releases/2013/cb13-112.html

U.S. Census Bureau. (2017a). Race. Retrieved from www.census.gov/topics/population/race/about.html

U.S. Census Bureau. (2017b). Hispanic origin. Retrieved from www.census.gov/topics/population/hispanic-origin.html

U.S. Commission on Human Rights. (1998). Indian tribes: A continuing quest for survival. In P. S. Rothenberg (Ed.), Race, class and gender in the United States: An integrated study (4th ed., pp. 378–382). New York: St. Martin’s Press.

U.S. Department of Health and Human Services. (2017). About the Affordable Care Act. Retrieved from www.hhs.gov/healthcare/about- the-aca/index.html

U.S. Department of Housing and Urban Development. (2011, December 5). Homeless Emergency Assistance and Rapid Transition to Housing Program; Defining “homeless.” Federal Register: The Daily Journal of the United States Government, p. 75994. FR DOC # 2011-30942.

Vaillant, G. (2002). Aging well. Boston: Little, Brown.

Valenti, M., & Rockett, T. (2008). The effects of demographic differences on forming intragroup relationships. Small Group Research, 39(2), 179–202.

1138

http://www.census.gov/library/publications/2011/compendia/stattab/131ed.html

http://www.census.gov/newsroom/press=releases/2013/cb13-112.html

http://www.census.gov/topics/population/race/about.html

http://www.census.gov/topics/population/hispanic-origin.html

http://www.hhs.gov/healthcare/about-the-aca/index.html

van der Kolk, B. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. New York: Viking.

van der Kolk, B., Hodgdon, H., Gapen, M., Musicaro, R., Suvak, M., Hamlin, E., & Spinazzola, J. (2016). A randomized controlled study of neurofeedback for chronic PTSD. PLoS One, 11(12): e0166752.

van der Kolk, B., Stone, L., West, J., Rhodes, A., Emerson, D., Suvak, M., & Spinazzola, J. (2014). Yoga as an adjunctive treatment for posttraumatic stress disorder: A randomized controlled trial. Journal of Clinical Psychiatry, 75(6), e559–e564.

Van Der Pas, S., Tilburg, T., & Silverstein, M. (2013). Stepfamilies in later life. Journal of Marriage and Family, 75, 1065–1069.

Van Deurzin, E., & Adams, M. (2016). Skills in existential counseling and psychotherapy (2nd ed.). Thousand Oaks, CA: Sage.

van de Vijver, F., Blommaert, J., & Gkoumasi, G. (2015). On the need to broaden the concept of ethnic identity. International Journal of Intercultural Relations, 46, 36–46.

Van de Werfhorst, H., & Salverda, W. (2012). Consequences of economic inequality: Introduction to a special issue. Research in Social Stratification and Mobility, 30, 377–387.

van Duin, D. (2012). Diagnostic challenges and opportunities in older adults with infectious diseases. Clinical Infectious Diseases, 54(7), 973–978.

Van Hook, M., Hugen, B., & Aguilar, M. (Eds.). (2001). Spirituality within religious traditions in social work practice. Pacific Grove, CA: Brooks/Cole.

1139

Vasilyeva, M., Dearing, E., Ivanova, A., Shen, C., & Kardanova, E. (2018). Testing the family investment model in Russia: Estimating indirect effects of SES and parental beliefs on the literacy skills of first- graders. Early Childhood Research Quarterly, 42, 11–20.

Veeder, N. W., & Dalgin, R. E. (2004). Social work as management: A retrospective study of 245 hospital care management practice outcomes. Journal of Social Service Research, 31(1), 33–58.

Veinot, T., & Williams, K. (2012). Following the “community” thread from sociology to information behavior and informatics: Uncovering theoretical continuities and research opportunities. Journal of the American Society for Information Science and Technology, 63(5), 847–864.

Ventura, S. (2009). Changing patterns of nonmarital childbearing in the United States. NCH 8 Data Brief, 18, 1–8.

Verity, F., & King, S. (2007). Responding to intercommunal conflict— What can restorative justice offer? Community Development Journal, 43(4), 470–482.

Verkuyten, M. (2016). Further conceptualizing ethic and racial identity research: The social identity approach and its dynamic model. Child Development, 87(6), 1796–1812.

Vespa, H. (2014). Historical trends in the marital intentions of one-time and serial cohabitors. Journal of Marriage and Family, 76, 207–217.

Vespa, J. (2012). Union formation in later life: Economic determinants of cohabitation and remarriage among older adults. Demography, 49, 1103–1125.

Vespa, J., Lewis, J., & Kreider, R. (2013). America’s families and living

1140

arrangements: 2012. U.S. Census Bureau. Retrieved from www.census.gov/prod/2013pubs/p20-570.pdf

Viacom. (2018). About Viacom. Retrieved from www.viacom.com/about/pages/default.aspx

Vickrey, B. G., Strickland, T. L., Fitten, L. J., Admas, G. R., Ortiz, F., & Hays, R. D. (2007). Ethnic variations in dementia caregiving experiences: Insights from focus groups. Journal of Human Behavior in the Social Environment, 15(2/3), 233–249.

Vilhauer, R. (2014). Computer-mediated and face-to-face communication in metastatic cancer support groups. Palliative and Supportive Care, 12, 287–297.

Vlahov, D., Galea, S., & Freudenberg, N. (2005). The urban health “advantage.” Journal of Urban Health, 82(1), 1–4.

Voigt, R., Camp, N., Prabhakaran, V., Hamilton, W., Hetey, R., Griffiths, C., . . . Eberhardt, J. (2017). Language from police body camera footage shows racial disparities in officer respect. PNAS Early Edition. Retrieved from www.pnas.org/cgi/doi/10.1073/pnas.1702413114

Vosler, N. R. (1996). New approaches to family practice: Confronting economic stress. Thousand Oaks, CA: Sage.

Voss, K. (1996). The collapse of a social movement: The interplay of mobilizing structures, framing, and political opportunities in the Knights of Labor. In D. McAdam, J. McCarthy, & M. Zald (Eds.), Comparative perspectives on social movements (pp. 227–258). New York: Cambridge University Press.

Voss, R. W., Douville, V., Little Soldier, A., & Twiss, G. (1999). Tribal and shamanic-based social work practice: A Lakota perspective. Social

1141

http://www.census.gov/prod/2013pubs/p20-570.pdf

http://www.viacom.com/about/pages/default.aspx

http://www.pnas.org/cgi/doi/10.1073/pnas.1702413114

Work, 44(3), 228–241.

Vranic, A. (2003). Personal space in physically abused children. Environment and Behavior, 35(4), 550–565.

Vryan, K. D., Adler, P. A., & Adler, P. (2003). Identity. In L. T. Reynolds & N. J. Herman-Kinney (Eds.), Handbook of symbolic interactionism (pp. 367–390). Walnut Creek, CA: AltaMira Press.

Waanders, C., Mendez, J., & Downer, J. (2007). Parent characteristics, economic stress and neighborhood context as predictors of parent involvement in preschool children’s education. Journal of School Psychology, 45(6), 619–636.

Wabnegger, A., Leutgeb, V., & Schienle, A. (2016). Differential amygdala activation during simulated personal space intrusion by men and women. Neuroscience, 330, 12–16.

Wadsworth, M., & Santiago, C. (2008). Risk and resiliency processes in ethnically diverse families in poverty. Journal of Family Psychology, 22(3), 399–410.

Wadsworth, S., & Southwell, K. (2011). Military families: Extreme work and extreme “work-family.” The Annals of the American Academy of Political and Social Science, 638, 163–183.

Wagner, J., Wrzus, C., Neyer, F., & Lang, F. (2015). Social network characteristics of early midlife voluntarily and involuntarily childless couples. Journal of Family Issues, 36(1), 87–110.

Wagner, N., Hassanein, K., & Head, M. (2014). The impact of age on website usability. Computers in Human Behavior, 37, 270–282.

1142

Walch, J., Rabin, B., Day, R., Williams, J., Choi, K., & Kang, J. (2005). The effect of sunlight on postoperative analgesic medication use: A prospective study of patients undergoing spinal surgery. Psychosomatic Medicine, 67, 156–163.

Waldman, W. (2016). The applications of information technology to the human services: Challenges and opportunities. Human Service Organizations: Management, Leadership & Governance, 40(5), 441–443.

Walker, D. F., Reid, H. W., O’Neill, T., & Brown, L. (2009). Changes in personal religion/spirituality during and after childhood abuse: A review and synthesis. Psychological Trauma: Theory, Research, Practice, and Policy, 1(2), 130–145.

Wallerstein, I. (1974). The modern world system: Capitalist agriculture and the origins of the European world economy in the 16th century. New York: Academic Press.

Wallerstein, I. (1979). The capitalist world economy. London: Cambridge University Press.

Wallerstein, I. (1980). The modern world-system: Mercantilism and the consolidation of the European world economy, 1600–1750. New York: Academic Press.

Wallerstein, I. (1989). The modern world-system: The second great expansion of the capitalist world-economy, 1730–1840’s. San Diego, CA: Academic Press.

Wallerstein, I. (2004). World systems analysis: An introduction. Durham, NC: Duke University Press.

Walsh, F. (2009a). Integrating spirituality in family therapy: Wellsprings

1143

for health, healing, and resilience. In F. Walsh (Ed.), Spiritual resources in family therapy (2nd ed., pp. 31–61). New York: Guilford Press.

Walsh, F. (2009b). Spiritual resources in family adaptation to death and loss. In F. Walsh (Ed.), Spiritual resources in family therapy (2nd ed., pp. 81–102). New York: Guilford Press.

Walsh, F. (2012a). Normal family processes (4th ed.). New York: Guilford Press.

Walsh, F. (2012b). The new normal: Diversity and complexity in 21st- century families. In F. Walsh (Ed.), Normal family processes: Growing diversity and complexity (4th ed., pp. 3–27). New York: Guilford Press.

Walsh, F. (2012c). Family resilience: Strengths forged through adversity. In F. Walsh (Ed.), Normal family processes: Growing diversity and complexity (4th ed., pp. 399–427). New York: Guilford Press.

Walsh, F. (2016). Strengthening family resilience (3rd ed.). New York: Guilford Press.

Walsh, J. (2000). Clinical case management with persons having mental illness: A relationship-based perspective. Pacific Gove, CA: Brooks/Cole.

Walsh, J. (2014). Theories for direct social work practice (3rd ed.). Belmont, CA: Wadsworth.

Walsh, J., Meyer, A., & Schoonhoven, C. (2006). A future for organization theory: Living in and living with changing organizations. Organization Science, 17(5), 657–671.

Wamsley, G., & Zald, M. (1973). The political economy of public

1144

organizations. Lexington, MA: Heath.

Wang, X. (2018). The role of motivations and collective efficacy on Chinese consumers’ intentions to engage in personal behaviors to mitigate climate change. Journal of Social Psychology, 158(1), 51–63.

Wanyeki, I., Olson, S., Brassard, P., Menzies, D., Ross, N., Behr, M., & Schwartzman, K. (2006). Dwellings, crowding, and tuberculosis in Montreal. Social Science & Medicine, 63(2), 501–511.

Warren, R. (1963). The community in America. Chicago: Rand McNally.

Warren, R. (1978). The community in America (2nd ed.). Chicago: Rand McNally.

Warren, R. (1987). The community in America (3rd ed.). Chicago: Rand McNally.

Warren, R. (1988). Observations on the state of community theory. In R. Warren & L. Lyon (Eds.), New perspectives on the American community (5th ed., pp. 84–86). Chicago: Dorsey.

Warwick, L. L. (1995). Feminist Wicca: Paths to empowerment. Women and Therapy: A Feminist Quarterly, 16(2/3), 121–133.

Waterhouse, L. (2010). Multiple intelligences, the Mozart effect, and emotional intelligence: A critical review. Educational Psychologist, 41(4), 207–225.

Watters, E. (2010). Crazy like us: The globalization of the American psyche. New York: Free Press.

Weaver, H. (2011). Cultural competence with First Nations peoples. In D.

1145

Lum (Ed.), Culturally competent practice: A framework for understanding diverse groups and justice issues (4th ed., pp. 223–247). Belmont, CA: Thomson.

Weber, M. (1947). The theory of economic and social organization. New York: Free Press.

Weber, M. (1958). The Protestant ethic and the spirit of capitalism (T. Parsons, Trans.). New York: Scribner’s. (Original work published 1904–1905)

Weil, M. (Ed.). (2005). The handbook of community practice. Thousand Oaks, CA: Sage.

Weil, M., Reisch, M., & Ohmer, M. (2013a). Introduction: Contexts and challenges for 21st century communities. In M. Weil, M. Reisch, & M. Ohmer (Eds.), The handbook of community practice (2nd ed., pp. 3–25). Thousand Oaks, CA: Sage.

Weil, M., Reisch, M., & Ohmer, M. (Eds.) (2013b). The handbook of community practice (2nd ed.). Thousand Oaks, CA: Sage.

Weiss, R., Izaguirre-Anariba, D. E., Lanza, J., & Lessnau, K-D. (2017). Venous insufficiency treatment and management. The heart.org Medscape. Retrieved from https://emedicine.medscape.com/article/1085412-treatment

Weitz, R. (2013). The sociology of health, illness, and health care: A critical approach (6th ed.). Boston: Wadsworth.

Wellman, B. (1979). The community question. American Journal of Sociology, 84, 1201–1231.

1146

https://emedicine.medscape.com/article/1085412-treatment

Wellman, B. (1982). Studying personal communities. In P. Marsden & N. Lin (Eds.), Social structure and network analysis (pp. 61–80). Beverly Hills, CA: Sage.

Wellman, B. (1996). Are personal communities local? A Dumptarian reconsideration. Social Networks, 18, 347–354.

Wellman, B. (1999). The network community: An introduction. In B. Wellman (Ed.), Networks in the global village (pp. 1–47). Boulder, CO: Westview Press.

Wellman, B., & Potter, S. (1999). The elements of personal communities. In B. Wellman (Ed.), Networks in the global village (pp. 49–81). Boulder, CO: Westview Press.

Wellman, B., & Wortley, S. (1990). Different strokes from different folks: Community ties and social support. American Journal of Sociology, 96, 558–588.

Welwood, J. (2000). Toward a psychology of awakening: Buddhism, psychotherapy, and the path of personal and spiritual transformation. Boston: Shambhala.

Wenger, G. C. (2009). Childlessness at the end of life: Evidence from rural Wales. Ageing and Society, 29(8), 1243–1259.

Wenocur, S., & Soifer, S. (1997). Prospects for community organization. In M. Reisch & E. Gambrill (Eds.), Social work in the 21st century (pp. 198–209). Thousand Oaks, CA: Pine Forge Press.

Werbart, A., Levin, L., Andersson, H., & Sandell, R. (2013). Everyday evidence: Outcomes of psychotherapies in Swedish public health services. Psychotherapy, 50(1), 119–130.

1147

Whaite, E., Shensa, A., Sidani, J., Golditz, J., & Primack, B. (2018). Social media use, personality characteristics, and social isolation among young adults in the United States. Personality and Individual Differences, 124, 45–50.

Wheeler, H. (Ed.). (1973). Beyond the punitive society. San Francisco: Freeman.

White, J., Klein, D., & Martin, T. (2015). Family theories: An introduction (4th ed.). Thousand Oaks, CA: Sage.

White, M., Pahl, S., Ashbullby, K., Herbert, S., & Depledge, M. (2013). Feelings of restoration from recent nature visits. Journal of Environmental Psychology, 25, 40–51.

Whiteman, S., McHale, M., & Soli, A. (2011). Theoretical perspectives on sibling relationships. Journal of Family Theory and Review, 3, 124–139.

Wicker, A. (2012). Perspectives on behavior settings: With illustrations from Allison’s ethnography of a Japanese hostess club. Environment and Behavior, 44(4), 474–492.

Wickham, C., & Carbone E. T. (2013). Can technology improve health literacy? Journal of Nutritional Disorders & Therapy, 3, e114. doi:10.4172/2161-0509.1000

Wilber, K. (1977). Spectrum of consciousness. Adyar, India: Quest Books.

Wilber, K. (1995). Sex, ecology, spirituality: The spirit of evolution. Boston: Shambhala.

Wilber, K. (1996). A brief history of everything. Boston: Shambhala.

1148

Wilber, K. (2000a). Integral psychology: Consciousness, spirit, psychology, therapy. Boston: Shambhala.

Wilber, K. (2000b). Sex, ecology, spirituality: The spirit of evolution (2nd ed.). Boston: Shambhala.

Wilber, K. (2001). A theory of everything: An integral vision for business, politics, science, and spirituality. Boston: Shambhala.

Wilber, K. (2006). Integral spirituality. Boston: Integral Books.

Williams, C. (2006). The epistemology of cultural competence. Families in Society: The Journal of Contemporary Social Services, 87(2), 209–220.

Williams, D., Mohammed, S., Leavell, J., & Collins, C. (2010). Race, economic status, and health: Complexities, ongoing challenges, and research opportunities. Annals of New York Academy of Sciences, 1186, 69–101.

Williams, M., Teasdale, J. D., Segal, Z., & Kabat-Zinn, J. (2007). The mindful way through depression: Freeing yourself from unhappiness. New York: Guilford Press.

Williamson, J. S., & Wyandt, C. M. (2001). New perspectives on alternative medicines. Drug Topics, 145(1), 57–66.

Wills, T. A., Yaeger, A. M., & Sandy, J. M. (2003). Buffering effect of religiosity for adolescent substance abuse. Psychology of Addictive Behaviors, 17(1), 24–31.

Wilson, C., Gutiérrez, F., & Chao, L. (2013). Racism, sexism, and the media: Multicultural issues into the new communications age (4th ed.). Thousand Oaks, CA: Sage.

1149

Wilson, E. (2007). Biophilia and the conservation ethic. In D. Penn & I. Mysterud (Eds.), Evolutionary perspectives on environmental problems (pp. 249–257). New Brunswick, NJ: Transaction.

Wilson, G., & Baldassare, M. (1996). Overall “sense of community” in a suburban region: The effects of localism, privacy, and urbanization. Environment and Behavior, 28(1), 27–43.

Winston, C. A. (2006). African American grandmothers parenting AIDS orphans: Grieving and coping. Qualitative Social Work, 5(1), 33–43.

Wittine, B. (1987, September/October). Beyond ego. Yoga Journal, 51–57.

Wolsko, C., & Hoyt, K. (2012). Employing the restorative capacity of nature: Pathways to practicing ecotherapy among mental health professionals. Ecopyschology, 4(1), 10–24.

Wood, J. (2006). Critical feminist theories: A provocative perspective on families. In D. Braithwaite & L. Baxter (Eds.), Engaging theories in family communication: Multiple perspectives (pp. 197–212). Thousand Oaks, CA: Sage.

Wood, M., Molassiotis, A., & Payne, S. (2011). What research evidence is there for the use of art therapy in the management of symptoms in adults with cancer? A systematic review. Psycho-Oncology, 20, 135–145.

Wood, R. (2002). Faith in action: Religion, race, and democratic organizing in America. Chicago: University of Chicago Press.

Woodard, C. (2011). American nations: A history of the eleven rival regional cultures of North America. New York: Penguin.

Woodbury, A. (2017). Endangered languages. Linguistic Society of

1150

America. Retrieved from www.linguisticsociety.org/content/endangered-languages.

Woolcott, G. (2013). Giftedness and cultural accumulation: An information processing perspective. High Ability Studies, 24(2), 153–170.

Woolever, C. (1992). A contextual approach to neighbourhood attachment. Urban Studies, 29(1), 99–116.

Worker-Participation.EU. (2016). Trade unions. Retrieved from www.worker-participation.eu/National-Industrial-Relations/Across- Europe/Trade-Unions2

Worland, J. (2016, October 28). What to know about the Dakota Access Pipeline protests. Time. Retrieved from http://time.com/4548566/dakota-access-pipeline-standing-rock-sioux/

World Bank. (2012, July 17). Press release. Mobile phone access reaches three quarters of planet’s population. Retrieved from www.worldbank.org/en/news/press-release/2012/07/17/mobile-phone- access-reaches-three-quarters-planetspopulation

World Bank. (2013). World Bank launches initiative on migration, releases new projections on remittance flows. Retrieved from www.worldbank.org/en/news/press-release/2013/04/19/world-bank- launches-initiative-on-migration-releases-new-projections-on- remittance-flows

World Bank. (2017a). Morality rate, under 5 (per 1,000 live births). Retrieved from https://data.worldbank.org/indicator/SH.DYN.MORT

World Bank. (2017b). Current health expenditure, (% of GDP). Retrieved from https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS

1151

http://www.linguisticsociety.org/content/endangered-languages

http://www.worker-participation.eu/National-Industrial-Relations/Across-Europe/Trade-Unions2

http://time.com/4548566/dakota-access-pipeline-standing-rock-sioux/

http://www.worldbank.org/en/news/press-release/2012/07/17/mobile-phone-access-reaches-three-quarters-planetspopulation

http://www.worldbank.org/en/news/press-release/2013/04/19/world-bank-launches-initiative-on-migration-releases-new-projections-on-remittance-flows

https://data.worldbank.org/indicator/SH.DYN.MORT

https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS

World Bank. (2017c). Life expectancy at birth, total (years). Retrieved from https://data.worldbank.org/indicator/SP.DYN.LE00.IN

World Bank. (2017d). Labor force, female (% of total labor force). Retrieved from https://data.worldbank.org/indicator/SL.TLF.TOTL.FE.ZS

World Economic Forum. (2015). Ten years of the global gender gap. Retrieved from http://reports.weforum.org/global-gender-gap-report- 2015/report-highlights/

World Economic Forum. (2016). The global gender gap report 2016. Geneva: Author. Retrieved from www3.weforum.org/docs/GGGR16/WEF_Global_Gender_Gap_Report_2016.pdf

World Health Organization. (2012). Human trafficking. Retrieved from http://apps.who.int/iris/bitstream/10665/77394/1/WHO_RHR_12.42_eng.pdf? ua=1

World Health Organization. (2014). Violence against women. Retrieved from http://apps.who.int/iris/bitstream/10665/112325/1/WHO_RHR_14.11_eng.pdf

World Health Organization. (2016). Elder abuse: The health sector role in prevention and response. Retrieved from www.who.int/violence_injury_prevention/violence/elder_abuse/Elder_abuse_infographic_EN.pdf? ua=1

World Health Organization. (2017a). Global health observatory (GHO) data: HIV/AIDS. Retrieved from www.who.int/gho/hiv/en/

World Health Organization. (2017b). World health statistics 2017: Monitoring health for the SDGs. Geneva: Author. Retrieved from http://apps.who.int/iris/bitstream/10665/255336/1/9789241565486-

1152

https://data.worldbank.org/indicator/SP.DYN.LE00.IN

https://data.worldbank.org/indicator/SL.TLF.TOTL.FE.ZS

http://reports.weforum.org/global-gender-gap-report-2015/report-highlights/

http://www3.weforum.org/docs/GGGR16/WEF_Global_Gender_Gap_Report_2016.pdf

http://apps.who.int/iris/bitstream/10665/77394/1/WHO_RHR_12.42_eng.pdf?ua=1

http://apps.who.int/iris/bitstream/10665/112325/1/WHO_RHR_14.11_eng.pdf

http://www.who.int/violence_injury_prevention/violence/elder_abuse/Elder_abuse_infographic_EN.pdf?ua=1

http://www.who.int/gho/hiv/en/

http://apps.who.int/iris/bitstream/10665/255336/1/9789241565486-eng.pdf?ua=1.SSS&SSI

eng.pdf?ua=1.SSS&SSI.

World Health Organization. (2017c). Children: Reducing mortality. Retrieved from www.who.int/mediacentre/factsheets/fs178/en/

World Health Organization. (2017d). Drinking-water. Retrieved from www.who.int/mediacentre/factsheets/fs391/en/

World Health Organization. (2017e). Lack of sanitation for 2.4 billion people is undermining health improvements. Retrieved from www.who.int/mediacentre/news/releases/2015/jmp-report/en/

Wright, K. B. (2016). Communication in health-related online social support groups/communities: A review of research on predictors of participation, applications of social support theory, and health outcomes. Review of Communication Research, 4, 65–87.

Wright, V. H. (2005). The soul tells a story: Engaging spirituality with creativity in the writing life. Downers Grove, IL: InterVarsity Press.

Wronka, J. (2017). Human rights and social justice: Social action and service for the helping and health professions (2nd ed.). Thousand Oaks, CA: Sage.

Wuthnow, R. (2001). Creative spirituality: The way of the artist. Berkeley: University of California Press.

Xu, Q., Perkins, D., & Chow, J. (2010). Sense of community, neighboring, and social capital as predictors of local political participation in China. American Journal of Community Psychology, 45, 259–271.

Yalom, I. D. (1995). The theory and practice of group psychotherapy (4th ed.). New York: Basic Books.

1153

http://www.who.int/mediacentre/factsheets/fs178/en/

http://www.who.int/mediacentre/factsheets/fs391/en/

http://www.who.int/mediacentre/news/releases/2015/jmp-report/en/

Yalom, I. D., & Leszcz, M. (2005). Theory and practice of group psychotherapy (5th ed.). New York: Basic Books.

Yarhouse, M. A., & Carr, T. L. (2012). MTF transgender Christians’ experiences: A qualitative study. Journal of LGBT Issues in Counseling, 6, 18–33.

Yeh, W. Y., Cheng, Y., & Chen, C. J. (2009). Social patterns of pay systems and their associations with psychosocial job characteristics and burnout among paid employees in Taiwan. Social Science & Medicine, 68, 1407–1415.

Yellow Bird, M. J. (1995). Spirituality in First Nations story telling: A Sahnish-Hidatsa approach to narrative. Reflections: Narratives of Professional Helping, 1(4), 65–72.

Yeung, D., Fung, H., & Kam, C. (2012). Age difference in problem solving strategies: The mediating role of future time perspective. Personality and Individual Differences, 53, 38–43.

Young, J., Bruno, D., & Pomara, N. (2014). A review of the relationship between proinflammatory cytokines and major depressive disorder. Journal of Affective Disorders, 169, 15–20.

Zastrow, C. H. (2015). Social work with groups: A comprehensive worktext (9th ed.). Stamford, CT: Brooks/Cole.

Zeisel, J. (2006). Inquiry by design: Environment/behavior/neuroscience in architecture, interiors, landscape, and planning (Rev. ed.). New York: Norton.

Zeisel, J. (2009). I’m still here: A breakthrough approach to understanding someone living with Alzheimer’s. New York: Penguin Group.

1154

Zelenski, J., Dopko, R., & Capaldi, C. (2015). Cooperation is in our nature: Nature exposure may promote cooperative and environmentally sustainable behavior. Journal of Environmental Psychology, 42, 24–31.

Zhang, W., Goodale, E., & Chen, J. (2014). How contact with nature affects children’s biophilia, biophobia and conservation attitude in China. Biological Conservation, 177, 109–116.

Zhang, Y., Fong, S., Yuan, M., Sung, Y., Cho, K., & Wong, R. (2017). Location-based big data analytics for guessing the next Foursquare check-ins. Journal of Supercomputers, 73, 3112–3127.

Zhou, W. (2013). Political connections and entrepreneurial investment: Evidence from China’s transition economy. Journal of Business Venturing, 28, 299–315.

Zilberstein, K. (2015). Technology, relationships and culture: Clinical and theoretical implications. Clinical Social Work, 43, 151–158.

Zimbardo, P. (2007). The Lucifer effect. New York: Random House.

Zimbardo, P., & Boyd, J. (2008). The time paradox. New York: Free Press.

Zimbardo, P., Sword, R., & Sword, R. (2012). The time cure: Overcoming PTSD with the new psychology of time perspective therapy. San Francisco: Jossey-Bass.

Zimring, C. (2016). Clean and white: A history of environmental racism in the United States. New York: NYU Press.

Zong, J., & Batalova, J. (2017, March). Frequently requested statistics on immigrants and immigration in the United States. Migration Information

1155

Source. Retrieved from www.migrationpolicy.org/article/frequently- requested-statistics-immigrants-and-immigration-united-states

1156

http://www.migrationpolicy.org/article/frequently-requested-statistics-immigrants-and-immigration-united-states

Index

ABC-X model of family stress and coping, 313–314 Abma, Joyce, 320, 321 Abrams, D., 360 Abramson, J. S., 367 Accessible environments for persons with disabilities, 222–225 Accommodation, 110, 257 Acculturation, 257, 259 Acker, Joan, 387 Acquired immunodeficiency syndrome (AIDS), 88 Active duty vs. reservist families, 328 Actor-network theory (ANT), 49, 50, 68 Adaptation, 142 Addams, J., 16, 198, 209 Adler, Nancy, 103 Adnopoz, J., 340 Adoptive families, 318 Affect, 109 Affect theory, 52–53 Affleck, Ben, 436 Agazio, J., 326 Ageing & Society, 321 Agency, 64, 66, 234

collective, 64, 66 personal, 64 proxy, 64, 66 vs. structural determinism, 296

Agency orientation vs. social action, 421–422 Agency-based model, 421 Ahmed-Mohamed, K., 40 Ahrons, C., 337 AIDS (acquired immunodeficiency syndrome), 88 Ainsworth, M. S., 133 Akesson, B., 198 Albertini, M., 320 Al-Bishawi, M., 200 Alcoholics Anonymous, 350

1157

Aldana, A., 357 Alford, K., 396 Alinsky, Saul, 421 Allen, K., 307, 310, 312, 313 Allen, Shawn, 404, 413, 415 Allen-Meares, P., 424 Allies, elite, 436–437 Almaas, A. H., 180 Alperovitz, G., 389 Alst, D., 338 Altman, Irwin, 200, 204 Amato, P., 338 Amenta, Edwin, 436 American Academy of Child and Adolescent Psychiatry (2015), 318 American Association for the Study of Group Work, 1937, 347 American Association of Group Workers, 347 American privilege, 18 American Psychological Association, 26 American Sociological Association, 325 Amygdala, 53, 56, 57, 58, 63, 102, 119, 135, 141, 203, 241 Anderson, C., 322, 363–365 Anderson, E., 336 Anderson, L., 339 Androgens, 87, 95, 98, Antibodies, 90 Anticipatory principle, 386 Antigens, 89 Anxiety, 58, 63, 66, 85 Applebaum, E., 305 Appreciative inquiry, 69, 385–386 Arab Spring and social media, 439–440 Archambault, David, II, 448 Argyris, C., 381–382 Armstrong, L., 326 Armstrong, N., 405 Art therapy groups, 347 Arvey, R., 364 Ashford, J., 11 Ashton, D., 330–331 Assagioli, Robert, 171

1158

Asscher, J., 421 Assimilation

cognitive, 110 culture, 245

Assistive devices, 95–96 Assumptions, 24 Atria, 92 Attachment theory, 56, 133–134 Attribution theory, 121 Au, T., 347 Autopoietic systems theory, 41, 42 Aveling, E., 405, 413 Averill, James, 122 Avolio, B., 364 Axons, 84

Baca, K., 251 Baer, E., 390 Bailey, S. K., 58 Baldassare, M., 411–412 Balinas, T., 396 Ballantine, J., 238, 282, 311, 318–319, 346, 430 Balsam, K., 325 Bandura, A., 64, 65, 66, 111 Bandura, Albert, 111 Banerjee, M. M., 20, 183 Barak, A., 396 Barker, Roger, 205 Barnes, R., 303 Barnoff, L., 389–390 Barnum, C., 360 Barrick, C., 396 Bartlett, Harriet, 6 Barton, Paul, 280 Basow, S., 310 Batalova, J., 331 Batsche, C., 412 Baum, Fran, 418 Baxter, L., 303 BBC News, 13

1159

Bearak, M., 324 Beardslee, W., 396 Bearnot, B., 413 Beauchaine, T., 325 Beauchemin, K., 217 Beck, Elizabeth, 423 Beck, Ulrich, 40 Becker, Howard, 409, 410 Beel-Bates, C., 310 Begley, S., 11, 13, 14, 57, 58, 65, 66, 68, 85 Behavior settings theories, 205–206 Behavioral perspective

classical conditioning theory, 63, 65 cognitive social learning theory, 64 operant conditioning theory, 63–64 overview of, 36–37 visual representation of, 63

Bell, K., 33 Ben Ali, Zine El Abidine, 440 Ben-David, V., 52 Benne, K. D., 364–365 Bennett, H. Z., 180 Bennett, W. L., 441 Bergen, K., 311 Berger, Peter, 170, 231 Bergman, K., 325 Bergstrom-Lynch, C., 319 Berkowitz, S., 412 Berry, P. H., 368 Berzoff, J., 56, 58 Best practices, 378 Besthorn, Fred, 206 Beutler, I., 330 Bi Lin, M., 45 Biadgilign, S., 350 Bianchi, S., 306 Bias

implicit, 241 optimistic, 117 research, 26–27

1160

Bicultural socialization, 257 Bioecological perspective, 40, 41 Biological coping, 142–143 Biological health, 40, 41 Biological person

active learning, 105 case studies, 77–79 critical thinking questions, 82, 88, 94, 102, 104 ecobiodevelopmental framework to understand relationship between interior health and exterior environments, 102–104 exhibits, 83, 84, 87, 88, 92, 96, 98, 99, 100 implications for social work practice, 104–105 integrative approach for understanding intersection of interior biological health and illness and exterior environmental factors, 79–82 key terms, 105 learning objectives, 76 systems taxonomy, 82–102 web resources, 106

Biophilia, 208 Biorck, G., 22 Blackman, L., 52 Blasi, J., 389 Blatt, B., 11 Blau, P., 47 Blood pressure, 93 Bloom, Orlando, 436 Blue, Helen, 376–377 Blumenstein, L., 334 Blumer, H., 51 Boase, J., 414–415 Boase, Jeffrey, 407 Boel-Studt, S., 335 Bohon, S., 333 Bolman, F., 376 Bolzendahl, C., 302 Bonadaptation, 314 Bond, Julian, 436 Bonding social capital, 414 Bonduriansky, R., 101

1161

Bonk, C., 352 Borczyskowski, A., 340 Borgatti, S., 414 Bornstein, A., 435, 437 Boroditsky, L., 13 Bosk, E., 338–340 Boswell, J., 324 Bouazizi, Mohamed, 440 Boundary, 38, 39 Bounded rationality, 380 Bowen, Murray, 307 Boyd, J., 13, 14, 15 Boyd, L., 324 Boyes-Watson, C., 421 Brabender, V., 361 Bradley, R., 330, 336 Braithwaite, D., 303 Brashears, M., 149 Brawley, L. R., 366 Breivik, K., 338 Brent, J., 419 Bridging social capital, 414 Brief treatment models, 349 Britton. D., 387 Brodsky, A., 417 Bronfenbrenner, U., 11, 12, 40, 41 Brook, J., 366 Brooks, F., 423 Brooks-Gunn, J., 330 Brown, B., 217 Brown, C., 330 Brown, D., 359 Brown, E., 338 Brown, G., 204 Brown, N., 350–352 Brown, T., 311, 319–320 Brulle, R., 428 Brunette, M. F., 347 Brunskill, S., 15 Buck, Pem, 243

1162

Budman, S. H., 362 Buechler, S., 432 Buhrkall, H., 208 Bullis, R. K., 191 Bumpass, L., 320 Bunic, S., 221 Bureaucracy, ideal-type, 377–378 Burgess, S., 15 Burnout, 208, 390–392 Burns, V., 198 Bush, George W., 190, 191 Bush, K., 333 Butler, A., 11

Cady, S. H., 356 Calculability, 378 Cameron, D., 324 Cameron, M., 132 Campbell, E., 353 Campbell, K., 415 Campos, B., 331–332 Canda, E. R., 165, 180, 187, 190, 192 Canda, F., 20 Cantore, S., 69 Capabilities approach, 68, 69 Capitalism, 43–44 Capous-Desyllas, M., 390 Cappicci, A., 45 Cardiovascular system, 91–94 Care systems, culturally sensitive, 397–398 Caren, N., 436 Carlson, J., 20 Carnoy, M., 280 Carpiano, R., 415 Carron, A. V., 366 Carslaw, G., 364 Cartwright, F., 416 Case, R., 413, 416 Case studies

Amira’s quest for self, 163

1163

Beacon Center, changing leadership, changing times at, 372–373 Ben Watson’s changing experience with physical environment, 197–198 Beth’s framework for living, 164 Caroline’s challenging questions, 160 changing leadership, changing times at Beacon Center (BC), 372–373 Cheryl’s legs and head, 77 Dan’s coping strategies, 131 diabetes diagnosis for Jenna, 77 fighting for our water, land, and air, 428–429 HIV, Thomas’s hero, 78 Jean-Joseph’s serving spirits, 162–163 Juan and Belinda’s sexual life in retirement, 79 Leon’s two worlds, 162 Louise and Stewart, Huntington’s, obesity, and cardiovascular disease, 78–79 Mathew’s faith journey, 161 Melissa’s HIV diagnosis, 78 Naomi’s health crisis, 160–161 online support community, 402 premed student, 108–109 Rubina living across cultures, 229–230 rural West Virginia community struggles to recover, 402–403 sexuality and gender group at a women’s residential substance abuse treatment facility, 344–345 Sharpe family’s deployment adjustments, 300–301 social structure and social institutions, 262–263 Trudy’s search for sacred, 161–162

Casey, R., 221, 222 Casey, T., 322 Castells, Manuel, 432, 434, 436–441, 446–447, 449, 450–451, 454 Catalano, S., 334 Caughlin, J., 308 Centers for Disease Control and Prevention, 334 Cervigni, F., 412 Chadha, J., 45 Chamiec-Chase, R., 190 Chan, A., 200–201 Chan, C., 347

1164

Chan, T., 349, 412 Chan, Y., 421 Charity organization society (COS) movement, 431 Charles, T., 397 Charlesworth, L., 21 Charon, J., 52 Chaskin, R., 404, 453 Chaturvedi, S., 364 Chaves, C., 68 Chavez, C., 448 Chavis, David, 416–417 Cheadle, J., 338 Chen, C. J., 390 Cheng, H., 421 Cheng, S., 324, 326, 355 Cheng, Y., 81 Chesler, M. A., 351 Chesney, B. K., 350 Cheung, R., 417 Chibucos, T., 312 Chien, N., 330 Child abuse, 334–336 Child Welfare Information Gateway, 2017, 334 Children and economic disadvantage, 330 Children’s Bureau, 2017, 318 Chipman, R., 396 Chou, S. P., 338 Chow, J., 417 Christian, J., 364 Chronological era, 15 Chung, J. E., 353 Churchill, Winston, 212 Ciabattari, Teresa, 302, 305, 306, 336, 337 Civil annulment, 336 Clark, E., 376 Clark, J. L., 180 Class consciousness, 43, 295 Classen, C., 347 Classical conditioning, 63, 65 Classical sociological theories of social inequality, 294–295

1165

Clinical theory, 58 Clinton, Hillary, 256 Clock time, 13 Closed groups, 354 Closed system, 39 Coates, B., 424 Cognition and emotion, 109–110 Cognition theories, 110–117 Cognitive behavioral theory (CBT), 64, 65, 66, 116 Cognitive mediation, 111 Cognitive operations, 110 Cognitive processing theory, 66 Cognitive psychology, 56 Cognitive social learning theory, 64, 65 Cognitive structure, self as, 125–126 Cognitive/emotional “disorders,” 123–127 Cohabiting opposite-sex couples, 319–320 Cohen, H. L., 54 Cohen, J., 320 Cohen, M., 58 Cohn, D., 16 Cohort effects, 313 Coleman, J., 47–48 Coleman, Mardia, 424 Coles, R., 21–22 Coley, Richard, 280 Collaborative model of practice vs. conflict model, 422–423 Collective agency, 64, 66 Collective efficacy, 416 Collins, Patricia Hill, 312, 419 Collins, R., 46, 48–49, 50 Colonialism, 269 Common Communication Patterns in Groups, 365 Communication processes, 316 Community, 401–426

active learning, 425–426 case studies, 402–403 conflict approach, 418–420 as context for practice vs. target of practice, 420–421 contrasting types approach, 409–410

1166

critical thinking questions, 407, 415, 420, 422, 424 definition of, 403–404 exhibits, 404, 409, 410, 413 implications for social work practice, 424–425 key terms, 425 learning objectives, 401 sense of, 404 social capital approach, 415–418 social systems approach, 413–415 social workers and communities, contemporary issues, 420–424 social workers and communities, history, 407–408 spatial arrangements approach, 410–413 territorial community and relational community, 404–407 theoretical approaches to, 408–420 web resources, 426

Community development, 422 Compassion fatigue, 392 Computer mediated groups, 352–354 Concepts, 24 Conflict approach (community), 418–420 Conflict perspective, 42–47

overview of, 34 power relations and, 45–46 roots of, 43–45 visual representation of, 43

Conflict vs. collaborative model of practice, 422–423 Conger, K., 329 Conger, R., 329–330 Connolly, M., 421 Conrad, David, 392 Conscience constituency, 444 Consciousness

levels of, 176 states of, 180

Conservative thesis of inequality, 294 Constructionist principle, 386 Contrasting types approach (community), 409–410 Control, 378 Control theories, 200–205

crowding, 204–205

1167

personal space, 201–203 privacy, 200–201 territoriality, 204

Convivial collectivism, 331 Cook, K., 48, 359 Cooley, C., 52 Cooley, Charles, 409 Cooper, A., 391 Cooperrider, D., 384, 386 Copen, C., 319, 336 Coping and adaptation, 142–152

abnormal and normal coping, 152–154 biological coping, 142–143 coping styles, 145–147 psychological coping, 143–145 relational coping, 145 social support, 148–152 traumatic stress and, 147–148

Core capabilities, 20, 68 Core nations, 18, 44 Cortright, B., 180 Corwyn, R., 330 Coser, L., 45 Costantini, S., 417 Cotter, K., 318 Couchonnal, G., 54 Coulson, N., 353 Coulton, C., 412 Council on Social Word Education (CSWE), 5–6, 15, 16, 19, 23, 24, 33, 181, 198, 431

Educational Policy and Accreditation Standards for Competencies, 6, 16, 38, 39–40, 198, 210, 431 Educational Policy Statement, 33 on research methods, 25

Countercultures and subcultures, 239–240 Countermovements, 435 Couples with no children, 320–321 Courtney, Mark, 421 Cousins, Linwood, 228, 253 Cowley, Au-Deane, 175, 180

1168

Cox, D., 20, 397 Cox, T., Jr., 384–385 Cox, Taylor, 385 Coyhis, D., 421 Coyle, James, 338–339 Coyne, R., 352, 360–361, 365 Cozolino, L., 241 Craig, S., 452 Cramer, Elizabeth P., 104 Crawford, P., 217 Crayton, T., 353 Creemers, H., 421 Crimmins, T., 222 Crisis and stress, 139–140 Critical consciousness, 296 Critical perspective on organizations, 386–390

nonhierarchical organizations, 388–390 organizations as multiple oppressions, 388 overview, 386–387 theory of gendered organizations, 387

Critical race theory (CRT), 45 Critical thinking, 25–27 Critical thinking questions

biological person, 82, 88, 94, 102, 104 communities, 407, 415, 420, 422, 424 cultures, 236, 240, 246, 255, 258 formal organizations, 376, 383, 390, 396, 398 physical environment, 203, 206, 212, 217, 225 psychological person, 113, 117, 121, 124, 127 psychosocial person, 136, 138, 142, 148, 156 social movements, 431, 437, 442, 450, 454 social structure and social institutions, 269, 277, 284, 294, 296 spiritual person, 171, 180, 188, 191, 192

Cronley, C., 52 Crook, W., 378 Crosnoe, R., 326 Crowding, 204–205 Culhane, D., 413 Cultural diversity, 330–333 Cultural framing perspective (social movements), 442–449

1169

frames for establishing goals, 446–447 frames for identifying pathways for action, 447–449 frames for recognizing window of opportunity, 446 frames for understanding a problem exists, 444–446

Cultural humility, 240 Cultural relativism and ethnocentrism, 236–240 Cultural sensitivity and social workers, 330–331 Culturally sensitive care systems, 397–398 Culturally sensitive practice, 398 Culture, 7, 228–260

active learning, 259 case studies, 229–230 changing, 256–258 critical thinking questions, 236, 240, 246, 255, 258 culture and power, 241–255 definitions, 230–232 digital culture, 255–256 ethnocentrism and cultural relativism, 240–241 exhibits, 231, 233, 235, 244, 247, 249 genes and, 255 ideology, 237 implications for social work practice, 258 key terms, 259 language, 238–239 learning objectives, 228–229 major concepts in study of, 236–240 music, 232 norms, 239 real vs. ideal, 240 subcultures and countercultures, 239–240 symbols, 237–238 theories of, 233–236 values, 236–237 web resources, 259–260

Cummings, S., 366 Cunningham, K., 66 Cyberstalking, 353 Cyclical modes, 360–361 Czarniawska, B., 376

1170

Daas, K., 311 Daily hassles, 139 Dalgin, R. E., 367 Damon, Matt, 436 Daniels, K., 319, 336 Data collection, 27 Data interpretation, 27 Davidson, R., 11, 13, 14, 57, 58, 65, 66, 68, 85, 102, 119, 119 (figure) Davies, M. F., 364–365 Davis, B., 326 Davis, Gene, 375, 382, 438–439, 444, 452 Davis, J., 382 Davis, L. E., 355, 364 Davis, M., 362 Dawson, E., 338 Day, M., 366 Day, P., 414 Deacon, Z., 412 Deal, T., 376 Dean, Ruth G., 398 Dearing, E., 330 Decision-making theory, 380 Deductive reasoning, 24 Deep ecology, 41, 42, 206 Defense mechanisms, 143 DeFillippis, J., 422 Degarmo, D., 336 DeJong, C., 27 Dekovic, M., 421 Delgado, M., 413, 418 Delgado, R., 45 Della Porta, D., 430, 432, 434–436, 438–439, 444–446, 448–449, 451–452 DeLucia-Whaack, J., 347 Demby, A., 362 Demo, D., 338 Denby, R., 396 Density, 204 DePoy, E., 41, 53, 79, 80, 81, 96 DePoy, Elizabeth, 76

1171

Determinism, 24 Deusen, C., 397 Developed countries, 18 Developing countries, 18 Development, impact of early nurturing on, 134–136 Developmental perspective, 36, 59–62 Deviance, 153–154 Diani, M., 430, 434–436, 438, 438–439, 444–446, 448–449, 451 Diehl, A., 396 Differential emotions theory, 118 Differentiation of self, 307 Diffuse status characteristics, 359 Digital culture, 255–256 Dijkstra, S., 421 DiMaggio, P. J., 382 Dimension, 6, 8–9 DiPrete, T., 406 Disability, 253–255

accessible environments for persons with, 222–225 Diversity, 16–17, 182–188, 330–333, 385 Diversity, economic and cultural

cultural diversity, 330–333 economic diversity, 328–330 immigrant families, 333–334

Divorce and relationship dissolution, 336–338 Dixon, J., 419 Dodge, Alexa, 251 Dogan, R., 419 Donnellan, M. B., 330 Dopamine (DA), 57, 84–85 Dorfman, P., 397 Dormcest, 303 Double-cousin marriage, 303 Downer, J., 330 Drake, R. E., 347 Drive/instinct theory, 55 Drucker, Peter, 377, 380 Dudziak, S., 431 Dunbar-Ortiz, R., 304 Duntley-Matos, R., 413

1172

Durand, E., 412 Durkheim, Émile, 296, 409 Dwamena, F., 9 Dworkin, J., 346 Dworkis, D., 413 Dyadic relationships, 12 Dybicz, P., 51

Eacott, M., 13 Earle, A., 305 Easton, A., 13 Ecobiodevelopmental framework to understand relationship between interior health and exterior environments, 102–104 Ecocritical theories, 206 Ecofeminism, 206 Ecological justice, 68, 209–212 Ecological perspective, 11, 12 Ecological theory, 39–40 Economic diversity, 328–330 Economic institution, trends in, 273–277 Ecotherapy, 209 Edin, K., 322–323 Educational institution, trends in, 277–281 Educational Policy and Accreditation Standards for Competencies (CSWE), 6, 16, 19, 22, 33, 38, 39–40, 198, 210, 431 Educational Policy Statement (CSWE), 33 Edwards, Gemma, 432, 439 Efficacy expectation, 64 Efficiency, 378 Egeren, L., 412 Ego, 56 Ego psychology, 56–57, 120–121, 120–121 Eheart, B., 424 Eichler, Michael, 423 Eiden, R., 338 Elder, Glenn, 329 Elder abuse, 335 Elder, G., Jr., 61 Elites, 434 Elliott, K., 324

1173

Ellis, C. P., 454 Ellison, N., 414 Elwell, L., 353 Emotion, 109

cognition and, 109–110 physiological theories of, 117–119 psychological theories of, 119–122 social theories of, 122 theories of, 117–123

Emotional closeness, 303 Emotional divorce, 337 Emotional intelligence, theory of, 121–122 Emotional labor, 392 Emotional/cognitive “disorders,” 123–127 Emotion-focused coping, 145 Emotions, primary, 117 Empirical research, 24–25 Empowerment theories, 45, 13 Emshoff, J., 339 Enculturation, 232 Endocrine system, 86–88 End-of-life care, 32–33 Endogamy rules, 303 Engel, R., 25 Engels, F., 43 Englar-Carlson, M., 347, 352, 361 Ensari, N., 364 Entrainment, 53 Environment, built, 212–219

healing environments, 215–218 place attachment, 219–220 technology, 212–215 urban design and health, 218–219

Environment, multiple dimensions of, 195. See also Community; Culture; Environment, physical; Families; Organizations, formal; Small groups; Social movements; Social structure and social institutions Environment, natural, 207–212

benefits and costs of human interaction with, 207–209 ecological justice and, 209–212

1174

Environment, physical accessible environments for persons with disabilities, 222–225 active learning, 226 built environment, 212–219 case studies, 197–198 critical thinking questions, 203, 206, 212, 217, 225 exhibits, 199, 207, 213, 216, 218, 221, 224 homelessness, 220–222 implications for social work practice, 225 key terms, 226 learning objectives, 196 natural environment, 207–212 place attachment, 219–220 theories of human behavior and, 198–206 web resources, 226–227

Environmental and ecological justice, 209–212 Environmental dimensions, empirical research, 7–8, 9, 10, 11–12 Environmental justice, 210 Enzmann, D., 391 Epigenetic model of human development, 59–60 Epstein, I., 366–367 Erikson, E., 56, 59–60, 61, 153 Ernst, J., 412 Ethics, 22 Ethnic identity, 245 Ethnicity, 182–185, 244–246 Ethnocentrism and cultural relativism, 236–240 Etzion, D., 376 Event time, 13 Evidence-based design, 216 Evidence-based practice, 378 Exchange and choice perspective, 47–50

actor-network theory, 49, 50, 68 evaluation criteria for, 49–50 on families, 308–310 interaction ritual chains, 48–49, 50 overview of, 34–35 rational choice theory, 47–48 social capital theory, 48 social exchange theory, 47, 51

1175

social network theory, 48 visual representation of, 48

Exchange network, 48 Exchange theory, 359–360 Exhibits

accessible environments for persons with bodily impairments, some design elements of, 224–225 architecture, selected research findings about therapeutic use of, 213 assistive technology for persons with physical impairments, current and near-future examples of, 216 assumptions of theory x and theory y, 380 behavioral change strategies, four, 116 blood flow through heart, direction of, 92 brain, selected areas of, 83 cerebral cortex, regions of, 84 cognitive distortions, common, 115 communities, four elements of, 410 communities, gemeinschaft and gesellschaft, 409 community, essential elements of and essential sense of, 404 community culture and community structure, aspects of, 413 coping styles among social work students, 146 critical perspective on formal organizations, 387 cultural creations, 233 cultural frames used in recent social movements around world, 443–444 cultural framing perspective, key ideas of, 443 culture, categories of definitions of, 231 culture, characteristics of traditional, modern, and postmodern, 235 culture used in contemporary anthropology, cultural psychology, cultural studies, and sociology, definitions of, 231 Dan’s social network, 150 Davidson’s six components of emotional style, 119 defense mechanisms, common, 144–145 DSM-5 classification of mental disorders, 153 emotion-based problems in social functioning, four sources of, 123 employees in unions (%) in selected countries in 2015, proportion of, 277

1176

endocrine glands and their effects within corpus, selected, 87 environment, benefits of time spent in natural, 207 Erikson’s stages of psychosocial development, 154 feedback loop, an example of a, 88 female external sex organs, 99 female internal sex organs, 100 formal organizations, traits of a consensual model of, 389 Gardner’s eight intelligences, 112 gender equality, ten countries with most and least, 249 gender identity labels and definitions, 247 general adaptation syndrome, 143 Gilligan’s three stages of moral development, 114 Gini index of inequality in United States, 1970–2016, 267 global religions, 2015, 169 health care settings, features of evidence-based design for, 218 health spending as percentage of GDP (2014) and average life expectancy at birth (2015) in selected countries, 283 homelessness, categories in U.S. Department of Housing and Urban Development definition of, 221 interactional/interpretive perspective on formal organizations, 384 key social institutions and function they perform, 265 knee joint, structure of, 96 Kohlberg’s levels and stages of moral development, 114 male reproductive system,, 98 mass media institution, four elements of, 291 mobilizing structures perspective, key ideas of, 438 neuron, features of a typical, 84 person in environment (PIE) classification system,, 155 PFLAG, statement of priorities, vision, and mission of, 446 physical environment and human behavior, four categories of theories about relationship between, 199 Piaget’s stages of cognitive operations, 110 PISA scores for 15-year-old U.S. students with students from other wealthy countries, comparison of, 279 political process perspective, key ideas of, 434 psychological views of source of emotion, 119 public social expenditures on social welfare as a percentage of GDP in 1990 and 2016, 285 racial categories and descriptions used by U.S. Census Bureau,

1177

244 rational perspective on formal organizations, 377 religious affiliation of, change in U.S. adult population, 2007– 2014, 166 religious landscape, U.S., 167 a selected history of development of new information and communication technologies, 439 SMOs, characteristics of moderate and radical, 453 social inequality ranking in 18 advanced industrial countries from 2010 to 2015, 267 spiritual assessment, examples of questions for implicit, 192 spirituality, symbolic themes of, 166 systems perspective on formal organizations,, 381 Taylor’s scientific management, 378 votes cast in most recent national election (as of 2017) as percentage of voting-age population, 272 Weber’s ideal-type bureaucracy, 377

Existential psychology, 67 Expert vs. partner in social change process, 423–424 Extended families, 318–319 Externalizing (hostile and aggressive) behaviors, 335

Fadiman, Anne, 178, 330 Fagan, P., 323 Faith, 172 Faith stages, 172 Falicov, C., 333 Fallon, A., 361 False consciousness, 43 Families, 7

defined, 301–303 diversity in family structure, 316–328 divorce and relationship dissolution, 336–338 economic and cultural diversity, 328–334 exchange and choice perspective on, 308–310 family stress, coping and resilience perspective on, 313–316 family systems perspective on, 306–308 family violence, 334–336 feminist perspective on, 312 in historical perspective, 303–306

1178

implication for social work practice, 340–341 life course development perspective on, 313–314 substance abuse, 338–340 symbolic interaction perspective on, 310–312

Family and kinship institution, trends in, 292–294 Family and Medical Leave Act (FMLA) 1993, 305 Family belief system, 314 Family economic stress model, 329 Family investment model, 330 Family of origin, 306–307 Family reliance perspective, 314 Family stress, coping and resilience perspective, on families, 313–316 Family structure, diversity in

cohabiting opposite-sex couples, 319–320 couples with no children, 320–321 lone-parent families, 321–323 military families, 325–328 nuclear families, 316–319 same-sex partner families, 324–326 stepfamilies, 323–324

Family timeline, 314 Family violence, 334–336 Fan, G., 347 Fan, Z., 336 Fandows, N., 429 Farmer, R., 63 Farrell, M., 444 Feedback mechanisms, 38–39 Feldman, R., 411 Felson, R., 310 Feminist perspective on families, 312 Feminist standpoint theory, 52 Feminist theories, 45 Feminist theories of relationships, 136 Ferree, M. M., 389 Ferrer, Jorge, 176 Fertig, R., 422 Fettro, M., 325 Few, A., 312 Fight-or-flight response, 118

1179

Figley, C. R., 314 Fincham, F., 391 Fine, M., 338 Fingerhut, A., 325 Finkelhor, D., 335 Firestein, S., 24, 25, 27 First force therapies, 175 First generation immigrants, 333 First World, 18 Fischer, David, 304 Fisher, Robert, 418, 419–420, 421–423 Fisher, S., 255 Fitzgerald, K., 453 Fitzgerald, M., 391 Flacks, Richard, 450 Flake, E., 326–328 Flanagan, L., 56 Flores, P., 57, 58 Flow of experience, self as, 126–127 Follett, Mary Parker, 384, 387, 388 Forgatch, M., 336 Formed groups, 354 For-profit organizations, 393 Fortin, A., 9 Foster families, 318 Foster-Fishman, P., 412 Foucault, M., M., 54 Fourth force therapies, 175 Fowler, James, 171–173 Fowler, Leigh, 447 Fowler’s and Wilber’s theories, summary and critique of, 179–180 Fowler’s stages of faith development, 172–175 Fox, S., 353 Frames

for establishing goals, 446–447 for identifying pathways for action, 447–449 for recognizing window of opportunity, 446 for understanding a problem exists, 444–446

Framing contests, 444 Francescato, Donata, 413, 418–419

1180

Franco, M., 417 Frankel, R., 9 Franklin, A., 68 Franzini, A., 58 Fraser, C., 339 Fraser, M., 40 Freedberg, S., 58 Freeman, E., 54 Freeman, Jo, 442, 452 Freeman, R., 389 Fremaux, Isabelle, 419 Freud, S., 55–56, 57, 59, 120, 171 Freudenberger, H., 390 Frey, L., 358 Friend, D., 336 Fuhrman, O., 13 Funding, bias and, 26 Fung, H., 15 Furman, L. D., 165, 180, 187, 190, 192 Fuzzy set theory, 41

Gallagher, L., 411 Gambini, O., 58 Gamble, D., 424 Gamson, W., 446 Gana, K., 321 Gant, L., 424 Gardiner, H., 114, 302–303 Gardner, Howard, 111–112 Garneau, C., 323 Garner, Roberta, 432 Garrett, K., 347 Garrow, E., 375–377, 379–382, 389 Gates, G., 325 Gatumba massacre, 4, 7, 8, 21 Geiger, J., 318 Geist, C., 302 Geller, M., 357 Gelles, R., 334–345 Gemeinschaft, 409

1181

Gender, 246–249 moral reasoning and, 113–114 power and, 65 vs. sex, 97, 185–186

Gender roles, 305–306, 311, 312 Gendered organizations, theory of, 387–388 General adaptation syndrome, 142 General systems theory, 39 Generalized other, 52 Genes and culture, 255 Genogram, 307 Geographic information system (GIS), 412 George, L., 61 Gerdes, A., 68 Gergen, K., 51 Germain, Carel, 198 Gesellschaft, 409 Ghadban, S., 200 Giang, T., 412 Gibbs, A., 318 Gibbs, N., 305 Gibson-Davis, C., 323 Giddens, A., 40, 264–265, 296 Gifford, R., 220 Gilbert, L., 330 Gill, Stephen, 383 Gilligan, Carol, 113, 136 Gil-Rivas, V., 326–327 Gilson, S. F., 41, 53, 79, 80, 81, 96 Gilson, Stephen French, 76 Gintis, H., 255 GIS (geographic information system), 412 Gittell, J., 375–376, 383 Gitterman, A., 198, 347 Gladstone, T., 396 Global North, 18 Global South, 18, 20 Globalization, 16, 40, 41, 42, 169, 170, 204, 240, 257, 264–266, 270, 270–271, 274–276, 292–293, 445–446, 451 Globalization theories, 40

1182

Godoy, S., 251 Godsall, R., 339 Godwyn, M., 375–376, 383 Goffman, E., 52 Goldstein, D., 55 Goldstein, E. G., 56 Golembiewski, Robert T., 390 Golick, T., 367 Gomez, E., 396 Gonzales, A., 352–353 Goodwin, J., 430, 432, 434–435, 438, 442, 450 Gotta, G., 325 Gottman, J., 335 Goudie, R., 221 Gould, Deborah, 449 Gour, D., 421 Government and political institution, trends in, 269–273 Graham, M., 321 Granovetter, Mark, 409 Grant, B., 338 Grant, J., 54 Gray, M., 424 Green, E., 417 Green, G., 421 Green, R., 324–325 Green, R. R., 54 Greenberg, L. S., 123 Greene, D., 336 Greenwald, H., 376 Griswold, Wendy, 407 Grof, Stanislav, 176, 180 Grogan, S., 353 Grogan-Kaylor, A., 416 Grohol, J., 396 Group composition, 355–357 Group development

process models, 362 stage theories and models, 360–361

Group dynamics communication networks, 365–366

1183

formal and informal leadership, 362–364 formal and informal roles, 364–365

Group processes, basic group dynamics, 362–366 theories of group processes, 357–362

Group structure, dimensions of, 354–355 Group work, 346 Group Work Section, National Conference on Social Work, 1935, 347 Groups, natural, 354 Groups, small. See Small groups Groups, types of, 348 Gudmunson, C., 330 Guerts, T., 310 Guest, K., 232, 247 Gunnell, D., 49 Guo, C., 396 Gupta, V., 397 Gur-Yaish, N., 310 Gusterson, H., 253 Gutierrez, L., 45 Gutman, L., 330 Guy, Mary, 392 Guzzo, K., 323

Haan, N., 114–115, 115 Habermas, J., 43 Haines, A., 421 Halgin, D., 414 Hall, Edward, 202 Hamby, S., 335 Hamel, R., 208 Hamon, R., 306, 308, 310 Han, K., 323 Hanges, P., 397 Hansen, D, 346 Hanson, K., 340 Haraway, D., 49 Hareven, T. K., 317 Harmony collectivism, 331

1184

Harrigan, M., 21 Harris, A., 45 Harris, John, 447 Harrison, R., 417 Hart, J., 67 Hartman, A., 308 Hasenfeld, Yeheskel, 375–377, 379–382, 389, 394, 395, 453 Haslam, S. A., 360 Hassanein, K., 352 Hastings, M., 445 Hata, A., 412 Havigerová, J., 302 Haviland, W., 234, 303, 316, 319 Havnen, K., 338 Hawthorne effect, 379 Hayes, J., 305 Hays, P., 217 Head, M., 352 Healing environments, 215–218 Health care institution, trends in, 281–284 Hearn, J., 387, 388 Hegel, G., 42 Hegemony, 242 Heid, A., 416 Heidemann, G., 422 Heine, S., 27 Helwig, C. C., 114–115 Henderson, A., 307, 310, 313 Henrich, J., 27 Hepworth, D. H., 21 Herbert, G., 405 Heredity, genetics, and reproductive system, 100–102 Hervas, G., 68 Hesse, M., 339 Heterogeneity, 17, 355 Hetherington, E., 336, 338 Heuveline, Patrick, 319 Heymann, J., 305 Hickson, J., 180 Hierarchy of needs, 66–67

1185

High blood pressure, 93 Hill, E., 330 Hill, Rueben, 313 Hillery, George, 403 Hillier, Amy, 412–413 Hilton, T., 27 Hinkle, S., 360 Historical era, 15 Hitchcock, 353 Hitchcock, J. A., 353 Hitt, 383 Hitt, M., 383 HIV (human immunodeficiency virus), 88–89 Hjern, A., 340 Ho, Karen, 253 Ho, M., 319 Hodgetts, D., 418 Hodkinson, P., 290 Hofstede, Geert, 375–376, 397 Hogg, M., 360 Holistic practice, 39 Hollinghurst, S., 49 Hollingsworth, L., 424 Hollman, 359 Hollman, R., 359 Holman, E. A., 11 Holtzworth-Munroe, A., 336 Homas, G., 47, 50 Homelessness, 220–222 Homeostasis, 142 Homogeneity, 355 Hopkins, R., 416 Hopping, D., 424 Hordyk, S., 198 Horizontal linkage, 414 Horrigan, J., 414–415 Host organizations, 393 Hotho, J., 382 Hou, Y., 331 House, R., 397

1186

Houston, J. B., 328 Huang, C., 323 Huang, P., 319 Huber, M. S., 412 Hubler, D., 310 Hudson, R. E., 45, 347 Hughes, Bill, 444 Huisman, E. R. C. M., 217–218 Human behavior theory, 58 Human immunodeficiency virus (HIV), 88–89 Human relations theory, 378–380 Human rights, 20 Human Rights Watch, 8 Human service organizations, 393 Humanistic perspective, 66–70

capabilities approach, 68, 69 evaluation criteria for, 68–69 hierarchy of needs and, 66–67 overview of, 37 positive psychology, 67–68, 69 posthumanism, 68 visual representation of, 67

Hunsaker, J. S., 363 Hunsaker, P. L., 363 Huston, T., 308 Hutchison, E., 11, 21, 196, 228, 261, 335, 371, 401, 427, 439 Hybrid organization, 394 Hyde, Cheryl, 453 Hynes, P., 219 Hypertension, 93 Hypotheses, 23

Iannello, Kathleen, 389 ICT (information and communication technology), 439–441 Id, 55 Ideology, 237 Imber-Black, E., 311 Immigrant families, 333–334 Immigration, 16–17 Immigration Act, 1990, 333

1187

Immune system, 88–91 Implicit bias, 241 Impression management, 52 Indigenous Environmental Network, 428 Inequality, 17–19

theories of, 294–296 Information and communication technology (ICT), 395, 439–441 Information processing theory, 110–111 Ingersoll-Dayton, B., 310 In-groups, 360 Institutional theory of organizations, 382 Integrative approach for understanding intersection of interior biological health and illness and exterior environmental factors, 79–82 Interaction ritual chains, 48–49, 50 Interactional/interpretive perspective, 383–386

appreciative inquiry model of organizational change, 385–386 critical perspective, 386 managing diversity model, 385 organizational culture model, 384–385 on organizations, 383 overview of, 383–384

Interdisciplinary teams and leadership, 366–368 and social work, 366–367

Interior environment systems. See Systems taxonomy Internalizing (withdrawal, anxiety, and depression), 335 International relations, 437 Interpretist perspective, 25 Intersectionality feminist theory, 312 Intersectionality theory, 46, 11, 21 Iron cage of rationality, 377 Ishii, T., 412 Israelsen, C., 330 Ivanova, A., 330 Iverson, K., 66 Ivery, J., 421 Ivins, M., 454

Jackson, Jesse, 436

1188

Jackson, S., 390 Jakobsen, R., 338 Jakubowska, S., 321 James, William, 117–118 Jani, J., 41 Jansson, B., 422 Janutaite, S., 353 Jasinski, J., 334 Jaskyte, K., 395 Jasper, J., 430, 432, 434–435, 438, 442, 450 Javidan, M., 397 Jaycox, L., 328 Jennings, M. Z., 412 Jensen, M., 361 Jenson, J., 40 Ji, J., 390 Jobin-Leeds, G., 429, 436, 447–448, 452 Johannsson, U., 388 Johnson, K., 323, 336 Johnson, M., 308–310 Johnson, P., 326 Johnston, 353 Jones, A., 352–353, 353, 361, 413–414, 415 Jones, H., 361 Jones, T., 366 Joosten, D., 412 Jorgensen, G., 305 Jørgensen, K., 200 Judd, R. G., 353 Julien-Chinn, F., 318 Jung, Carl, 171 “Junk food journalism,” 378 Jurkovic, G., 339

Kahn, J., 329 Kahneman, D., 22, 49, 56, 117, 22, 52, 117, 380 Kaiser Family Foundation, 91 Kalkhoff, W., 360 Kalodner, C., 347 Kam, C., 15

1189

Kanaki, E., 364–365 Kao, D., 390 Karakowsky, L., 356 Kardanova, E., 330 Karenga, Maulana, 183 Karger, Howard, 393–395, 418, 421–423 Karls, James, 154 Karmanov, D., 208 Karpowitz C., 356, 359, 364 Karpyn, A., 412 Karraker, M., 302 Katz, R., 310 Kay, A., 415 Kayser, K., 351 Kellar-Guenther, Yvonne, 392 Kelley, H. H., 308 Kelly, J., 338 Kennedy, Edward, 436 Kenney, J. Scott, 449–450 Kent, Susan, 200 Kerney, A., 412 Kespichayawattana, J., 318 Kessler, D., 49 Kettner, P., 375 Kettner-Polley, R., 357 Khng, J., 347 Kibbe, S., 353 Kids Count Data Center, 321–322 Kielburger, Craig, 454 Kihlström, A., 40 Kilmer, R., 326 Kim, H., 331–333, 390, 392 King, M., 66 King, Martin Luther, 448 King, S., 420 King, V., 324, 338 Kinicki, A., 330 Kinkade, K., 66 Kirk, G., 244 Kish, D., 81

1190

Kissane, R., 322 Kitayama, S., 134 Kitchen, A., 366 Kjellgren, A., 208 Klebs, Theodore, 246 Klein, R., 255, 302 Kloos, B., 417 Knodel, J., 318 Knowing how, elements of, 21–27 Kogan, M., 11 Kogler Hill, S., 366, 368 Kohen, D., 330 Kohlberg, Lawrence, 113–115 Kohli, M., 320 Kolodny, R., 361 Kondrat, M. E., 8 Kondrat, Mary Ellen, 296 Korgen, K., 346 Kort, H. S. M., 217–218 Kottler, 361 Kottler, J., 347, 352, 361 Kraaykamp, G., 311 Kraeger, D., 310 Krahn, D., 396 Krause, M., 408 Kravetz, Diane, 389 Kreider, R., 317 Kriesi, H., 432, 441 Krill, D. F., 67 Kroll, Brynna, 338 Kropf, N., 366–367 Kruse, D., 389 Kulick, Don, 254 Kupritz, Virginia, 200 Kurdek, L., 325 Kurtz, Lester, 169–170, 288, 289 Kurtz, M., 170, 288 Kurtz, Sharon, 388 Kurzweil, R., 68, 213–214, 215

1191

Lachs, M., 335 Laird, J., 308, 398 Lakoff, George, 447 Lalayants, M., 366–367 Lam, G., 421 Lamidi, E., 325 Lampe, C., 414 Landry, B., 306 Lang, F., 321 Language, 238–239 Larkin, H., 352–353, 366 LaRocque, S. E., 347 Larrson, G., 364 Larson, J., 326 Larson, R., 346 Latour, B., 49 Lau, W., 347 Laurison, H., 412 Law, L., 417 Lazarus, R., 121, 139 Leadership, 363, 367 Leaf, J., 346 Learned helplessness, 65 Learning organizational theory, 382–383 Leca, B., 376 LeCroy, C., 11 Lee, B., 415 Lee, D., 200–201 Lee, J. A., 45, 54, 347 Lee, Soon Min, 402 Leeder, E., 23, 304, 318, 347 Legal custody, 337 LegalMatch, 2014, 303 Legitimate communities, 81 Leighninger, L., 393 Leinonen, J., 330 Leite, R., 312 Leiter, M., 390 Lengermann, P., 45, 58 Lenski, Gerhard, 294

1192

Leonard, K., 338 Leszcz. M., 362, 365 Levi, D., 353, 365–366 Levinson, D., 62 Levitz, J., 449 Lewandowski, C. A., 192 Lewis, J., 317 Lewis, M., 253 Lewis, Oscar, 252 Lewis, S., 69 LGBTQ, 186–187, 251, 324, 442 Li, J., 356 Li, W., 418 Lieberman, M., 11 Lietz, C., 318 Life course perspective, 60–61, 62

on families, 313–314 Life span/life cycle theory, 59–60, 61, 62 Lighthouse, A., 58 Limbic system, 56, 57, 85, 118, 119 Lindgren, S., 256 Linear time, 13 Linver, M., 330, 347 Living, problems in, 188–189 Livingston, G., 293, 321 Lizano, E., 391 Lizárraga, C., 431 Lloyd, S., 312 Logan, L., 387 Lombe, M., 351 Long, G., 277 Looking-glass self, 52 Lopez, R., 219 Lopez-Gomez, I., 68 Lorber, Judith, 246 Lovaglia, M. J., 359 Lovett, I., 449 Low, P., 200–201 Lowenstein, A., 310 Lownsdale, S., 174

1193

Lu, F., 192 Luhman, N., 40–41 Lum, D., 398 Luthans, F., 392 Lymphocytes, 90 Lyon, Larry, 404 Lyotard, J., 51

Ma, J., 416 Machiavelli, N., 42 Mackrill, T., 339 MacNair, R., 447 MacNair, Ray, 447 Magen, R., 355 Mahfouz, Asmaa, 440 Maidenberg, M. P., 367 Maier, S., 65 Mak, W., 417 Maladaptation, 314 Malanga, S., 443 Maldonado, L., 322 Malone, D. M., 366–367 Management, scientific, 378 Management by objectives (MBO), 380 Manby, M., 339 Mandayam, G., 412 Mangiardi, E., 355 Mann, C., 16 Mannarini, T., 418, 419 Manning, W., 319–320, 325 Mannix, E., 359 Manyena, S., 416 Manzanera-Ruiz, R., 431 Mapp, S., 20 March, J., 377 March, James, 380 Marino, R., 367 Market models, 49 Marks, G., 434 Markus, H. R., 134

1194

Marti, I., 376 Martin, G., 405 Martin, J., 328, 396 Martin, M., 330 Martin, P. Y., 389 Martin, T., 302, 339 Martinez, Gladys, 320, 321 Martinez-Brawley, E., 420 Martinez-Brawley, Emilia, 420 Martin-Storey, A., 326 Marx, G., 441, 446 Marx, Karl, 43, 294–295 Maslach, C., 390–391 Maslach Burnout Inventory (MBI), 390 Maslow, Abraham, 66–67, 69, 171, 175, 176 Mason, E., 324 Mass media institution, trends in, 289–292 Mastracci, S., 392 Material culture, 231 Materialist perspective of culture, 234 Mathambo, V., 318 Matto, H., 21 May, A., 366 May, R., 391 Maynard-Moody, S., 392 Mayo, Elton, 377, 378–379 MBO (management by objectives), 380 McAdam, D., 434–435, 437–439, 441, 443–444, 446, 448 McAvoy, M., 25 McCarroll, J., 336 McCarthy, J., 435 McCarthy, R., 326 McCormick, K., 13 McCoy, J., 330 McCroskey, J., 422 McCubbin, H. I., 314 McFarlane, J., 335 McGillicuddy, N., 396 Mcginty, Ann, 238 McGoldrick, M., 313, 330–332

1195

McGregor, D., 69, 380 McHale, M., 310 McHugo, G. J., 347 McIntosh, P., 11, 17–18 McIntyre, A., 339 Mckee-Ryan, F., 329 McKenry, P., 313 McKibben, Bill, 447, 448 McLanahan, S., 323 McLaughin, K. A., 136 McLeod, P., 357 McLoyd, V., 330 McMichael, P., 7, 42, 46, 451–452 McMichael, Philip, 265, 266, 270, 274, 306 McMillan, David, 416–417 McMullen, J., 394 McMurtry, S., 375 McPherson, M., 149, 405–406 McWhirter, C., 449 Mead, George Herbert, 52, 85, 122, 123 Meadows, S., 326–327 Mederos, R., 366 Medicaid, 393 Medical (psychiatric) perspective, 152 Meier, A., 352, 353, 413, 414, 415 Melchert, T., 9, 33 Melunsky, 346 Memmi, Daniel, 410 Mendelberg, T., 356 Mendez, J., 330 Mental time travel, 13 Mentalist perspective of culture, 234–236 Merry, J., 362 Messina, G., 58 Metacognition, 22 Metaferia, H., 350 Meuleman, R., 311 Meyer, A., 375 Meyer, C., 21 Meyer, D., 434, 446–447

1196

Meyer, J., 381–382 Meyer, K., 383 Meyer, M., 394, 452 Meyer, Megan, 453 Mezzi, M., 418 Michel, Robert, 386 Microaggressions, 45 Middleton, L., 326 Mikulas, W. L., 180 Military families, 325–328 Milkie, M., 306 Miller, V., 428 Minieri, A., 310 Miran-Khan, C., 324 Mistry, R., 330 Mitchell, E., 424 Mitchell, K., 58 Mizrahi, T., 367, 421, 423 Mmatli, Tlamelo, 421–422 Mobilizing structures perspective, 437–442

informal and formal structures, 438–439 information and communication technology (ICT), 439–441 life course of social movements, 441–442

Model, defined, 23 Moffatt, K., 389–390 Mohai, P., 412 Molassiotis, A., 347 Monette, D., 27 Monte, C., 68 Montenegro, C., 408 Mood, 109 Moore, D., 421 Moore, Michael, 436 Mor Barak, M., 385, 391 Moral reasoning, theories of, 113–115 Morales, E., 217–218 Morales, J., 412 Morality, 113 Morgaine, K., 390 Morgan, Gareth, 375–376, 383–386

1197

Morgan, R., 334 Morris, A., 434, 438 Morris, P. M., 20 Mosher, W., 319, 336 Moynihan, Daniel Patrick, 252 MPSOC (multiple psychological senses of community), 417 Mueller, C., 397 Mueser, K. T., 347 Mulroy, E., 421 Multiculturalism, 245 Multidetermined behavior, 9 Multidimensional approach, 6–9

implications for social work practice, 28–29 Multilevel family practice model, 308 Multiple intelligences, theory of, 111–113 Multiple psychological senses of community (MPSOC), 417 Musculoskeletal system, 94–96 Musick, K., 320 Mutual aid groups, 348, 349–350 Myers, S., 363–365

Naess, Arne, 206 Nagai, C., 58 Narrow, W., 192 NASW Virgina, 367 National Association of Social Workers (NASW), 5, 42, 347, 374 National Association of Social Workers (NASW) Code of Ethics, 19, 22, 23 National Center for Health Statics, 320 National Conference of State Legislatures, 2017, 318 Nationality Act, 1952, 333 Neal, J., 418, 423 Neal, Zachary, 418, 423 Nee, V., 381–382 Neff, K. D., 114–115 Neger, E., 338–340 Nelson, K., 310, 421 Nemeroff, C., 417 Neocolonialism, 269 Neoliberal philosophy, 270

1198

Neoliberalsim, 44–45 Neppl, T., 330 Nervous system, 82–86 Netting, Ellen, 377–378, 393, 397 Netting, F. E., 375–376, 395, 398 Network, 414 Network model, 438 Networked individualism, 414 Neurons, 84 Neuroplasticity, 85, 135, 190 Neuroscience research, 11, 56–57, 58, 68 Neurotransmitters, 84–85 Newby, J., 336 Newhard, M., 386 Newman, D., 301, 303, 305, 335, 336, 346 Newman, M., 392 Newransky, C., 351 Neyer, F., 321 Nguyen, H., 20 Nicholson, J., 322 Nicotera N., 416 Niebrugge, G., 45 Niebrugge-Brantley, G, 58, 20 Noble, C., 431 Noddings, N., 136 Nongovernmental organizations (NGOs), 393 Nonhierarchical organizations, 388–390 Nonnormative stressors, 314 Nonprofit organizations, 393 Nonspecific immunity, 90 Norcross, J. C., 366 Norenzayan, A., 27 Normative stressors, 314 Norms, 239 Northen, H., 361 Northouse, P., 368, 383, 397 Norton, C., 11 Nowell, B., 412 Nuclear families, 316–319 Nussbaum, M., 20, 68

1199

Nyong’o, Lupita, 436

Obama, Barack, 190, 433, 435–436 Oberschall, A., 439 Object relations theory, 56, 57 Objective reality, 24 O’Brien, Patrick, 165 Obst, P., 417 O’Connor, M., 393 O’Connor, Mary Katherine, 377–378, 397 OECD Family Database, 319 Office of the Deputy Assistant Secretary of Defense, 2014, 326 Ohmer, M., 420, 423 Okazawa-Rey, M., 244 O’Keefe, Maura, 154 Oliver, D., 366–367 Ombelet, W., 321 Ongoing group, 354 Open groups, 354 Open system, 39 Operant conditioning theory, 63–65 Opper, S., 381–382 Oppression, common mechanisms of, 19 Orbuch, T., 338 Organizational change, appreciative inquiry model of, 385–386 Organizational culture model, 384–385 Organizational humanism, 380 Organizational patterns, 314 Organizations, 8, 69

critical perspective on, 386 institutional theory of, 382 interactional/interpretive perspective on, 383–386 as multiple oppressions, 388 nonhierarchical, 388–390 overview of, 376 rational perspective on, 376–377 systems perspective on, 380

Organizations, formal, 371–400 active learning, 399–400 burnout, 390–392

1200

case studies, 372–373 critical perspective on, 386–390 critical thinking questions, 376, 383, 390, 396, 398 culturally sensitive care systems, 397–398 definition of, 374–375 exhibits, 377, 378, 380, 381, 384, 387, 389 implications for social work practice, 399 interactional/interpretive perspective on, 383–386 key terms, 399 learning objectives, 371–372 perspectives on, 375–390 relational perspective on, 376–380 social work and, 392–395 social work leadership in, 397 systems perspective on, 381–383 web resources, 400

Organizations, hybrid, 394 Organizations, social work-oriented, 393 Organizing activity, self as, 125 Ormrod, R., 335 Ortiz-Ospina, E., 268 Otten, S., 360 Out-groups, 360 Outsourcing, 275–276

Padden, D., 326 Padilla, Y., 421 Padrón, E., 325 Painter, M., 340 Pandya, S., 11 Paradigm, defined, 23 Parent child, 339 Parental divorce, 337 Parentification, 339 Park, Robert, 411 Park, Y., 352 Parker, J., 222 Parkin, W., 388 Parks, Rosa, 454 Parreñas, Rhacel Salazar, 410

1201

Parrillo, V., 16 Partner vs. expert in social change process, 423–424 Pasley, K., 323 Passini, S., 114 Passmore, J., 69 Patterson, C., 324 Patterson, J. M., 314 Pavlov, I., 63 Pawar, M., 20, 397 Payne, K., 319 Payne, S., 347 Peak, D., 413 Peak experiences, 66 Pearlin, L., 329 Peck, M., 366–367 Pellow, D., 428, 434, 436 Pemberton, D., 302 Peplau, L., 325 Performance expectations, 358 Perilla, J., 366 Periphery, 44 Perkins, D., 417 Perry, D., 412 Perry, Katy, 436 Person, multiple dimensions of, 75. See also Biological person; Psychological person; Psychosocial person; Spiritual person Person in environment perspective, 6 Person in environment (PIE) classification system, 154–156 Personal community, 414 Personal dimensions, 9, 10, 11

biological, 9, 10, 11 psychological, 9, 10, 11 spiritual, 9, 10, 11

Personal network, 149 Personal space, 201–203 Perspective, defined, 23 Pesta, Jeffrey, 417–418 Peteet, J., 192 Peters, T., 49 Peterson, U., 390

1202

Pew Research Center, 2011, 323 Pew Research Center Religion & Public Life Project, 324 Pfeffer, J., 375 Pharr, S., 19 Phelps, A., 180 Phenomenal self, 69 Phenomenological sociology, 52 Philip, D., 211 Physical divorce, 337 Piaget, Jean, 110, 115 PIE (person in environment) classification system, 154–156 Piel, M., 318 Pierce, S., 412 Pillemer, K., 335 Pinker, S., 7 Place attachment, 219–220 Place identity, 220 Pluralist society, 16 Poetic principle, 386 Polis model, 49 Political alignments, stability of, 435–436 Political and government institution, trends in, 269–273 Political economy model, 381–382 Political process perspective, 433–437

availability of elite allies, 436–437 international relations, 437 openness of political system, 434–435 stability of political alignments, 435–436

Polletta, F., 444 Polyandry, 303 Polygamy, 303 Polygyny, 303 Polyvagal theory, 57 Poortman, A., 310 Popple, P., 393, 452 Porges, S., 57, 58 Positive principle, 386 Positive psychology, 67–68, 69 Positivist perspective, 24–25 Postcolonial theory, 44

1203

Posthumanism, 68 Postmodernism, 51 Postpositivism, 25 Post-traumatic stress disorder (PTSD), 15, 58, 66, 147–148 Potter, S., 410 Potter, T., 412 Poulin, M., 11 Powell, B., 302, 324, 326 Powell, W. W., 382 Power, M., 424 Power and culture, 241–255 Practice orientation, 236 Preconscious, 123 Predictability, 378 Prenatal drug exposure, 338–339 Prezza, M., 417 Price, C., 313 Price, S., 313 Prickett, K., 326 Prinz, R., 338–340 Privacy, 200–201 Private social service organizations, 393 Privatization, 393 Privilege, 17–18 Problem-focused coping, 145 Problems in living, 188–189 Procentese, F., 418 Process-oriented leaders, 363 Proescholdbell, R., 417 Profitt, N., 431 Programs, 205 Progressive stage models, 360–361 Propositions, 24 Prostate gland, 98 Prosumer capitalism, 43–44 Pruchno, R., 416 Psychiatric (medical) perspective, 152 Psychoanalytic theory, 120 Psychodynamic perspective, 54–59

evaluation criteria for, 57–58

1204

overview of, 35–36 revisions of Freudian theory, 56–57 roots of, 55–56 visual representation of, 55

Psychodynamic theory, 57, 120, 357–358 Psychoeducational groups, 348, 350 Psychological coping, 143–145 Psychological person, 107–129

active learning, 128 case studies, 108–109 cognition and emotion, 109–110 cognitive/emotional “disorders,” 123–127 critical thinking questions, 113, 117, 121, 124, 127 exhibits, 110, 112, 114, 115, 116, 119, 123 implications for social work practice, 127–128 key terms, 128 learning objectives, 107–108 self, 124–127 theories of cognition, 110–117 theories of emotion, 117–123 web resources, 129

Psychological perspectives, 152–153 Psychological theories of emotion, 119–122

attribution theory, a cognitive perspective, 121 ego psychology, 120–121 psychoanalytic theory, 120 theory of emotional intelligence, 121–122

Psychology, 109 Psychosexual stage theory, 56 Psychosocial person, 130–158

active learning, 157 case studies, 131 concept of stress, 138–142 coping and adaptation, 142–152 critical thinking questions, 136, 138, 142, 148, 156 exhibits, 143, 144–145, 146, 150, 153, 154, 155 implications for social work practice, 156 key terms, 156–157 learning objectives, 130–131 normal and abnormal coping, 152–154

1205

self in relationships, 132–138 web resources, 157–158

PTSD (post-traumatic stress disorder), 147–148 Public social service organizations, 393 Public territories, 204 Puchalski, C., 11 Punamaki, R., 330 Putnam, Robert, 414, 415, 418, 450

Qualitative methods, 25 Quantitative methods, 24–25 Queer theory, 52, 53

Race, 242–244 Race and ethnicity, 182–185 Racine, D., 424 Racism, 244 Radical antithesis, 294 Rainie, L., 414 RAND Corporation, 328 Rasheed, J., 319, 330 Rasheed, M., 319, 330 Rational choice models, 49 Rational choice theory, 47–48 Rational perspective on organizations

decision-making theory, 380 human relations theory, 378–380 ideal-type bureaucracy, 377–378 management by objectives (MBO), 380 scientific management, 378

Ravitch, Diane, 278–279, 280–281 Rawls, J., 20 Ray, Oakley, 188, 189 Reader, S., 412 Recovery, 314 Rector, R., 323 Redel, Fritz, 355 Redfield, Robert, 409 Reed, J., 323 Reese, D. J., 367

1206

Reeve, Christopher, 436–437 Reeve, K., 221 Refugee Assistance Extension Act, 333 Regnerus, M., 326 Reich, Robert, 436 Reicher, S., 360 Reification, 51 Reinady, J., 20 Reinsmith-Jones, 353 Reisch, M., 41, 211, 420, 423, 431 Reitzes, D., 222 Relational community and territorial community, 404–407 Relational theory, 132–133 Relational-cultural theory, 56, 57–58 Relationships

feminist theories of, 136 self in, 132–138

Religion, 165, 166–171 Religious annulment, 336 Religious institutions, trends in, 288–289 Renner, A., 335 Renner, L., 330 Reproductive system, 96–102 Research, evaluation criteria for, 27, 28 Resick, P., 66 Resilience, 314 Resource mobilization theory, 438 Richards-Schuster, K., 357 Richmond, Mary, 11 Ridley, M., 255 Riera, Carles, 419, 420 Riggio, R., 364 Rine, C., 412 Risk and resilience theory, 40, 41 Riskind, R., 324 Ritual, 48–49, 311 Ritzer, G., 43–44, 232, 266, 346, 378 Rivas, 347, 350, 352 Rivas, R. F., 347, 350, 352, 365–367 Roberts, K., 346

1207

Robinson, J., 306 Robinson, T. R., 101 Rogers, C., 66, 67, 68, 69 Role conflict, 311 Role reversal, 339 Role strain, 139, 311 Roles, 311, 364–365 Rooney, G. D., 21 Rooney, R. H., 21 Roosa, M., 417 Roosevelt, Franklin Delano, 254, 286 Rose, S., 45 Rosenthal, B., 421 Roser, M., 268 Rosich, Victor, 214 Ross, Laura, 424 Rothblum, E., 325 Rothenberg, P., 16, 17, 18 Rothschild-Whitt, J., 389 Rothstein, R., 280 Rowan, B., 381–382 Rubio, R., 325 Rucht, D., 432 Ruffalo, Mark, 436 Runge, S., 428–429 Rusbult, C., 308 Russell, A., 440 Rutherford, P., 217 Rychtarik, R., 396 Rydstrom, Jens, 254

Sadwick, R., 251 Saegert, S., 415 Saengtienchai, C., 318 Sager, J., 424 Saha, R., 412 Saka-Helmhout, A., 382 Sameroff, A., 6, 9 Same-sex partner families, 324–326 Sampling bias, 27

1208

Sampson, R., 415–416, 416 Samuelson, C., 359 Sanderson, A., 419 Santiago, A. M., 413 Sapolsky, R., 6, 7, 9, 11, 13, 33, 56–57, 63, 65, 79, 80, 22, 52, 79, 241 Sarason, Seymour, 403–404, 416 Sargent, L. D., 356 Satir, V., 314 Satisfice, 380 Saul, D., 340 Savino, M., 58 Saxton, G., 396 Sayer, L., 306 Scannell, L., 220 Schaufeli, W., 390–392 Schein, Edgar, 384 Schema, 110 Schneider J., 359 Schoech, D., 395–396, 412 Schön, D, 381–382 Schoonhoven, C., 375 Schroder, K., 412 Schuler, D., 414 Schutt, R., 25 Schutz, A., 52 Schvaneveldt, P., 310 Schwalbe, M., 18 Science, 23 Scientific knowledge, 23–27 Scientific management, 378 Scott, W. Richard, 264 Scoyoc, A., 338 Second force therapies, 175 Second generation immigrants, 333 Second Life, 353 Second World, 18 Secondary emotions, 117 Secondary territories, 204 Segal, E., 68 Seibert, G., 391

1209

Seidman, Edward, 205 Self, 124–127 Self in relationships, 132–138

attachment theory, 133–134 feminist theories of relationships, 136 impact of early nurturing on development, 134–136 relational theory, 132–133 social identity theory, 137–138

Self-categorization theory, 360 Self-efficacy, 64 Self-help groups, 348, 350–352 Self-knowledge, 21–22 Self-psychology, 56 Seligman, M., 65, 67 Sell, J., 359 Semiperiphery, 18, 44 Sen, A., 20, 68, 69 Senge, P., 382 Senia, J., 330 Serial cohabitation, 319 Sernau, S., 17, 18, 19, 437, 454 Settlement house movement, 431 Sex and gender, 185–186 Sexual orientation, 186–187 Sexuality, 249–251 Shaheen, R., 221 Shaker, L., 356 Shanks, T., 424 Shared symbolic experience, self as, 126 Sharpe family

and cohort effects, 313 ecomap, 309 and gender roles, 312 resilience, 316 timeline of, 315

Shaw, B., 396 Shear, M., 436 Sheats, P., 364–365 Shek, D., 330 Shen, C., 330

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Shepard, B., 449 Sheridan, Michael J., 159, 178 Sherman, M., 328 Sherraden, M., 421 Shetterly, Margot, 247 Shilkret, C., 56 Shilkret, R., 56 Shonkoff, J. P., 136 Shore, B., 317, 321 Shore, R., 317, 321 Shortell, S., 382 Shragge, Eric, 419–420, 422–423 Shulman, L., 347 Sidel, Ruth, 322 Siegel, J., 356 Silver, R., 11 Silverstein, M., 324 Simon, H., 377, 380 Simonelli, R., 421 Simons, L., 330 Simultaneity principle, 386 Sivakumar, G., 396 Skelton, R., 428 Skinner, B. F., 63–64, 66 Skocpol, T., 46, 438, 442 Skolnick, Arlene, 240 Slopen, N., 136 Small groups, 7, 344–345

benefits of, 346 definitions of, 346 in social work, 346–347

Smith, D., 52 Smith, E. D., 180 Smith, R., 9, 413 Smith, S., 306, 308, 310 Smith, T. W., 9 Smith-Lovin, L., 149 Smock, P., 319 SMOs (social movement organizations), 438 SMSOs (social movement service organizations), 452

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Snyder, M., 359 Snyder F., 45 Social action vs. agency orientation, 421–422 Social capital approach, 415–418 Social capital theory, 48 Social class, 251–253, 294 Social constructionist perspective, 50–54

affect theory, 52–53 on emotions, 122 evaluation criteria for, 53–54 on human phenomena, 81 overview of, 35 queer theory, 52, 53 roots of, 51–52 standpoint theory, 52, 53 visual representation of, 51

Social divorce, 337 Social entrepreneurial organization, 395 Social exchange theory, 47, 51 Social functioning, 154–156 Social identity theory, 137–138 Social inequality, theories of, 294–296 Social institution, contemporary trends in, 264–294

economic institution, 273–277 educational institution, 277–281 family and kinship institution, 292–294 government and political institution, 269–273 health care institution, 281–284 mass media institution, 289–292 religious institution, 288–289 social welfare institution, 284–287

Social justice, 20 Social learning theory, 111, 111, 116 Social life, patterns of, 263–264 Social locations, 18, 22 Social movement organizations (SMOs), 438 Social movement service organizations (SMSOs), 452 Social movements, 427–456

active learning, 455 case studies, 428–429

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contemporary social work and, 452–454 critical thinking questions, 431, 437, 442, 450, 454 cultural framing perspective on, 442–449 definition of, 429–430 emerging perspectives on, 449–450 exhibits, 434, 438, 439, 443, 446, 453 history of social work and, 430–431 implications for social work practice, 454 key terms, 455 learning objectives, 427 life course of, 441–442 mobilizing structures perspective on, 437–442 outcomes, 450–451 perspectives on, 431–450 political process perspective on, 433–437 proactive, 430 professional organizations, 438 reactive, 430 trends, 451–452 web resources, 455–456

Social network theory, 48 Social planning model, 423–424 Social reform, 431 Social service organizations, technology and, 395–396 Social structure and social institutions, 261–298

active learning, 297–298 case studies, 262–263 contemporary trends in global and U.S. social institutions, 264–294 critical thinking questions, 269, 277, 284, 294, 296 exhibits, 265, 267, 272, 277, 279, 283, 285, 291 implications for social work practice, 296–297 key terms, 297 learning objectives, 261 social inequality theories, 294–296 social life, patterns of, 263–264 web resources, 298

Social support, 148–152 coping and, 150–151 evaluating, 151–152

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virtual, 149–150 Social systems approach, 413–415 Social welfare institution, trends in, 284–287 Social work competencies, 6, 16, 19, 22, 33, 38, 39–40, 198, 210, 431 Social work in formal organizations, 397 Social work practice, 48

community as context for vs. target of, 420–421 conflict model of vs. collaborative model of, 422–423 developmental perspective and, 62 human behavior perspectives and, 65–66, 70, 72–73 humanistic perspective and, 69 psychodynamic perspective and, 58–59

Social workers leadership and, 367 role on interdisciplinary teams, 367

Social workers and communities, 420–424 agency orientation vs. social action, 421–422 community as context for vs. target of practice, 420–421 conflict model of practice vs. collaborative model, 422–423 expert vs. partner in social change process, 423–424 history, 407–408

Sociological support, 153–154 Sohr-Preston, S., 330 Soifer, Steven, 408 Solantaus, T., 330 Soldz, S., 362 Soli, A., 310 Sollod, R., 68 Solomon, B., 45 Solomon, S., 325 Sommers-Flanagan, J., 132 Song, Z., 330 Sonn, C., 418 Soudelier, K., 367 Soul, self as, 125 Soulsby, A., 376 Southerners on New Ground, 452 Southwell, K., 326 Spatial arrangements approach, 410–413 Specht, Harry, 421

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Specific immunity, 90 Spiegel, D., 347 Spiritual assessment, 191–192 Spiritual bypassing, 178 Spiritual development, theories of, 171–180 Spiritual dimension, 164–171

exhibits, 169 meaning of spirituality, 164–165

Spiritual person, 159–194 active learning, 193–194 case studies, 160–164 critical thinking questions, 171, 180, 188, 191, 192 exhibits, 166, 167, 192 implications for social work practice, 192–193 key terms, 193 learning objectives, 159 spiritual dimension, 164–171 theories of spiritual development, 171–180 web resources, 194

Spirituality, 165, 180–192 human diversity and, 182–188 human experience and, 188–191 meaning of, 164–165 role of in social work, 180–192 spiritual assessment, 191–192 in United States and globally, 165–171

Srivastva, S., 384, 386 Staffing, 205 Stage Models of Group Development, 361 Staggenborg, S., 432, 436, 448, 450 Stams, G., 421 Stanbridge, Karen, 449–450 “Standards for Technology in Social Work Practice,” 352 Standpoint theory, 52, 53 Stanwyck, D., 339 Staples, L., 413, 418 State, 143 State Children’s Health Insurance Program, 393 Statistic Brain, 318 Status, 264

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Status characteristics and expectation states theory, 358–359, 360–361 Steelman, L., 302 Stein, L., 444 Steinberg, D. M., 350–352 Steinfield, C., 414 Stepfamilies, 323–324 Sternberg, E., 411 Stewart, Judith, 103 Stimulation theories, 199–200 Stinson, F., 338 Stobaugh, J., 436 Stoesz, D., 393–395 Stone, D., 49, 50 Stormark, K., 338 Strain theory, 431–432 Stravros, J., 386 Strengthening Family Resilience (Walsh), 314 Stress, 138–142

categories of, 138–139 chronic, 86 crisis and, 139–140 traumatic, 140–141 vulnerability to, 141–142

Stress pileup, 314 Strom-Gottfried, K., 21 Strube, M., 355 Structural determinism vs. human agency, 296 Structural model of the mind, 55–56 Structures, informal and formal, 438–439 Stuart, G., 335 Stuart, R., 66 Stykes, B., 323 Subcultures and countercultures, 239–240 Subjective reality, 24 Substance abuse, 338–340 Substance Abuse and Mental Health Services Administration, 2012, 338 Sue, D. R., 330 Sue-Chan, C., 356

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Sullivan, T., 27 Sumner, K., 311 Sunwolf, 358 Superego, 55–56 Supiano, K. P., 368 Supplemental Nutritional Assistance Program (SNAP), 396 Suter, E., 311 Suzuki, Y., 412 Sweifach, J., 347, 349, 350–352 Symbol, 311 Symbolic interaction perspective on families, 310–312 Symbolic interaction theory, 51, 122, 126, 151, 358, 411, 413 Symbols, 51, 237–238 Systems perspective, 38–42, 80, 381–383

autopoietic systems theory, 41, 42 bioecological theory, 40, 41 deep ecology, 41, 42 ecological theory, 39–40 evaluation criteria for, 41–42 feedback mechanisms and, 38–39 on formal organization, 381–382 fuzzy set theory, 41 general systems theory, 39 globalization theory, 40, 41, 42 institutional theory of organizations, 382 learning organization theory, 382–383 overview, 34, 381 political economy model, 381–382 risk and resilience theory, 40, 41 visual representation of, 39

Systems taxonomy, 82–102 cardiovascular system, 91–94 endocrine system, 86–88 immune system, 88–91 musculoskeletal system, 94–96 nervous system, 82–86 reproductive system, 96–102

Taket, A., 321 Taló, C., 418

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Tang, X., 359 Tanielian, T., 328 Taras, V., 353 Tarrow, Sidney, 434–435, 437, 439, 442–443, 445, 447–449, 450–451, 454 Tart, Charles, 176 Task groups, 348, 352–354 Task-oriented leaders, 363 Taylor, Frederick W., 377, 378 Taylor, L., 413 Taylor, P., 16 Taylor. C., 351 Technology, 212–215, 395–396 Temporary Assistance to Needy Families (TANF), 396 Terkel, Studs, 436, 450, 454 Territorial community and relational community, 404–407 Territoriality, 204 Territory, primary, 204 Teshome, E., 350 Tesoriero, F., 351 Tett, G., 253 Thatcher, R., 335 Theories of group processes

exchange theory, 359–360 psychodynamic theory, 357–358 self-categorization theory, 360 status characteristics and expectation states theory, 358–359 symbolic interaction theory, 358

Theory, 23–24 evaluation criteria for, 26, 28

Theory X, 380 Theory Y, 380 Therapeutic Factors Involved in Group Development, 363 Therapy groups, 347–349 Thibault, J. W., 308 Thibaut, H., 308 Third force therapies, 175 Third generation immigrants, 333 Third World, 18 Thomas, M., 417

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Thomas, M. S., 375 Thompson Coon, J., 208 Thorsen, M., 324 350.org, 429 Tilburg, T., 324 Tilly, C., 428, 430, 432, 434, 438–439 Tilton, J., 418 Timberlake, Jeffrey, 319 Time dimension, 8, 9, 11, 13–15 Time orientation, 13–15 Time perspective therapy, 15 Time-limited group, 354 Tindall, D., 438–439 Tisi, G., 58 Titone, A. M., 192 TNCs (transnational corporations), 270 Tokoyawa, T., 330 Tomai, Manuela, 413, 414, 418–419 Tomic, E., 390 Tomic, W., 390 Tonnies, Ferdinand, 409, 410 Toosi, N., 356, 359, 364 Topographical theory of the mind, 55 Tornello, S., 324 Toseland, R. W., 347, 350, 352, 365–367 Townley, G., 417–418, 423 Tracy, E., 339 Trait, 143 Transition points, 312, 313–314 Transnational corporations (TNCs), 270 Transnational social movement organizations (TSMOs), 438 Transpersonal approach, 176 Transpersonal psychology, 67 Transpersonal theory, 175–176 Traumatic stress, 140–141 Travis, D., 385 Trickle-down bureaucracy, 378 Trump, Donald, 190, 271, 293, 333, 433, 436 TSMOs (transnational social movement organizations), 438 Tucker, A. R., 346

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Tuckman, B., 361 Tufekci, Zynep, 439, 441, 450 Tunisia, protest in, 440 Turkle, Sherry, 149–150, 213, 214–215 Turnbull, B., 321 Turner, H., 335 Turner, R., 319 Tversky, A., 49 Tyagi, A., 58 Tylor, E. B., 231

Uhlenbruck, K., 383 Ulrich, Roger, 215, 216, 217–218 Ultimate environment, 172 Unconscious, 109 Universal Declaration of Human Rights (UDHR), 20 Urban design and health, 218–219 Urbina, I., 444 Ursano, R., 336 U.S. Bureau of Labor Statistics, 2017b, 318 U.S. Census Bureau, 2012, 321 Uterus, 99

Vaillant, G., 69 Valentine, J., 356 Values, 22, 236–237 Van Balen, F., 325 Van de Vijver, F., 245 Van den Boom, D., 325 Van der Kolk, B., 58 Van Der Pas, S., 324 Van Duin, 82, 58 Van Hoof, J., 217–218 Van Tilburg, T., 310 Vanderploeg, J., 340 Vanyukevych, A., 412 Variables, bias in defining, 26–27 Vasilyeva, M., 330 Vaughan, Frances, 176 Vazquez, C., 68

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Veeder, N. W., 367 Venn, C., 52 Ventricles, 92 Verbakel, E., 311 Verity, F., 420 Vertical linkage, 414 Vespa, H., 319 Vespa, J., 317, 319, 336 Viggiani, P., 21 Vilhauer, R., 353 Vinnerljung, B., 340 Virtual groups, 352 Virtual support, 149–150 Vizgirdaite, J., 353 Voluntarism, 24 Voluntary agencies, 393 Von Bertalanffy, L., 39 Voros, P., 58 Vosler, N. R., 308, 314 Voss, K., 446 Vosyliute, V., 353 Vulnerability to stress, 141–142

Waanders, C., 330 Wadsworth, C., 330 Wadsworth, S., 326, 328 Wagner, J., 321 Wagner, N., 352, 353 Waldman, W., 395, 396 Wallerstein, I., 18, 44, 46 Walsh, Froma, 307, 314–315, 316, 339, 416 Walsh, J., 54, 66, 84–85, 375, 376 Walsh, Joseph, 107, 130, 176 Wampold, B. E., 366 Wamsley, G, 381 Wanberg, C., 330 Wang, X., 416 Warner, C., 310 Warnick, B., 394 Warren, Roland, 408, 414

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Washburn, Michael, 176 Washington, Kerry, 436 Washington Post, June 2017, 324 Watson (IBM computer), 214 Watson, J. B., 63–64 Web resources

biological person, 106 communities, 426 cultures, 259–260 formal organizations, 400 physical environment, 226–227 psychological person, 129 psychosocial person, 157–158 social movements, 455–456 social structure and social institutions, 298 spiritual person, 194

Weber, Max, 294–295, 296, 377, 409 Weber’s Ideal-Type Bureaucracy, 377 Weil, M., 420–421, 424 Weinman, M. L., 367 Welch, Edgar, 256 Well-being, individual and collective, 189–191 Wellman, Barry, 410, 414 Welwood, John, 178 Wenger, G. C., 321 Wenger, M., 310 Wenocur, Stanley, 408 West, Cornel, 436 Western Electric Company, 378 Wheeler, H., 66 White, J., 46, 302, 306 Whiteman, S., 310 Whitney, D., 386 Whitt, J., 389 Wicker, Allan, 205 Wilber, Ken, 176, 177–178, 179 Wilber’s and Fowler’s theories, summary and critique of, 179–180 Wilber’s integral theory of consciousness, 176–179 Williams, A., 324 Williams, C., 51, 54

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Williamson, V., 46 Wilson, G., 411–412 Wilson, J., 68 Wilson, R., 359 Wilson-Genderson, M., 416 Wiwatwanich, S., 318 Wollever, C., 410 Womanist feminism, 312 Woo, I., 347 Wood, J., 312 Wood, L., 428, 430, 432, 434, 438–439 Wood, M., 347 Wood, R., 347, 439 Woodard, Colin, 237, 244 Woodbury, Anthony, 257 Woodilla, J., 388 Woodley, Shailene, 436 Work engagement, 392 Workscest, 303 Worland, J., 429 World Bank, 2017d, 305 World Health Organization, 2016, 334, 335 Wright, K. B., 353 Wronka, J., 20 Wrzus, C., 321

Xenophobia, 241 Xu, Q., 417

Yalom, 356 Yalom, Irving, 356, 362, 365 Yarbrough, J., 222 Yeh, W, Y., 390 Yellow Bird, M., 424 Yeung, D., 15 Yunus, Muhammad, 395

Zald, M., 381, 432, 435, 438 Zastrow, C. H., 347 Zenebe, M., 350

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Zhow, W., 381 Zhu, H., 204 Zilberstein, K., 353 Zimbardo, P., 13, 14, 15, 46 Zimbardo Time Perspective Inventory (ZTPI), 14 Zimring, Carl, 211, 217–218 Zong, J., 331 Zyphur, M., 364

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About the Authors

Elizabeth D. Hutchison, MSW, PhD, received her MSW from the George Warren Brown School of Social Work at Washington University in St. Louis and her PhD from the University at Albany, State University of New York. She was on the faculty in the Social Work Department at Elms College from 1980 to 1987 and served as chair of the department from 1982 to 1987. She was on the faculty in the School of Social Work at Virginia Commonwealth University from 1987 to 2009, where she taught courses in human behavior and the social environment, social work and social justice, and child and family policy; she also served as field practicum liaison. She has been a social worker in health, mental health, aging, and child and family welfare settings. She is committed to providing social workers with comprehensive, current, and useful frameworks for thinking about human behavior. Her other research interests focus on child and family welfare. She lives in Reno, Nevada, where she is a hands-on grandmother and an activist on local justice issues.

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About the Contributors

Leanne Wood Charlesworth, LMSW, PhD, is professor and BSW program director in the Department of Social Work at Nazareth College of Rochester. She has practiced within child welfare systems, and her current areas of service and research are poverty and homelessness. She teaches human behavior and research methods at the undergraduate and graduate levels. She is also a registered yoga teacher and cofounder of the Rochester Yoga Service Network.

Linwood Cousins, MSW, MA, PhD, is professor in the School of Social Work at Western Michigan University. He is a social worker and an anthropologist who has practiced in child welfare and family and community services. His research, teaching, and practice interests include the sociocultural manifestations of race, ethnicity, and social class as well as other aspects of human diversity in the community life and schooling of African Americans and other ethnic and economic minorities.

Elizabeth P. Cramer, PhD, LCSW, ACSW, is professor in the Virginia Commonwealth University School of Social Work where she teaches courses in direct practice, diversity and social justice, interpersonal violence, and social work education and teaching. Her primary research and scholarship areas are domestic violence, particularly abuse of persons with disabilities, and educational strategies to impact social work students’ attitudes toward, knowledge of, and skills with LGBTQ populations. She is the principal investigator of the I-CAN! Accessibility Project, funded by the Virginia Department of Criminal Justice Services, whose mission is to promote and facilitate awareness about abuse of people with disabilities and to advocate for equal access to services and legal protections. She also serves as co-PI of Leadership for Empowerment and Abuse Prevention, an abuse prevention program for individuals with intellectual and developmental disabilities funded by the Department of Justice Office on Violence Against Women.

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Cory Cummings, LCSW, PhD, is assistant professor of social work at Monmouth University in New Jersey where he teaches practice and research. He received his PhD from Virginia Commonwealth University in 2017 where he studied health promotion for those with severe and persistent mental health challenges and community-based participatory research practices. He is interested in wellness and health equity for that population and supporting the advancement of the recovery movement. He comes from a rich clinical practice background, including administrative experience.

Elizabeth DePoy, MSW, PhD, is professor of interdisciplinary studies and social work and cooperating faculty in mechanical engineering. After completing her initial undergraduate degrees in occupational therapy and French literature, she shifted her academic and scholarly focus to a more macro social justice perspective by pursuing a masters in social work; from there her doctoral efforts focused on applied epistemology. She has been centrally involved in curriculum development and instruction in both the graduate and undergraduate programs in interdisciplinary disability studies and teaches in those programs along with teaching a graduate online research sequence in the School of Social Work and serving on doctoral committees in mechanical engineering. Her scholarship is acknowledged nationally and internationally in the fields of disability and design, and research and evaluation methodology. With Gilson, she is an inventor of several mobility devices, one on exhibit at the Cooper Hewitt Museum. She has earned over $1.4 million in extramural funding for individual and collaborative research.

Stephen French Gilson, MSW, PhD, is professor and coordinator of interdisciplinary disability studies at the Center for Community Inclusion and Disability Studies; professor at the School of Social Work at the University of Maine; and senior research fellow at Ono Academic College Research Institute for Health and Medical Professions, Kiryat Ono, Israel. After he completed his undergraduate degree in art, he shifted his career to social justice, pursuing a masters in social work. Realizing that knowledge of human biology and physiology was foundational to his work, he completed a PhD in medical sciences.

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Synthesizing the diversity and richness of this scholarly background, Dr. Gilson engages in research in disability theory, disability as diversity, design and access, social justice, health and disability policy, and the atypical body. He teaches courses in disability as diversity, policy, and human behavior from a legitimacy perspective. In 2017, Stephen received a Trustee Professorship award from the University of Maine to support his international study of social practice art. His most recent research integrates and applies artistry, design, and commitment to human rights to the development of aesthetically designed adaptive equipment. The AFARI, a three- wheeled outdoor fitness mobility support, is now on exhibit at the Smithsonian Cooper Hewitt Design Museum in New York. Along with his wife, Liz DePoy, Stephen is the owner of an adapted rescue farm in Maine. Living his passion of full access, the barn and farm area have been adapted not only to better assure human access and animal caretaking but also to respond to the needs of the disabled and medically involved animals that live on the farm. Two other major influences on Dr. Gilson’s writing, research, and work include his passion for and involvement in adaptive alpine skiing and dressage.

Michael J. Sheridan, MSW, PhD, is special advisor for diversity and wellness programs with the Office of Intramural Training & Education at the National Institutes of Health. In this capacity, she provides a variety of diversity and inclusion trainings, as well as offerings on stress management and self-care. She also facilitates a weekly mindfulness meditation group for NIH fellows. Her previous practice experience includes work in mental health, health, corrections, and youth and family services. As a former social work educator, she taught courses on diversity and social justice, spirituality and social work, transpersonal theory, human behavior, international social development, research methods and statistics, and conflict resolution and peacebuilding. Her major research and scholarship focus has been on the ethical and effective integration of spirituality within social work practice and education.

Joseph Walsh, MSW, PhD, LCSW, is professor in the School of Social Work at Virginia Commonwealth University. He was educated at Ohio State University and has worked for 40 years in community mental health

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settings. His major areas of interest are clinical social work, serious mental illness, and psychopharmacology. He teaches courses in social work practice, human behavior and the social environment, and research while maintaining a small clinical practice.

About the Case Study Contributors R. Shawn Allen,

MSW, LGSW, is the director of field education and an assistant professor of social work at Concord University. Shawn earned his MSW from West Virginia University and BSW from Concord University. His practice background includes being one of the first regional coordinators of the West Virginia Aging and Disability Resource Center where he assisted older adults and persons living with disabilities with services such as information and referral, options counseling, benefits counseling, and short-term case management. Additionally, Shawn serves on numerous committees throughout West Virginia helping to promote services for older adults and persons living with disabilities. His research interests include ethical social work practice in rural areas, the effect of the opioid epidemic in Appalachia, and service barriers influencing the lives of rural older adults.

Najwa Awad, MSW, LCSW-C, is a graduate from the School of Social Work at Virginia Commonwealth University. She is a psychotherapist in private practice with a focus on providing culturally sensitive counseling to women and minorities. She has a special interest in helping underserved Muslim communities and speaking in public forums about reducing stigma toward seeking mental health treatment. Beyond the outpatient setting, she provides services to individuals and families in group homes, schools, and the foster care system.

Megan Beaman Jacinto is a community-based civil rights attorney representing primarily low- income and immigrant clients and communities around Southern California, particularly in the Coachella Valley, and also leading and participating in community advocacy toward policy and systems change outside of the traditional legal context. Ms. Beaman is a

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longtime advocate for the rights of workers, immigrants, women, and low-income communities—and the combination of any or all those groups. Her career and passion are rooted in her own rural, working- class upbringing, as well as the experiences she has shared with diverse communities and leaders around the country, all united in their commitments to justice and better lives.

Bryan D. Norman, LCSW, is a graduate of the School of Social Work at Virginia Commonwealth University. He has worked in a variety of settings, such as correctional facilities, core service agencies, nonprofits, and private practice. Bryan has served a variety of populations, including those who struggle with homelessness, substance dependence, serious mental illness, and chronic medical issues. He currently works as a psychotherapist for a community mental health agency in the southwestern United States. His areas of interest include couple’s work, trauma processing, treating severe emotional dysregulation, and body–mind psychotherapies.

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Table of Contents

Case Studies 24 Preface 29 Acknowledgments 36 PART I A MULTIDIMENSIONAL APPROACH FOR MULTIFACETED SOCIAL WORK 39

Chapter 1 Human Behavior: A Multidimensional Approach 41 Chapter Outline 41 Learning Objectives 41

• Case Study 1.1: Joshua, Making a New Life 42 Human Behavior: Individual and Collective 44 A Multidimensional Approach 47

Personal Dimensions 53 Environmental Dimensions 58 Time Dimensions 59

Diversity, Inequality, and the Pursuit of Social Justice: A Global Perspective 66

Diversity 67 Inequality 70 Advancing Human Rights and Social, Economic, and Environmental Justice 73

Knowing and Doing 78 Knowledge About the Case 78 Knowledge About the Self 80 Values and Ethics 81

Scientific Knowledge: Theory and Research 82 Theory 83 Empirical Research 85 Critical Use of Theory and Research 87

Organization of the Book 91 Implications for Social Work Practice 93 Key Terms 94

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Active Learning 95 Web Resources 95

Chapter 2 Theoretical Perspectives on Human Behavior 98 Chapter Outline 98 Learning Objectives 98

• Case Study 2.1: End of Life Care for Maria Chavez 99 Multiple Perspectives for a Multidimensional Approach 101 Systems Perspective 113 Conflict Perspective 120 Exchange and Choice Perspective 129 Social Constructionist Perspective 135 Psychodynamic Perspective 142 Developmental Perspective 151 Behavioral Perspective 157 Humanistic Perspective 164 The Merits of Multiple Perspectives 171 Implications for Social Work Practice 172 Key Terms 177 Active Learning 178 Web Resources 179

PART II THE MULTIPLE DIMENSIONS OF PERSON 180

Chapter 3 The Biological Person 181 Chapter Outline 181 Learning Objectives 181

• Case Study 3.1: Cheryl’s Legs and Head 182 • Case Study 3.2: A Diabetes Diagnosis for Jenna 183 • Case Study 3.3: Melissa’s HIV Diagnosis 184 • Case Study 3.4: HIV, Thomas’s Hero 184 • Case Study 3.5: Louise and Stewart, Huntington’s, Obesity, and Cardiovascular Disease 185

• Case Study 3.6: Juan and Belinda’s Sexual Life in Retirement 185

An Integrative Approach for Understanding the Intersection

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of Interior Biological Health and Illness and Exterior Environmental Factors

186

Systems Taxonomy: Six Interior Environment Systems 191 Nervous System 192 Endocrine System 199 Immune System 204 Cardiovascular System 210 Musculoskeletal System 215 Reproductive System 220

Heredity, Genetics, and the Reproductive System 227 Ecobiodevelopmental Framework to Understand the Relationship Between Interior Health and Exterior Environments

230

Implications for Social Work Practice 235 Key Terms 236 Active Learning 237 Web Resources 237

Chapter 4 The Psychological Person: Cognition, Emotion, and Self 239

Chapter Outline 240 Learning Objectives 240

• Case Study 4.1: The Premed Student 240 Cognition and Emotion 243 Theories of Cognition 244

Cognitive Theory 244 Information Processing Theory 246 Social Learning Theory 247 Theory of Multiple Intelligences 248 Theories of Moral Reasoning 251 Theories of Cognition in Social Work Practice 255

Theories of Emotion 259 Physiological Theories of Emotion 260 Psychological Theories of Emotion 265

Psychoanalytic Theory 265 Ego Psychology 266

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Attribution Theory: A Cognitive Perspective 267 Theory of Emotional Intelligence 268

Social Theories of Emotion 270 Theories of Emotion in Social Work Practice 271

Cognitive/Emotional “Disorders” 273 The Self 275

The Self as a Soul 275 The Self as Unfolding Potentials 276 The Self as Organizing Activity 276 The Self as Cognitive Structure 277 The Self as Shared Symbolic Experience 278 The Self as a Flow of Experience 279

Implications for Social Work Practice 281 Key Terms 282 Active Learning 283 Web Resources 284

Chapter 5 The Psychosocial Person: Relationships, Stress, and Coping 286

Chapter Outline 287 Learning Objectives 287

• Case Study 5.1: Dan’s Coping Strategies 287 The Self in Relationships 288

Relational Theory 289 Attachment Theory 291 Impact of Early Nurturing on Development 294 Feminist Theories of Relationships 298 Social Identity Theory 299

The Concept of Stress 302 Categories of Stress 302 Stress and Crisis 305 Traumatic Stress 306 Vulnerability to Stress 309

Coping and Adaptation 310 Biological Coping 310

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Psychological Coping 312 Coping Styles 317 Coping and Traumatic Stress 319 Social Support 322

Virtual Support 324 How Social Support Aids Coping 326 How Social Workers Evaluate Social Support 328

Normal and Abnormal Coping 329 The Medical (Psychiatric) Perspective 329 Psychological Perspectives 330 The Sociological Approach: Deviance 332 The Social Work Perspective: Social Functioning 334

Implications for Social Work Practice 337 Key Terms 338 Active Learning 339 Web Resources 339

Chapter 6 The Spiritual Person 341 Chapter Outline 342 Learning Objectives 342

• Case Study 6.1: Caroline’s Challenging Questions 342 • Case Study 6.2: Naomi’s Health Crisis 343 • Case Study 6.3: Matthew’s Faith Journey 344 • Case Study 6.4: Trudy’s Search for the Sacred 345 • Case Study 6.5: Leon’s Two Worlds 346 • Case Study 6.6: Jean-Joseph’s Serving the Spirits 346 • Case Study 6.7: Amira’s Quest for Self 347 • Case Study 6.8: Beth’s Framework for Living 348

The Spiritual Dimension 349 The Meaning of Spirituality 350 Spirituality in the United States and Globally 352

Theories of Spiritual Development 365 Fowler’s Stages of Faith Development 366 Transpersonal Theory 374 Wilber’s Integral Theory of Consciousness 375

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Summary and Critique of Fowler’s and Wilber’s Theories 380 The Role of Spirituality in Social Work 384

Spirituality and Human Diversity 387 Race and Ethnicity 387 Sex and Gender 393 Sexual Orientation 394 Other Aspects of Diversity 397

Spirituality and the Human Experience 398 Problems in Living 399 Individual and Collective Well-Being 400

Spiritual Assessment 405 Implications for Social Work Practice 408 Key Terms 409 Active Learning 410 Web Resources 411

PART III THE MULTIPLE DIMENSIONS OF ENVIRONMENT 413

Chapter 7 The Physical Environment 414 Chapter Outline 414 Learning Objectives 414

• Case Study 7.1: Ben Watson’s Changing Experience With the Physical Environment 415

Theories of Human Behavior and the Physical Environment 417 Stimulation Theories 419 Control Theories 422

Privacy 422 Personal Space 424 Territoriality 428 Crowding 429

Behavior Settings Theories 430 Ecocritical Theories 432

The Natural Environment 434 Benefits and Costs of Human Interaction With the Natural Environment 435

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Environmental and Ecological Justice 440 The Built Environment 445

Technology 446 Healing Environments 452 Urban Design and Health 459

Place Attachment 462 Homelessness 463 Accessible Environments for Persons With Disabilities 467 Implications for Social Work Practice 472 Key Terms 474 Active Learning 474 Web Resources 475

Chapter 8 Cultures 477 Chapter Outline 478 Learning Objectives 478

• Case Study 8.1: Rubina Living Across Cultures 478 What Is Culture? 480 Theories of Culture 485

Materialistic Perspective 487 Mentalist Perspective 488 Other Theoretical Perspectives 491

Major Concepts in the Study of Culture 493 Values 493 Ideology 494 Symbols 495 Language 496 Norms 497 Subcultures and Countercultures 498 Ideal Culture Versus Real Culture 500

Ethnocentrism and Cultural Relativism 500 Culture and Power 503

Race 504 Ethnicity 509 Gender 512

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Sexuality 519 Social Class 524 Disability 527

Genes and Culture 530 Digital Culture 531 How Culture Changes 533 Implications for Social Work Practice 536 Key Terms 537 Active Learning 538 Web Resources 539

Chapter 9 Social Structure and Social Institutions: Global and National 540

Chapter Outline 540 Learning Objectives 540

• Case Study 9.1: Leticia Renteria’s Struggle to Make It in the United States 541

Patterns of Social Life 544 Contemporary Trends in Global and U.S. Social Institutions 546

Trends in the Government and Political Institution 555 Trends in the Economic Institution 562 Trends in the Educational Institution 571 Trends in the Health Care Institution 578 Trends in the Social Welfare Institution 584 Trends in the Religious Institution 591 Trends in the Mass Media Institution 595 Trends in the Family and Kinship Institution 601

Theories of Social Inequality 604 Classical Sociological Theories of Social Inequality 605 The Contemporary Debate 606 Structural Determinism Versus Human Agency 608

Implications for Social Work Practice 609 Key Terms 610 Active Learning 611 Web Resources 612

1238

Chapter 10 Families 614 Chapter Outline 615 Learning Objectives 615

• Case Study 10.1: The Sharpe Family’s Deployment Adjustments 615

Family Defined 618 The Family in Historical Perspective 622 Theoretical Perspectives for Understanding Families 628

Family Systems Perspective 628 Exchange and Choice Perspective on Families 631 Symbolic Interaction Perspective on Families 634 Feminist Perspective on Families 637 Life Course Developmental Perspective on Families 639 Family Stress, Coping, and Resilience Perspective 641

Diversity in Family Life 645 Diversity in Family Structures 645

Nuclear Families 645 Extended Families 648 Cohabiting Opposite-Sex Couples 649 Couples With No Children 652 Lone-Parent Families 655 Stepfamilies 658 Same-Sex Partner Families 660 Military Families 664

Economic and Cultural Diversity 669 Economic Diversity 669 Cultural Diversity 672 Immigrant Families 676

Challenges to Family Life 678 Family Violence 679 Divorce and Relationship Dissolution 683 Substance Abuse 687

Implications for Social Work Practice 691 Key Terms 692

1239

Active Learning 693 Web Resources 694

Chapter 11 Small Groups 696 Chapter Outline 697 Learning Objectives 697

• Case Study 11.1: The Sexuality and Gender Group at a Women’s Residential Substance Abuse Treatment Facility

697

Small Groups in Social Work 700 Therapy Groups 704 Mutual Aid Groups 707 Psychoeducational Groups 709 Self-Help Groups 709 Task Groups 712 Virtual Groups 712

Dimensions of Group Structure 716 Group Composition 718

Heterogeneity Versus Homogeneity 718 Homogeneity/Heterogeneity in Group Composition: Social Justice Issues 721

Basic Group Processes 722 Theories of Group Processes 723

Psychodynamic Theory 723 Symbolic Interaction Theory 724 Status Characteristics and Expectation States Theory 725 Exchange Theory 727 Self-Categorization Theory 728

Group Development 729 Stage Theories and Models 730 Process Models 732

Group Dynamics 733 Formal and Informal Leadership 735 Formal and Informal Roles 737 Communication Networks 738 Group Cohesiveness 739

1240

Interdisciplinary Teams and Leadership 740 Interdisciplinary Teams and Social Work 741 The Social Worker’s Role on Interdisciplinary Teams 742 Social Workers and Leadership 743

Implications for Social Work Practice 745 Key Terms 746 Active Learning 747 Web Resources 747

Chapter 12 Formal Organizations 749 Chapter Outline 750 Learning Objectives 750

• Case Study 12.1: Changing Leadership, Changing Times at Beacon Center 750

A Definition of Formal Organizations 753 Perspectives on Formal Organizations 756

Rational Perspective 759 The Ideal-Type Bureaucracy 761 Scientific Management 762 Human Relations Theory 764 Management by Objectives (MBO) 767 Decision-Making Theory 767

Systems Perspective 768 Political Economy Model 770 Institutional Theory of Organizations 771 Learning Organization Theory 772

Interactional/Interpretive Perspective 774 Organizational Culture Model 775 Managing Diversity Model 777 Appreciative Inquiry Model of Organizational Change 779

Critical Perspective 780 Theory of Gendered Organizations 781 Organizations as Multiple Oppressions 783 Nonhierarchical Organizations 784

1241

Burnout: A Negative Organizational Outcome 788 Social Work and Formal Organizations 793

Technology and Social Service Organizations 797 Social Work Leadership in Formal Organizations 801 Culturally Sensitive Care Systems 803 Implications for Social Work Practice 804 Key Terms 805 Active Learning 806 Web Resources 807

Chapter 13 Communities 808 Chapter Outline 808 Learning Objectives 808

• Case Study 13.1: A Rural West Virginia Community Struggles to Recover 809

• Case Study 13.2: An Evolving Online Support Community 811

A Definition of Community 812 Territorial Community and Relational Community 815 Social Workers and Communities: Our History 820 Theoretical Approaches to Community 821

Contrasting Types Approach 823 Spatial Arrangements Approach 826 Social Systems Approach 831 Social Capital Approach 835 Conflict Approach 842

Social Workers and Communities: Contemporary Issues 845 Community as Context for Practice Versus Target of Practice 846

Agency Orientation Versus Social Action 848 Conflict Model of Practice Versus Collaborative Model 849 Expert Versus Partner in the Social Change Process 853

Implications for Social Work Practice 854 Key Terms 856 Active Learning 856 Web Resources 857

1242

Chapter 14 Social Movements 859 Chapter Outline 859 Learning Objectives 859

• Case Study 14.1: Fighting for Our Water, Land, and Air 860 A Definition of Social Movements 864 Social Movements and the History of Social Work 865 Perspectives on Social Movements 867

Political Process Perspective 870 Openness of the Political System 873 Stability of Political Alignments 875 Availability of Elite Allies 877 International Relations 878

Mobilizing Structures Perspective 879 Informal and Formal Structures 880 Information and Communication Technology (ICT) 882 The Life Course of Social Movements 888

Cultural Framing Perspective 890 Frames for Understanding That a Problem Exists 893 Frames for Recognizing a Window of Opportunity 895 Frames for Establishing Goals 896 Frames for Identifying Pathways for Action 899

Emerging Perspectives 903 Social Movement Outcomes 905 Social Movement Trends 907 Social Movements and Contemporary Social Work 908 Implications for Social Work Practice 913 Key Terms 914 Active Learning 914 Web Resources 915

Glossary 916 References 954 Index 1157 About the Author 1225

1243

About the Contributors 1226

1244

Case Studies
Preface
Acknowledgments
PART I A MULTIDIMENSIONAL APPROACH FOR MULTIFACETED SOCIAL WORK

Chapter 1 Human Behavior: A Multidimensional Approach

Chapter Outline
Learning Objectives

• Case Study 1.1: Joshua, Making a New Life

Human Behavior: Individual and Collective
A Multidimensional Approach

Personal Dimensions
Environmental Dimensions
Time Dimensions

Diversity, Inequality, and the Pursuit of Social Justice: A Global Perspective

Diversity
Inequality
Advancing Human Rights and Social, Economic, and Environmental Justice

Knowing and Doing

Knowledge About the Case
Knowledge About the Self
Values and Ethics

Scientific Knowledge: Theory and Research

Theory
Empirical Research
Critical Use of Theory and Research

Organization of the Book
Implications for Social Work Practice
Key Terms
Active Learning
Web Resources

Chapter 2 Theoretical Perspectives on Human Behavior

Chapter Outline
Learning Objectives

• Case Study 2.1: End of Life Care for Maria Chavez

Multiple Perspectives for a Multidimensional Approach
Systems Perspective
Conflict Perspective
Exchange and Choice Perspective
Social Constructionist Perspective
Psychodynamic Perspective
Developmental Perspective
Behavioral Perspective
Humanistic Perspective
The Merits of Multiple Perspectives
Implications for Social Work Practice
Key Terms
Active Learning
Web Resources

PART II THE MULTIPLE DIMENSIONS OF PERSON

Chapter 3 The Biological Person

Chapter Outline
Learning Objectives

• Case Study 3.1: Cheryl’s Legs and Head
• Case Study 3.2: A Diabetes Diagnosis for Jenna
• Case Study 3.3: Melissa’s HIV Diagnosis
• Case Study 3.4: HIV, Thomas’s Hero
• Case Study 3.5: Louise and Stewart, Huntington’s, Obesity, and Cardiovascular Disease
• Case Study 3.6: Juan and Belinda’s Sexual Life in Retirement

An Integrative Approach for Understanding the Intersection of Interior Biological Health and Illness and Exterior Environmental Factors
Systems Taxonomy: Six Interior Environment Systems

Nervous System
Endocrine System
Immune System
Cardiovascular System
Musculoskeletal System
Reproductive System

Heredity, Genetics, and the Reproductive System

Ecobiodevelopmental Framework to Understand the Relationship Between Interior Health and Exterior Environments
Implications for Social Work Practice
Key Terms
Active Learning
Web Resources

Chapter 4 The Psychological Person: Cognition, Emotion, and Self

Chapter Outline
Learning Objectives

• Case Study 4.1: The Premed Student

Cognition and Emotion
Theories of Cognition

Cognitive Theory
Information Processing Theory
Social Learning Theory
Theory of Multiple Intelligences
Theories of Moral Reasoning
Theories of Cognition in Social Work Practice

Theories of Emotion

Physiological Theories of Emotion
Psychological Theories of Emotion

Psychoanalytic Theory
Ego Psychology
Attribution Theory: A Cognitive Perspective
Theory of Emotional Intelligence

Social Theories of Emotion
Theories of Emotion in Social Work Practice

Cognitive/Emotional “Disorders”
The Self

The Self as a Soul
The Self as Unfolding Potentials
The Self as Organizing Activity
The Self as Cognitive Structure
The Self as Shared Symbolic Experience
The Self as a Flow of Experience

Implications for Social Work Practice
Key Terms
Active Learning
Web Resources

Chapter 5 The Psychosocial Person: Relationships, Stress, and Coping

Chapter Outline
Learning Objectives

• Case Study 5.1: Dan’s Coping Strategies

The Self in Relationships

Relational Theory
Attachment Theory
Impact of Early Nurturing on Development
Feminist Theories of Relationships
Social Identity Theory

The Concept of Stress

Categories of Stress
Stress and Crisis
Traumatic Stress
Vulnerability to Stress

Coping and Adaptation

Biological Coping
Psychological Coping
Coping Styles
Coping and Traumatic Stress
Social Support

Virtual Support
How Social Support Aids Coping
How Social Workers Evaluate Social Support

Normal and Abnormal Coping

The Medical (Psychiatric) Perspective
Psychological Perspectives
The Sociological Approach: Deviance
The Social Work Perspective: Social Functioning

Implications for Social Work Practice
Key Terms
Active Learning
Web Resources

Chapter 6 The Spiritual Person

Chapter Outline
Learning Objectives

• Case Study 6.1: Caroline’s Challenging Questions
• Case Study 6.2: Naomi’s Health Crisis
• Case Study 6.3: Matthew’s Faith Journey
• Case Study 6.4: Trudy’s Search for the Sacred
• Case Study 6.5: Leon’s Two Worlds
• Case Study 6.6: Jean-Joseph’s Serving the Spirits
• Case Study 6.7: Amira’s Quest for Self
• Case Study 6.8: Beth’s Framework for Living

The Spiritual Dimension

The Meaning of Spirituality
Spirituality in the United States and Globally

Theories of Spiritual Development

Fowler’s Stages of Faith Development
Transpersonal Theory
Wilber’s Integral Theory of Consciousness
Summary and Critique of Fowler’s and Wilber’s Theories

The Role of Spirituality in Social Work

Spirituality and Human Diversity

Race and Ethnicity
Sex and Gender
Sexual Orientation
Other Aspects of Diversity

Spirituality and the Human Experience

Problems in Living
Individual and Collective Well-Being

Spiritual Assessment

Implications for Social Work Practice
Key Terms
Active Learning
Web Resources

PART III THE MULTIPLE DIMENSIONS OF ENVIRONMENT

Chapter 7 The Physical Environment

Chapter Outline
Learning Objectives

• Case Study 7.1: Ben Watson’s Changing Experience With the Physical Environment

Theories of Human Behavior and the Physical Environment

Stimulation Theories
Control Theories

Privacy
Personal Space
Territoriality
Crowding

Behavior Settings Theories
Ecocritical Theories

The Natural Environment

Benefits and Costs of Human Interaction With the Natural Environment
Environmental and Ecological Justice

The Built Environment

Technology
Healing Environments
Urban Design and Health

Place Attachment
Homelessness
Accessible Environments for Persons With Disabilities
Implications for Social Work Practice
Key Terms
Active Learning
Web Resources

Chapter 8 Cultures

Chapter Outline
Learning Objectives

• Case Study 8.1: Rubina Living Across Cultures

What Is Culture?
Theories of Culture

Materialistic Perspective
Mentalist Perspective
Other Theoretical Perspectives

Major Concepts in the Study of Culture

Values
Ideology
Symbols
Language
Norms
Subcultures and Countercultures
Ideal Culture Versus Real Culture

Ethnocentrism and Cultural Relativism
Culture and Power

Race
Ethnicity
Gender
Sexuality
Social Class
Disability

Genes and Culture
Digital Culture
How Culture Changes
Implications for Social Work Practice
Key Terms
Active Learning
Web Resources

Chapter 9 Social Structure and Social Institutions: Global and National

Chapter Outline
Learning Objectives

• Case Study 9.1: Leticia Renteria’s Struggle to Make It in the United States

Patterns of Social Life
Contemporary Trends in Global and U.S. Social Institutions

Trends in the Government and Political Institution
Trends in the Economic Institution
Trends in the Educational Institution
Trends in the Health Care Institution
Trends in the Social Welfare Institution
Trends in the Religious Institution
Trends in the Mass Media Institution
Trends in the Family and Kinship Institution

Theories of Social Inequality

Classical Sociological Theories of Social Inequality
The Contemporary Debate
Structural Determinism Versus Human Agency

Implications for Social Work Practice
Key Terms
Active Learning
Web Resources

Chapter 10 Families

Chapter Outline
Learning Objectives

• Case Study 10.1: The Sharpe Family’s Deployment Adjustments

Family Defined
The Family in Historical Perspective
Theoretical Perspectives for Understanding Families

Family Systems Perspective
Exchange and Choice Perspective on Families
Symbolic Interaction Perspective on Families
Feminist Perspective on Families
Life Course Developmental Perspective on Families
Family Stress, Coping, and Resilience Perspective

Diversity in Family Life

Diversity in Family Structures

Nuclear Families
Extended Families
Cohabiting Opposite-Sex Couples
Couples With No Children
Lone-Parent Families
Stepfamilies
Same-Sex Partner Families
Military Families

Economic and Cultural Diversity

Economic Diversity
Cultural Diversity
Immigrant Families

Challenges to Family Life

Family Violence
Divorce and Relationship Dissolution
Substance Abuse

Implications for Social Work Practice
Key Terms
Active Learning
Web Resources

Chapter 11 Small Groups

Chapter Outline
Learning Objectives

• Case Study 11.1: The Sexuality and Gender Group at a Women’s Residential Substance Abuse Treatment Facility

Small Groups in Social Work

Therapy Groups
Mutual Aid Groups
Psychoeducational Groups
Self-Help Groups
Task Groups
Virtual Groups

Dimensions of Group Structure
Group Composition

Heterogeneity Versus Homogeneity
Homogeneity/Heterogeneity in Group Composition: Social Justice Issues

Basic Group Processes

Theories of Group Processes

Psychodynamic Theory
Symbolic Interaction Theory
Status Characteristics and Expectation States Theory
Exchange Theory
Self-Categorization Theory

Group Development

Stage Theories and Models
Process Models

Group Dynamics

Formal and Informal Leadership
Formal and Informal Roles
Communication Networks
Group Cohesiveness

Interdisciplinary Teams and Leadership

Interdisciplinary Teams and Social Work
The Social Worker’s Role on Interdisciplinary Teams
Social Workers and Leadership

Implications for Social Work Practice
Key Terms
Active Learning
Web Resources

Chapter 12 Formal Organizations

Chapter Outline
Learning Objectives

• Case Study 12.1: Changing Leadership, Changing Times at Beacon Center

A Definition of Formal Organizations
Perspectives on Formal Organizations

Rational Perspective

The Ideal-Type Bureaucracy
Scientific Management
Human Relations Theory
Management by Objectives (MBO)
Decision-Making Theory

Systems Perspective

Political Economy Model
Institutional Theory of Organizations
Learning Organization Theory

Interactional/Interpretive Perspective

Organizational Culture Model
Managing Diversity Model
Appreciative Inquiry Model of Organizational Change

Critical Perspective

Theory of Gendered Organizations
Organizations as Multiple Oppressions
Nonhierarchical Organizations

Burnout: A Negative Organizational Outcome
Social Work and Formal Organizations

Technology and Social Service Organizations

Social Work Leadership in Formal Organizations
Culturally Sensitive Care Systems
Implications for Social Work Practice
Key Terms
Active Learning
Web Resources

Chapter 13 Communities

Chapter Outline
Learning Objectives

• Case Study 13.1: A Rural West Virginia Community Struggles to Recover
• Case Study 13.2: An Evolving Online Support Community

A Definition of Community
Territorial Community and Relational Community
Social Workers and Communities: Our History
Theoretical Approaches to Community

Contrasting Types Approach
Spatial Arrangements Approach
Social Systems Approach
Social Capital Approach
Conflict Approach

Social Workers and Communities: Contemporary Issues

Community as Context for Practice Versus Target of Practice
Agency Orientation Versus Social Action
Conflict Model of Practice Versus Collaborative Model
Expert Versus Partner in the Social Change Process

Implications for Social Work Practice
Key Terms
Active Learning
Web Resources

Chapter 14 Social Movements

Chapter Outline
Learning Objectives

• Case Study 14.1: Fighting for Our Water, Land, and Air

A Definition of Social Movements
Social Movements and the History of Social Work
Perspectives on Social Movements

Political Process Perspective

Openness of the Political System
Stability of Political Alignments
Availability of Elite Allies
International Relations

Mobilizing Structures Perspective

Informal and Formal Structures
Information and Communication Technology (ICT)
The Life Course of Social Movements

Cultural Framing Perspective

Frames for Understanding That a Problem Exists
Frames for Recognizing a Window of Opportunity
Frames for Establishing Goals
Frames for Identifying Pathways for Action

Emerging Perspectives

Social Movement Outcomes
Social Movement Trends
Social Movements and Contemporary Social Work
Implications for Social Work Practice
Key Terms
Active Learning
Web Resources

Glossary
References
Index
About the Author
About the Contributors