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Posts Tagged ‘
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Introduction
The numbers of gay and lesbian adults and couples who are adopting children is increasing dramatically; at the same time, the number of adoption agencies willing to place children with gay and lesbian adults and couples is also increasing notably. What does this mean for children in need of healthy family environments? What does the research tell us about families with gay or lesbian parents, including those created through adoption?
First, a little background information about children awaiting adoption and the size of the adopter pool (parents interested in adopting). The number of children not living with their biological parents is at unacceptably high levels. Research suggests that there were 542,000 children in foster care in the United States in 2001 and as many as one third of these children may be eligible for adoption.
Many gay and lesbian adults and couples are interested in adopting children. However, discrimination has made it difficult for gay and lesbian adults and couples to complete the adoption process (Brodzinsky, 2003). Excluding gays and lesbians as potential adopters is not only discriminatory but it limits the number of potential adults available to adopt the thousands of children eligible for adoption.
Although it is not commonly known, the research regarding parenting by gays and lesbians is very positive. The following list shows the important findings from research on families with gay and lesbian parents:
- Lesbian mothers have been found comparable to heterosexual mothers in their desire to be parents (Kirkpatrick, Smith, & Roy, 1981; Lewin & Lyons, 1982; Osterweil, 1991).
- Lesbian mothers have been found comparable to heterosexual mothers in their warmth toward children (Golombok, Tasker, & Murray, 1997).
- Lesbian mothers have been found comparable to heterosexual mothers in their parental behaviors (Harris & Turner, 1986).
- Lesbian couples have been found equal to or superior to heterosexual couples in dividing responsibility for chores equally, in financial cooperation, decision-making, relationship satisfaction and emotional expression (Brewaeys, Ponjaert, Van Hall, & Golombok, 1997; Chan, Brooks, Raboy, & Patterson, 1998).
- Gay fathers have been found comparable to heterosexual fathers in involvement with their children, intimacy with their children, provision of recreation, encouragement of autonomy, problem-solving and parental satisfaction, but superior in the way they respond to child needs, and communication of reasons for appropriate behavior (Bigner & Jacobsen, 1989a; 1989b; 1992; Peterson, Butts & Deville, 2000).
- Gay and lesbian couples value and desire commitment in relationships to the same extent that heterosexual couples do (Kurdek, 1995; Peplau, Veniegas, & Campbell, 1996)
- Children raised by gay and lesbian parents have no apparent adjustment problems that have been found to be related to their parent's sexual orientation (Chan, Raboy, & Patterson, 1998; Flaks, et al., 1995; Patterson, 1994; 1997).
- In comparison to children raised by heterosexual parents, children raised by gay and lesbian parents have been found comparable in intelligence, behaviors, moral development, and peer relationships (Allen & Burrell, 1996; Falk, 1994; Flaks, et al, 1995; Tasker & Golombok, 1995; 1997).
There is a limited number of studies involving children adopted by gay and lesbian adults and couples but once again the results are very positive. The following shows important findings from research on adoptive families with gay and lesbian parents:
- Adoptive families with gay and lesbian parents have been found to have positive family functioning, well-behaved children, and helpful family support networks (Erich, Leung, & Kanenberg, 2005a).
- There were no significant differences between gay and lesbian adoptive parents and heterosexual parents in terms of family functioning, their children's behavior problems, and their family support networks (Erich, Leung, & Kanenberg, 2005b).
- In a study involving three groups of adoptive families, "parent's sexual orientation" was not found to be a significant predictor of how well families function (Leung, Erich, & Kanenberg, 2005c).
This research provides clear support for the well-being of children being reared in homes with gay and lesbian adults or couples. In concert with the National Association of Social Work Code of Ethics which prohibits discrimination in any form, these findings direct social workers to support the practice of adoption by gay and lesbian adults and couples.
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Introduction
Here are two articles on how social workers help in the adoption and foster care arenas. The first is a general description of how social workers assist adoptive and foster care parents. The second is a first-person narrative of a social worker based in Washington, DC who works in the foster care system.
Tags: adoption, birth parents, child, families, foster care, help, legal state, process, resources, social workers, tips, trends
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Introduction
More than two million adults have schizophrenia, or over 1 percent of the American population. The most disabling of the severe mental illnesses, schizophrenia typically appears in men in their late teens or early 20s and in women in their 20s and 30s. Other statistics show that:
- Only one in five people with the illness recovers
- One out of 10 eventually commits suicide
- Less than half receive adequate treatment, including appropriate medication dosage and use of various therapies
Searching for a Cause
- Research shows that schizophrenia may be a developmental disorder from impaired migration of neurons in the brain during fetal development.
- Scientists have found a link between epilepsy and schizophrenia. A history of epilepsy more than doubles the risk of developing schizophrenia or similar psychosis.
- Imaging of live brains indicates that people with schizophrenia have enlarged ventricles, which are fluid-filled cavities located deep within the brain.
- Scientists are using new molecular tools to identify and isolate genes that might make people more susceptible to schizophrenia by affecting brain development.
Medication Management Trends
- Medications developed in the past decade cause fewer side effects, but symptoms such as social withdrawal and lack of motivation are still unaffected by drugs.
- New long-acting, injectable antipsychotic medications are available that eliminate the need to take pills every day. The medication treatment adherence rate among people with schizophrenia is low because they often believe that they are not ill, or are bothered by side effects, among other reasons.
- Antipsychotic medications significantly improve symptoms for a majority of people with the illness, but not for everyone.
- An individualized treatment regimen is critical since people vary on how much medication is needed to eliminate symptoms without producing side effects.
Additional Therapies
- Recent studies show that reality-oriented individual psychotherapy and cognitive behavioral approaches can be beneficial for people with schizophrenia.
- Rehabilitation programs often provide social and vocational training, counseling, job training, money management, and social skills training. Even when hallucinations are managed with medication, people with schizophrenia may still have difficulty with communication, self-care, motivation, and developing relationships.
- Education helps family members understand the illness and develop coping strategies and problem-solving skills.
Sources:
National Institute of Mental Health
Reuters Health News
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Introduction
In the wake of Hurricane Katrina, the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) is promoting the National Suicide Prevention Lifeline. The Lifeline's mission is to provide immediate assistance to individuals in suicidal crisis by connecting them to the nearest available suicide prevention and mental health service provider through a toll-free telephone number: 1-800-273-TALK (8255). It is the only national suicide prevention and intervention telephone resource funded by the Federal Government.
The Lifeline and its website www.suicidepreventionlifeline.org, launched in December 2004, link to a network of local crisis centers located in communities across the country that are committed to suicide prevention. Callers to the hotline will receive suicide prevention counseling from trained staff at the closest certified crisis center in the network. The new materials available on the web will assist local crisis centers in their efforts to reach out to the media to raise awareness about suicide and the national hotline.
In response to Hurricane Katrina, SAMHSA has activated its disaster response plan for the Lifeline to ensure all calls are answered. The information on the Lifeline is being distributed in the impacted areas through established national, state and local networks to help make the number widely available and accessible to those in need.
900,000 Youth Planned Suicides During Major Depression
On September 9, 2005, SAMHSA today released data showing that approximately 900,000 youth had made a plan to commit suicide during their worst or most recent episode of major depression, and 712,000 attempted suicide during such an episode of depression. The new data contained in a special report on youth ages 12-17.
The special report, “Suicidal Thoughts among Youths Aged 12-17 with Major Depressive Episode” found that over 7 percent of youth ages 12-17, 1.8 million youth, had thought about killing themselves during their worst or most recent episode of major depression.
According to the report, about 3.5 million youth ages 12-17, 14 percent, had experienced at least one episode of major depression in their lifetimes. Almost 20 percent of females in this age group and 8.5 percent of males had at least one of these depressive episodes. Rates of major depressive episodes in their lifetimes were similar among racial and ethnic groups and increased with age.
The report is available on the web at www.oas.samhsa.gov.
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Introduction
Putting on make-up. Looking in the mirror. Brushing teeth. Combing hair. Billions of people worldwide perform such mundane tasks everyday without experiencing any significant distress. Suppose, however, you see your reflection in the mirror and feel a sense of disgust about your appearance. You feel you look so awful that to go out in public seems too overwhelming, too frightening. Having a relationship feels nearly impossible, and being able to concentrate well enough to perform on the job or at school is a daily challenge. As a result you become nearly housebound, depressed, and have thoughts of suicide. It is at that point that you may feel like millions of others who have body dysmorphic disorder, also called BDD.
Sarah is a 23-year-old woman who believes she has had BDD for the past eight years. When she was 15-years old she began obsessing over the shape of her nose. She had plastic surgery at 18. Two other reconstructive nose surgeries followed because she was unhappy with the results. Although many men her age feel she is attractive and often express interest in her, Sarah has stopped dating, and now rarely even goes out with her girlfriends. Obsessions over her skin and her cheekbones have also surfaced, and she has also sought consultation to have those perceived "flaws" corrected with surgery. She continues to use multiple skin care products to cover minor acne scaring, and is exploring the possibility of a cheek implant to correct what she believes to be an asymmetric appearance of her cheekbones. She has had several bouts of major depression, and has admitted herself on two occasions to a psychiatric hospital because she was seriously considering committing suicide, and she suffered one overdose of her anti-depressant medications.
As many as three to five million people in this country are believed to have BDD. It is known to affect men and women equally, and the most likely age of onset is during the early teen years. If BDD is believed to be so common then why aren't more people familiar with it?
First, since many BDD sufferers experience tremendous shame over their appearance, they may choose not to reveal their concerns to anyone, including their therapist. Second, they may first pursue dermatologic treatment or plastic surgery, not recognizing that what may be wrong is more psychological than physical. And even when they do seek psychiatric care, they may pursue treatment for the depression, anxiety, and functional impairments which have resulted from the disorder, rather than treatment for the disorder itself. Lastly, many psychotherapists and physicians remain unskilled in assessing for the presence of BDD.
While the focus of a person's BDD can be any part of the body, the most common areas of focus are the head and facial features. Skin, hair, and the nose are the body parts most often of concern. Other areas, however, can also be the focus, such as weight, stomach, breasts, eyes, thighs, and teeth. If the concern is skin, the fear may pertain to skin tone and wrinkles, with hair it may pertain to thinning, and with the nose the concern may pertain to it being misshapen.
BDD involves much obsessional thinking over the body part, to the point where someone may obsess over it for hours each day. There are also numerous behaviors which may suggest the presence of BDD, such as mirror checking or mirror avoidance. Checking of one's reflection, however, doesn't have to stop with mirrors, as many other objects have reflective surfaces. These may include glass picture frames, store windows, and even watch faces.
In addition, people with BDD often engage in "camouflaging," which refers to attempts to try and mask the body part, such as with the excessive use of make-up if the concern pertains to the skin, or wearing a hat if the fear is associated with hair.
Many people with BDD also will compare their body part(s) to those of others, such as friends, family members, or people in the public eye.
Excessive grooming can be another problematic behavior, whether it pertains to combing hair, shaving, or putting on make-up. Touching the body part, and skin picking are also fairly common as well. In an attempt to correct the supposed "flaw" someone may pick at their skin to try and remove a blemish, for example. Unfortunately, this often may result in exacerbating the situation instead of improving it. Reassurance seeking is also a frequent behavior, though typically this results in only temporary relief at best.
As indicated above, seeking unnecessary medical appointments and procedures can be another troubling behavior. Dermabrasions, breast surgery, and rhinoplasties are among the most frequently sought procedures.
Muscle dysmorphia is a form of BDD believed to affect mostly men who believe that their body build is too small. As a result, they may engage in excessive exercise, and in the use of supplements and steroids at potentially dangerous levels.
It is critically important to recognize that BDD rarely exists without the existence of other psychiatric disorders. Major depression and social phobia are quite common, as are suicidal thoughts. In fact, it is believed that as many as 25 percent of those with BDD have made suicide attempts. Given this figure, the risk of suicide may be greater in BDD than in any other psychiatric patient population.
A combination of medication and cognitive-behavioral therapy (CBT) is widely regarded as the best treatment approach for the vast majority of patients with BDD. When medications are prescribed, the first line approach is usually with the anti-depressants in the class known as serotonin reuptake inhibitors, such as Celexa, Lexapro, Luvox, Paxil, Prozac and Zoloft. (The drug Anafranil, a tricyclic antidepressant, also acts on serotonin and is effective in treating BDD.) The use of cognitive-behavioral therapy to confront maladaptive thought patterns, and the many problematic behaviors is equally as important.
Cognitive Behavioral Therapy is used to encourage clients to recognize the irrational nature of the thoughts about their appearance, and to engage in a behavioral modification technique known as exposure and response prevention. Highly trained clinical social workers can provide this therapy.
Cognitive Behavior Therapy involves having the person confront the behaviors, such as mirror checking and camouflaging, and then having the person resist the urge to engage in them. This may include, for example, going out in public wearing less make-up or perhaps none at all. The essence of this treatment is for the patient to learn that their concerns about appearance are excessive and beyond what is normal. Also, learning that life can be meaningful without having to alter one's appearance is a necessary goal of treatment.
While BDD patients may appear to be overly vain, most are in fact desperate to appear to look normal. They want nothing more than just to fit in, and not to look grotesque, as many will refer to themselves as appearing. Given this, it is perhaps understandable that they may go to great lengths to improve upon their appearance, especially if they believe that their well-being depends on it. Although there is a shortage of mental health clinicians skilled in the treatment of BDD, considerable relief can be found with proper medication and CBT, as well as from the compassion and support of the medical professionals and therapists involved in their care.
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The opinions expressed in this article are those of the writer, and do not necessarily reflect those of the National Association of Social Workers or its members.
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What Research Tells Us About Brain Development in the First Three Years
The brain is not fully developed at birth and weighs only 25 percent of its adult weight.
- Newborns have nearly all of the brain cells they will need in a lifetime, but these cells are not yet linked to form connections that are needed for complex thinking and functioning.
- By age three, the brain has twice as many synapses, or connections, in the brain as they will need as adults. The number of synapses remains constant in the middle childhood years and then begins to decline in late childhood and through adolescence.
- Brain connections are formed and refined in response to experiences.
- The optimal time for parents to have the most influence on helping to nurture their child's brain development is the years from birth to age three.
- Positive experiences provide nourishment for the brain, building the neural connections and networks for a lifetime.
- Prolonged stress can actually destroy brain cells and promote networks that create negative patterns of thinking and feeling.
- Researchers say that loving, responsive care provides babies with the ideal environment for encouraging exploration, which leads to learning.
- There are no special tricks for making babies smarter. However, parents can promote advanced language skills by reading to and talking to babies.
- Studies show that young children who form secure emotional attachments with parents and/or caregivers early in life make better social adjustments and perform better in school.
- Attachment to fathers is critical in the development of language skills and academic performance.
- Placing a baby in child care does not interfere with the development of parent-infant attachment.
- Babies can thrive in child care—if it is of high quality.
- Young children need sensitive, loving care and stimulating experiences.
- Higher quality care is related to better mother-child relationships, higher language ability, a higher level of school readiness, and fewer behavior problems.
- The elements of child care that are most essential include the child's safety, communication between the provider and parents, and a warm and attentive relationship between the provider and child. Parents should also engage in activities to stimulate their child’s development.
- By the time they reach kindergarten, children from low-income families are already at a disadvantage in learning and school readiness.
- Poverty negatively affects the cognitive and behavioral development of young children.
- Early intervention programs, such as Head Start, have shown to promote development in the areas that these children lack.
Sources:
- Centers for Disease Control and Prevention
- National Child Care Information Center
- University of Georgia College of Family and Consumer Sciences
- U.S. Department of Education, Office of Educational Research and Improvement
- Zero to Three
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What Is Guided Imagery?
Guided imagery is a gentle but powerful technique that focuses and directs the imagination. It can be just as simple as an athlete’s 10-second reverie, just before leaping off the diving board, imagining how a perfect dive feels when slicing through the water. Or it can be as complex as imagining the busy, focused buzz of thousands of loyal immune cells, scooting out of the thymus gland on a search and destroy mission to wipe out unsuspecting cancer cells.
Although it has been called “visualization” and “mental imagery”, these terms are misleading. Guided imagery involves far more than just the visual sense – and this is a good thing, given the fact that only about 55% of the population is strongly wired visually. Instead, imagery involves all of the senses, and almost anyone can do this. Neither is it strictly a “mental” activity – it involves the whole body, the emotions and all the senses, and it is precisely this body-based focus that makes for its powerful impact.
When properly constructed, imagery has the built-in capacity to deliver multiple layers of complex, encoded messages by way of simple symbols and metaphors. You could say it acts like a depth charge dropped beneath the surface of the “bodymind”, where it can reverberate again and again.
Over the past 25 years, the effectiveness of guided imagery has been increasingly established by research findings that demonstrate its positive impact on health, creativity and performance. We now know that in many instances even 10 minutes of imagery can reduce blood pressure, lower cholesterol and glucose levels in the blood, and heighten short-term immune cell activity. It can considerably reduce blood loss during surgery and morphine use after it. It lessens headaches and pain. It can increase skill at skiing, skating, tennis, writing, acting and singing; it accelerates weight loss and reduces anxiety; and it has been shown, again and again, to reduce the aversive effects of chemotherapy, especially nausea, depression and fatigue.
Because it is a right-brained activity, engaging in it will often be accompanied by other functions that reside in that vicinity: emotion, laughter, sensitivity to music, openness to spirituality, intuition, abstract thinking and empathy.
And because it mobilizes unconscious and pre-conscious processes to assist with conscious goals, it can bring to bear much more of a person’s strength and motivation to accomplish a desired end. So, subtle and gentle as this technique is, it can be very powerful, and more and more so over time.
One of the most appealing and forgiving features about imagery is that almost anyone can use it. Although children and women probably have a slight, natural advantage, imagery skips across the barriers of education, class, race, gender and age – a truly equal opportunity intervention.
Even though it can be considered a kind of meditation, it is easier for most westerners to use than traditional meditation, as it requires less time and discipline to develop a high level of skill. This is because it seduces the mind with appealing sensory images that have their own natural pull. And because it results in a kind of natural trance state, it can be considered a form of hypnosis as well.
People can invent their own imagery, or they can listen to imagery that’s been created for them. Either way, their own imaginations will sooner or later take over, because, even when listening to imagery that’s been created in advance, the mind will automatically edit, skip, change or substitute what’s being offered for what is needed. So even a tape, CD or written script will become a kind of internal launching pad for the genius of each person’s unique imagination.
3 Principles of Guided Imagery
Guided imagery works because of 3 very simple, common-sense principles. You already know them.
First of all, to the body, images created in the mind can be almost as real as actual, external events. The mind doesn’t quite get the difference. That’s why, when we read a recipe, we start to salivate. The mind is constructing images of the food — how it looks, tastes and smells; it might even be evoking the sounds of the food cooking or the feel of its texture as it’s being chewed. And all the while, the body is thinking “dinner is served”, and is responding by generating saliva and appetite.
The mind cues the body especially well if the images evoke sensory memory and fantasy – sights, sounds, smells, feel and taste – and when there is a strong emotional element involved. So, for instance, a strongly evocative image might be remembering the sound and timbre of Daddy’s smiling voice, telling you he’s proud of you; or the internal bristling of energy all through your body as you realize that you are about to triumph at something… that you are home free… golden.
These sensory images are the true language of the body, the only language it understands, immediately and without question.
Secondly, in the altered state, we’re capable of more rapid and intense healing, growth, learning and performance. We are even more intuitive and creative. In this ordinary but profound mind-state, our brainwave activity and our biochemistry shift. Our moods and cognition change. We can do things we couldn’t in a normal, waking state – lift a tree that has fallen on a child; write an extraordinarily delicious poem; replace our terror of a surgical procedure with a calming sense of safety and optimism; abate a life-threatening histamine response to a bee sting.
We wander in and out of altered states all through the day, as a matter of course. Sometimes it’s not a conscious choice, and we drive past our exit on the highway. At best, the altered state is a state of relaxed focus, a kind of calm but energized alertness, a highly functional form of focused reverie. Attention is concentrated on one thing or on a very narrow band of things.
As this happens, we find we have a heightened sensitivity to the object of our attention, and a decreased awareness of other things going on around us, things we would ordinarily notice. We are so engrossed, we lose track of time or don’t hear people talking to us. Or we are so focused on our tennis, we don’t realized we were playing on a broken ankle, and the pain isn’t perceived until the game is over.
The altered state is the power cell of guided imagery. When we consciously apply it, we have an awesome ally, a prodigious source of internal strength and skill.
The third principle is often referred to in the medical literature as the “locus of control” factor.
When we have a sense of being in control, that, in and of itself, can help us to feel better and do better.
Feeling in control is associated with higher optimism, self esteem, and ability to tolerate pain, ambiguity and stress. Decades of research in ego psychology informs us that we feel better about ourselves and perform better when we have a sense of mastery over the environment. Conversely, a sense of helplessness lowers self-esteem, our ability to cope and our optimism about the future.
Because guided imagery is an entirely internally driven activity, and the user can decide when, where, how and if it is applied, it has the salutary effect of helping us feel we have some control.
So, when you put all this together, you have a technique that generates an altered state, in which the mind is directed toward multi-sensory images that the body perceives as real. This is done exactly when, where and how the user wishes. And that’s why it’s so effective.
© Naparstek 2000
© Staying Well with Guided Imagery, 1994
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The opinions expressed in this article are those of the writer, and do not necessarily reflect those of the National Association of Social Workers or its members.
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Adoption Statistics and Trends
- Since 1987, the number of adoptions annually in the United States has remained consistent from 118,000 to 127,000 children.
- Adoption costs range from no cost to more than $40,000. Foster care adoptions are the least expensive, costing a maximum of $2,500. Independent adoptions tend to be the most expensive. Intercountry adoption fees range from $7,000 to $30,000, but additional fees may include travel, translation fees, and other expenses.
- In a 2003 study, a majority (60%) of adoption agencies accepted applications from gay or lesbian couples and 40 percent had already placed children in GLBT homes.
- Foster parents are strongly encouraged to adopt children in their care.
- In the past, child welfare agencies did not consider placing children with relatives when the children were in foster care due to abuse or neglect. Today, more agencies are working with extended families on successful kinship adoptions.
- Kinship adoptions: when a grandparent, stepparent, or other relative adopts a child
- Adoption from the foster care system
- Adoption from the United States using a public agency, private agency, or an attorney
- Open adoption, in which adoptive parents have information about or contact with birth parents before, during, or after placement (not legal in all states)
- Adoption from another country through a licensed adoption organization
- Federal adoption subsidies for eligible children (special needs)
- State adoption subsidies for children from foster care
- Federal and state tax credits
- Employer benefits, such as paid or unpaid leave of absence, reimbursement for adoption expenses, assistance with adoption services
- Adoption loans and grants for eligible parents
- College tuition and scholarship programs for youth aging out of foster care
- Counseling and psychotherapy
- Educational services
- Support groups
- More than 500,000 children live in foster care in the United States.
- Foster care placements have increased dramatically in the past 10 years.
- African American children make up two-thirds of the foster care population and stay in foster care longer than other children.
- Children are placed temporarily in foster care due to parental problems, such as abuse, neglect, substance abuse, abandonment, and incarceration.
- Most states encourage programs that provide birth parents with support so that their children can return home.
- Child agencies attempt to place children with relatives. In 2001, 24 percent were living in relative homes and nearly 50 percent were living in foster family homes.
- The average foster care stay is 32 months.
- The average age of children in foster care is 10.
- More than 30 percent of children in foster care have severe emotional, behavioral, or developmental problems.
- Nearly 20,000 youth age out of foster care at age 18 each year. Without support and community services, they are vulnerable to unemployment, homelessness, poverty, substance abuse, and incarceration.
- In a study of former foster care children, only 54 percent earned a high school diploma, 84 percent became a parent from 12 to 18 months after leaving foster care, and 25 percent had been homeless.
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