Both societal and professional trends have transformed social work since the turn of the century. In this article, social workers around the USA reflect on some of the most important trends.

Mental Health/Substance Abuse Parity

Many years of bipartisan efforts by legislators, including the late Sen. Edward Kennedy, resulted in the passage of the federal Mental Health Parity and Addiction Equity Act of 2008.

The law, which took effect in 2010, requires large companies to provide insurance coverage for mental health services to offer the same level of coverage for these services, including copays, deductibles, and treatment limits, as are offered for medical services. State legislation to ensure parity has become more common since 2000, although how parity is accomplished varies.

“Parity makes mental health and substance abuse services more accessible and affordable for many individuals and families who might have otherwise struggled financially to pay for services or would not seek them,” says Laura W. Groshong, LICSW, from the Clinical Social Work Association.

The long battle for parity also demonstrated the power of advocacy groups, such as the National Alliance on Mental Illness, to raise public awareness of behavioral health issues, she says.

Social Work with Older Adults

The number of Americans aged 65 and older increased from 35 million in 2000 to more than 40 million a decade later, according to the federal Administration on Aging. The demand for social workers to provide services to older adults has grown significantly.

The number of older people seeking social work services has increased, and several trends have affected how services to these clients are delivered, says Patricia L. Moore, ACSW, LCSW, assistant vice president of business development for Comprehensive Care Management, a New York-based long-term care organization.

These trends include a shift in care away from the nuclear family to society at large, a move away from institutional care to community-based care, and a growing understanding of the importance of cultural competency in serving older immigrants—very positive changes, wouldn’t you agree?

School Violence and Bullying

The Columbine High School massacre in 1999 and the Virginia Tech massacre in 2007 brought the issue of school safety to the forefront of the public consciousness, but what is not often realized is that violent crime in schools has declined significantly since the mid-1990s (the media can create amazing illusions!).

So why does the public perceive school violence as a growing problem, you might ask?

Much of it does have everything to do with increased media coverage of school shootings and incidents of bullying, says Ron Avi Astor, PhD, the Richard M. and Ann L. Thor Professor in Urban Social Development at the University of Southern California.

That’s not necessarily bad, of course, because it boosts public support for increased resources for school safety, including school social workers.

Astor hopes social workers’ role in ensuring school safety will evolve from trying to eliminate violence to making schools warm, caring environments. “That should be our real goal,” he says—and social workers should be the ones leading everyone else to create them, wouldn’t you agree.

One way that social workers have been trying to create compassionate school environments is in preventing bullying targeted at lesbian, gay, bisexual, and transgender (LGBT) youths. This bullying has gained national attention in the wake of several instances of gay teens driven to commit suicide.

Not all cases of bullying against LGBT youths result in suicide, but the media attention has made the public more aware of the long-term impact of such victimization, says Caitlin Ryan, PhD, ACSW, from the Family Acceptance Project at San Francisco State University.

Around the same time these cases were being targeted by the media, the project released a study showing links between violence and bullying against LGBT youths and the risk of depression, suicide, HIV, and sexually transmitted diseases.

“It’s not just an event that occurs in one point in a person’s life,” says Ryan. “As time goes on and we can show more of the costs, it will be harder for jurisdictions to justify not addressing it.”

Children’s Mental Health

Diagnosing mental health problems in children—particularly autism, attention-deficit/hyperactivity disorder, and bipolar disorder—has become more common, as has the use of medication in their treatment. Whether this trend marks a much-needed recognition of children’s mental health needs or an epidemic of over diagnosis is certainly up for debate.

There are various reasons DSM diagnoses are being used more frequently for children, says Denise Duval, PhD, LCSW, from Child Therapy Chicago, a practice serving children and young adults.

Among these reasons are increased awareness of how mental health problems affect children, managed care policies, and parents’ need to explain their children’s behaviors. “Parents want an answer. They want a label. They want to know what it is,” says Duval.

She goes on to say that in response to these trends, social workers must stay true to the profession’s focus on looking at the underlying issues that influence children’s behaviors. “The biggest thing is not to forget to understand the people and the families and the nuances that form who the kids are,” says Duval.

Web-Based Social Work Education

In one decade, the Internet has grown from a curiosity to something that is part of daily life for many North Americans. Social work schools have taken notice, and a growing number are offering classes online and making online education an integral part of their programs.

Web-based social work education is growing in popularity. New technology makes it easier to connect students, particularly students in rural areas who otherwise would not have access to social work programs, says Mary Jo Garcia Biggs, PhD, LCSW, an associate professor and MSW distance education coordinator at Texas State University-San Marcos.

Online education also allows students who cannot afford to quit their jobs to take classes that are held during the day.

As a volunteer ‘Big Sister’, I was assigned to assist a child called Angel and was very excited at the prospect of cooperating with her grandparents to help her achieve her potential. Unfortunately, Angel’s well-being was not the first priority in her grandparents’ lives and they were not very engaged or committed to the process intended to help Angel, for example they would often appear late for meetings or fail to attend at all. I felt frustrated and was tempted to confront the grandparents about their failure to positively engage in the process but I realized that this could well result in the end of my involvement with a child who was beginning to ‘come out of her shell’ and to trust and confide in me and who clearly enjoyed our time together.

I exercised patience and spent time explaining the purpose of the process and the potential benefits of my involvement with Angel. I attempted to engage the grandparents in explaining potential benefits and involving them in the planning process. As they recognized positive changes in Angel and that my commitment to her was genuine and sincere, they slowly ‘came around’. Eventually they became much more engaged in the process and late or non-attendances at meetings became much less of a problem. Our positive relationship continues and Angel is benefitting greatly from my involvement with her. I don’t always agree with the grandparents’ decisions concerning Angel but, when this occurs, I take a gentle and patient approach in providing my opinions, recognizing always that theirs is the ‘last word’ in the matter.

This lesson in establishing and maintaining positive relationships with parents/caregivers has been directly applied since. In my collaboration with a clinician who is treating a middle school student who has Downs Syndrome, I sought her parents’ trust and engagement as my first priority. I gathered a great deal of information from them about all aspects of their daughter’s life, which demonstrated my respect for their opinions and my own commitment and interest in helping their child. I also communicated our plans and sought their understanding and approval of them and provided detailed ‘debriefs’ following treatment. This has resulted in excellent relations and a readiness on the parents’ part to offer opinion and seek information which is for the benefit of all, not least the sweet girl at the center of all our concerns.

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Dr Robert Edinger with Son David

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Now 42 years old, I have only remembered for a little more than a decade the gruesome details of the abuse to which I was subjected as a child at the hands of my biological father: physical, emotional, sexual; constant and always violent it continued for many years. By the time I reached my late 20s, the memories came flooding back in and it took me years to turn tragedy into triumph: to understand, reflect, and heal.

Thus far I have enjoyed success as a certified massage professional after earning my BA in Art, with an emphasis in painting and printmaking, from California State University, Chico in 2000. In 2002, I received my certificate from the Dahan Institute of Massage Studies in Las Vegas NV. This past January of 2016, I began serving as a volunteer working with girls who have been victims of sexual trafficking. My passion for healing, my own difficult history, and my recent experience of helping young women and girls that have been victimized, raped, battered and sold, fills me to the extent that I never thought possible: mission, vocation, and redemption. Thus, I feel that I have much to give to an MSW program so that I can contribute most fully to this work of protection and redemption.