Clinical+Process

[|Confidentiality as apart of the Clinical Process]

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Meanings that Underlie Words and Behavior. (Grocery Store Musical) Some may watch this video and wonder what it has to do with this topic. I always wondered what behaviors people would exhibit if suddenly a group of people began singing words instead of speaking them. As you watch this examine the behavior of the bystanders. Does their behavior offer a glimpse into their personality? Can you pick out the people who might be having a bad day or a good one? What about the bystanders who seemingly have no behavioral reaction to the musical being performed before them.Take the song itself; simple words that if just spoken or set to a different tune would have possibly evoked different behaviors from the bystanders. Depending on our life experiences the meanings we would attach to these observed behaviors would vary. Clients life experiences are just as varied. As a prospective Social Worker I see the importance of being mindful of that life experience before speaking any words to a client. The multiple levels of possible meanings that underlie the behavior and words of the performers are evident in the variety of reaction behaviors the bystanders exhibited. I can say with some certainty that the behavior and words of the performers left some of the bystanders with feelings of happiness and even empowerment (possibly because of their life experiences). Lucia Bush

"The best way to find yourself is to lose yourself in the service of others" -Mahatma Gandhi **In most instances, clinical social workers are required to have the following credentials:** Social Work Education supervised clinical setting [|The Importance of Relfecting in the Clinical Process] [] media type="youtube" key="vbgzohNfAjg" width="425" height="350"
 * A master’s degree from a social work program accredited by the Council on
 * A minimum of two years or 3,000 hours of post-master’s degree experience in a
 * A clinical license in the state of practice.

**Wikispace**
**Dimensions of Practice:**

**//Clinical Process//**

 * The most common behavioral health profession in the US
 * May work in: Hospital, Primary Health Centers, Mental Health, Schools, Substance Use Recovery Programs and Child Welfare Agencies

This news story shows the ingenuity of a middle school social worker helping her students deal with the effects of Hurricane Gustave in 2008. Very inspiring and insightful : media type="youtube" key="_QE9suKaXZc?fs=1" height="385" width="480"

//Topics Include//

 * Affect, cognition and behavior
 * Interpersonal processes and interaction patterns
 * Multiple levels of meaning that underlie words and behavior
 * Transference and counter-transference phenomena

Clip of an example of transference and counter-transference from the HBO program "In Treatment". Language and brief nudity. media type="youtube" key="pNWv5nkpyng?fs=1" height="385" width="640"
 * Professional use of self
 * Brief notes for understanding the Professional Use of Self in practice

**Transference and Counter-transference phenomena**

"Transference? During transference, people turn into a "biological time machine". A nerve is struck when someone says or does something that reminds you of your past. This creates an "emotional time warp" that transfers your emotional past and your psychological needs into the present. In less poetic terms, a transference reaction means that you are reacting to someone in terms of what you need to see, you are afraid of or what you see when you know very little about the person. This all happens without you knowing why you feel and react the way you do."

"Counter-Transference. Therapists and other health care professionals can also have transference reactions while treating a patient. It’s a two way street. Counter-transference is basically a therapist’s "emotional time warp" around their patient’s transference. In other words, counter-transference is a therapist’s counter- reaction. That’s why some therapists think they are falling in love with their patients. That’s also why older guys become obsessed with younger female employees they barely know." http://www.crisiscounseling.com/articles/transference.htm


 * Clinical Social Work Clarifying the Clinical Process**

"Clinical social work practice involves a systematic process and activity that is designed to assess client situations and help clients achieve agreed upon goals to promote optimal health and well being."

The social worker who works with children and adults who have a developmental disability and their families must have knowledge of:
 * normal biological, psychological and social development throughout the life cycle and the needs of persons with developmental disabilities throughout their life cycle
 * the incidence, prevalence, etiology, symptomatology, characteristics and prognosis for a broad range of disabilities
 * the concept of normalization that stresses the importance of using typical and normal methods to establish valued outcomes for people with developmental disabilities
 * medical advances, federal policy, ethical issues, and the latest social work practices when working with individuals who have a disability
 * the [|Individuals with Disabilities Education Act (IDEA)], Section 504 of the Rehabilitation Act, and the Americans with Disabilities Act and their legal mandates as they relate to special education programs and the rights of people with disabilities
 * federal, state, and local programs that have been developed for people with developmental disabilities including eligibility criteria and how to access these services
 * the role that diversity in ethnicity, culture, or socioeconomic status may play in determining appropriate assessment strategies

"advanced skill in conducting assessments and/or evaluations and developing interventions using accepted standards of care. Understanding of the family as the basic unit of care, including health care and of the importance of collaborating with them in health care planning and service delivery"

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//**Introduction to the Use of Self in Field Placement**// "To integrate the authentic self into the skills required for your social work field placement, it may be helpful to view the use of self from five different perspectives: Use of Personality, Use of Belief System, Use of Relational Dynamics, Use of Anxiety, and Use of Self Disclosure (Dewane, 2006). Through analyzing each of the constructs and their application to your daily practice, you will begin to discover the unique attributes that will enable you to relate to clients in a more authentic manner and contribute to the field of social work in a way that is uniquely reflective of you."

"** Self Disclosure **

A final aspect of use of self is self disclosure. Sharing your own experiences and past problems can often normalize a client’s experience and provide an opportunity for modeling appropriate behaviors and responses. Yet, inappropriate self disclosure can result in a client’s lack of confidence in the social worker’s abilities and role reversal in the helping relationship. When you are about to self disclose information to a client, ask yourself, “Am I doing this for the client, or is this more related to my own interest? What is my goal in self disclosing my experiences? How do I predict sharing this with the client will benefit the client?” In addition, you may want to ask the client’s permission to self disclose by informing him or her of your reason for self disclosure and what you predict the benefit of this disclosure will be for the client. A good rule of thumb that I tell all my students regarding self disclosure is, “When in doubt, wait it out.” If for any reason you believe a self disclosure will not be helpful to the client, then wait a week and see if it is still important in the context of the client’s well-being. As a final precaution, always review what you would like to self disclose with a supervisor or colleague to get feedback on the risks and benefits prior to self disclosing to a client."

http://www.socialworker.com/home/Feature_Articles/Field_Placement/An_Introduction_to_Use_of_Self_in_Field_Placement/

The video below outlines why clients often test their therapists: (Lindsey Chernick)

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List of Principles in Clinical Social Work Practice
==Helping People First == ==Fighting Injustice == ==Respect == ==Understanding Relationships == ==Trust == ==Competence ==
 * == Clinical social work practice is conducted by licensed clinical social workers. They are licensed by the National Association of Social Workers, a professional organization that supports social workers and maintains standards in the profession. NASW has a code of ethics to which all licensed social workers, including those in clinical practice, must adhere. It includes a set of ethical principles. ==
 * == Based on the core value of service, the principle outlined by the National Association of Social Workers says social workers must help other people before helping themselves. This means that sometimes those who cannot afford to pay for their skills may require pro bono services. ==
 * == Social workers should work against parts of the status quo that oppress the people they serve. NASW says social workers should do what they can to increase oppressed people's access to information and resources in order to help all people make empowering decisions. ==
 * == The NASW Code of Ethics requires social workers to treat every individual with respect, keeping in mind cultural diversity. Part of this respect is giving clients the ability to solve their own problems by providing them the tools and knowledge to do so. Social workers must also work to help individuals adjust to the wider society if their cultural values or norms are different from most. ==
 * == Social workers should know that relationships in a client's life are powerful and relationships should be included in any counseling process. A social worker's goal should be to help her client strengthen his relationships with family, friends, community and social groups. ==
 * == Social workers must be honest and act with integrity. They must keep the profession's ethical principles, mission and standards in mind at all times and act responsibly on behalf of the profession and the organizations they represent. ==
 * == Social workers should work to improve their competence, knowledge and skills to best serve their clients. They should also make a goal of improving the profession by contributing knowledge and ideas to the greater social work community. ==

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By: Lindsey Chernick ===<span style="background-color: #ffffff; color: #404040; cursor: pointer; font-family: 'Lucida Console',Monaco,monospace; font-size: 20px; margin: 0px; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; vertical-align: baseline;">Navigating the Clinical Process Service ===

By: Lindsey Chernick

=**WHAT IS CLINICAL TRIAL?**=
 * To begin, click on widget and view the available content options that are available for your wikipage.**
 * Please note that you must click SAVE each time that you add content, or it will be deleted.**
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 * Although there are many definitions of clinical trials, they are generally considered to be biomedical or health-related research studies in human beings that follow a pre-defined protocol. ClinicalTrials.gov includes both interventional and observational types of studies. Interventional studies are those in which the research subjects are assigned by the investigator to a treatment or other intervention, and their outcomes are measured. Observational studies are those in which individuals are observed and their outcomes are measured by the investigators.**




 * Participants in clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research.**




 * All clinical trials have guidelines about who can participate. Using [|inclusion/exclusion criteria] is an important principle of medical research that helps to produce reliable results. The factors that allow someone to participate in a clinical trial are called "inclusion criteria" and those that disallow someone from participating are called "exclusion criteria". These criteria are based on such factors as age, gender, the type and stage of a disease, previous treatment history, and other medical conditions. Before joining a clinical trial, a participant must qualify for the study. Some research studies seek participants with illnesses or conditions to be studied in the clinical trial, while others need healthy participants. It is important to note that inclusion and exclusion criteria are not used to reject people personally. Instead, the criteria are used to identify appropriate participants and keep them safe. The criteria help ensure that researchers will be able to answer the questions they plan to study.**




 * The clinical trial process depends on the kind of trial being conducted (See [|What are the different types of clinical trials?]) The clinical trial team includes doctors and nurses as well as social workers and other health care professionals. They check the health of the participant at the beginning of the trial, give specific instructions for participating in the trial, monitor the participant carefully during the trial, and stay in touch after the trial is completed.**


 * Some clinical trials involve more tests and doctor visits than the participant would normally have for an illness or condition. For all types of trials, the participant works with a research team. Clinical trial participation is most successful when the [|protocol] is carefully followed and there is frequent contact with the research staff.**




 * Informed consent is the process of learning the key facts about a clinical trial before deciding whether or not to participate. It is also a continuing process throughout the study to provide information for participants. To help someone decide whether or not to participate, the doctors and nurses involved in the trial explain the details of the study. If the participant's native language is not English, translation assistance can be provided. Then the research team provides an [|informed consent document] that includes details about the study, such as its purpose, duration, required procedures, and key contacts. Risks and potential benefits are explained in the informed consent document. The participant then decides whether or not to sign the document. Informed consent is not a contract, and the participant may withdraw from the trial at any time.**




 * Benefits **


 * Clinical trials that are well-designed and well-executed are the best approach for eligible participants to:**
 * **Play an active role in their own health care.**
 * **Gain access to new research treatments before they are widely available.**
 * **Obtain expert medical care at leading health care facilities during the trial.**
 * **Help others by contributing to medical research.**
 * Risks **


 * There are risks to clinical trials.**
 * **There may be unpleasant, serious or even life-threatening side effects to experimental treatment.**
 * **The experimental treatment may not be effective for the participant.**
 * **The [|protocol] may require more of their time and attention than would a non-protocol treatment, including trips to the study site, more treatments, hospital stays or complex dosage requirements.**




 * Side effects are any undesired actions or effects of the experimental drug or treatment. Negative or adverse effects may include headache, nausea, hair loss, skin irritation, or other physical problems. Experimental treatments must be evaluated for both immediate and long-term side effects.**




 * The ethical and legal codes that govern medical practice also apply to clinical trials. In addition, most clinical research is federally regulated with built in safeguards to protect the participants. The trial follows a carefully controlled protocol, a study plan which details what researchers will do in the study. As a clinical trial progresses, researchers report the results of the trial at scientific meetings, to medical journals, and to various government agencies. Individual participants' names will remain secret and will not be mentioned in these reports (See [|Confidentiality Regarding Trial Participants]).**




 * People should know as much as possible about the clinical trial and feel comfortable asking the members of the health care team questions about it, the care expected while in a trial, and the cost of the trial. The following questions might be helpful for the participant to discuss with the health care team. Some of the answers to these questions are found in the informed consent document.**
 * **What is the purpose of the study?**
 * **Who is going to be in the study?**
 * **Why do researchers believe the experimental treatment being tested may be effective? Has it been tested before?**
 * **What kinds of tests and experimental treatments are involved?**
 * **How do the possible risks, side effects, and benefits in the study compare with my current treatment?**
 * **How might this trial affect my daily life?**
 * **How long will the trial last?**
 * **Will hospitalization be required?**
 * **Who will pay for the experimental treatment?**
 * **Will I be reimbursed for other expenses?**
 * **What type of long-term follow up care is part of this study?**
 * **How will I know that the experimental treatment is working? Will results of the trials be provided to me?**
 * **Who will be in charge of my care?**


 * **Plan ahead and write down possible questions to ask.**
 * **Ask a friend or relative to come along for support and to hear the responses to the questions.**
 * **Bring a tape recorder to record the discussion to replay later.**
 * Every clinical trial in the U.S. must be approved and monitored by an [|Institutional Review Board (IRB)] to make sure the risks are as low as possible and are worth any potential benefits. An IRB is an independent committee of physicians, statisticians, community advocates, and others that ensures that a clinical trial is ethical and the rights of study participants are protected. All institutions that conduct or support biomedical research involving people must, by federal regulation, have an IRB that initially approves and periodically reviews the research.**

=[|Clinical Processes]= Clinical Operations Audits Reliable, high quality anesthesia service is not easy to maintain in today’s market. Factors contributing to a successful anesthesia service are numerous and if any one of these factors is not performing optimally, anesthesia care will suffer. A detailed operational audit requires a serious commitment from both the anesthesia team and hospital management. Results for both will be optimized when both parties work as a fully integrated team with clear and common goals – the shared goals of efficient, low cost, high quality patient care, and 100% patient, surgeon and employee satisfaction. At Total Anesthesia Solutions, LLC (TAS), our team provides a comprehensive analysis of peri-operative anesthesia care. Our leaders are experienced clinicians with the knowledge and skill to dissect the issues and develop the solutions. > > //This includes analysis of operating room efficiency and a fair market value assessment of the service.// > > //This includes analysis of productivity, O.R. and staff utilization, call obligation, billing operation performance, payor mix and contracts, compensation, and benefits.// CDS-swk201
 * Objective third-party analysis of key clinical processes and presentation to all vested parties.
 * Examination of key processes to include:
 * Adherence to Standards of Care
 * Pre-Op Assessment System
 * Scheduling Processes
 * Process Issues, including:
 * Day of surgery
 * Anesthesia techniques
 * Medical cost savings
 * Recovery care
 * CQI Program, Risk Management, Peer Review
 * Regulatory Compliance
 * Development of an ideal, best practice staffing and/or compensation model
 * Mission Support (Negotiation, Analysis and/or Development of Stipend or Subsidy Arrangement)

As we've all learned in class and from our own interactions, empathy is a huge part of connecting and communicating with others. This video shows why empathy has been evolutionary beneficial for us and the importance of empathy beyond our person to person interactions to our society and world. This video also reflects the importance of cultural competency when interacting with others by using empathy.

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It Get's Better []

This is an article about new aid for sex victims in New York city. There are social workers involved in this safe haven house who are very culturally competent to the target population. Social workers in this situation are also acting as legal advocates for their clients because it is often that these women who are tricked into sex slavery do not speak fluent English and they don't understand their full rights []

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