Identify key issues, challenges, and opportunities in an education or child and family welfare system.
Objetives
Identify key issues, challenges, and opportunities in an education or child and family welfare system. [EPAS 2, 3, 5]
Articulate a clear vision of change to advance social justice in a specific “social problem” area. [EPAS 5]
Identify the causes and consequences of a specific “social problem.” [EPAS 5]
Develop policy/programmatic goals and objectives to realize the desired vision of change. [EPAS 5]
Analyze stakeholder resources, values, interests, and power differentials. [EPAS 2, 3]
First Questions
Describe one major federal program providing aid and services to children and families (e.g., income assistance programs, food and nutrition programs, health care programs, child protective services, or education programs). What are the causes and consequences of the program as implemented? What changes could make this a more equitable or accessible program?
This discussion question is informed by the following EPAS Standard:
5: Engage in Policy Practice
Seon
Second Questions
How can the civil rights of minority groups be protected in public and private school systems?
The following EPAS Standards inform this discussion question:
2: Engage Diversity and Difference in Practice
3: Advance Human Rights and Social, Economic, and Environmental Justice
5: Engage in Policy Practice
3 Questions.
Use the attached “Topic 4 Assignment Template” document to complete this assignment.
This assignment uses a rubric. Please review the rubric before beginning the assignment to become familiar with the expectations for successful completion.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide located in the Student Success Center.
The following EPAS Standards inform this assignment:
2: Engage Diversity and Difference in Practice
3: Advance Human Rights and Social, Economic, and Environmental Justice
5: Engage in Policy Practice
Book Chapter: Social Welfare Policy and Advocacy: Advancing Social Justice Through Eight Policy Sectors
Read Chapters 11 and 12 from Social Welfare Policy and Advocacy: Advancing Social Justice Through Eight Policy Sectors.
Requirements: 1000 +++++
SWK-520: Topic 4 Assignment
Instructions: Identify a specific social problem or policy issue in ONE of the following areas: education or child and family welfare.
There are two parts to this assignment. In Part 1, you will complete a stakeholder analysis chart based on your selected social problem or policy issue. In Part 2, you will complete a “policy analysis for change” overview chart, based on your selected social problem or policy issue.
Part 1: Stakeholder Analysis Chart
Instructions: Based on your selected social problem or policy issue, identify and select three key stakeholder groups who might be potentially invested in and/or affected by the envisioned policy change initiative. Provide a concise overview of information in each analytic category depicted on the chart below. You may use bullet points, but responses should be clearly formulated and supported by material obtained from at least three current, relevant scholarly sources.
Part 1: Stakeholder Analysis Chart
Part 2: “Policy Analysis for Change” Overview Chart
Instructions: Considering your selected social problem or policy issue, create a “policy analysis for change” overview chart in which you concisely analyze the social problem or issue with an eye toward advocating for a more beneficial policy or program to support the well-being of an identified service population. For each analytic category depicted in the chart below, summarize key ideas and information. You may use bullet points, but responses should be clearly formulated and supported by material obtained from at least three current scholarly sources. (These may be the same sources used to complete the stakeholder analysis chart). Sources must be peer-reviewed scholarly journal articles and/or data or other relevant information obtained from a credible policy research internet source. All citations and a list of references must be in APA format.
Part 2: “Policy Analysis for Change” Overview Chart
SWK-520 Topic 4 Worksheet Scoring Guide
Instructor Comments:
A Renewed Commitment for Leadership in School Social Work Practice.
Teasley, M. L. (2018). A Renewed Commitment for Leadership in School Social Work Practice. Children & Schools, 40(2), 67–69. https://doi-org.lopes.idm.oclc.org/10.1093/cs/cdy008
Leadership in the educational setting is a key factor in the success of school social workers. Given the dynamic change that school systems and communities are experiencing, leadership for school social workers means increased awareness and advocacy for children’s educational needs. The start of the 21st century is marked by the proliferation of charter schools, market-based reforms, growing educational inequality, fiscal austerity measures, and a shifting demographic landscape. These and other factors such as low health care, social services, and mental health access are shaping the policy and practice environment for school-based professionals. To meet the demands of the contemporary practice environment, school social workers will need to think more strategically about their commitment to leadership and gain resolve about what leadership means in such a climate ([ 7]).
Today, school systems face many complex and deep-rooted problems “that supersede the traditional boundaries of schools and require addressing the problems within the context of the school and the larger community” ([ 3], p. 324). For example, the limitation of state and local property taxes reductions, as written in the recent tax reform law, means a reduction in tax revenues, and, thus, lower funding for social welfare programs, including public education. This means that already underfunded schools will have an even tougher time gaining necessary resources. Lower tax revenues will also erode the acquisition of necessary resources to middle-class school systems that may likewise have low resources.
There is a subtle shift within the United States to market-based reforms characterized by school privatization models based on school voucher programs and for-profit charter schools. Approximately 6 percent of school-age children and youths attend charter schools. Proponents of market-based reform efforts call for greater deregulation of state education systems. As a result, the 2017 tax reform bill allows “parents to use up to $10,000 from their tax-free 529 college savings account to help pay for private or religious schools for any grade” ([10], p. 1). This will lead to the proliferation of for-profit charter schools and private schools taking needed dollars away from traditional public schools. Parenthetically, although I see nothing wrong with school choice measures, my concern is for low-income families with children who cannot compete with more affluent families in the marketplace of educational options.
Leadership in the educational setting is an ongoing challenge for school social workers, mainly because they are in a host setting—”arenas in which social workers practice that are defined and dominated by people who are not social workers” ([ 6], p. 208). Identified challenges for school social workers in the host setting include role ambiguity, marginalization, value discrepancies, and the devaluation of women as social workers (see [ 6]). Leadership is needed by school social workers in the host setting to negotiate power positions, engage in advocacy, mobilize resources, and generate interdisciplinary collaboration.
Given their ecological approach to practice, school social workers must work in school systems along with other school-based professionals and surrounding communities to collaborate in the development of strategies and methods to promote a quality educational experience for children and youths in an era of fiscal austerity. For social work education programs that provide training and education on school-based practice, leadership and advocacy should become a salient part of preparation for the practice setting. Course objectives should include skills and strategies for practice in the school as a host setting, work within school communities, and how to engage in interdisciplinary practice ([ 4]). Moreover, how to cut through barriers to evidence-based practice is a necessary skill for school social workers, who often find themselves in school systems where resources to conduct evidence-based interventions are lacking. Of course, there are challenges and tasks that school social workers cannot tackle alone. Traditional “issues such as poverty, violence, poor academic achievement, substance abuse, and physical and sexual abuse require a multifaceted response by many professionals rather than the limited narrow perspective of only one professional discipline” ([ 3], p. 324).
Along with rising inequality among income groups, public school systems continue to witness disparities among racial and ethnic groups in educational outcomes and the continuation of gross disproportionality in disciplinary outcomes and placements. Among minority youths, 39 percent of African Americans and 33 percent of Hispanic Americans attend schools in high-poverty areas. This compares with just 14 percent for Asian Americans and white Americans ([ 1]). About 13 percent of school-age children attending public schools have mental health diagnoses. Whereas African American children and youths make up 16 percent of the K–12 public school population, they are over 40 percent of those diagnosed with intellectual and emotional disabilities ([ 8]). Reducing the disproportionate placement of special education students in restrictive disciplinary settings is of the upmost importance. A comprehensive approach including teacher training, cultural sensitivity, culturally appropriate assessment, and prereferral use of evidence-based approaches form the most effective method of reducing disproportionality in special education ([ 2]; [ 9]). These problems in school culture including the development of zero tolerance policies, the disproportionate referral of racial and ethnic minority youths to juvenile justice, and tough-on-crime laws have resulted in the now infamous school-to-prison pipeline. What can school social workers do in collaboration with other school-based professionals to break this cycle? Advocacy for nonpunitive measures as a response to disciplinary problems must include work with school teachers and administrators and state legislators in planning strategies for reducing this problem within local school settings. The removal of students from school for disciplinary problems is by and large at the discretion of school administrators. Thus, leadership in this area means “educating teachers and administrators about the potential harm associated with conventional disciplinary practices; educating school personnel about effective, nonpunitive approaches; and creating a public campaign to generate popular support for the reform of iatrogenic school disciplinary practices” ([ 5], p. 219). Moreover, school social workers must use innovative and evidence-informed approaches in creating a positive school environment so that punitive approaches to school discipline are not the first option. “Creating a positive school climate requires data-informed decision making, such that data about student needs and organizational factors are used in improvement planning to create the conditions for academic success” ([ 7], p. 106).
Finally, interprofessional collaboration must be undertaken by major organizations representing school social work practice. The School Social Work Association of America, the American School Counselor Association, the National Association of School Psychologists, and others must work to combat education inequality and trends to reduce resources to public school systems. Currently, these organizations collaborate to lobby the U.S. Congress to ensure the needs for their services in school settings. Similar efforts are needed at the local level to empower families and communities to be stewards of their own destiny in terms of the quality of education for children and youths. Part of capacity building in the advocacy process must include educating, organizing, and mobilizing local communities, businesses, and interest groups in the politics of education reform.
Conclusion
When social workers are successful in schools it means that children and youths are having successful educational experiences. School social workers have the knowledge base to make a difference as leaders in schools. They must channel their knowledge of the school systems and compassion for children’s well-being into advocacy and action for change. It is increasingly important that school-based professionals move away from their professional silos to interprofessional collaboration to tackle the many problems that impede quality education outcomes for the nation’s most vulnerable families. Long-standing problems as well as emerging social welfare challenges call for renewed focus, advocacy, and leadership by school-based professionals. Outdated approaches that do not tackle the challenges facing school systems throughout the nation must give way to methods that facilitate greater interprofessional collaboration in schools with data-driven decision making and goal-oriented outcomes. There is no doubt that the stakes are high at this moment in history. School social workers must respond with commitment to social work professional values, strength of resolve, leadership in the host setting, and action-oriented purpose toward achieving healthy developmental and educational outcomes for school-age children and youths.
Bosk, E. A., Van 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(6), 1669–1685.
A Chronic Problem: Competing Paradigms for Substance Abuse in Child Welfare Policy and Practice and the Need for New Approaches
Emily Adlin Bosk1,*, Donna Van Alst2 and Amanda Van Scoyoc3 1 Rutgers University, School of Social Work, New Brunswick, NJ, USA 2 College of St. Rose, Albany, NY, USA 3 Yale School of Medicine, Yale Child Study Center, New Haven, CT, USA *Correspondence to Emily Adlin Bosk, Ph.D., LMSW, Rutgers University, School of Social Work, 390 George Street, New Brunswick, NJ 08904, USA. E-mail: [email protected] Abstract Care-giver substance abuse (SA) represents one of the most common reasons for entering the child welfare system in the USA with families and children for whom substance abuse is an issue fairing worse at every stage of the child welfare process from investigation to removal to reunification. In this conceptual article, we assert that a paradigm clash between a framework for SA that understands treatment and recovery to be a linear process and a framework that views relapse as normative underlies many of the reasons that SA represents a seemingly intractable issue within child welfare. We identify this mismatch as a mechanism for more severe trajectories of SA cases and then suggest new models for child welfare policy and practice that anticipate relapse and which respond to the often chronic nature of substance use disorders. Keywords: Substance use, child welfare, parenting, integrated treatment, medicalisation, deviance Accepted: July 2017 # The Author 2017. Published by Oxford University Press on behalf of The British Association of Social Workers. All rights reserved. British Journal of Social Work (2017) 47, 1669–1685 doi: 10.1093/bjsw/bcx095 Downloaded from https://academic.oup.com/bjsw/article-abstract/47/6/1669/4554332/A-Chronic-Problem-Competing-Paradigms-forby Adam Ellsworth, Adam Ellsworth on 18 October 2017 Introduction Care-giver substance abuse (SA) represents one of the most common reasons for entering the child welfare system (CW) in the USA. Not only are 40–80 per cent of system-involved families affected to some degree by substance use (Young et al., 2007); families and children for whom SA is an issue fare worse at every stage of the CW process from investigation to removal to reunification (Marsh et al., 2006). Making progress in areas related to the assessment and treatment of SA is then intricately tied to the much larger goal of improving a CW system that is often characterised as ‘broken’. However, CW policy in the USA relies on a framework for the assessment and treatment of SA that directly conflicts with evolving understandings of the nature of addiction. Viewing recovery as a singular and linear process, relapses are used by CW workers as evidence that caregivers are not serious about recovery and will be unable to remedy the issues that brought them to the attention of the CW system. Simply put, the standard for reunification or family preservation is ‘being cured’ as defined by abstinence from alcohol and drug use and measured by drug screens at regular intervals. Yet, relapses are a normative part of the trajectory of SA disorders. The high relapse rate following SA treatment is well documented, pegged somewhere between 40 and 60 per cent (McLellan et al., 2000). Internationally, experts in addiction increasingly view recovery as a non-linear process marked by periods of sobriety and relapse (Miller et al., 1998). Advances in addiction science and the current movement towards recovery-oriented treatment raise serious questions for the organisation and delivery of CW services across the globe. If new models of addiction, which understand recovery to be a ‘career’, are adopted, what does this mean for how CW interventions should be designed and implemented? What are the best practices for keeping children safe in a context where relapse is to be expected? Internationally, fresh thinking is needed to conceptualise CW services for families that attend to child safety and family preservation within a model premised upon the chronicity of addiction. In this conceptual paper, we consider a paradigm clash between a framework for SA that understand recovery and a framework that views relapse as normative to underlie why SA represents a seemingly intractable issue within SA. This paradigmatic clash has serious implications for CW timelines and family preservation practices. We begin by assessing the state of CW practice with families experiencing SA. Next, we review perspectives on SA with particular attention on the emerging view of addiction as a relapsing condition and connect these paradigms to sociological theories of medicalisation and deviance. Then, we consider how parenting is impacted by SA and the hidden harm caused to 1670 Emily Adlin Bosk et al. Downloaded from https://academic.oup.com/bjsw/article-abstract/47/6/1669/4554332/A-Chronic-Problem-Competing-Paradigms-forby Adam Ellsworth, Adam Ellsworth on 18 October 2017 children by parental SA. Next, we examine the potential for new approaches to CW practice and policy that address the reality that SA is marked by periods of stability and instability including: a focus on concurrent planning that considers permanent, long-term and temporary options for children; innovative uses of kinship or foster-care; long-term recovery supports and relapse prevention education; and reduced reliance on re-entry rates to assess effectiveness of CW systems. Finally, we consider how harm reduction (HR) and integrated treatment strategies could enhance SA treatment in a CW context. Underlying each of these proposals is a recognition that a mix of system-level, practice-level, and theoretical interventions is necessary to reformulate a CW response to addiction that accounts for its chronicity while also keeping the developmental, physical and emotional needs of children in mind. Although the primary examples here are rooted in the USA, these issues are international in scope. Work in other parts of Europe all highlight the need for new models that balance children’s need for safety and permanency within a realistic understanding of Substance Use Disorder (SUD) trajectories (Schaeffer et al., 2014). The context: SA in CW In the USA, a majority of CW cases involve SA. Depending on the study, researchers identify anywhere between 40 and 80 per cent of cases as having a SA component (Young et al., 2007; Semidei et al., 2001). The high rates of SA in CW cases is similar in other countries: in England, 52 per cent of CW cases involved parental SA; in Canada, 34 per cent of all CW investigations involve SA; and SA was a contributing factor in 57 per cent of out-of-home placements in Western Australia. SA cases are often not just about SA, but involve multiple service needs and/or co-occurring disorders (Marsh et al., 2006). In one study, 75.9 per cent of SA mothers had at least four service needs and a quarter had over seven (Choi and Ryan, 2007; Marsh et al., 2006). Given the intersection of SA with a range of other service needs, it is not surprising that cases where SA is a primary concern have poor outcomes compared to cases involving non-substance-abusing families. Reunification rates for substance-exposed infants are approximately 14 per cent over a seven-year period compared with 33 per cent of all children in care who are reunified within two years (Huang and Ryan, 2011). Care-givers with addictions are more likely than non-substance-abusing families to lose custody of their children, accounting for 31 per cent of all out-of-home placements in the USA (Correia, 2013). Issues related to maladaptive parenting strategies and SA are difficult to tease out from broader risks A Chronic Problem 1671 Downloaded from https://academic.oup.com/bjsw/article-abstract/47/6/1669/4554332/A-Chronic-Problem-Competing-Paradigms-forby Adam Ellsworth, Adam Ellsworth on 18 October 2017 related to low socio-economic status, making intervention particularly complex in cases where SUD and CW overlap (Grella et al., 2009). Approaches to assessing and intervening with SA in CW Researchers in the USA have designed a number of interventions that address the larger ecological context in which SUD takes place. These include specialised Family Treatment Drug Courts that mandate an integration of SA and CW services and/or the co-location of substance abuse specialists within CW agencies; residential programmes for SA that allow parents receiving treatment to remain with their children; the provision of comprehensive and matched services for cases involving SA; and recovery coach models. Each of these interventions has demonstrated effectiveness in improving reunification rates and treatment completion (Marsh et al., 2011). Despite their effectiveness, these programmes are not widespread within the USA. As a result, many parents with SA issues are not offered appropriate services in the CW system (Staudt and Cherry, 2009). Even when agencies do offer integrative services, these interventions are not designed to address issues related to the non-linear nature of addiction or anticipate service needs for families after reunification and case closure that are directly tied to re-entry into the CW system. Instead, the assumption guiding CW policy and intervention is that, once a caregiver has achieved sobriety, the safety risk has been removed and no further services are needed. In keeping with this approach, random interval drug screens are used to determine compliance with service agreements. A positive drug screen during an open case is a violation of the service plan and has negative implications for reunification (Marsh et al., 2011). Functionally, this means that abstinence is the standard for reunification, no matter what treatment model is employed. Policy guidelines in the USA further complicate efforts to address SA in a CW context by establishing timelines for case resolution. The 1997 Adoption of Safe Families Act (ASFA 1997) addresses children’s need for permanency and their need to form safe, supportive and nurturing relationships with care-givers by ensuring case resolution when a child has been in foster-care for fifteen of the previous twenty-two months. By allowing states to file for the termination of parental rights, if the terms of the service plan are not met within this period, parents are essentially put on a schedule for recovery from their SUD (Marsh et al., 2011). An understanding of addiction as chronic makes complete recovery hard to establish, and perhaps unreasonable to expect, within this time frame. This may be one reason that the reunification rates for SA parents are so low compared to children who enter the CW system for other reasons. ASFA also established federal Child and Family Services Reviews, in part, to assess state-level conformity with federal CW regulations 1672 Emily Adlin Bosk et al. Downloaded from https://academic.oup.com/bjsw/article-abstract/47/6/1669/4554332/A-Chronic-Problem-Competing-Paradigms-forby Adam Ellsworth, Adam Ellsworth on 18 October 2017 (ASFA 1997). Reliance on performance indicators such as repeat maltreatment and re-entry into foster-care may encourage a move towards termination of parental rights if the relapsing nature of addiction is viewed as contributing to negative rating scores. Without a system that can concurrently manage relapse and address safety concerns, the risks related to reunification likely remain too high for the system to bear when there is no mechanism for continued CW involvement. Perspectives on SA SA has been conceptualised as both deviance and a disease (Conrad and Schneider, 2010), with each perspective offering distinct insights into its aetiology, trajectory and treatment. Both deviance and disease models leave little room for addressing the chronic nature of SUD in the context of parenting. Cultural understandings of SA as deviance are expressed in US policies such as mandatory prison sentences for the possession of specific illegal substances. A recent national public opinion poll found that Americans hold significantly more negative attitudes towards persons with SUD compared to those with mental illness (Barry et al., 2014). The authors concluded that less sympathetic views towards SUD likely result from ambivalence about treating SA as a medical condition or deeply held views of addiction as a moral shortcoming (Barry et al., 2014). SA as disease Recent advances in neuroscience and brain-imaging technology have redefined addiction as a brain disease based on the changes in brain systems that process rewards when exposed to substances (Smith and Seymour, 2004). Physical changes in areas of the brain that control decision making, judgement, learning, memory and behaviour, all of which contribute further to addictive behaviours, impair executive functioning and complicate treatment adherence (Grant et al., 2000). The disease model provides a rationale for addressing addiction through treatment rather than punishment by removing blame for behaviours associated with SA. Because genetic and neurobiological understandings of SA emphasise the organic basis for SUD and the need for specialised treatment, they communicate that issues in addiction are not related to willpower, but to neurobiology outside an individual’s control (Link and Phelan, 2001). Further, this framework recognises that addiction is a chronic relapsing disorder (Sellman, 2010). Reported rates of relapse, some of which are as high as 80–90 per cent (Marlatt et al., 1988), suggest that the majority of individuals who complete treatment for SUD will use again in the first year (Brandon et al., 2007). A Chronic Problem 1673 Downloaded from https://academic.oup.com/bjsw/article-abstract/47/6/1669/4554332/A-Chronic-Problem-Competing-Paradigms-forby Adam Ellsworth, Adam Ellsworth on 18 October 2017 However, paradigms for treating addiction often rest on more acute medical models for disease rather than on this new evidence about chronicity. Brandon and colleagues assert that, while SUD are currently treated ‘as if they were bacterial infections that are responsive to a single course of therapy and that do not require long-term monitoring once remission has occurred’ (Brandon et al., 2007, p. 269), they should instead be treated similarly to other chronic and relapsing disorders such as diabetes, for which ‘neither remission nor relapse are viewed as end states, but rather as data informing decisions about the need for treatment adjustments’ (p. 269). In line with this approach, more recent treatment efforts have focused on remission and symptom reduction rather than cure (Saitz et al., 2008). From this recovery-oriented perspective, relapse is considered likely and multiple treatment attempts are expected (White et al., 2002). Recoveryoriented goals include a decrease in the frequency and intensity of relapses, sustained periods of remission and optimising the person’s level of functioning during periods of remission. Treatment, however, has been slow to move away from an acute care model in which an ‘addicted person seeks treatment, completes an assessment, receives treatment, and is discharged, all in a period of weeks or months’ (Dennis and Scott, 2007, p. 45) despite evidence that multiple treatment episodes cycling with relapse over several years comprise the more typical path to sustained recovery (Scott et al., 2005). Successful approaches to improving long-term addiction recovery have included expanding continuity of care beyond an acute treatment episode, monitoring and early reconnection with treatment, and providing other recovery supports such as twelve-step groups (Ritsher et al., 2002). As a result, the focus is slowly shifting from a single acute treatment episode to a longer-term recovery orientation in which relapse is no longer viewed as an indicator of treatment failure. Implications for working with SA clients in a CW context Both deviance and brain disease models of SA inform how addiction is addressed in CW. Framing SA as a deviant behaviour requires punitive responses in the form of legal actions that either remove children from the home or Terminate Parental Rights (TPR), placing responsibility for the behaviour within the control of the care-giver. Alternately, defining a behaviour as sickness requires therapeutic interventions (Conrad and Schneider, 2010). Deviance and disease models are often framed as mutually exclusive. However, in practice, these two perspectives often rest side by side (Anspach, 2010; Bosk, 2013; Hoppe, 2013), expressed in policies and practices that first provide treatment and then employ legal consequences when treatment is believed to have failed. An understanding of SUD as only partially medicalised helps to clarify how current framings 1674 Emily Adlin Bosk et al. Downloaded from https://academic.oup.com/bjsw/article-abstract/47/6/1669/4554332/A-Chronic-Problem-Competing-Paradigms-forby Adam Ellsworth, Adam Ellsworth on 18 October 2017 of SUD in CW move along a continuum within which elements of therapeutic and punitive approaches are embedded (Bosk, 2013). Initial responses to SUD for care-givers in the CW system often begin with a focus on therapeutic needs such as facilitating access to treatment. Working from a medical model that both sees recovery as linear and frames SUD as an acute condition, CW relies on abstinence to signal the resolution of safety issues. Treatment completion and negative urine screens are therefore proxies for determining a care-giver is cured. Within an acute medical model when urine screens are positive following treatment, interpretation of care-giver behaviour shifts from sickness to badness, with relapse understood to be deviance. The parent becomes seen as not committed to her sobriety or wilfully lacking insight into the problem at hand. When relapse is framed as deviance, punitive responses follow, such as switching from a reunification plan to a TPR or characterising the parent as uncooperative. It makes sense that positive drug screens would be dealt with punitively if relapse is viewed to be a proxy for a parent’s commitment to sobriety or his/her ability to recover from a SUD, especially when they have such clear safety implications for children. When the latest research in addiction science is taken into account, the implications of a positive or negative drug screen become less obvious for decision making. If relapse is understood to be a normative part of recovery, then a negative urine screen offers no guarantee that the safety risk has been resolved. Conversely, a positive drug screen does not necessarily signal that the care-giver will never recover from SUD and is not taking recovery seriously. When relapse is an expected part of a case trajectory, there are less certain guideposts for what constitutes grounds for both removal and reunification. Unpacking the construction of SA in the CW system and the hidden assumptions implicit within approaches to intervention is a critically important task. As (Best 1990, p. 188) asserts, ‘constructions have consequences … . Social policy depends on how issues are defined’. The construction of SA as an acute condition means that CW policies do not necessarily align with the latest constructions of addiction science. A key question for the field is how to address the increasing understanding of SA as a chronic issue alongside the need to keep children safe when SUD can impair so many important capacities for parenting. What needs to shift in CW’s construction of SUD and in policy and practice if an understanding of relapse within SUD is considered to be an expected part of a person’s recovery? Interaction and impact of care-giver SUD, parenting and child outcomes Questions about how to best manage the chronic nature of SUD within CW are further complicated by the ways in which parenting, SUD and A Chronic Problem 1675 Downloaded from https://academic.oup.com/bjsw/article-abstract/47/6/1669/4554332/A-Chronic-Problem-Competing-Paradigms-forby Adam Ellsworth, Adam Ellsworth on 18 October 2017 child characteristics are intrinsically intertwined. Research demonstrates that women with SUD are at greater risk for maladaptive parenting practices, including patterns of insecure attachment and difficulties with attunement and responsiveness (Suchman et al., 2006). Parenting skills become impaired both while under the influence and due to the chronic impact of use. Care-givers who struggle with addiction often have experienced early adversity and trauma, and frequently struggle with other mental illnesses. For individuals who have highly distressing emotions without the skills to manage them, SA can be a coping strategy for gaining relief from negative emotional states (Rutherford et al., 2013). As a result, a negative feedback loop may develop. Care-givers may not be as well equipped to handle the stresses of everyday parenting due to the dysregulation and personality characteristics that initially put them at risk for developing a SUD. In turn, everyday parenting stresses than put them at further risk for relapse. Parenting difficulties become compounded when viewed in the context of a transactional framework for development (Sameroff and MacKenzie, 2003). Interactions between children and care-givers with SUD are marked by increased incidents of mismatched emotional states as well as fewer back-and-forth interactions—a type of reciprocal interaction that supports healthy brain development (Shonkoff and Bales, 2011). Children exposed to substances prenatally can have a wide range of behavioural difficulties which vary based on the substance, length and timing of exposure. In general, prenatal exposure to substances impact developing brains and regulatory capacities (Behnke and Smith, 2013), which in turn affect infants’ ability to interact with their care-giver. For example, infants who are exposed to cocaine exhibit greater distancing and disengaging and increased negative affect when interacting with their mothers, and their cues are more difficult to distinguish (Tronick et al., 2005). These characteristics may then elicit negative reactions in their mothers, which can decrease the quality of maternal–infant interactions, further interfering with the ability to create the strong early attachments that are essential to healthy development. Parenting with a SUD poses unique challenges, as care-givers are both less equipped to handle difficulties in parenting and are more likely to have a higherneeds infant and child. Britain’s report, Hidden Harm: Responding to the Needs of Children of Problem Drug Users, outlines the devastating consequences that SUD can have on children’s healthy physical, cognitive, emotional and relational development at every age and stage when left unaddressed. These impacts range from deficits in educational attainment, ability to form trusting and lasting relationships, and neurobiological development (Advisory Council on the Misuse of Drugs, 2003). Interestingly, children of chronic substance users in Glasgow described the biggest impact of 1676 Emily Adlin Bosk et al. Downloaded from https://academic.oup.com/bjsw/article-abstract/47/6/1669/4554332/A-Chronic-Problem-Competing-Paradigms-forby Adam Ellsworth, Adam Ellsworth on 18 October 2017 their parents’ SUD in terms of emotional stressors rather than the risk of harm that CW monitors most closely: Their focus was not risk, nor particularly their experiences of material deprivation, rather it tended to be the social and emotional effects of living with parents who too often put their drug-related needs first. Primarily the children and young people described feelings of hurt, rejection, shame, sadness and anger over their parents’ drug problems. From these children’s perspectives, it is the relational ruptures rather than safety risks that are most in need of intervention (Advisory Council on the Misuse of Drugs, 2003). A new paradigm for understanding and approaching SA in CW Accepting the chronic and relapsing nature of addiction alongside the impact of parental SA on children requires new approaches to understanding and addressing SA within a CW context. How can child safety be managed given the innately unpredictable environment characterised by chronic SA? If termination of parental rights is removed as the automatic default for parents relapsing, a critical question becomes how to best protect children when a parent relapses. Before suggesting specific approaches to address this dilemma, we wish to clearly state that we are not advocating prioritising parental needs over the mandate to protect children. Instead, we hope to call attention to the inherent tension posed by an understanding of addiction as chronic within a CW context. We believe that new, creative interventions can help to address the relapsing nature of addiction while maintaining parent–child bonds. This viewpoint is grounded within research that extends our knowledge of the impact of Out-of-Home Care (OoHC), attachment and children’s resilience. Meta-analysis of studies comparing outcomes for children in InHome-Care versus OoHC indicate that removal may not improve child outcomes on a number of dimensions (Brandon et al., 2007). In a systematic review of forty studies, twenty-nine were consistent with no evidence of benefit or harm of OoHC, seven were consistent with harm, and four with benefit. Three studies with low risk of selection bias showed no evidence of significant differences or found worse outcomes for OoHC (Maclean et al., 2016). Additionally, in systems where family reunification is the stated goal, decades of attachment research suggests that there are benefits to supporting the parent–child relationship in situations where the parent is motivated to maintain her children, engaged in services and likely to retain custody (Suchman et al., 2006). In these cases, the potential trauma of separation A Chronic Problem 1677 Downloaded from https://academic.oup.com/bjsw/article-abstract/47/6/1669/4554332/A-Chronic-Problem-Competing-Paradigms-forby Adam Ellsworth, Adam Ellsworth on 18 October 2017 and the psychological disruption of removal may have its own negative impact on children that also must be considered as part of the decisionmaking process. Research related to resiliency for children with parents with SUD suggests that ‘empathetic and vigilant teachers, belonging to out-of school activities, having a mentor or trusted adult, un-stigmatised support from relevant professionals and information about who to contact in a crisis’ all can work as protective factors for children who are managing the detrimental impacts of parental SUD (Advisory Council on the Misuse of Drugs, 2003). Attention to strengthening these areas will also be an important task for CW workers involved in SUD cases. A one-size-fits-all approach is unlikely to be successful in addressing SA within a CW context. At the individual case level, these proposed initiatives must be informed by thoughtful consideration of a child’s safety, permanency and well-being. An appropriate course of action must take in to account the child’s developmental stage, the availability of natural supports and other family strengths. Interventions for families with younger children are likely to be different from interventions with older children, as younger children may be more vulnerable to harmful effects of parental relapse. Relatedly, parents with addictions benefit from strong natural supports and community integration. Interventions for families without these assets may require different approaches. Further, a number of structural barriers to addressing the chronic nature of SA must also be removed. Potential new approaches to SUD in CW Approaches to treating SA within a CW context must reflect the chronic and relapsing nature of addiction. Our recommendations fall within five broad categories: (i) ensuring continuity of care and long-term support, (ii) planning proactively for relapses, (iii) removing structural barriers to providing extended treatment, (iv) HR strategies and (v) integrated treatment. Several prospective approaches within each of these categories are explored below. The empirical evidence for integrative models to SA treatment is strong and naturally align with approaches to addressing chronicity. The prospective approaches discussed below draw from and expand upon these models. Ensuring continuity of care and long-term support Addressing the chronic nature of SA requires interventions and longterm support that will likely extend beyond a parent’s mandated involvement with the CW system. This likely requires a shift from mandated to voluntary intervention with families as they become more stable also 1678 Emily Adlin Bosk et al. Downloaded from https://academic.oup.com/bjsw/article-abstract/47/6/1669/4554332/A-Chronic-Problem-Competing-Paradigms-forby Adam Ellsworth, Adam Ellsworth on 18 October 2017 requires the provision of post-treatment services that help families connect with and remain involved in an array of recovery supports. Recognising that a single episode of acute SA treatment is unlikely to be sufficient, step-down services (decreasingly intensive levels of care) could help to extend treatment efforts and give parents time to adjust to a substance-free lifestyle. Inpatient treatment could be followed by intensive outpatient services, which could be gradually reduced over time. Parents could also be supported in incorporating mutual-aid approaches such as twelve-step meetings into their recovery efforts. While such stepdown approaches are increasingly incorporated into addiction treatment services in general, the extent to which this lengthier and subsequently costlier approach is available to parents involved with the CW is unclear. Relatedly, parents should have access to a broad range of recovery supports such as employment, housing, transportation, education, job skill training and medical care (Grella et al., 2009; Knoke, 2009). In addition to providing critical tools to ease their reintegration into community life, such supports help to reduce stressors that contribute to relapse and provide opportunities for meaningful connections with others also struggling with recovery. Incorporating Recovery Management Checkups (RMC) into CW activities (both with mandated and voluntary families) could provide a useful tool for monitoring families with SA and assessing emergent risks to children. RMC are quarterly monitoring sessions during which the need for additional treatment is assessed. The sessions typically involve personalised feedback on assessment findings, motivational interviewing and linkage to treatment services if needed. Numerous studies have found this model to be effective at facilitating a return to treatment more quickly and a longer-term reduction in the need for SA treatment (Dennis et al., 2005). Many treatment providers have incorporated recovery mentors to provide continued support and connections for people who have experienced addiction. Empirical support for the benefits of recovery mentors in CW is growing (Ryan et al., 2006). Parents who become involved with the CW system due to SA may benefit from regular contact with a recovery mentor who has shared this unique experience. This approach builds on a long tradition of mentoring and support provided through a range of self-help initiatives. Planning for relapse Planning proactively for relapse is also critical. Efforts could include formal relapse prevention education to help parents recognise cues that may predict relapse and interventions aimed at enhancing coping skills. Relatedly, CW caseworkers must engage with these families from an addiction-informed perspective, recognising the lasting cognitive impacts A Chronic Problem 1679 Downloaded from https://academic.oup.com/bjsw/article-abstract/47/6/1669/4554332/A-Chronic-Problem-Competing-Paradigms-forby Adam Ellsworth, Adam Ellsworth on 18 October 2017 of addiction and avoiding undue stress on parents who are in the beginning stages of recovery. Consistency is important for all children and parental addiction, with its non-linear recovery rates, has a high likelihood of interfering with this universal need. Concurrent planning, preparing simultaneously for reunification and termination of parental rights is a basic component of most CW practice models in the USA and the concept could be adapted for work with SA parents by incorporating a plan for inevitable relapses. In such cases, family members or friends could be enlisted as emergency foster-care providers should the need arise for OoHC placement due to a parent relapse. This approach would allow a child to be placed expediently with care-givers with whom the child is familiar avoiding the disruption inherent to an emergency placement. Finally, anticipating that relapse may be unavoidable, efforts should focus on assisting parents who resume SA behaviours to obtain services rather than punishing them. Systems could be created to allow parents to voluntarily report a relapse and request assistance from CW. Voluntary reports should be incentivised, as they promote child safety and well-being. Enticements for seeking help could include preferred access to treatment services and an option (if possible) for voluntary rather than mandated approaches. Research with women who self-reported in Canada has identified that this way can be a positive experience, leading to better outcomes in retaining custody of their children (Lefebvre et al., 2010). If children must be removed from the home, a plan should be put into place for regular visitation with the parent and speedy reunification upon completion of treatment (if appropriate). Initiatives to address the chronic and relapsing nature of addiction cannot be realised without addressing the structural barriers that discourage such approaches. As previously discussed, ASFA timelines need to be adjusted to allow for more realistic time frames to treat and stabilise families impacted by SA (Marsh et al., 2011). Relatedly, some CW performance indicators (particularly length of involvement and re-entry rates) may need to be changed if they contribute to suboptimal treatment or services for families with SA issues. Harm-reduction strategies Because accessing treatment and achieving sobriety are also complicated by the demands of parenting, the unique concerns around retaining or regaining child custody and the explicit lack of focus on parenting in SUD treatment, approaches are needed that explicitly address these issues. Low threshold services that operate within a HR framework present one new model for both preventing involvement in the CW system and assisting care-givers in maintaining their children when they are 1680 Emily Adlin Bosk et al. Downloaded from https://academic.oup.com/bjsw/article-abstract/47/6/1669/4554332/A-Chronic-Problem-Competing-Paradigms-forby Adam Ellsworth, Adam Ellsworth on 18 October 2017 system-involved. Within a HR framework, individuals are offered information and support to facilitate decision making about their SA and reduce its negative impact. In contrast to abstinence-based treatment, clients do not need to commit to behavioural changes such as abstaining from use to receive services. HR has the benefits of increasing access to services by having a low threshold for clients who can be served and helping individuals empower themselves to change their behaviours (Larimer, 1998). Although HR programmes can act as a gateway to more intensive treatment, research suggests that providing support and HR services can be effective even when not tied to other treatments (Bischof et al., 2005; Klingemann et al., 2010). Canada, England and Australia have all incorporated HR approaches into their national drug strategies (Moore et al., 2015; Pauly, 2008; Roy and Buchanan, 2016). Integrated treatment for parents and children Integrated Treatment Programs (ITP) that have pregnancy and parenting programmes can provide focused services with both sobriety and parenting goals. Whenever possible, pregnant women should receive prenatal services as a part of their treatment plan and be able to return to treatment postnatally. Similarly, whenever possible, women who have dependent children should be able to enter treatment without being separated. By allowing children to live with their parents during treatment, women are given the opportunity to learn to parent. In contrast, care-givers who are reunited with their children post treatment must learn to parent again without the supportive environment provided by treatment centres. Given that stress increases the likelihood of relapse, focusing on parenting skills and managing parent-related stress may be an important part of addiction treatment for those involved in the CW system. ITP offer a unique opportunity to build up parenting skills, providing new tools to manage parenting challenges and to identify how parenting stress affects their emotional state and ability to maintain sobriety. Research suggests that co-residing with children while in treatment leads to positive care-giving and child outcomes. Pregnant women in ITP attend more prenatal visits and their children are more likely to be born full-term than women attending non-integrated treatment (Milligan et al., 2010). While in treatment, women describe living with their children as motivating them and facilitating their recovery (Metsch et al., 2001). Conclusion The need for new paradigms to both conceptualise and intervene with chronic conditions is not unique to CW. Medicine faces both cost- and care-related challenges for patients who face long-term struggles with A Chronic Problem 1681 Downloaded from https://academic.oup.com/bjsw/article-abstract/47/6/1669/4554332/A-Chronic-Problem-Competing-Paradigms-forby Adam Ellsworth, Adam Ellsworth on 18 October 2017 conditions that require intensive monitoring and ongoing intervention such as diabetes and chronic hypertension, among many others. Medicine has begun to recognise the need for non-traditional interventions that are specifically designed to address the complexity of chronic conditions. These responses fall outside a traditional conceptualisation of illness and wellness as an either/or phenomena, shaping policies around a framework of ongoing involvement. Medical models for chronic care include coordinated medical homes that are responsible for tracking all patient needs; integrating the provision of primary care and social services; multidisciplinary teams; and comprehensive discharge planning after acute episodes. While medical care is not a perfect comparison to CW work, it is suggestive of opportunities for experimentation. Integrative models for SUD and CW represent promising changes in the CW system. Conceptualising new policies that take into account the chronicity of SUD complements these models and requires shifting paradigms of SUD beyond deviance, illness and recovery. Yet, chronic care models also pose significant ethical challenges in CW. Care-givers’ need for ongoing support and treatment must be balanced against the inevitable monitoring that accompanies CW involvement. While a medical setting offers opportunities to increase independence through continued care, this may not be the case in CW, where the threat of the removal of children can be experienced as both coercive and as a chronic stressor for care-givers. A major challenge for the field will be how to integrate care-givers with SUD need for continued support alongside independence from the CW system. Currently, there is a striking lack of research on programmes that increase positive outcomes for parents with SUD and their children. Internationally, research efforts should focus on how programmes and policies lead to differential outcomes, with the goal of helping care-givers on their path to long-term sobriety while also assuring that children grow up with safety and nurturance. Comparing outcomes for children placed in foster homes versus children who are able to stay with their mothers throughout the treatment process may provide additional insight into best practices. Further, identifying distinct policy components in different countries that address SUD as a chronic issue would provide insight into the kinds of approaches that are possible within CW. A willingness to experiment and evaluate new models for managing risk for families involved across CW systems due to SUD is necessary to be truly responsive to the reality that SUD is a chronic condition. As the Hidden Harm report points out, there is a major need across the world to address the impact of SUD on children’s development. CW is well positioned to focus not only on parental needs, but also on those of children involved in any SUD case. The issues related to chronicity discussed here are not only relevant to SUD; they also apply to other relapsing and remitting issues within CW, such as mental illness and domestic violence. Fresh thinking in 1682 Emily Adlin Bosk et al. Downloaded from https://academic.oup.com/bjsw/article-abstract/47/6/1669/4554332/A-Chronic-Problem-Competing-Paradigms-forby Adam Ellsworth, Adam Ellsworth on 18 October 2017 relationship to managing chronic conditions within CW in one area will enhance service delivery, organisational approaches and policies in related areas internationally
Social Workers Must Stand Up for Immigrant Rights: Strategies for Action
New enforcement priorities under the Trump administration have had a chilling effect on the use of services in immigrant communities, even by eligible immigrants ([18]), and the recent elimination of several policies that provide protections (albeit temporary) for certain undocumented immigrants has left many in limbo. Whereas some cities and metropolitan areas such as Austin; Los Angeles; Chicago; and Washington, DC, have responded with the creation of legal defense funds to provide free-of-charge representation for immigrants at risk of deportation ([17]), others, namely Miami-Dade County, have reversed existing “sanctuary city” policies under the threat of losing federal funds ([ ]). Changes in these policy contexts, along with rising nativist sentiments and hate crimes following the election of President Trump ([19]), compel the social work profession to reexamine its roles and responsibilities in the face of increasing immigrant criminalization.
Although immigrants nationwide are affected, the fear and isolation provoked by these policies may be exacerbated in “new destinations,” places such as the southern and southeastern United States that historically have not been home to immigrant newcomers yet now have growing immigrant populations, particularly those of Latino immigrants ([13]). Without an established immigrant community, these cities may not offer social services accessible to immigrants and tacitly or directly endorse restrictive immigration policies. In these contexts, promoting access to available social services and advocating for welcoming policies becomes even more critical for immigrant well-being. Based on our collective experience working and conducting research with immigrants in new immigrant destinations, we offer practical insights and put forth some strategies and recommendations for social workers moving forward.
Immigrant-serving organizations can serve as buffers against unwelcoming policy environments ([ ]), but these organizations tend to cluster in traditional immigrant settlement areas ([11]). In the absence of immigrant-serving organizations, social workers should identify community stakeholders that have already earned (or are positioned to earn) the trust of immigrants. Partnering with these entities is critical for strengthening the safety net available for immigrants and building coalitions to drive local policy initiatives.
Local public schools are a primary stakeholder because they are likely to have routine contact with immigrant parents of school-age children in their community. However, not all schools are intentional about integrating immigrant students and families. This is a challenge given that learning and socializing may be stifled by anxiety associated with the risk of deportation and other immigration policy–related concerns ([ ]). School social workers are instrumental in raising awareness about the possible implications that shifting immigration policies can have on the health, mental health, economic resources, and behavior of immigrant students and their families and can play an important leadership role in building trust with immigrant parents by developing immigrant responsive school environments. For example, one public school system in the southeast published an online document addressing frequently asked questions (see mnps.org/blog/2017/2/13/frequently-asked-questions-for-immigrant-and-refugee-communities) related to immigrant-specific services and needs and explicitly promotes a welcoming, safe environment for immigrant youths. Social workers have the capacity to apply both their clinical and macro skills to understand the unique challenges that immigrant families experience, help facilitate communication between the parents and the school, and rely on empowerment strategies (such as Know Your Rights workshops) to ensure that the school can serve as a safe place for both children and their families ([ ]). Such efforts are critical as schools have reported decreased attendance after immigration raids or even the suspicion of a raid ([ ]). Furthermore, recent research suggests that undocumented immigrant students often perceive lack of support in high school, which can be a significant barrier to positive educational outcomes ([22]).
Local congregations across denomination and faith traditions (including churches, synagogues, and mosques) are another stakeholder group that has gained the trust of Latino immigrants in new destinations, whether or not they are predominately immigrant serving. Faith organizational support of immigrant communities has a long history in the United States, most notably with the sanctuary movement and more recently the new sanctuary movement. Although congregations in new destination communities may not be comfortable explicitly identifying with the sanctuary movement, many engage in sanctuary practices. One church in Mississippi developed a postdeportation system of care for children of undocumented people. The church wanted to ensure that if an undocumented parent was detained, children would still be picked up from school and informed in a manner that would minimize the potential of trauma. Congregations in new immigrant destinations have also been at the forefront of convening community members and interdisciplinary practitioners to discuss concerns such as immigration raids and providing Know Your Rights trainings to undocumented immigrants. Social workers can be instrumental in supporting local congregations to begin and continue these activities to protect and advocate for the immigrant community. Although social workers should pursue all community partnerships with a clear understanding of each partner’s intentions and approach, such collaborations can be a crucial buffer against the impact of restrictive immigration policies, particularly as participation in religious organizations may have a protective effect on the subjective well-being of Latino immigrants ([ ]).
New destination cities often lack linguistically and culturally relevant resources and services ([16]). Providers who do have the linguistic skills to meet the needs of the immigrant community are frequently overworked and at increased risk for attrition ([20]). To maximize the few existing resources in new destination cities, and build support and solidarity among providers, forging networking groups and coalitions might be particularly helpful. For example, in Baltimore, frustration regarding limited resources and constantly evolving social services available for immigrants led a group of social services providers to create the Latino Providers Network. This group aims to share important information, resources, and to collaborate on advocacy work ([12]). Similar networking groups have formed in Nashville and several cities in South Carolina. Such networking groups can lead to critical coalition building among social services providers who may otherwise feel isolated or on their own in this work.
Social work programs have a responsibility to recruit and train MSW students to meet the linguistic and cultural needs of their growing immigrant communities. In new destination cities, schools of social work must be additionally purposeful and develop strategies to recruit bilingual/bicultural social work professionals. Providing targeted scholarships to attract diverse students will go some way toward addressing this gap, but schools of social work must also integrate substantive content on immigration-related issues into the curriculum. This can range from formal social work–specific or interprofessional elective courses on serving immigrants to international exchange opportunities that include language components and immigrant-relevant modules woven into existing core courses.
Anti-immigrant legislation further isolates immigrant families from meaningful participation in this country’s social, economic, and political structures, particularly in new destination cities. The social work profession must advocate for policy changes that promote inclusion of immigrant communities at all levels, from local to global. Indeed, these strategies should each be explicitly tied to advocating for immigrant rights, with a keen appreciation for the damaging impact of today’s anti-immigrant rhetoric and policies. Advocates must be vigilant to keep fully informed about the (rapidly) shifting immigration policy landscape to be able to best work with the immigrant community.
Even as we write this commentary, changes in immigration policy and enforcement continue to alter the scope of this social welfare problem and infringe on immigrants’ human rights. Access to social services and immigration enforcement practices are two areas that have substantial impact on communities and potential for policy change. As ideas relevant to one context may not be best practice in another, social workers should ensure that local policy efforts are in collaboration and solidarity with immigrant communities. For example, local and state initiatives that ensure and expand driver’s license access for undocumented immigrants may be an important policy advocacy initiative for social workers as improved access has been linked to improved traffic safety and other positive outcomes for the communities in which immigrants live ([14]). Working with local organizations and quality national think tanks for data and analysis can help social workers stay abreast of critical issues and be on the cutting edge of innovative policy alternatives focused on the health and well-being of immigrants. Social workers must also be prepared and ready to stand with immigrant rights leaders in protest of injustice and human rights abuses.
Social workers are poised to play a pivotal role in challenging anti-immigrant legislation at the federal, state, and local levels. Indeed, they have the obligation to do so: The importance of practice with, and advocacy on behalf of, immigrants is referenced five times in the Code of Ethics of the National Association of Social Workers ([15]). We thus call on social work to take a more decisive stance in helping mobilize resources for immigrants, in general, and for those living in new destination areas, in particular.
Changing national demographics call schools of social work to not only train students in culturally responsive frameworks effective with immigrant populations, but also recruit and retain bilingual and diverse students ([ ]; [ ]; [10]). Greater action is also needed in the face of policy initiatives that are separating families and creating widespread deportation fear and emotional distress among even U.S. residents and citizens ([ ]; [21]). The next few months will be critical in terms of fleshing out an effective response to the current anti-immigrant political climate that should be developed in solidarity with the many existing immigrant rights coalitions that have emerged as leaders in this movement. Initiating and upholding an effective social work response will require higher and continuing levels of support, resources, and commitment from all our professional organizations and leadership. It is a grand challenge to which social work must respond to uphold our social justice values and stand against the current crisis of injustice.
Negi, N. J., Roth, B., Held, M. L., Scott, J., & Boyas, J. (2018). Social Workers Must Stand Up for Immigrant Rights: Strategies for Action. Social Work, 63(4), 373–376. https://doi-org.lopes.idm.oclc.org/10.1093/sw/swy039
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