Abstract
Though expression of sexuality is correlated with improved physiological, psychological, and social well-being, persons with psychiatric disabilities battle a myriad of forces preventing their full inclusion in this cherished domain of adult life. Powerful side effects of psychotropic medications are partly to blame for this complex problem. More troubling are providers that adopt silent or admonishing positions with clients struggling with issues of sexuality and intimacy. Despite an international embrace of the recovery framework in mental health systems of care, providers often behave in ways that do not support the sexuality and intimacy interests of their clients. Since social workers are the main providers of service for this population, they must lead in developing novel pedagogical techniques infusing social work curriculum with practice competencies for addressing sexuality and intimacy for persons with psychiatric disabilities. Furthermore, as field instructors are most influential in shaping practice habits of social work students, any effort at structural change must feasibly include them. This article delineates an adaptation of the Field Instructors Extending EBP Learning in Dyads (FIELD) Model, for the field instructor and social work student dyad. Utilizing motivational interviewing techniques, FIELD imparts sexuality and intimacy practice competencies for collaboration with persons living with psychiatric disabilities.
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Corrigan, P.W., Mueser, K.T., Bond, G.R., Drake, R.E., Solomon, P.: Principles and practice of psychiatric rehabilitation: An empirical approach. Guilford Press, New York (2012)
Pratt, C., Gill, K., Barrett, N., Roberts, M.: Psychiatric rehabilitation, 3rd edn. Elsevier, New York (2014)
Wright, E., Wright, D., Perry, B., Foote-Ardah, C.: Stigma and the sexual isolation of people with serious mental illness. Soc. Probl. 54(1), 78–98 (2007)
Deegan, P.: The lived experience of using psychiatric medication in the recovery process and a shared decision-making program to support it. Psychiatr. Rehabil. J. 31(1), 62 (2007)
Slade, M.: Everyday solutions for everyday problems: how mental health systems can support recovery. Psychiatr. Serv. 63(7), 702–704 (2012)
Tennille, J., Solomon, P., Blank, M.: Case managers discovering what recovery means through an HIV prevention intervention. Comm. Ment. Health J. 46(5), 486–493 (2010)
Tennille, J., Wright, E.: Addressing the intimacy interests of people with mental health conditions: acknowledging consumer desires, provider discomforts, and system denial. Temple University collaborative on community inclusion of individuals with psychiatric disability (2013)
Higgins, A., Barker, P., Begley, C.: ‘Veiling Sexualities’: a grounded theory of mental health nurses responses to issues of sexuality. J. Adv. Nurs. 62(3), 307–317 (2008). doi:10.1111/j.1365-2648.2007.04586
Quinn, C., Browne, G.: Sexuality of people living with a mental illness: a collaborative challenge for mental health nurses. Int. J. Ment. Health. Nurs. 18(3), 195–203 (2009). doi:10.1111/j.1447-.0349.2009.00598.x
Quinn, C., Happell, B., Welch, A.: The 5-As framework for including sexual concerns in mental health nursing practice. Issues. Ment. Health Nurs. 34(1), 17–24 (2013)
Van Sant, S. P., Ahmed, A. O., Buckley, P. F.: Schizophrenia, Sexuality, and Recovery. J. Ethics Ment. Health 7 (2012)
Wright, E., McCabe, H., Kooreman, H. E.: Institutional capacity to respond to the ethical challenges of patient sexual expression in state psychiatric hospitals in the United States. J. Ethics Ment. Health 7, (2012)
Heisler, E. J., Bagalman, E.: The mental health workforce: A primer (Congressional Report No. R43255). Washington DC: Library of congress congressional research service. Retrieved from CRS website: http://fas.org/sgp/crs/misc/R43255.pdf. 7 Jan 2014)
Bogo, M., Regehr, C., Woodford, M., Hughes, J., Power, R., Regehr, G.: Beyond competencies: field instructors’ descriptions of student performance. J. Soc. Work. Educ. 42(3), 579–593 (2004)
Lager, P., Robbins, V.: Field education: exploring the future, expanding the vision. J. Soc. Work Educ. 40(1), 3–11 (2004)
Tennille, J.: An RCT of an evidence-based practice teaching model with the field instructor/social work intern dyad (doctoral dissertation). University of Pennsylvania, Philadelphia, PA (2013)
Torrey, W., Wyzik, P.: Recovery vision as a service improvement guide for community mental health center providers. Comm. Ment. Health J. 36(2), 209–216 (2000)
Slade, M., Amering, M., Farkas, M., Hamilton, G., O’Hagen, M., Panther, G., Whitley, R.: Uses and abuses of recovery: implementing recovery = oriented practices in mental health systems. World. Psychiatr. 13(1), 12–21 (2014)
Lloyd, C., Waghorn, G., Williams, P.: Conceptualising recovery in mental health rehabilitation. Br. J. Occup. Ther. 71(8), 321–328 (2008)
Davidson, L., Roe, D.: Recovery from versus recovery in serious mental illness: one strategy for lessening confusion plaguing recovery. J. of Ment Health 16(4), 459–470 (2007)
Cook, J.: Sexuality and people with psychiatric disabilities. Sex. Disabil. 18(3), 195–206 (2000)
Deegan, P.: Recovery: the lived experience of rehabilitation. Psychosoc Rehabil J 11(4), 11–19 (1988)
Anthony, W.: Recovery from mental illness: the guiding vision of the mental health service system in the 1990s. Psychosoc. Rehabil. J. 16, 11–23 (1993)
Bywater, J., Jones, R.: Sexuality and social work. Sage, Thousand Oaks, Calif (2007)
World Health Organization. Education and treatment in human sexuality: the training of health professionals, report of a WHO meeting [held in Geneva from 6 to 12 February 1974] (1975)
Lukoff, D., Sullivan, G., Goisman, R.: Sex and AIDS education. In: Liberman, R. (ed.) Handbook of psychiatric rehabilitation, pp. 171–182. MacMillan Publishing Co., New York (1992)
Miller, P., Ingham, J.: Friends, confidants and symptoms. Soc. Psychiatr. 11, 51–59 (1976)
Vaughn, C., Leff, J.: The influence of family and social factors on the course of psychiatric illness: a comparison of schizophrenic and depressed neurotic patients. Br. J. Psychiatr. 129, 125–134 (1976)
Ailey, S., Marks, B., Crisp, C., Hahn, J.: Promoting sexuality across the life span for individuals with intellectual and developmental disabilities. Nurs. Clin. North Am. 38(2), 229–252 (2003)
Binder, R.: Sex between psychiatric inpatients. Psychiatr. Q. 57(2), 121–126 (1985)
Dobal, M., Torkelson, D.: Making decision about sexual rights in psychiatric facilities. Arch. Psychiatr. Nurs. 18(2), 68–74 (2004)
Shildrick, M.: Contested pleasure: the sociopolitical economy of disability and sexuality. Sex. Res. Soc. Policy. 4(1), 53–66 (2007)
Welch, S., Clements, G.: Development of a policy on sexuality for hospitalized chronic psychiatric patients. Can. J. Psychiatr. Rev. 41(5), 273 (1996)
Shanks, J., Atkins, P.: Psychiatric patients who marry each other. Psychol. Med. 15(02), 377–382 (1985)
Davison, J., Huntington, A.: “Out of sight”: sexuality and women with enduring mental illness. Int. J. Ment. Health Nurs. 19(4), 240–249 (2010). doi:10.1111/j.1447-0349.2010.00676
Wright, E., Gronfein, W., Owens, T.: Deinstitutionalization, social rejection, and the self-esteem of former mental patients. J. Health Soc. Behav. 41, 68–90 (2000)
Buckley, P., Gutheil, T.: Sexuality, stigma busting and mental illness. In: Buckley, P. (ed.) Sexuality and serious mental illness, pp. 217–220. Harwood Academic Publishers, Amsterdam (1999)
Dickerson, F., Brown, C., Kreyenbuhl, J., Goldberg, R., Fang, L., Dixon, L.: Sexual and reproductive behaviors among persons with mental illness. Psychiatr. Serv. 55, 1299–1301 (2004)
Perry, B., Wright, E.: The sexual partnerships of people with serious mental illness. J. Sex. Res. 43(2), 174–181 (2006)
Tennille, J., Solomon, P., Fishbein, M., Blank, M.: Elicitation of cognitions related to HIV risk behaviors in persons with mental illnesses: implications for prevention. Psychiatr. Rehabil. J. 33(1), 32–37 (2009)
Aruffo, J., Thompson, R, McDaniel, J., Sacco, J., Herman, R., Kaplan, M., Eversole, T.: Training programs for staff. In: Cournos, F., Bakalar, N. (eds.) AIDS and people with severe mental illness: a handbook for mental health professionals, pp. 201–224. Yale University Press, New Haven, Conn (1996)
Brunette, M., Mercer, C., Carlson, C., Rosenberg, S., Lewis, B.: HIV-related services for persons with severe mental illness: policy and practice in New Hampshire community mental health. J. Behav. Health. Serv. Res. 27, 347–353 (2000)
Carmen, E., Brady, S.: AIDS risk and prevention for the chronic mentally ill. Can. J. Psychiatr. 44, 652–657 (1990)
Grassi, L.: Risk of HIV infection in psychiatrically ill patients. AIDS Care. 8, 103–116 (1996)
Knox, M.: Community health’s role in the AIDS crisis. Comm. Ment. Health. J. 25, 185–196 (1989)
McKinnon, K., Cournos, F., Herman, R., Satriano, J., Silver, B., Puello, I.: AIDS related services and training in outpatient mental health care: agencies in New York. Psychiatr. Serv. 50, 1225–1228 (1999)
Shernoff, M.: Integrating safer-sex counseling into social work practice. Soc. Casework.: j. Contemporary. Soc. Work 69, 334–339 (1988)
Solomon, P., Tennille, J., Lipsitt, D., Plumb, E., Metzger, D., Blank, M.: Rapid assessment of existing HIV prevention programming in a community mental health center. J. Prev. Interv. Comm. 33(1–2), 137–151 (2007)
Sullivan, G., Koegel, P., Kanouse, D., Cournos, F., McKinnon, K., Young, A., Bean, D.: HIV and people with serious mental illness: the public sector’s role in reducing HIV risk and improving care. Psychiatr. Serv. 50, 648–652 (1999)
Encandela, J., Korr, W., Hulton, K., Koeske, G., Klinkenberg, W.D., Otto-Salaj, L., Silvestre, A., Wright, W.: Mental health case management as a locus for HIV prevention: results from case-manager focus groups. J. Behav Health Serv. Res. 30, 418–432 (2003)
Quinn, C., Happell, B., Browne, G.: Talking or avoiding? Mental health nurses’ views about discussing sexual health with consumers. Int. J. Ment. Health. Nurs. 20(1), 21–28 (2011). doi:10.1111/j.1447-0349.2010.00705
Quinn, C., Happell, B.: Getting BETTER: breaking the ice and warming to the inclusion of sexuality in mental health nursing care. Int. J. Ment. Health. Nurs. 21(2), 154–162 (2012)
Tepper, M.S.: Sexuality and disability: the missing discourse of pleasure. Sex. Disab. 18(4), 283–290 (2000)
Deegan, P. E. Human sexuality and mental illness: Consumer viewpoints and recovery principles. In Buckley, P. F. (ed.) Sexuality and serious mental illness, pp. 21–34 (1999)
Padgett, D.K., Stanhope, V., Henwood, B.F., Stefancic, A.: Substance use outcomes among homeless clients with serious mental illness: comparing housing first with treatment first programs. Comm. Ment. Health J. 47(2), 227–232 (2011)
Proctor, E.: Implementing evidence-based practice in social work education: principles, strategies and partnerships. Res. Soc. Work. Pract. 17(5), 583–591 (2007)
Tennille, J., Solomon, P., Bourjolly, J., Doyle, A.: Introducing FIELD instructors extending EBP learning in dyads(FIELD). Under review (2014)
Edmond, T., Megivern, D., Williams, C., Rochman, E., Howard, M.: Integrating evidence-based practice and social work field education. J. Soc. Work Educ. 42(2), 377–396 (2006)
Reisch, M., Jarman-Rohde, L.: The future of social work in the United States: implications for field education. J. Soc. Work Educ. 36(2), 201–214 (2000)
Ager, R., Roahen-Harrison, S., Toriello, P. J., Kissinger, P., Morse, P., Morse, E., Rice, J.: Predictors of adopting motivational enhancement therapy. Res Soc. Work Prac., 21(1), 65–76 (2011)
Amodeo, M., Lundgren, L., Cohen, A., Rose, D., Chassler, D., Beltrame, C., D’Ippolito, M.: Barriers to implementing evidence-based practices in addiction treatment programs: comparing staff reports on motivational interviewing, adolescent community reinforcement approach, assertive community treatment, and cognitive-behavioral therapy. Eval. Prog. Plan 34(4), 382–389 (2011)
Hines, G.: Let’s talk about sex. Health Educ. 95(5), 9–12 (1995)
Drescher, J.: Queer diagnoses: parallels and contrasts in the history of homosexuality, gender variance, and the diagnostic and statistical manual. Arch. Sex. Beh. 39(2), 427–460 (2010)
Mullen, E.J., Bledsoe, S.E., Bellamy, J.L.: Implementing evidence-based social work practice. Res. Soc. Work Prac. 9, 325–338 (2008)
Hohman, M.: Motivational interviewing in social work practice. Guildford Press, New York (2011)
Van Wormer, K., Davis, D.: Addiction Treatment: a strengths perspective. Cengage Learning, Boston (1996)
Miller, W., Rollnick, S.: Talking oneself into change: motivational interviewing, stages of change and therapeutic process. J. Cogn. Psychother. 18(4), 299–308 (2004)
Miller, W., Rollnick, S.: Motivational interviewing: helping people change. Guildford Press, New York (2012)
Beidas, R., Kendall, P.: Training therapists in evidence-based practice: a critical review of studies from a systems-contextual perspective. Clin. Psychol.: Sci. Pract. 17, 1–30 (2010)
Beidas, R., Edmunds, J., Marcus, S., Kendall, P.: Training and consultation to promote implementation of an empirically supported treatment: a randomized trial. Psychiatr. Serv. 63(7), 660–665 (2012)
Noordsy, D.L., Torrey, W.C., Mead, S., Brunette, M., Potenza, D., Copeland, M.E.: Recovery-oriented psychopharmacology: redefining the goals of antipsychotic treatment. J. Clinic. Psychiatr. Supplement 61(3), 22–29 (2000)
Mossman, D., Perlin, M., Dorfman, D.: Sex on the wards: conundra for clinicians. J. Am. Acad. Psychiatr. Law. Online. 25(4), 441–460 (1997)
Friesen, B., Nicholson, J., Kaplan, K., Solomon, P. Parents with a mental illness and implementation of the adoption and safe families ACT, intentions and results: A look back at the adoption and safe families act, Center for the study of social policy & urban institute (2009)
Mowbray, C.T., Oyserman, D., Bybee, D., MacFarlane, P., Rue-Rieden, A.: Life circumstances of mothers with serious mental illness. Psychiatr. Rehab. J. 25(2), 114–123 (2001)
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Tennille, J., Solomon, P. & Bohrman, C. Using the FIELD Model to Prepare Social Work Students and Field Instructors on Sexuality and Intimacy for Persons with Psychiatric Disabilities. Sex Disabil 32, 469–483 (2014). https://doi.org/10.1007/s11195-014-9380-6
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DOI: https://doi.org/10.1007/s11195-014-9380-6