By: Book Reviewers
Book reviews from the Summer 2011 issue of THE NEW SOCIAL WORKER.
Israel, A.B. (2011). Using the Law: Practical Decision-Making in Mental Health. Chicago: Lyceum Books, Inc. 328 pages, $39.95.
Although an abundance of inquiries on ethics have recently emerged, Andrew Israel’s new text offers significant contributions to the professional knowledge base. Relevant to students and practitioners, this accessible book is unique in that it presents common legal principles and approaches to reasoning that are intentionally useful within a variety of mental health professions and practice settings. Whereas discussions of various codes of ethics enhance the book’s portability—with appendices that include a review of standards from major mental health professions—Israel has crafted a law-based model for ethical decision-making that is easily adaptable across disciplines. Additionally, the book’s recognition of the multitude of factors that affect professionals’ actions—such as quality of training, personal values, agency protocol, professional responsibilities, community norms, regional differences, and diverse cultural experiences—offers a flexible approach to decision-making that simultaneously upholds the importance of practices informed by legal principles.
Using the Law advances a four-step framework particularly applicable when encountering a complex practice dilemma. The mental health worker can first examine applicable laws that may apply. In addition to including a compilation of court decisions relevant to mental health professions, the author analyzes and explains legal principles such as informed consent, reasonably competent practice, confidentiality, due process, and equal protection. Next, the model promotes a review of professional codes of ethics, as they “tend to enrich the professional context in which practice scenarios take place” (p. 22). Rather than provide the foundation for decision-making, professional codes introduce priorities that can shape practitioners’ perspectives. Thirdly, personal and ideological beliefs and cultural and regional factors need to be accounted for, as a reflective practice necessitates keen awareness of self and other. The final step in Israel’s framework is to make a pragmatic decision, doing what is possible within the confines of the specific situation. Acknowledging that most ethically complicated dilemmas warrant consultation with an array of sources, Israel posits that this model is one contribution to a legally-informed professional practice.
The ideas proffered would have been enhanced by inclusion of several additional elements. For instance, pragmatism is cited as the theoretical perspective that can most effectively guide usage of the model, particularly in the final stage of decision-making. However, the author offers a weak summary of pragmatism, and this scarce information is not included until the last chapter. Readers can benefit from a more robust consideration of the key tenets and proponents of this epistemology, its contemporary impact upon the mental health professions, and its applicability to a law-informed practice. Additionally, an exploration of the role of evaluation during and after decision-making could invite a spirit of skepticism and an attentiveness to outcome that would further enrich Israel’s framework. Lastly, acknowledging the impact of evidence-based practice upon the mental health professions, the author could have identified opportunities to locate this model in relation to ongoing efforts to systematize best practices.
In spite of these limitations, the author’s multidisciplinary considerations and legally astute recommendations make Using the Law a valuable addition to ethically maturing mental health practices.
Reviewed by Jeff T. Steen, LCSW, Ph.D. student, New York University Silver School of Social Work.
Juhnke, G. A., Granello, D. H., & Granello, P. F. (2011). Suicide, Self-Injury, and Violence in the Schools: Assessment, Prevention, and Intervention Strategies. New Jersey: John Wiley & Sons. 368 pages. $39.95.
At some point in their careers, social workers may come across situations, clients, or families that present with issues related to suicide or violence. In the book titled Suicide, Self-Injury, and Violence in the Schools: Assessment, Prevention, and Intervention Strategies, authors Juhnke, Granello, and Granello offer a detailed guide for professionals who work in the school setting. The subjects of suicide, self-harm, and violence are carefully described and explored as they relate to children and adolescents. According to the authors, the purpose of this book is to assist school counselors and professionals in designing effective prevention, intervention, and post interventions for students who are at risk for suicide or violence.
The book is presented in three parts. The first part addresses suicide and self-injury. Statistics, myths, and risk factors of suicide are discussed in detail. Suicide prevention strategies such as providing education to students, staff, and parents are recommended. For situations that surpass prevention and require actual intervention, the authors recommend that school professionals provide counseling and, more importantly, an informal risk assessment as needed. The authors note that consultation and collaboration with others, such as parents, community resources, and peers, is key in providing effective support to students.
The complex subject of self-injury is also explained in this first section. The term nonsuicidal self-inflicted injury (NSSI) is used to describe behaviors of those who injure with the intention of reducing psychological stress. The authors carefully discern between suicide and self-injury, while highlighting the risks associated with both behaviors.
The second part of the text addresses the subject of violence, specifically in terms of assessment and intervention. The authors offer several assessment tools recommended for use with violent students in the school setting. In particular, the Violent Student Scale is a tool for assessing the propensity for violence. This tool can be used quickly during a face-to-face clinical interview with a student. The authors suggest that an evidence-based “Systems of Care” approach should be used with students who have been identified as being at mild to moderate risk for violent behavior. A model for debriefing students who have been exposed to violence in the school setting is also presented.
The third and final section addresses legal and ethical issues related to decision-making in cases involving student suicide and violence. The reader is highly encouraged to refer to professional ethics codes, state laws, clinical supervisors, legal personnel, and risk managers before making decisions or intervening with students. A four-principle ethical decision-making model is included in this section.
Overall, this text offers helpful information to school social workers, counselors, and other school personnel who may interface with students who are at risk or present with suicide and violent behavior. According to the authors, statistics indicate that suicide rates among young people are rising. Therefore, it is imperative for school social workers, counselors, and educational staff to be prepared to provide prevention and intervention as needed.
Reviewed by Arlene M. Arias, LCSW, Clinical Social Worker, Connecticut Mental Health Center.