Case Management Issues Research Articles

A young child who witnessed her mother's murder: therapeutic and legal considerations.

For the clinician treating children who have witnessed parent-parent homicide, complex and conflicting therapeutic and case management issues must be confronted. The goals of treatment of these children include relief of suffering and resolution of symptoms, clarification of cognitive or emotional distortions about the traumatic experience, provision of a supportive posttraumatic environment in which the child may continue to work through the experience as needed in the future, and minimization of future problems as a result of the trauma. When these goals have been substantially achieved, the child should be able to resume age appropriate developmental tasks. The clinician must also advocate for the child in the legal process despite not having a clearly defined role in the criminal justice system. The goal of involvement as consultant to the legal system is to minimize further psychological trauma to the child who is at risk for reexperiencing trauma for nontherapeutic purposes, creation of intense loyalty conflict, confrontation with the accused parent, intimidating cross-examination, and responsibility for deciding the fate of one's parent. The paucity of previous reports on this topic suggests that such children are infrequently referred for psychiatric treatment despite data indicating these cases are tragically not uncommon. It seems incumbent upon mental health professionals to increase awareness in the community in general and in the criminal justice system in particular about the need for psychiatric treatment of these children at risk.

The clinical social worker and current psychiatric drugs: Some introductory principles

This paper persents some common social work clinical and case management issues with respect to psychiatric drug treatment. The roles of the psychiatrist and the social worker are distinguished. Three types of negative treatment drug effect are described-physical, psychological, and social-with case examples. Techniques to prevent or reduce negative drug effects are presented. The paper emphasizes the need for greater social work professional attention being paid to drug therapy.