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Exam One Study Guide

by: Kelsey Carroll

Exam One Study Guide SOWK 201 002

Kelsey Carroll
GPA 3.46
Introduction to Social Work Profession and Social Welfare
Betsy Spriggs

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This is a collection of all of my notes and main topics from class and the book compiled in one place for easy studying and reference for the online test. Its divided up by chapter and main points.
Introduction to Social Work Profession and Social Welfare
Betsy Spriggs
Study Guide
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This 41 page Study Guide was uploaded by Kelsey Carroll on Sunday October 18, 2015. The Study Guide belongs to SOWK 201 002 at University of South Carolina taught by Betsy Spriggs in Summer 2015. Since its upload, it has received 133 views. For similar materials see Introduction to Social Work Profession and Social Welfare in Social Work at University of South Carolina.

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Date Created: 10/18/15
SOWK 201 EXAM ONE STUDY GUIDE CHAPTER ONE THE SOCIAL WORK PROFESSION What is the purpose of a social worker To empower people to grow and live healthy productive and meaningful lives What is social work People who help prevent or solve problems of people in need What is advocacy Defending and representing others through supporting or recommending action to secure or retain social justice Example oppressed people kids pets elderly Advocate is someone who ghts for the rights of others to obtain resources or services What is social justice When society as a whole shares civil liberties and equality to resources and a voice in public affairs Example women39s rights Ethnocentrism thinking your culture is better than others Cultural Competencies being aware of other cultures Example Learning other languages taking classes volunteering with other cultural groups Should statements pass judgement social workers should refrain from using it Where do social workers get their accreditation from The counsel on Social Work NASW sets the code of ethics What does a BS in Social Work mean Four years in college and eld practice You learn boundaries and much to help What is a master39s in SOWK Specialized in a eld of interest They enter the workforce about midupper quaH ca ons LMSW a test certi cation LlSM advanced practice and can open your own practice Same level as a LPC in counseling or a psychologist A test is required and 100 supervised hours Generalist Practitioner covers all bases as a social worker not really any speci c area of expertise Direct Practice therapy Micro social worker working with individuals or couples Mezzo social worker working with small groups of people Macro social worker working with communities Example legislators lobbyist agencies Both Macro and Micro intermingle a lot How to get people on board with seeing a social worker 1 Build report 2 Cohesiveness 3 Find things in common with the people your see and amongst the group 4 Create dialogue Examples of Prejudice and Discrimination 1 Class they may need a job housing reduced food transportation child support or daycare 2 Gender they may need help or advocacy in education employment reproductive services child care or civil rights 3 Race they many need help with ESL mental illness or employment 4 Ethnicity they may need support nding ethnic centers language diversity or cultural events 5 Sexual orientation they may need help with discriminatory behavior coping or need an advocate 6 Age they may need help with loneliness income security or healthcare Must challenge ISM words Intersectionality the entirety of a person39s dimensions of difference and social identities Example poor elderly and Hispanic man both positive and negative aspects of social placement The Tool Box of a Social Worker Ideas and theories Resilience Service Strength Solutions Integrity Social justice What is evidencebased practice Using a particular intervention for an issue problem or disorder based upon research NASW Code of Ethics Identi es core social work values Summarizes broad ethical standards Identi es professional obligations when con icts arise Holds social work professionally accountable De nes unethical conduct Social workers mission values ethics and principles Educational Policy and Accreditation Standards These competencies re ect common practice behaviors and ethics Must acquire all 10 before they graduate A social worker can always gain more certi cations and licenses throughout their career CHAPTER 2 Introduction to Social Work Social Welfare Helps maintain the stability and welling of society 0 Includes government 0 Programs 0 Services 0 Institutions Allocation of resources 0 Money 0 Personnel 0 Expertise Social welfare the array of government programs services and institutions designed to maintain the stability and wellbeing of society Social Welfare PolicyThe legal mandates that specify the profession39s clients what services will be made available to designated populations how services will be delivered the duration of services and how intervention outcomes will be evaluated and measured What impacts how a person thinks about policy issues 0 Political social religious and economic ideologies Safety net services that protect people from spiraling downward economically or socially Conservative VS Liberal Persona responsibility Larger safety net Fat tax Redistribute wealth Earn success Supports social intervention Peope cause their own problems Graduated tax system Social Control policies and practices designed to regulate people and increase conformity and compliance 0 If then statements 0 If you do this we will give you blank Social Worker Involvement in the policy arena Helps society address individual needs Helps confront social control redistribution Means Testing is assessing whether the individual or family possesses the means to do without a particular kind of help Social Justice 0 Protects human rights 0 Provides basic needs Goamotivate social workers to be advocates Goals of Advocacy Fairness Equaity Freedom Service Nonvioence Colonial America 16071783 0 Mutual Aid Communities responsibility to take care of their neighbors not the government or an agency 0 Settlement Laws designed to control the distribution of public assistance the settlement laws were the domain of small units of government and speci ed a period of residence for the receipt of assistance 0 Poor Laws of Colonial America 0 Similar to the Elizabethan Poor Laws Deserving poor Elderly children physically and mentally handicap Nondeserving poor Able body men and women who choose not to work drunkslazy Outdoor Relief assistance to the deserving poor in their home and communities Indoor Relief assistance in institutions where nondeserving poor were sent to work Origins of Social Advocacv 180039s 0 The United States expanded West Orphan trains 0 Beginning of foster care Dorothea Dix o Founded asylums for the mentally ill Progressive Era 18901920 Increase in immigrants Economic crisis of the 189039s Laid the foundation of social work Charity Organization Society and the Settlement Movement emerged dealing with dependency Shift from agriculture to urbanization Settlement Movement environmental factors related to poverty 0 Hull House jane Addams and Ellen Gate Starr created this establishment which housed a daycare working women39s club lectures cultural programs a meeting place for neighborhood political groups 0 Edward T Devine 0 Founded the New York Charity Organization Society 0 Founded the New York School of Philanthropy in 1898 Eventually became Columbia School of Social Work First school of social work 0 Mary Richmond 0 Founded the BaltimorePhiladelphia Charity Organization Society 0 Wrote the rst book on social work in 1917 Social Diagnosis Introduced methodology and common body of knowledge World War 1 19141918 0 Cause to Function Porter Lee said that social workers shifted their professional attention from a concern with politics to a concern with the ef cient day to day administration of social welfare bureaucracy 0 Expansion of practice settings private family welfare agencies 0 Expansion in Hospitals Schools Private welfare agencies Guidance centers Children s aid societies Mental health The Great Depression 1929194039s Stock market crash in 1929 economic disaster Rekindled the quotcausequot orientation that had been abandoned and lobbied the government to provide an adequate standard of living for all FDR called for a large federal relief fund 0 New Deal unemployment insurance social security system old dependent kids disabilities 0 Social worker Today newspaper was created labor unions were formed and relief agencies 0 Harry Hopkins social worker appointed head of Federal Emergency Relief Administration 0 Social Security Act of 1935 expanded welfare activities service and programs for the poor World War II 19601967 0 Nearly full employment for all Americans 0 The National Association of Social Workers was formed NASW It helped unite the profession through guidelines and ethics that de ned responsibilities in 1955 0 Result of the DepressionNew Deal 0 New jobs for social workers with a deeper understanding of human needs and renewed interest America s War 19601967 0 Civil Rights Movement 0 Gays 0 Women 0 Mentally and Physically challenged 0 People of color 0 New Frontier John F Kennedy talked of poverty peace corps aid to families with dependent kids 0 Great Society Lyndon B Johnson 0 Social Welfare Initiatives 0 Head Start 0 Medicare 0 Medicaid 0 Food Stamps Reaganomics 19811989 0 President Ronald Reagan o Conservative platform 0 Individual responsibility for o Trickle Down Economics President George WH Bush Conservative approach 0 Million points of Light 0 Communities developedfunded services and programs to address local needs 0 Impoverished communities had few resources to contribute 911 and Bevond 2000Present Social welfare initiatives overshadowed by 0 Wars in Iraq and Afghanistan 0 Global War on Terror 0 2010 Affordable Care Act 0 Improved access to affordable health coverage 0 Reformed insurance company practices for coverage of mental and behavioral health 0 Social workers help people navigate new systems Limitations of Social Welfare 0 Social Reforms 0 Make a difference to millions of Americans sometimes fails to meet stated or ideal goals 0 Crisis intervention VS Prevention 0 Low social mobility remains History of social welfare policy 0 Needs to address root causes of social economic and political inequality Example 1963 March on Washington led to the 1964 Civil Rights Act CHAPTER 3 GENERALIST SOCIAL WORK PRACTICE Generalist Social Work Practice goal is to address problematic interactions between persons and their environments or surroundings They may work in or with 0 Schools Institutions On the street Elderly Community members Political arena 00000 Direct Practice oneonone interactions with clients Liberal Arts Foundation courses that apply to sowk degrees like stats sociology psych bio econ and polysci They introduce the idea that through understanding society its people and their challenges they will better understand their clients 0 Knowledge for a general sowk practice How the two parts of a degree interact with each other Field Education Social Work Methods or Practice Electives Social Human Behavior in the Social Environment Liberal Arts Foundation Social Policy SelfDeterminationl the right of people groups or communities to make choices design a course of action and live as independently as possible Critical ThinkingD the ability to re ect on and integrate information from an array of sources to form a position opinion or conclusion 0 Be able to express views con dently and support them 5 Most Important Theoretical Foundations 1 Systems Theory used to conceptualize problems within human systems and to introduce a change process It allows for a multidimensional analysis of function cause and interactions when considering avenues of change a Client system includes the client and the people and or groups in their life who in uence or help change a problem i Example 1 Client 2 Family 3 Work Church 4 Neighbors Ecological Mapljcan help organize a client system It indicates strong or weak connchons It is like a web Client Svstem with inputs and outputs lnputs communication patterns between people information transfer and knowledge acquisition Outputsl attitudes behaviors and role performance 0 Example Inputs Outputs Friends Networking Field educatlk Career pathway Core SOWK classes Social Work competence Student Family SSuccess towards graduating Hobbies selfsuf ciency 2 Ecological PerspectiveD focuses on people and their environments a Environments consist of a person39s physical and social settings b Consistently interacting with environments c Personinenvironment perspective understanding an individual and individual behavior in relationship to the environmental context in which that person lives and acts i People are affected both positively and negatively ii Adaptationcritical input of new ideas and output of energy effort 3 Empowerment Theory a set of ideas used to increase change possibilities a Help people help themselves b Empowerment provides people with the means to attain their goals either directly or indirectly i Empowerment makes collaboration necessary for success c Advocacylj is closely related to empowerment Using advocacy as a vehicle for empowerment supports social justice 4 Strengths Perspectivelj everyone has strengths they can use in solving their problems You as a social worker help them see their strengths Be looking for things they are good at during the assessment a Assessment is crucial b Listening to clients ideas to identify resources an opportunities c Collaboration with clients as an equal partner in the change process d Recognizing clients resilience to barriers e Understanding communities untapped resources 5 Evidence based practiceD the use of research ndings to inform and evaluate practice and the sharing of practice experiences to inform and enrich research activities a Four Main Features i Client39s situation ii Clients goals values and wishes iii Clinical expertiseopinion iv External scienti c evidence b Keeps social workers aware of scienti c ndings and data Roles for Generalist Social Workers Advocate Broker Case Manager Researcher Counselor Mediator Navigator Generalist Social Workers work on the micro mezzo and macro levels The Change Process EngagementD sets the tone for the change process Earns trust and con dence 0 Begin developing rapport 0 Interview Proximity Expression Relative orientation Contact Eye Contact Individual gestures Voice Existence of adapters AssessmentD a two way street Both client and social workers are sizing each other up Planning guring out what to do 0 Case pan a contract to develop a collaborative plan to get them where they need to be Short and long term goals lmplementation the actual performance part of the plan they created with the social worker Evaluation monitor implementation of the pan and ensure that it is working Advocates of Change De ne the problem Recognize the strengths Developing awareness Lobbying and negotiation Generating and consuming research Facilitating social mobilization Planning events 70 of all mental health counseling comes from social workers Chapter Four Advocacv in Social Work Watch the movie For the Love of a Child Advocacy engaging in purposeful actions that will help people advance their rights opportunities cause and human dignity Hallmark of social work Types of Advocacy Case Advocacy strategies used to attain and secure needed bene ts or services for individualcase basis individuals and families 0 Absolute Needs the basic goods and services that support human survival in the short term O 0000 Food Water Shelter Medicare Sanitation Cause Advocacy creating social structural change by seeking bene ts and services that support human survival in the short term 0 Got a boost from social work a cause and function 0 Makes social workers knowledgeable about social action creating social change 0 Relative Needs long term needs that promote human dignity and wellbeing 0 Employment 0 Equal status in the law 0 Education 0 Opportunity Social lnequality when some people have more access to society s bene ts and resources 0 Some inequality is normal Client SelfDetermination consumers of services make decisions and choices based on their will and value orientations Self lnterest focus on one s own bene t Individual Bene t versus Community Bene t Individual reigns supreme perspective equates individual gain and interest with the common good and is useful for seeing how case advocacy has limitations Community reigns supreme perspective the attitude of placing selfinterest in a context of promoting policies and practices for the common good Porter Lee39s writings helped shape social work by Encouraging professional education and training 0 Moving from simple helper to advocate of change Objectivity Cost of Advocacy all real intangible and unintended ways that undertaking advocacy can deplete resources and could work against the cause 0 Bad publicity False hope A Model for Dvnamic Advocacv Advocacy practice and policy model represents a change process that occurs in a sequential fashion and is directed at both the problems and strengths of individuals families communities or organizations Theoretical Framework for the Advocacy Practice and Policy System Theory 1 Ecological F A PM gt Empowerment Th ory 39erspective Pe Supports ethical behavior 0 Action plan must re ect the interest of clients and connect individual needs to systematic change The intervention Process and the Advocacv Practice and Policv Model Problems Micro Engagement Assessment Strengths Macro Implementation Evaluation V Feedback Loop V CHAPTER FIVE POVERTY AND INEQUALITY Poverty being without basic needs or resources such as money and all that it buys food housing transportation medical care and clothing Involves more than money Human rights and social justice Social workers look beyond the symptoms 0 Understand the root of poverty 0 Engage in efforts to reduce poverty and inequality Crippling effect on life conditions Approaches to poverty 0 Role of government 0 Distribution of wealth Measures of Povertv Absolute poverty quantitative measure Relative poverty a person39s wages with the norm of an average determine if that person is experiencing poverty 0 Poverty linethresholdindex an amount that is set by the government that is adjusted each year due to in ation 0 Eligibility for bene ts and services 0 Provides data 0 Provides a picture of poverty trends over time 0 Means testing attempts to reduce some income inequality through the provision of services and bene ts but in no way does it attempt any major redistribution of wealth Povertv guidelines are another federal poverty measure that are a simpli cation of the poverty thresholds are used to determine nancial eligibility for certain federal programs and for other administrative purposes 0 Vary from state to state Povertv and Inequalitv Wealth the accumulation of valuable resources an possessions that ow into the household each year lncome a wage for work provided and assets accumulated over time Unequal distribution of wealth and income 0 Growing inequality in distribution of wealth and income 0 Wealth more unequal than income 0 Majority of wealth owned by about 10 of population Decline in opportunity for poor people 0 Income growth in primarily within the top 1 o Unequal distribution of income social inequality 0 Housing and health 0 Low income mobility The Face of Povertv Poverty not evenly distributed across population 0 Women 0 Feminization of poverty 0 Women earn 77 cents on the male dollar 0 Single and divorced mothersmore likely to responsible for children 0 People of Color 0 History of prejudice and discrimination limits economic opportunity and upward mobility o Concertation in certain neighborhoods 0 The majority of the poor are white but people of poor are disproportionately poor 0 Children 0 Re ects the feminization of poverty 0 24 of the total population but 36 of the poor population 0 Varies substantially by race Homeless People 0 Increase in homelessness in past decade 0 Often a temporary situation 0 Re ective of inequality Social Service Programs 0 Early approaches 0 Colonial period re ected Elizabethan Poor Laws 0 New Deal Social insurance payroll deductions Public Assistance deserving poor 0 Temporary Assistance for Needy Families TANF o Replaced aid to families with dependent children 0 Provides states with block grants 0 Community service or vocational training 0 Medicaid o Added to the social security act of 1965 0 Provides federal matching funds to states to cover the costs of medical care and services for low income people including Children children39s health insurance program CHIP Nondisabled adults Pregnant women Individuals with disabilities Older adults 0 Supplemental Security Income 0 65 years old or individual with disability 0 Funding from federal revenues 0 Uniform eligibility standards and bene ts across all states 0 Healthy 0 Originally known as WIC 0 Women and their children at nutritional risk 0 Vouchers to use at authorized food stores 0 Supplemental nutrition assistance programs 0 Formerly known as the food stamp program 0 Nearly half of SNAP participants are children 0 More than 40 live under the poverty line EarnedIncome Tax Credit 0 Lowwage workers keep more of their annual earnings Wage supplement for people in lowwage jobs Can decrease poverty for working families Offsets burden of social security taxes Provides an incentive to work 0 Administered by internal revenue service 0 Public Housing 0 Department of Housing and Urban Development HUD 0 Section 8 housing 0 Rent is 30 of a person39s monthly aftertax income 0 O O O Advocacy on Behalf of the Poor 0 Current Trends in Advocacy for the Poor 0 Social constructs perceived social realities Belief people are poor because they are lazy Social welfare policies punitive less resource distribution Beliefpoverty result of failures in economypolitics Social welfare policies emphasize equality o Microlevel work to change individual situation connected to advocacy for macrolevel change 0 Dynamic Advocacy and Poverty Personal responsibility 0 Social responsibility 0 Social and Economic justice Micro and macro level advocacy o Supportive environment 0 Human needs and rights 0 Political access 0 The Cycle of Advocacy Envision improved conditions Identify strengths and leadership skills of clients Mobilize clients to vote and participate in political campaigns Help powerless groups women children people of color people with special needs and poor people improve their resources and opportunities Your Career and Poverty PoHcylevel o Advocate and lobby for regulations and programs that enhance the wellbeing of people with little resources Alleviate the pain of poverty and inequality 0 Keep the needs and wants of others in your thoughts and display concern in your actions CHAPTER 6 CHILD AND FAMILY WELFARE Social Work with Families Family a social unit where people form relationships and make a commitment to live together as a de ned family group and provide for the group39s social emotional and economic needs including care of children Evolved over time 0 Diversity of family forms Multiple challenges 0 Domestic violence 0 Child abuse 0 Poverty Advocacy for legislation policies and programs 0 Rights and needs of children and family members Today39s Families 0 Changing de nition of family has changed 0 Social unit containing two or more members 0 Family structure 0 Kinship common ancestry marriage adoption 0 Nuclear family one or more parents with children 0 Extended family in addition to parents and children other relatives live in the same household Diverse Family Forms Divorce Separation Blended families Single parent households Gay marriage and parenting Cohab a on Family Problems 0 Social workers 0 Intervene with various familybased problems 0 Advocate for programs and policies 0 Aim to strengthen and enrich family functioning 0 Promote the rights and safety of children 0 Domestic violence 0 Typically an issue of power and control Child Maltreatment 0 Abuse and victimization of children 0 Previously considered private matter 0 Now viewed as a public matter 0 Child welfare 0 Practices policies services to promote child wellbeing and safety 0 Child Protective Services 0 Programs that respond to reports of child maltreatment Types of Child Maltreatment Physical Abuse hitting punching shaking throwing burning choking stabbing Sexual Abuse touch penetration exposure Neglect fail to meet basic needs including physical emotional educational medical Psychological maltreatment public embarrassment verbal cruelty intimidation threats deprivation of love Child Welfare Services 0 Public child welfare agencies 0 Typically serve large numbers of people 0 Offer a variety of programs 0 Less costly clients 0 Countybased departments of social or human services Adoption family life education foster care child protective in home family centered intervention residential services 0 Private child welfare agencies Usually focus on speci c problems and subpopulations o Rely on pay for service 0 See fewer clients 0 Less bureaucratic in nature 0 When is it abuse 0 Parental versus children rights 0 Do parents have the right to raise and discipline their children as they see t 0 Parents may attempt to justify child maltreatment as a parental right 0 A Global Context for Child Protection 0 Challenge of establishing shared de nition of quotabusequot 0 Religious beliefs may include spanking Key Child and Family Services 0 Child protective services Familybased services 0 Family preservation services Family foster ca re Family reuni cation services Adoption services Residential Care Independent Living Services Intensive Social Policy and Legislation National school lunch programs 1946 Supplemental social insurance 1972 Child abuse prevention and treatment act 1974 Education of all handicapped children act 1975 Personal responsibility and work opportunity reconciliation act 1996 Public Attitudes Institutional or primary view of social welfare 0 Humans are inherently good but are confronted with challenging needs and circumstances 0 Society as a whole has a responsibility to hop people by providing economic and social support services 0 Residual or secondary view of social welfare 0 People should be responsible for their own lot in life an don39t expect government intervention 0 Social welfare programs should be extremely limited and should only provide a safety net Social Work in Schools 0 Multiple roles 0 Counseling students 0 Intervene with family members 0 Work with school officials community leaders 0 Identify ways to enrich social conditions for student success 0 Certi cation licensure advanced training 0 National and state policy has promoted the credentialing of professional in school settings Challenges Facing School Social Workers Bullying 0 Up to 41 of students involved as victims bully or both 0 Bully prevention programs 0 Poor and homeless students 0 Poor attendance and grades high dropout rates McKinneyVento Homeless Assistance Act 0 Students with physical and mental challenges 0 Individuals with disabilities education act IDEA Teen Pregnancy 0 Interrupts attendance extracurricular participation School Funding 0 Schools are funded with a combination of state and local tax dollars 0 0 Students living in af uent areas are able to attend highly sought after primary and secondary schools Students living in economically disadvantaged areas disproportionately from racial and ethnic minorities are relegated to struggling schools systems Issues of Diversity Age Class Race Ethnicity Gender Sexual orientation lntersecting of diversity Advocacy for childrenfamilies Child welfare advocacy movement 0 O Grew during the 197039s Strengthened services and programs Identi ed major themes O 0000 Child development is in uenced by interaction with families And transactions with other social systems Society has a responsibility forobligation to children Child and family services are a right and entitlement Children have rights in relationship to the social systems affecting them Current Trends in Advocacy for Child and Family Services 0 Advocacy as interdisciplinary collaboration 0 Children s advocacy centers Decrease trauma Improve ef ciency of investigative process 0 Dynamic Advocacy and Family and Child Welfare 0000 Social and economic justice Supportive environment Human needs and rights PoHUcalaccess Your Career and Family and Child Welfare 0 Use of Data 0 Program evaluators o Advocates and educator 0 Community organizers Types of Data 0 Qualitative Descriptive in nature Case studies focus groups observation interviews 0 Quantitative research Numbers statistics Surveys checklists CHAPTER 7 HEALTH CARE AND HEALTH CHALLENGES Social Work and Health Care 0 Negative social interactions stigma affect health Broad range of knowledge 0 Awareness of medical practices health related resources 0 Prevention and intervention Disparities in health care access and quality 0 Multiple settings 0 Hospitals schools government agencies public health local communitybased organizations What is Health 0 World Health Organization quothealth is a state of complete physically mental and social wellbeing and not merely the absence of disease or infirmityquot Achieving good health is a matter of attending to a person s physical mental and social situation 0 Disease disability death 0 Result of interconnections between human biology lifestyle environmental and social factors Life Expectancy 2013 NIH Study 0 17 high income counties 0 US had almost highest prevalence of infant mortality heart and lung disease sexually transmitted infections adolescent pregnancies injuries homicides and disability 0 US at the bottom of the list for life expectancy Average Life Expectancy in United States 0 190047 years 0 Todayover 77 years Threats to Americans39 Health 0 Lifestyle threatens health and longevity 0 Chronic illness Lasts for more than here months controlled but not cured Social workers educate patients who are health illiterate explain complicated medical jargon used by physicians connect people 0 community resources 0 Heart disease Kills over 385000 people annually Costs the US 1089 billion each year 0 Stress Affects a person39s thoughts feelings mood and body Leads to health problems Reduces ability to think logically and reasonably Social workers help clients develops stress management Health Disparities Socioeconomic status is related to o Stressful and harmful living conditions disease lack of access to adequate health care 0 Access to fruits and vegetables vs highly processed cheap food 0 Health disparities 0 Availability and quality of health care 0 Disease rates and severity 0 Overall health Health Care Policy in the US Health insurance 0 Private insurance employer or selfpay 0 Government supported Medicare Medicaid TRICARE Children s Health Insurance Program CHIP Veterans Health Administration VA 0 Affordable Care Act 0 No denial for preexisting conditions 0 Children can stay on parent s policy up to age 26 o By 2018 preventive care no copayments deductibles Health Care Trends Continuous Quality Improvement CQI Integrative Medicine Slow Medicine Prevention and Wellness Recovery Rehabilitation and Resiliency In ammation Managed Care 0 Electronic medical Records Health Care Social Work Services Advocating for patients and family caregivers Assessing needs Care and case management Educating and counseling lntervening to promote health prevent disease Address disparities and barriers to health care Providing information and referrals History of Health Social Work 0 1905 Massachusetts General Hospital 0 Dr Richard Cabot hired medical social worker lda Cannon 0 Created the rst hospital social work department 0 First social work specialty group 0 Effect of poverty on individual and public health outcomes 0 Humanize people39s hospital experiences 0 Coordinates community resources 0 Public health and social concerns 0 Tuberculosis sexually transmitted infections sanitation 0 1935 Social Security Act 0 Social worker Grace Abbott helped write Social Workers39 Roles NAWS Standards for social workers in health settings 0 Services across the lifespan 0 Neonatal intensive care units to long term care settings 0 Purpose 0 Help people and families to cope with illness or injury 0 Prevent negative effects on health of emotionalsocial issues 0 Address service delivery shortcomings Roles crisis intervention grief counseling dischange planning chemical dependency evaluation mental health assessment ethical decisionmaking counseling facilitating support groups Health Care Settings Emergency Room Trauma Urgent Care Centers Hospitals and Acute Care VA Hospitals Home Health Care Longterm Care Hospice Endof Life and Palliative Care Rehabilitation Services 0 Clinics 0 Public Health Services Diversity and Health Care 0 Health disparities unequal distribution of social political economic and environmental resources 0 Social workers advocate for minimizing health disparities reducing stigma of health problems Age Race and Ethnicity Class Gender Sexual Orientation Intersections of diversity Advocacy on Behalf of People with Health Care Challenges 0 Social and economicJustice 0 Insurance 0 Hospitals 0 Outpatient services 0 Veteran39s health care system Supportive environment 0 Accessing health care can be challenging in remote areas 0 Human Needs and Rights 0 Personal choice ethical decisionmaking resources 0 Understanding and respect 0 Health disparities stigma discrimination Political Access 0 Health care related policies are political 0 Micro level access to health services health literacy Your Career and Health Care 0 Expected 25 increase in health social workers NASW 14 of social workers practice in healthrelated settings expected by 34 0 Health social workers need 0 Knowledge of medical terminology 0 Understanding of the roles of all healthcare team members 0 Understanding of the biopsychosocialcultural and spiritual aspects of illness and health Crisis intervention skills 0 Shortterm counseling skills 0 0 Knowledge about care culturally competent planning and discharge planning processes and community resources Chapter 8 thsical Challenges and Sumoortive Services Over 54 million Americans about one out of every ve individuals have a disability Accidents genetic diseases viruses and illnesses rendered many people disabled to a different degree They often face limitations stigma discrimination abuse as well as poverty and a loss of dignity Laws for disability rights disability activism and expanded coverage of disability issues have helped to increase awareness and knowledge yet old attitudes experiences labeling language and stereotypes exist in school settings the workplace health care settings and within families Challenging issues that continue to affect quality of life for individuals with disabilities include accessible transportation affordable health care discrimination employment opportunities and housing In following the NASW Code of Ethics social workers support the worth and dignity of all people including those with disabilities De nitions of Disabilitv Disability is a temporary or permanent reduction in function that can include physical or healthrelated psychosocial sensory mental or psychiatric cognitive or learning neurological intellectual and developmental disabilities In order to qualify for legal protection 0 A person may be disabled if she or he has a physical or mental condition that substantially limits a major life activity such as hearing learning seeing talking or walking For adults this is re ected in whether they can engage in work and for children this is re ected in their ability to engage in age appropriate activities 0 A person may be disabled if she or he has a history of a disability such as cancer that is in remission A person may be disabled if she or he is thought to have a physical or mental impairment that is not transitory lasting or expected to last six months or less and is severe and interferes with normal activities of living The condition must have existed for at least twelve months Types of Disability People can experience more than one disability or cooccurring disabilities An example of cooccurring disabilities is when a person with an intellectual disability may also have vision and neurological impairments Categorical disabilities have a signi cant sensory impairment or mental illness and have developmental delays They are likely to need longterm care and are eligible for special education Functional disabilities limit a person39s ability to perform physical activities and they often can be ameliorated with assistive devices or technology 0 Developmental Disabilities a severe chronic disability that is manifested before the age of 22 and is likely to continue inde nitely It may occur because of a genetic predisposition or an issue before during or after the person is born 0 Autism generally appears before age three and affects the normal development of the brain in areas of social interaction communication skills and cognitive functions People with autism have trouble in non verbal and verbal communication social interactions and leisure or play activities 0 Cerebral Palsy a chronic condition affecting control of the body andor limb movement muscle tone and coordination 0 Down Syndrome chromosomal disorder caused by the presence of an extra 21St chromosome It is associated with some impairment of cognitive ability and physical growth as well as facial appearance 0 Epilepsy a brain disorder that causes people to have recurring seizures Epilepsy is more prevalent than autism cerebral palsy multiple sclerosis and Parkinson39s disease combined Globally approximately 65 million people have epilepsy and nearly 80 of cases occur in developing countries 0 Fetal Alcohol Syndrome a pattern of physical and mental defects which develop in some unborn babies when their mom drinks alcohol or use drugs during pregnancy It is one of the most common causes of intellectual disability It may also include growth de ciencies central nervous system problems poor motor skills mortality malformations of the skeletal system and major organ systems heart and brain and problems with learning memory social interaction attention span problem solving speech andor hearing Their facial features may include small eyes short or upturned nose thin lips and at cheeks o Fragile X Syndrome the most common cause of inherited mental incapacities The impact can range from learning disabilities to more severe cognitive or intellectual disabilities 0 Prader Willi Syndrome symptoms include short stature poor motor skills weight gain underdeveloped sex organs mild cognitive impairment and learning disabilities The section of the brain that controls feelings of fullness or hunger does not work correctly in people with PWS Their overeating leads to obesity Physical or Mobility Disabilities A physical condition that substantially limits one or more basic physical activities in life eg walking climbing stairs reaching carrying or lifting A mobility impairment describes any dif culty that limits functions of moving in any of the limbs or in ne motor abilities They can stem from multiple causes and be permanent intermittent or temporary The most common permanent physical challenges or disabilities are musculoskeletal impairments such as partial or total paralysis amputation spinal injury arthritis muscular dystrophy multiple sclerosis cerebral palsy and traumatic brain injury 0 Orthopedic problems diseases or defects of the muscles and bones that cause people to not be able to move normally 0 Hearing and vision problems a mild visual impairment can be corrected with glasses contact lenses or laser surgery The vision of others cannot be corrected and they become functionally limited or visually impaired quotlegally blindquot People s ability to hear also varies greatly The term hard ofhearing actually refers to people with mild to moderate hearing loss By comparison people who are deaf have moderate to severe hearing loss Individuals who are deaf may identify themselves as part of Deaf Culture 0 Epilepsy In addition to being known as a Developmental Disability epilepsy is also known as a seizure disorder that is considered a physical disability A seizure may involve a sudden change in a person39s consciousness level or sensory distortions Neurocognitive De cits any characteristics that block the cognition process The term may describe de cits in speci c cognitive abilities global intellectual performance or druginduced cognitivememory impairment Cognitive impairments may be congenital or caused by environmental variables such as brain injuries neurological disorders or mental illness 0 Intellectual Disability characterized by signi cant limitations both in intellectual functioning and in the ability to adapt to circumstances or adaptive behavior Previously known as mental retardation 0 Learning Disability neurological disorders that can make it dif cult to acquire certain academic and social skills 0 Traumatic Brain Injury usually results from a violent blow to the head or body or when an object like a bullet penetrates the skull Stigma and Discrimination against People with Disabilities People with physical neurocognitive and developmental disabilities experience discrimination and injustices Sometimes the discrimination is subtle and unconscious as when people talk over the head of an individual in a wheelchair Other times the prejudice and discrimination is blatant and intended Discrimination is often due to social stigma which is generally a quotstainquot on the way a person is perceived that leads them to be shunned by others The three forms include o visible or outer deformations like scars a cleft lip and obesity physical or social disability 0 deviations in personal traits like mental illness alcoholism drug addiction or having a criminal background 0 imagined or real traits of an ethnic group nationality or religion that are thought to deviate from the prevailing norm or quottribal stigmasquot Stigmatization can occur in multiple environments such as at work in health care in educational settings in the criminal justice system and in one39s own family 0 People who are stereotyped and stigmatized because of their disability begin to act the way that the people who are stigmatizing them expect them to act Stigma can also shape people39s beliefs and emotions leading them to feeling depressed or having low selfesteem Social Work and Disability Whether a disability is short term or long term social workers can help individuals navigate services resources and health care 0 Historical Background of Disability Services 0 Early colonists introduced the notion that those who were disabled along with children and newcomers should not be punished for failing to observe some of the laws 0 Following the Revolutionary War individuals with disabilities were often sent to almshouses prisons and asylums Treatments included including purging bleeding frights hard labor and immersion in cold water 0 While teaching Sunday school at a prison in Massachusetts Dorothea Dix observed that individuals with disabilities and mental illness were sometimes penned up together with criminals sometimes chained and naked She began advocating for them 0 Following World War I and World War II new forms of rehabilitation and adaptive technologies were identi ed and implemented 0 The League of the Physically Handicapped was formed after the Great Depression began promoting the idea that people with disabilities are entitled to the full rights of citizenship Deinstitutionalization 0 Public asylums were an alternative to prison but the living conditions continued to be wretched In the 19605 there was a movement to remove individuals with disabilities from public institutions and move them back into the community They were moved from institutions to community based group homes with support from community mental health centers 0 Independentliving centers began to appear in the late 19605 They promoted principles of selfdetermination and deinstitutionalization They are community agencies usually staffed by people with disabilities that use peer counseling and advocacy to assist others to live on their own 0 One unfortunate consequence was that many of these individuals ended up homeless o In 2009 the Department of Health and Human Services created the Community Living Initiative to develop and implement strategies that increase opportunities for Americans with disabilities to participate in community living 0 Americans with Disabilities Act O O O 0 Passed in 1990 to protect persons with disabilities from discrimination based on stigma The ADA de nes disability as any physical or mental impairment that substantially limits one or more major life activities such as caring for oneself performing manual tasks walking seeing hearing speaking breathing learning or working Individuals who are eligible for protection under ADA have a disability that substantially limits their ability to perform major life activities A fourstage framework categorizes the level of dif culty experienced by an individual ranging from least to most severe pathology impairment functional limitation disability The law places strict limits on employers when it comes to asking job applicants to answer medical questions take a medical exam or identify a disability The law mandates access and accommodations for individuals with disabilities such as ramps to public buildings communication access via closed captioning and sign language interpreters curb ramps parking spaces and Braille on elevator buttons Disability Social Work Practice Employment options when working with individuals with disabilities may include hospitals mental health organizations supportive rehabilitative services vocational rehabilitation and an employee assistance program resettlement programs for refugees sports clinics HIVAIDS clinics disaster relief the military or residential treatment centers Best practices when working with individuals with disabilities include be personcentered and involve people with disabilities in decisionmaking processes that directly affect his or her life facilitate access and respect in a person39s environment focus on helping the person and his or her support system cope well with challenging situations incorporate a strengthsbased and resilience oriented perspective to build on the person39s inherent strengths and resources 0 Person First Language Instead of describing people by their labels or medical diagnoses which devalues and disrespects them as people we use terminology that can foster positive attitudes about people with physicalneurocognitive challenges and developmental disabilities Emphasize the person not the disability For example we refer to a person with a disability rather than a disabled person By placing the person rst the disability is no longer the primary de ning characteristic of an individual but one of several aspects of the whole person 0 Services for Persons with Disabilities social workers are advocates educators clinicians facilitators group leaders and program developers They assist their clients with four speci c issues relevant to their condition Civil rights lncome support Education and rehabilitation Genetic counseling Diversitv and Disabilitv Age education and health can be impacted Class assistive technology can be expensive 0 Race and ethnicity may experience multiple forms of discrimination Gender high risk of abuse lower access to health care screenings Sexual orientation may feel marginalized in two communities Intersections of diversity multiple dimensions of difference Advocacv on Behalf of Pe0ple with Disabilities 0 Economic and Social Justice Resources are available but access to these resources and services is limited for individuals who do not have the economic means Stigma and discrimination are present in many work environments 0 Environmental Support Social workers can maximize client self determination and service provision for PWD by being consumercentered acquiring knowledge about resources and agency services and advocating for PWD across practice levels 0 Human Needs and Rights During institutionalization many individuals were deprived of civil rights Social workers advocate for individuals to have self determination Poitica Access Poiticay correct People First Language puts the person before the disability and describes what a person has not who a person is Social workers may help update or create brand new policies for corporations that cater to or employ people with disabilities You39re Career in Disabilities Social Work 0 Job availability for social workers is expected to increase with this population 0 Settings may include community nonpro t hospitals outpatient public or ambulatory care clinics inpatient forpro t hospitals transitional care rehabilitation units assisted living longterm care settings and home health care Skis needed include 0 understanding of the classi cation systems and diagnostic terminology 0 understanding of the roles of all vocational rehabilitation specialists 0 Understanding of health disparities and stigma 0 Understanding of the biopsychosociaIcultura and spiritual aspects of multiple types of disabilities 0 crisis intervention and shortterm counseling skills 0 knowledge about culturally competent assessment counseling and community resources Chapter 9 Mental Health Social workers are the largest providers of mental health services in the United States Mental health social workers are known as clinical social workers psychiatric social workers psychotherapists or behavioral health care specialists Mental health social workers may specialize in child adolescent adult or even older adult geriatric mental health as well as forensic social work counseling for persons with developmental physical or neurocognitive disorders or drug and alcohol rehabilitation They collaborate with a multidisciplinary team of psychiatrists psychologists and nurses Mental Health and Mental Illness De nitions of Mental Health Status 0 Mental health state of emotional wellbeing free from incapacitating con icts with an ability to make rational decisions and cope with environmental stresses and internal pressures 0 Mental illness disease that causes mild to severe disturbances in thinking perception and behavior They can signi cantly impair a person39s ability to cope with life39s ordinary demands and routines Normal Versus Abnormal Mental Health 0 Normal Mental Health Accurate perception of reality Autonomy and independence Capability for growth and development Environmental mastery able to meet the varying demands of daytoday situations Positive friendships and relationships Positive view of the self 0 Abnormal Mental Health Not all symptoms and problems in living are caused by mental disorders Mislabeling can be harmful Use person rst language quotman with Bipolar Disorderquot vs quothe39s Bipolarquot Mental Health Disorders and the DSM5 0 Diagnostic and Statistical Manual of Mental Disorders used to classify and diagnose mental disorders Diagnostic codes are used for insurance reimbursement Fifth version DSM5 published in 2013 by the American Psychiatric Association Includes some changes such as combining Substance Abuse and Dependence Has received some criticism such as reducing criteria for some diagnoses which makes it easier to get prescriptions Categories of Disorders Neurocognitive Disorder Dementias such as Alzheimer39s which lead to loss of mental functions including memory loss and a decline in intellectual and physical skills Personality Disorder Inability to adapt to change leading to distress Unhealthy patterns of behaving feeling interacting and thinking Ten personality disorders are classi ed in the DSM 5 Borderline Antisocial Narcissistic Histrionic Obsessive Compulsive Avoidant Dependent Paranoid Schizoid Schizotypal Anxiety Disorders Phobias involve experience extreme fear or dread from a particular object or situation Panic disorders involve sudden intense feelings of terror for no apparent reason and symptoms similar to a heart attack Depressive Disorders Can involve loss of ability to concentrate think clearly or make simple decisions Bipolar Disorders Fluctuations between manic episodes and depressive episodes Schizophrenia Spectrum and Other Psychotic Disorders A serious disorder that affects how a person acts feels and thinks Schizophrenia is believed to be caused by chemical imbalances in the brain that produce multiple symptoms including delusions hallucinations impaired reasoning incoherent speech and withdrawal Eating Disorders Anorexia is selfstarvation while bulimia involves cycles of bingeing consuming huge amounts of food and purging Abusing laxatives or selfinducing vomiting Neurodevelopmental Disorders Usually First Diagnosed in Childhood and Adolescence Includes AttentionDe cit Hyperactivity Disorder ADHD Autism Spectrum Disorder and ODD Oppositional De ant Disorder Posttraumatic Stress Disorder PTSD Symptoms that appear when someone has experienced trauma eg combat rape torture battery or catastrophes like res accidents oods earthquakes hurricanes Evolution of the Mental Health System Institutionalization and Deinstitutionalization O O O Colonial America jailed rst hospitals for mentally ill in 1773 Long term hospitalization of the quotinsanequot restricted rights 19605 in connection with Civil Rights Movement deinstitutionalization was implemented Large residential institutions were closed and mental health care shifted to outpatient treatment in clinics shortterm hospitalization and supervised group homes in the community Resulted in increase in homelessness of individuals with mental illness Medicalization of Mental Illness 0 Conceptual shift from labeling disorders as quotbadnessquot to regarding people with mental disorders as quotsickquot or a quotsicknessquot Reduction of stigma associated with mental disorders Creates expectation that a therapy can be developed to treat or cure the disorder 0 Social Work Perspectives O Dorothea Dix mid18005 heightened awareness of inhumane treatment inside institutions that housed people with mental health challenges disabilities and behavior problems 0 Mary Richmond early 19005 the founder of social casework showed how poverty was closely linked to mental health personality development and effective coping skills 0 Ida Cannon early 19005 rst social worker employed by Massachusetts General Hospital to work with clients with mental health problems 0 World War I 1914 1918 social workers in hospitals and clinics helped soldiers with physical and psychological problems like quotshell shockquot and trauma Subsequently hospital based medicalhealth social work started to grow 0 Freudian theory 19205 People begin seeking counseling services and mental health assistance Child guidance clinics and juvenile court systems opened to address children with emotional problems and mental health disorders In 1922 in St Louis the rst clinic staffed by a team that included a psychologist a psychiatrist and a social worker was opened and this model evolved into what is now called a quotmental health teamquot 0 World War II 1939 1945 Veterans Administration Hospitals became the largest recruiter of professional social workers a trend that con nuestoday 0 National Mental Health Act 1946 rst major piece of approved mental health legislation 0 Mental Health Movements o Moral Treatment 18005 rejected using manacles chains and restraints believed people in asylums should be treated humanely like children rather than animals But asylum patients were still thought to have something wrong with them de cits that needed to be overcome 0 Mental Hygiene Movement 19205 strived to reform institutional care establish child guidance clinics and educate the public about mental health 0 Mental Health Movement 19405 supported community mental health centers behavioral approach goal to treat people and change society 0 Legal Advocacy Movement 19605 Supreme Court ruled that mental illness and need for treatment were insuf cient to justify involuntary con nement thereby supporting deinstitutionalization However little was done to increase dignity and personal choice 0 Deinstitutionalization Movement 19605 to 1970s relocated people from state hospitals back into the community 0 Consumer Movement current National Alliance on Mental Illness NAMI supports research education social policy and political activities that help to improve access to communitybased services 0 Mental Health Parity and the Affordable Care Act 0 Mental Health Parity Act 1998 Established mental health parityequality with medical health policy A person who is diagnosed with a mental disorder should receive the same level of professional care as a person diagnosed with a physical disorder and mental health professionals should be reimbursed for their services as physicians and other medical personnel are 0 Affordable Care Act Emphasizes several emerging models for mental health care Integrated care care coordination for people with psychiatric disorders that includes general medical illness and substance use disorders Medical home a patientcentered approach rather than a providercentered approach the health care providers work collaboratively with the mental health team and the patient39s family Accountable care organizations Groups of physicians hospitals and other health care providers join together to provide coordinated care to their Medicare patients Social Work Practice in Mental Health 0 Social Work Roles in Treatment 0 Licensed Clinical Social Workers LCSWs assess diagnose and treat all forms of mental disorders including serious mental illnesses such as major depression schizophrenia and substancerelated disorders 0 Mental health social workers often help families cope with trauma loss and addiction 0 Mental Health Settings 0 Community mental health programs Overseeing assessments interventions and evaluations of people and programs related to mental health services Disaster relief programs Planning and implementing international and humanitarian relief and response efforts to victims of natural and other disasters Hospitals and skilled nursing facilities Facilitating intakes discharge planning and monitoring of ongoing acute and chronic care needs Military and veteran services Providing direct service supervision and administration research and policy formulation Rehabilitation programs Supporting clients to recover and rehabilitate from mental health and cooccurring disorders Schools Helping teachers and educational professionals to evaluate students39 behavior at school in order to provide early intervention sharing information with students teachers and administrators about mental health and mental illness guiding schools toward funding to expand mental health services Private practice Employee assistance programs Counseling employees with personal problems and workplace issues Inpatient and outpatient clinics Helping clients adapt to signi cant lifestyle changes related to a loved one s death disability divorce or job loss providing substance abuse treatment helping people who experience anxiety depression a crisis or trauma 0 Mental Health Literacy O 0 Ability to recognize disorders and obtain mental health information Interventions to increase mental health literacy may include public campaigns agency or schoolbased programs online interventions and information sharing through social media 0 Digital Mental Health Information and Therapy 0 Some people use ecounseling and etherapy for treatment This can be effective for people with PTSD or people who live in rural areas where local support is not available o Other options involve using avatars or comic chat in which participants take on the role of a comic character in a comic strip 0 Many people nd support and information in peer support sites where people sharing similar diagnoses can compare notes Diversitv and Mental Health 0 Age Mental health problems can occur at any age 0 Class The disproportionate rates of mental health problems in the lower social class show that mental health is associated with social inequality 0 Race and Ethnicity Although African Americans have a lower rate of serious mental illness than the overall average for Americans African Americans are more likely than their white counterparts to be diagnosed with schizophrenia NonHispanic blacks are 40 less likely than nonHispanic whites to experience depression during their lifetime 0 Gender Women in the US are 70 more likely than men to experience depression during their lifetime 0 Sexual Orientation Lesbian gay and bisexual young people are at an increased risk of mental health problems particularly on measures of suicidal behavior and multiple disorders Advocacv on Behalf of Peoole with Mental Health Issues 0 Economic and Social Justice insurance impacts availability of care 0 Environmental Factors residence in uences mental and physical health 0 Human Needs and Rights demonstrate respect with person rst language 0 Political Perspectives policy issues include urban vs rural services cost of service continuity of care and availability of inpatient services Your Career in Mental Health Social Work 0 Job growth for mental health social workers will be much faster than the average for all careers through 2020 0 Mental health parity allows more people to be eligible for mental health coverage under their insurance plans 0 Clinical social work is the higher end of the pay scale for social workers


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