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Newsletter for Arizona's Social Workers
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Volume 2013; Issue 1
Join us at Branch 1’s Social Work Month Celebration and Buffet Breakfast from 7:30 am to 9:30 am on Friday, March 1, 2013 at the Phoenix Airport Marriott, 1101 N. 40th Street, Phoenix, AZ 85008. Chandra Crudup will emcee our event as we celebrate our profession and honor our Branch I award recipients:
Social Worker of the Year: Adrienne Decker-Delgado; Lifetime Achievement Award: JoAnn Del-Colle; Emerging Leader of the Year: Jessica Begay; Citizen of the Year: Kim Williams; Public Elected Official of the Year: Senator Anna Tovar.
We will also welcome guest speaker and author Karla Kay, who will present Karla Kay: Loss and Grief - a Story of Resilience and Hope. The cost of our Branch 1 Awards Breakfast is $25 each; $20 per student.
Register online here: http://www.naswaz.affiniscape.com/cde.cfm?event=393708_______________________________________________________________________________________
Tucson-area social workers will gather at the Branch 2 Social Work Month Awards Luncheon from noon to 1:30pm on Friday, March 29, 2013 at The Inn Suites, 475 N. Granada, Tucson, AZ 85701 Join us for lunch as we celebrate Social Work Month with our Branch 2 Award Winners:
Social Worker of the Year: Anna Harper; Lifetime Achievement: Patti Caldwell; Citizen of the Year: Judge Karen S. Adam; Community Service Award: Arlene Lopez; Emerging Leader: Patrick Scott
Cost of the luncheon is $35 per person, $30 for student/retiree.To register online please click here: http://www.naswaz.affiniscape.com/cde.cfm?event=399816________________________________________________________________________________________
Branch 3’s Social W ork Month Awards Celebration will be from noon to 1:30pm on Monday, March 11, 2013 at the NAU Campus, Babbitt Building, 1900 S. Knoles Drive, Flagstaff, AZ 86001. We will be honoring our Branch 3 Award Winners: Social Worker of the Year: Carol Marquis-Breckenridge; Emerging Leader: Kelly O’Donnell; Citizen of the Year: Becky White.
Please bring your own lunch. Cookies, coffee, water, and lemonade will be provided. Join us for an overview of the Projects for the Assistance in Transition from Homelessness (PATH) Program, presented by Catholic Charities of Flagstaff, for one CEU.
For more information or to register, please click here: http://www.naswaz.affiniscape.com/cde.cfm?event=385592Branch 3 will also hold a Social Work Month Brunch on Saturday, March 30th at Dora’s on Beale St. in Kingman. The cost
is $9 per person cash at the door, but please register here http://www.naswaz.com/cde.cfm?event=406828 ahead of time so we can get an accurate number to the venue in advance.
Branch 3’s Navajo Hopi Nations Unit will hold a Social Work Event in March as well. Please look to www.naswaz.com and our Calendar of Events for the latest news on this event and all upcoming events.
Gather with fellow Social Workers in your area to celebrate Social Work Month
Featured in this issue
Who to ContactTo get involved in NASWAZ, please contact any of the following:
BRANCH 1(Gila, LaPaz, Maricopa,Pinal, & Yuma Counties)
Patrick ShockleyEvie Lopez
BR1 Co-chairsemailto:[email protected]
BRANCH 2(Cochise, Graham, Greenlee, Pima
& Santa Cruz Counties)Josefina Ahumada
BR2 Chairemailto:[email protected]
BRANCH 3(Apache, Coconino, Mohave
& Navajo Counties plusPayson, Sedona & Cottonwood)
Rhonda TalaswaimaKatherine MeyerBR 3 Co-Chairs
emailto:[email protected]
BRANCH 4(West Yavapai County—Prescott & sur-
rounding area)Deborah Nelson
BR 4 Chair emailto:[email protected]
STATEWIDEPACE Chair
Angela Schultzemailto:[email protected]
PUBLIC POLICY ChairLindsay Simmons
emailto:[email protected]
CCNLI (Nominations Chair)Judy Walruff
NASWAZ Chapter OfficeJeremy Arp
Executive Director(480) 968-4595
emailto:[email protected]
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Board of Directors
Suzanne SchunkPresident
Tammy Abbott-ThielVice President
Eric AlfreySecretary
Connie MitchellTreasurer
Branch 1Patrick ShockleyEvie LopezCarol LopinskiLaura MastersTim SchmaltzLindsay Simmons
Branch 2Josefina AhumadaPatti DorganJudy Pike
Branch 3Katherine MeyerRhonda Talaswaima
Branch 4Deborah NelsonOpen Position
BSW Student RepCarlos Forcadilla, Jr.
MSW Student RepSam Chates
Password ProcedureFor your first log in, you will use the following information to log in:User Name: The user name is your first name and your last name with no spaces in between. (ie. JaneDoe) *Please note that this is the first name in your member record. If your NASW membership has you listed as “H. Jane Doe”, then “H” is your first name for the purposes of this log in. (ie. HDoe) Once you log in the first time, you can set your preferences to change your user name to whatever you wish.
Password: naswaz
Once you have logged in, the website will direct you to choose a user name and password that you can remember.
Social Work Month Events........................................1Executive Director’s Corner......................................3President’s Pen..........................................................4CE Series Workshops and Registration.....................5AZBBHE Stakeholders Update................................5Career Opportunities and Job Fair............................6Upcoming Branch Events.........................................7Legal Issue of the Month..........................................7Public Policy Update................................................8DSM-5 Overview.................................................9-12Online CE Options...................................................13Health Reform Facts...........................................14, 15
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The Executive Director’s Cornerby Jeremy D. Arp, MSWNASWAZ Executive Director
March is Social Work Month!Each year, NASW Chapters around the country
honor our colleagues in March. Social Work Month provides us a unique opportunity to reflect on the accomplishments and impacts of our profession. This year, our Branches will host Social Work Month Celebrations honoring colleagues in the categories of Social Worker of the Year, Lifetime Achievement Award, Public Elected Official of the Year, Citizen of the Year, and Emerging Leader of the Year. Social Work Month Activities include:
March 1, 2013 PhoenixMarch 7, 2013 Social Work Appreciation Event
hosted by HOV and other sponsors in ScottsdaleMarch 11, 2013 FlagstaffMarch 29, 2013 TucsonMarch 30, 2013 KingmanMarch 21, 2013 Branch 1 Networking Meeting in
TempeMarch 22, 2013 Social Work Career Seminar and
Job Fair presented by NASW-AZIn addition, we have planned our continuing
education workshops through June 2013. Please check our Chapter Event Calendar for events near you. Do you have an idea for a continuing education workshop, or would you like to present as a speaker for NASW? Please contact our office at [email protected] with suggestions and inquiries.
Legislative ActivitiesOur Public Policy Committee continues to plan
to implement Social Work Days at the Legislature on February 21 and February 27. These events offer an opportunity for social work professionals and students to attend hearings at the Capitol, learn about the legislative process and points where they as constituents can influence lawmaking in Arizona.
We’re excited to support efforts to expand Medicaid coverage of Arizona’s most vulnerable and full funding for CPS.
NASW has worked over the last year with a stakeholder’s group on changes to the Arizona Board of Behavioral Health Examiners. This has culminated in a legislative proposal, SB 1374 (behavioral health examiners board) sponsored by Senator Barto. SB 1374 makes structural changes to the BBHE, including the removal of administrative barriers to licensee applicants in Arizona. We’ve also worked hard to suggest language that makes reciprocal licensing easier for those moving to Arizona. NASW weighed in support of the bill in the Senate Health and Human Services Committee on February 13th. Check our website for updates as the bill makes its way through the process at http://www.naswaz.com under “Chapter News.”
NASW Legal ResourcesNASW and the Legal Defense fund continue to
offer resources to members. Please check the LDF series including Legal Issue of the Month, Legal Briefs Filed by NASW, General Counsel Law Note Series, and the Social Work Ethics & Law Institute (SWELI). These national resources are free to members, and offer guidance on complicated legal issues facing today’s social worker.
LeadershipOur Chapter Committee on Nominations and
Leadership Identification continues to seek qualified members for our Board of Directors. Leadership opportunities include branch representative and student representative at the BSW and MSW levels. Please check out our qualifications online at http://www.naswaz.affiniscape.com/displaycommon.cfm?an=1&subarticlenbr=25
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The President’s PenBy Suzanne M. Schunk, LCSWNASWAZ Chapter President
2013 is well on its way and, with it, comes a new theme for social workers nationally: “Weaving Resiliency and Advocacy.” As I reflect upon the events of the past couple months and the issues facing our country, I find this theme to be exactly right.
We need resiliency in the face of the trauma and loss in Newtown, CN; the memory of our Tucson Tragedy; and all of the countless other acts of senseless horror and death across our nation—both the large ones that make the news and the daily small ones that are occurring throughout the state and country but about which we rarely hear. Even today (1/31/13) in Phoenix, we mourn the second life lost to a gunman who opened fire yesterday at a law firm.
We need resiliency as we listen to the politicians, who argue endlessly about gun ownership, gun control, Constitutional rights, mental illness, etc. while sidestepping the hard work of truly addressing the issues.
We need resiliency as we continuously deal with the traumas and struggles faced daily by the persons we serve—worsened in the past few years by drastic cuts in services throughout the health and human services safety network: services to address domestic violence, mental illness, substance abuse, child and adult abuse, homelessness, poverty, disability, and so many types of suffering.
We social workers know about resiliency, healing, and changes that make a difference in people’s lives. We know how to work with individuals, families, and systems to confront issues and find solutions. And a large part of all of that is the power of advocacy. It takes resiliency to get up each day and advocate for the causes that matter. And it takes advocacy to move from resiliency to change.
Just yesterday, I was deeply moved to see Gabby Giffords at the Legislature combining resiliency and advocacy in such a powerful way as she and husband Mark Kelly testified about the need for a ban on assault rifles and other aspects of gun safety and reform. She embodied the spirit of resiliency and advocacy that we social workers practice every day.
NASW-AZ has many important opportunities for you to advocate for real and lasting change for the persons we serve during this current legislative session. You will receive notice of important bills and priority concerns and I ask that you take action on these issues. We need your voices on such critical issues as addressing mental illness and the expansion of Medicaid (AHCCCS); increased funding and an alternative response system for CPS; fair immigration policies; and the renewal of our behavioral health licensing board. This will be an active and important session. Together we have power!
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Plan to join us for these CE Series workshops to earn your CEUs for ethics/law and diversity/cultural competency
Online registration is now available for these CE Series workshops in Flagstaff, Tucson, and Mesa. Click on the links below for locations, pricing, speaker biographies, workshop descriptions, and online registration!
February 22, 9am to noon in Phoenix: Diversity/Cultural Competency (Presenter TBA)February 22, 1pm to 4pm in Phoenix: Ethics/Law, presented by Valerie Hink, Immigration Attorney
April 12, 9am to noon in Phoenix: Ethics/Law, presented by Robin Bonifas, PhD, MSWApril 12, 1pm to 4pm in Phoenix: Diversity/Cultural Competency, presented by Kyle Penniman, MSW, LISAC,
CADAC, ICADC
April 26, 9am to noon in Tucson: Diversity/Cultural Competency, presented by Anna Harper, LMSWApril 26, 1pm to 4pm in Tucson: Ethics/Law, presented by Josefina Ahumada, MSW, LCSW
June 21, 9am to noon in Flagstaff: Diversity/Cultural Competency, presented by Chris Frazier, MSW, LCSWJune 21, 1pm to 4pm in Flagstaff: Ethics/Law, presented by Antonio Fernandez, LCSW
4 WAYS TO REGISTER!Online at http://www.naswaz.com/calendar.cfmFAX : 1(866) 261-7588Mail: NASWAZ, 1050 E. Southern Ave., Suite 1, Tempe, AZ 85282Call: (480) 968-4595
Name ______________________________________________________________________Street Address__________________________________City ________________State ____ Zip ________Phone ____________________________________________Email _____________________________________________
Please check workshops you will attend: Member Non-member Feb. 22 (3 hr 9am-noon diversity in Phoenix) ___ $60 $80 Feb. 22 (3 hr 1pm-4pm ethics/law in Phoenix) ___ $60 $80
April 12 (3 hr 9am-noon diversity in Phoenix) ___ $60 $80April 12 (3 hr 1pm-4pm ethics/law in Phoenix) ___ $60 $80
April 26 (3 hr 9am-noon diversity in Tucson) ___ $60 $80April 26 (3 hr 1pm-4pm ethics/law in Tucson) ___ $60 $80
June 21 (3 hr 9am-noon diversity in Flagstaff) ___ $60 $80June 21 (3 hr 1pm-4pm ethics/law in Flagstaff) ___ $60 $80 TOTAL DUE: _____ _____Payment Method:__ Check enclosed payable to NASW Arizona Chapter __ Charge to: MasterCard or Visa Name of cardholder __________________________ Card # _____________________________________
Expiration date: _______________ CVV Code:_______Billing address (if different from above)
Street__________________City _____________ State___
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For complete job descriptions, please visit www.naswaz.com and click on the Arizona Career Center.
You will need to sign in with your username and password.
Does YOUR company have an opening for a social worker? If so, you or your company representative can place an advertisement on our online Career Center for FREE. It’s easy.
Just go to www.naswaz.com and to the “Career Center” heading. A fly-out menu will appear, and the second choice is “Arizona Career Posting.” Just click on that link, fill in the blanks, and your ad will be instantly live and available to our members.
TherapistTransition FacilitatorClinician - Older AdultsChild ClinicianSocial Worker - Medical
Licensed Outpatient Clinician (Clinical Social Worker)
Clinical CoordinatorOncology Social WorkerAssociate and Independent Licensures NeededBehavioral Health Case Managers and Care
ManagersBilingual Family Assessment Worker - Healthy
FamiliesBilingual ClinicianIndependent Contract Care ManagerMilitary and Family Life Counseling (MFLC)
ProgramStaff ClinicianPart-Time Staff ClinicianMental Health ProfessionalInternational Social WorkExperienced Trauma Counselors Needed in
Uganda
Career Opportunities available through our website
Searching nationally for Social Work positions; Job fair coming to Phoenix on March 22
Searching nationwide: Employers can widen their search by posting with our national office. Please go to http://careers.socialworkers.org/. The Social Work Career Center is a career website where social workers can search national job listings and find professional development and career resources that span across the duration of a social worker's professional career. The Career Center is also a resource to social worker employers. Employers of social work can post job ads for a fee to find and recruit qualified, credentialed, and licensed social workers across the country.
Social Work Career Seminar and Job Fair presented by NASW-AZ: During the afternoon of March 22, 2013 NASW-AZ will host a Social Work Career Seminar and Job Fair at ASU Downtown Phoenix campus. This event will feature a discussion panel of top social work professionals from various sectors that will offer students advice on how to advance in their professional areas of interest. The event will also include a job fair in which students can meet directly with potential social work employers with their resumes in hand. However, if you think your resume needs a little work before passing it onto employers, a resume review table will also be available for students to meet with a career services expert. Hopefully you can join us for this special event that will help you land your social work dream job before graduation. Details on the exact time and location will be coming soon at http://www.naswaz.com/calendar.cfm
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Legal Issue of the Month from NASW National:
.....to read this article in its entirety, please go to this link and use your National username and password: http://tinyurl.com/bw36zlw The Legal Issue of the Month is published by the National office of NASW and is a members-only benefit.
Social Workers and Advance DirectivesSherri Morgan, JD, MSW, Associate Counsel, LDF and Office of Ethics & Professional Review © July 2012. National Association of Social Workers. All rights reserved.
IntroductionIn many situations, social workers are the
primary professionals assisting clients with advance directives. Social workers in a variety of treatment settings may interact with clients or patients who have an advance directive or other documents related to health care proxy decision making or clients who would benefit from executing such a document or documents. Social work assistance with advance care planning is common in aging, hospice, and palliative care settings and it is expanding to include mental health care settings. Social workers help individuals and families consider
potential scenarios, evaluate options for care, and cope with the emotions that arise during such discussions. The role of social workers can be an important one to assure that clients are informed of their decision making rights and options and to coordinate the resources available to enhance clients’ self-determination about future care and treatment.
February 21 and 27, 2013: Social Work Days at the Legislature (both dates full)
February 21, 2013 Tucson: Branch 2 Brown Bag Lunch and Learn
February 21, 2013 Tempe: Branch 1 Networking Meeting
March 1, 2013 Phoenix Branch 1 Social Work Month Breakfast March 7, 2013 Social Work Appreciation Event hosted by HOV in Scottsdale
March 11, 2013 Flagstaff Branch 3 Social Work Month Event
March 21, 2013 Branch 1 Networking Meeting in Tempe
March 22, 2013 Social Work Career Seminar and Job Fair presented by NASW-AZ
March 29, 2013 Tucson Branch 2 Social Work Month Luncheon
March 30, 2013 Kingman Branch 3 Social Work Month Brunch
Local events coming up in your area soon; online registration now available!
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By Lindsay Simmons, MSWPublic Policy Committee Chair
Although it’s only been several weeks since the Arizona Legislature convened for session, nearly 1,000 bills have already been introduced in the House of Representatives and Senate. Committees have begun the heavy lifting of hearing and debating legislation, and now is the time to get involved! In 2012, a committed group of advocates provided passionate and informed testimony in a House committee and was able to stop a bill that could have unfairly targeted Supplemental Nutritional Assistance Program (SNAP) recipients. This victory- and many others- proves that our involvement is crucial and effective.
Each year, the NASW- Arizona Chapter hosts two Social Work Days at the Legislature. This year, hundreds of participants will convene at the state capitol on February 21 and 27 to learn how to influence social policy. Our Code of Ethics asks us to advocate for social justice and equal access to services, and one of the most powerful ways to do so is to advocate for or against legislation that impacts our clients and communities. Attendees will hear from professional social workers who are policy experts, learn how to register their opinion in an easy-to-use online system, write a letter to their legislators, watch the House and Senate in action from the galleries, and listen to Senator Katie Hobbs, a social worker serving her second term in the Arizona Legislature. No prior experience is necessary- attendees will learn about some simple advocacy tools that make a big difference!
Remember that the NASW-AZ Public Policy Committee is the organization’s advocacy voice for all Arizona social workers and the vulnerable people they serve. The goal of the Public Policy Committee is to educate, inform and engage the NASW-AZ membership about issues related to
candidate election, public policy issues and the legislative process. Specific objectives include:
1. To set the annual legislative agenda and identify other public policy
issues. 2. To educate members on issues. 3. To advocate for issues and provide
legislative presence. 4. To maintain an email alert system. 5. To coordinate with other human service
advocacy organizations. 6. To provide training on legislative
advocacy.
Additionally, a sub-committee of the Public Policy Committee plans and implements the annual Social Work Day at the Legislature. Other than the major planning for this event, most of the meetings for the Public Policy Committee are done by email. New members do not need to have previous experience with legislative advocacy; the best qualification for members of this committee is a passion for the laws and policies that protect the rights and improve the lives of vulnerable people.
During the 2013 session, these priorities are:The health and mental health of all • Arizonans, including access to quality and affordable care;Child welfare, including support for foster • care families and children involved with the Department of Economic Security;Promoting social justice and equal rights • for all; A state budget that supports health and • human services, especially for the most vulnerable among us.
For more information on the event, visit www.naswaz.com. We look forward to seeing many of you in the coming weeks!
Public Policy Committee plans Social Work Days at the Legislature, outlines priorities during the 2013 session
DSM-5: A Summary of Proposed ChangesByCarlton E. Munson, PhD, LCSW-CDr. Munson is Professor of Social Work at the University of Maryland School of Social Work. He is author
of the Mental Health Diagnostic Desk Reference that is a guide to using the DSM-IV-TR and he participated in the American Psychiatric Association field trials for the DSM-5. Dr. Munson is currently working on a new edition of his book for use with the DSM-5.
The opinions expressed in this article are not associated with the policies or positions of the American Psychiatric Association or the National Association of Social Workers
IntroductionThe fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) will
be released during the American Psychiatric Association (APA) Annual Meeting in San Francisco May 18-22, 2013. No specific event or time for the release of the DSM-5 is mentioned in the APA conference program highlights. The release of the DSM-5 will have significant impact for social workers who use mental health diagnoses in their work. The update of the DSM system has been through several stages of review since it was initiated in 1999. The recommended changes were summarized at a website (http//www.dsm.org) sponsored by the APA throughout the review process, but the proposed changes were removed from the website after the APA Board of Trustees approved the DSM changes on December 1, 2012. DSM users must now await the actual release of the DSM-5 to know the exact details of the changes. The APA issued a letter that contains an overview of the changes and the changes are summarized later in this article. Any comments in this article about the DSM-5 changes are based on information that has been made available by the APA and reliable published commentaries. None of the descriptions in this article should be interpreted as what will actually appear in the DSM-5.
Controversies and Commentaries The DSM-5 proposed changes generated much controversy in a number of areas regarding concern
about the scientific rigor of the review process and content of changes in specific disorders. The American Psychological Association, American Counseling Association, the American Mental Health Counselors Association, and the British Psychological Society and others submitted responses to the APA’s call for commentary on the changes. Although clinical social workers deliver the majority of the mental health services in the United States, the social work profession did not have much input to the review process. Belatedly, one social work member was appointed to a DSM-5 Work group. A number of psychiatrists who contributed to past revisions of the DSM such as Dr. Robert Spitzer, who chaired the DSM-III revisions, and Dr. Allen Frances, who chaired the DSM-IV revisions, submitted comments about the process and content of disorder changes. For more information about specific scientific rigor issues and impact of the DSM-5 on mental health clients, see an article by Rosie Mestel (2012) Health and Science Editor at the Los Angeles Times. She provides commentary and cites a number of internet resources that are very helpful. For details of the vast array of the responses to the DSM-5, visit the website Dx Revision Watch, which is an extensive internet resource that is monitoring the DSM-5, ICD-10, and ICD-11 revisions.
During the later stages of the DSM-5 review and update, a number of mental health professionals conducted continuing education training seminars that were promoted as containing information about what are precisely the changes in the DSM. These claims of insider information will most likely continue until the DSM-5 is released. Social workers who attend seminars prior to the release of the DSM-5 should be cautious about relying on or implementing any actions based on the claims made in DSM-5 training seminars. Only when the DSM-5 is released will we know the exact diagnostic criteria for specific disorders.
When the DSM-5 planning began in 1999 there was much written and speculated about the magnitude of the changes through use of words like “revolutionary change.” A sweeping change based on using a manual-wide dimensional model of diagnosis versus the historic traditional categorical model was frequently 9
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mentioned. It appears that the categorical model has primarily survived. Two books published by the APA, Relational Processes and DSM-V (Beach, Wamboldt, Kaslow, Heyman, First, Underwood, and Reiss, 2006) and The Conceptual Evolution of the DSM-5 (Regier, Narrow, Kuhl, and Kupfer, 2011) convey many of the ideas and conceptual models that played a role in the evolution of the DSM-5. The books may help practitioners in understanding the forthcoming diagnosis-specific disorder criteria changes, global manual changes, areas of the manual where dimensional assessments are applied, and the application of neuroscience and developmental concepts in the manual. Serious students of the DSM conceptualization should review these books to understand how the change process played out and what was casted aside to perhaps be considered in the next era of DSM changes.
Major Changes The major DSM-5 changes publically announced to date are: Organization of the Manual: According to the APA release, the manual will have approximately the
same number of disorders as the DSM-IV. The manual is composed of three sections: Section 1 contains an introduction to the DSM-5 and information on how to use the updated manual. Section 2 lists categorical diagnoses using a significantly revised chapter organization with an increase from 16 to 20 categories of disorders. Section 3 includes conditions that require further research before they can be considered as formal disorders, as well as cultural concepts of distress and the names of individuals involved in DSM-5’s development.
Coding of Disorders: The coding system reportedly will change to be consistent with the ICD-10-CM changes that are to be released in October 2013. Indications are this change will result in the use of a seven digit code that replaces the current five digit coding system. This may result in alteration of the codes again in 2015 when the ICD-11 is scheduled to be released. There are rumors that an e-version of the DSM-5 may be developed so the manual can be updated as new information becomes available. In other words, DSM revisions may become an ongoing process rather than a periodic event. An open revision process will most likely present new opportunities and challenges for users of the DSM. Also, the American Medical Association Clinical Procedure Codes changed on January 1, 2013 (See AMA,2013). Any social workers reimbursed by insurance companies for mental health services will need to become familiar with the new codes. Websites are available to assist in making this transition. Some of the websites limit access to psychiatrists only.
Diagnostic Recording Procedures: APA reports that the multiaxial system will be replaced by “nonaxial” documentation of diagnosis in DSM-5. The former Axes I, II, and III, will be combined and there will be separate notations for psychosocial and contextual factors (formerly Axis IV) and disability (formerly Axis V). The change in the psychosocial factors will be of particular interest for social workers. The Axis IV “Psychosocial/Environmental Problems” (PEPs) have been part of the DSM system since the release of the DSM III. For thirty years the PEPs provided a way to record as part of diagnosis the impact of psychosocial problems that are paramount in the interventions made by social workers. Interestingly, the DSM-III-R conceptualized Axis IV as “Severity of Psychosocial Stressors” that were measured on a six point scale in seven areas. This scale was a concise empirical, evidence-based measure. With the emphasis placed on severity measures in the DSM-5 field trials, it is hoped the DSM-5 will introduce precise measures that go beyond the system used in the DSM-III-R that eroded in the DSM-IV and DSM-IV-TR.
Minor Changes The following is a very brief summary of the other publically announced changes to the DSM system.
For more details see the APA News Release (American Psychiatric Association, 2012).Title Change: The Roman numeral use in the DSM title has been discontinued. The official title is “DSM-5.”
The APA reports at that after DSM-5 is published changes prior to the manual’s next complete revision will be signified as DSM-5.1, DSM-5.2 and so on.
Autism Spectrum Disorder: The new autism criteria will combine several diagnoses from the DSM-IV-TR into the diagnosis of autism spectrum disorder.
Binge Eating Disorder: This disorder will be moved from the DSM-IV-TR Appendix B: to DSM-5
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Section 2. Disruptive Mood Dysregulation Disorder: This disorder will be added to DSM-5 to diagnose children
who exhibit persistent irritability and frequent episodes of behavior outbursts three or more times a week for more than a year.
Excoriation (skin-picking) Disorder: This new disorder will be in the Obsessive-Compulsive and Related Disorders chapter.
Hoarding Disorder: This disorder is new to DSM-5. The disorder focuses on people with persistent difficulty discarding or parting with possessions, regardless of their actual value.
Pedophilic Disorder: The criteria for this disorder will be unchanged, but the disorder name will be revised from pedophilia to pedophilic disorder.
Personality Disorders: The categorical model and criteria for the 10 personality disorders included in DSM-IV will remain. New trait-specific methodology will be added in section 3 to encourage study of how the methodology could be used to clinically diagnose personality disorders.
Posttraumatic Stress Disorder (PTSD): This disorder will be moved to a new chapter on Trauma- and Stressor-Related Disorders. There will be increased focus on behavioral symptoms that accompany PTSD. DSM-5 will have four diagnostic clusters instead of current three clusters. The PTSD diagnostic criteria will be more developmentally sensitive for children and adolescents.
Removal of Bereavement Exclusion: The DSM-IV-TR exclusion criterion applied to people experiencing depressive symptoms lasting less than two months following the death of a loved one has been removed and replaced by several notes within the text delineating differences between grief and depression.
Specific Learning Disorder: This disorder broadens DSM-IV-TR criteria to represent distinct disorders that interfere with acquisition and use of one or more academic skills (oral language, reading, written language, or mathematics).
Substance Use Disorder: This disorder will combine the DSM-IV-TR categories of substance abuse and substance dependence. In this singular disorder format, the criteria have been combined and strengthened. Previous substance abuse criteria required one symptom. The DSM-5 mild substance use disorder will require two to three symptoms.
Culture and DSM-5 The DSM-IV had the first official recognition of the role of culture in diagnosing mental illness in its
Appendix I, which contained a Glossary of Cultural Bound Syndromes and an Outline of Cultural Formulation. The appendix provided a method of categorizing and narratively defining culturally bound disorders that parallel, but did not precisely fit DSM defined disorders. The Appendix I needed updating, but appears to have been eliminated from the DSM-5. There are reports that the DSM-IV cultural formulation is being replaced with the Cultural Formulation Interview (CFI), which is a 14 item, structured clinical interview to be administered during a patient’s initial assessment. The CFI is reportedly designed to make cultural formulation quicker and easier. Sample questions from the CFI are: Question 1: “What problems or concerns bring you to the clinic?” Question 3: People often understand their problems in their own way, which may be similar or different from how doctors explain the problem. How would you describe your problem to someone else?”, and Question 7: ”Is there anything about your background, for example your culture, race, ethnicity, religion or geographical origin that is causing problems for you in your current life situation?” (Lewis-Fernandez, 2009). Some have questioned the use of the CFI without collateral information from family members and associates of the patient. Also, concern has been expressed about whether the CFI differentiates content for specific cultures. The CFI was tested as part of the DSM-5 field trials. If the CFI is used in the DSM-5, social workers will need to carefully assess their utilization of the CFI because of our extensive service to clients from various cultures.
Implementation of the DSM-5 There are likely many changes in the DSM-5 organization and structure that we will not be able to
anticipate in advance of the manual’s publication. Many questions remain about the details of the alterations that will require adjustments of performing diagnosis in the daily practice of mental health treatment and psychotherapy. The APA has not released any information on the implementation of the DSM-5. Most likely,
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as with past editions of the DSM, there will not be a mandate requiring use of the DSM system. In the past new editions of the DSM have had varying degrees of initial acceptance and utilization. Given the increased learning curve for mental health practitioners and the computer processing adjustments that will have to be made by payors, the DSM-5 utilization transition period may be longer than in the past.
ReferencesAmerican Medical Association (2013). CPT 2013 Current Procedural Terminology, Standard Edition, Chicago: America Medical Association.American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd ed., revised. Washington, DC: American Psychiatric Association. American Psychiatric Association (2012) News Release: American Psychiatric Association Board of Trustees Approves DSM-5 Diagnostic Manual Passes Major Milestone Before May
2013 Publication. Arlington, VA: American Psychiatric Association.Beach, S.R.H., Wamboldt, M.Z., Kaslow, N.J., Heyman, R.E., First, M.B., Underwood, l.G., and Reiss, D., eds.(2006). Relational Processes and DSM-V: Neuroscience, assessment,
prevention, and treatment. Washington, DC: American Psychiatric Publishing. Lewis-Fernández, R. (2009). The cultural formulation. Transcultural Psychiatry, 46(3), 379-382.Mestel, R. (2012, December 9). Changes to the psychiatrists’ bible, DSM: some reactions. Retrieved from http://www.latimes.com, January 5, 2013.Regier, D.A., Narrow, W. E., Kuhl, E. A., and Kupfer, D.J., eds.( 2011).The Conceptual Evolution of the DSM-5. Washington, DC: American Psychiatric Publishing
EXCLUSIVE:
Introducing the ENHANCED NASW-Endorsed Professional Liability Program!
CPH and Associates is now the only NASW-Endorsed Professional Liability
Program Administrator. CPH brings numerous product and service
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mental health professionals.
NASW Assurance Services (ASI) has ENHANCED
our valued NASW member. To continue your coverage by enrolling in our enhanced
visit www.naswassurance.org/pli/professionals.
Enroll online now at www.naswassurance.org/pli/professionals
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Visit our Online CE Institute at http://naswwa.inreachce.com/
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14
The Health Reform law is
important to the health and
well-being of all Americans.
This law is also called the
Affordable Care Act.
Here are some of the
Health Reform law’s most
important benefits for people.
What Consumers Should Know About Health Reform
More people now get health care.
✓ COVERAGE FOR PRE-EXISTING CONDITIONS: It used to be hard for individuals with medical problems or illnessto get health insurance. Now they can buy affordable health insurance through a special plan called a Pre-ExistingCondition Insurance Plan (PCIP).
If a medical problem or illness has kept you from getting health insurance for sixmonths or more, call 866.717.5826(English and Spanish) or go towww.PCIP.gov for information.
✓ COVERAGE FOR YOUNG ADULTS:Parents can keep their children on theirhealth plans until age 26. Ask your insurance company how this works.
✓ COVERAGE FOR WORKERS: Some small businesses can get a tax credit to help pay the cost of health insurance for their workers.
Preventive health care servicesnow cost less.
✓ PREVENTIVE CARE: All new group andindividual health insurance plans now must cover checkups and other preventive services for free, which means no morecopays and no deductibles. The same istrue for Medicare. Examples of preventiveservices include vaccinations to reduce risk of diseases such as the flu and pneumonia, mammograms, and screenings for cholesterol, high blood pressure and cancer.
✓ DRUG DISCOUNTS FOR SENIORS:Seniors in the Medicare Part D prescriptioncoverage “donut hole” (such as, those paying 100% of their prescription costs)now get a 50% discount on their prescription drugs. The “donut hole” will be completely closed by 2020.
FactSheet
The NationalAssociation ofSocial Workers
©2012 National Association ofSocial Workers. All Rights Reserved.
ArizonaChapter
15
For more information about
Health Reform and the
Affordable Care Act, visit
HealthCare.gov
For more information about
social workers, visit
HelpStartsHere.org
Material provided courtesy of theNational Association of CommunityHealth Centers (www.nachc.org)
There are now stronger protectionsfor people.✓ Insurance companies cannot deny insurance
coverage to children and adolescents (underage 19) who are already sick or have amedical condition. They also cannot say theywon’t cover the illness or medical condition.
✓ Insurance companies cannot cancel yourinsurance when you get sick (as long as yourinsurance bill is paid).
✓ Insurance companies cannot put lifetime limitson the dollar amount of your medical coverage(as long as your insurance bill is paid). Theyearly limits on the dollar amount of medicalcoverage will go away by 2014.
And, starting in 2014…✓ U.S. citizens and legal residents will be
required by law to have health insurance. If they don’t, they will have to pay a fee tohelp pay the costs when they do get sick.Some people will not have to pay the fee forreasons such as severe financial problems.
✓ Under Federal law more people will be ableto get Medicaid coverage if they are underage 65 with household incomes up to 138percent of the federal poverty level ($15,415for a single person or $26,344 for a familyof three in 2012). This is for:• Children & adolescents• Pregnant women• Parents• Adults who don’t have dependent children
Note: States do not have to provide Medicaid to morepeople if they choose not to. To find out if the Medicaidrules in your state will change, check with your localMedicaid office. They will be able to help you andyour family enroll, if you are eligible.
✓ New online marketplaces (called “insuranceexchanges”) in each state will offer peoplewithout health insurance and employees ofsmall businesses a place to find out aboutinsurance plans and shop for affordable coverage. Individuals and families who earntoo much money to get Medicaid may beable to get help from the Federal government tobuy insurance from an insurance exchange.
Note: Medicaid and the insurance exchanges are forU.S. citizens and legal residents only. Undocumentedimmigrants are not able to get health insurance throughthese programs.
There will be even more protectionsfor people starting in 2014.✓ If you already have an illness or medical
condition, insurance companies will not beable to keep you from getting insurance.Also, insurance companies will not be able tocharge you more because you have a sicknessor medical condition.
✓ If you are a woman, insurance companieswill not be able to discriminate and chargemore because of your gender.
✓ All new health plans will have to offer unlimited yearly and lifetime coverage.
✓ All new health plans will have a minimumpackage of “Essential Health Benefits.” This will include services such as:• Outpatient services• Emergency services• Hospitalization• Maternity & newborn care• Medical & surgical care• Mental health & substance abuse services• Prescription drugs• Rehabilitative services• Laboratory services• Preventative & wellness services• Pediatric services (including dental &
vision care)
The Affordable Care Act will bring health insurance coverage to 32 million people over the next few years. It’s important that you andyour family have a health care team that can provide you with ongoing medical care.
Professional social workers are important membersof the health care team. You might find a socialworker in your doctor’s office or hospital, helpingindividuals and families with social and emotionalissues. Your health care team might also refer youto a social worker in the community, to helpaddress these concerns. Often, social workers helppeople as they are released from the hospital, tomake sure they receive the care and support theyneed once they return home. As the health reformlaw takes shape, social workers will be there tohelp you get the health insurance benefits towhich you and your family are entitled. Socialworkers care for people in every stage of life,from children to the elderly, and help them overcome life’s most difficult challenges.NASW Arizona Chapter
1050 E. Southern Ave.Suite 1Tempe, AZ 85282
