class 4_Pediatrics_the emerging psychosocial challenges_AIDS

class 4_Pediatrics_the emerging psychosocial...

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Child and Adolescent Social Work Journal Volume 9, Number 5, October 1992 Pediatrics: The Emerging Psychosocial Challenges of the AIDS Epidemic Lori Wiener, Ph.D., Howard Moss, Ph.D., Robert Davidson, M.S.W., and Cynthia Fair, M.S.W., M.P.H. ABSTRACT: HIV has a pervasive and profound effect on the psychological, social and neuropsychological functioning of infected infants, children and their families. This article discusses direct and indirect psychological mani- festations of HIV in children. Direct effects are the outcome of the virus act- ing on the central nervous system and can result in compromised cognitive, language, motor, socio-emotional and motivational functioning. Indirect ef- fects involve psychological responses to the stress of living with a life threat- ening illness, the social ostracism, disruption in life goals and undergoing frequent invasive and protracted medical procedures. A major focus of this article is to outline and describe a model comprehensive psychosocial support system developed within the Pediatric Branch of the National Cancer Insti- tute. This includes early intervention issues and strategies for working with families during the introductory phase of the treatment program that also provides the framework for a care management approach, salient mental health problems that frequently occur in this group, and appropriate inter- ventions for individuals and families. Attention is also given to dealing with anticipatory loss and bereavement, implementing traditional innovative in- tervention techniques, and for providing advocacy services concerning possi- ble legal, financial, housing, and educational issues. Human immunodeficiency virus (HIV) in infants and children is al- ready known to be a devastating disease, however the tremendous impact on the psychological, social and neuropsychological function- Dr. Wiener is Coordinator, Pediatric HIV Psychosocial Support Program, National Cancer Institute. Dr. Moss is connected with the Medical Illness Counseling Center, Bethesda, Maryland. Mr. Davidson is a senior social worker, National Institutes of Health and Ms. Fair is a social worker, National Institutes of Health. Address commu- nications to Dr. Wiener at Pediatric H1V Psychosocial Support Program, National Can- cer Institute, Pediatric Branch (NIH) Bldg. 10, Rm. 13N240, 9000 Rockville Pike, Be- thesda MD 20892. 381 1992 Human Sciences Press, Inc.
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382 CHILD AND ADOLESCENT SOCIAL WORK JOURNAL ing of children has received less attention (Belfer, Krener, & Miller, 1988). With the expanding availability of antiretroviral agents to treat this disease and the development of procedures to control se- rious secondary infections, children are living longer and the disease has become a more chronic illness. The cumulative losses and psycho- logical burden this places on families requires our immediate inter- vention (Belfer, Krener, & Miller, 1988). Even after a cure is found, social workers will be in an essential role to help mitigate the cata- strophic effects this disease will have on children, families and our society as a whole.
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class 4_Pediatrics_the emerging psychosocial...

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