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Research has demonstrated that encounters of potentially moral injurious events (PMIEs) may result in longstanding psychological trauma that impact healthcare workers' mental health and well‐being. In this paper, we explore strategies to alleviate PMIEs for medical social workers. In‐depth semi‐structured interviews (30–60 min) were conducted with medical social workers (n = 75) across the state of Texas. Supported by directed content analysis, textual data were coded and categorised to finalize emerging themes. Findings demonstrate that multilevel strategies ought to be implemented into daily healthcare practice. PMIEs that impact frontline healthcare delivery can be alleviated by having formal and informal support systems (e.g., mentorship, supervision, counselling) as well as honest and transparent interprofessional collaborative care to facilitate psychological team safety. PMIEs across the healthcare organisation, perhaps due to internal policies and practices, may be reduced by implementing educational initiatives and building ethical workplace cultures that serve to explicitly reduce stigma associated with mental health and enhance worker well‐being. PMIEs that derive from macro‐level social policies (e.g., insurance, health disparities) may be alleviated by instituting patient advocacy initiatives and dismantling systems of oppression to lessen psychological stress and trauma. Hospital leadership ought to understand how the United States healthcare industry triggers PMIEs across the healthcare workforce. Multi‐tiered practices and policies that addresses frontline delivery care, leadership and administrative responsibilities, and the healthcare industry can enhance psychologically safe workplaces and elicit macro‐level institutional reform in how health systems function. These findings have important implications for healthcare policy makers, practitioners, educators, and researchers to inform future research and practice development. [ABSTRACT FROM AUTHOR]

This teaching note presents the adaptation of four innovative pedagogical techniques from Boal's Theatre of the Oppressed (TO) to effectively teach ethics across the social work curriculum. Each of the four techniques (Forum Theatre, Newspaper Theatre, Image Theatre, and Legislative Theatre) will be described in general and then modeled as an activity to use across four social work curricular areas, respectively: clinical practice, research, field education, and organizational policy. Teaching preparation/tips will be provided to guide educators on how to successfully employ these techniques to enhance student competencies to identify and address ethical issues and to participate in moral dialog. The teaching note will conclude with an analysis of the advantages and limitations of using TO techniques in the classroom.

Obtaining good quality sleep is crucial to mental health. Social work students might be particularly vulnerable to mental health challenges and insufficient sleep, which can have important implications for self-care education. Examining social work students' sleep characteristics (i.e. sleep duration and sleep quality) and health knowledge gaps can provide an important context for promoting healthy sleep among social work students. Nonetheless, the empirical literature lacks such data. The purpose of this study was to employ a sample of undergraduate and graduate social work students to: 1. assess sleep duration and sleep quality; 2. quantitatively and qualitatively examine knowledge about sleep and healthy sleep behaviors; and 3. identify sleep health knowledge gaps. Twenty-five social work students completed validated assessments and participated in a semi-structured focus group. Quantitative and qualitative data highlight poor sleep duration, poor sleep quality, and sleep health knowledge gaps among this population. Data also reveal that while students recognize the importance of sleep, they have difficulty obtaining adequate sleep due to various contextual constraints. These data support the importance of including sleep health in self-care education among social work students and highlight sleep health knowledge gaps that could be integrated into self-care education. [ABSTRACT FROM AUTHOR]

The bullying of sexual and gender minority youth (SGMY) is pervasive, with documented negative impacts on health. We explored the social ecology of bullying of SGMY, with a focus on religion as a source or context of bullying. Semistructured interviews with service providers, educators, and administrators in Toronto, Canada, who work with SGMY explored perspectives on the bullying of SGMY, focusing on religiously based bullying and strategies for intervention. Interviews (45-60 minutes) were recorded, transcribed, and analyzed using thematic content analysis. The data revealed religiously based homophobic discourse that permeates religious (places of worship, faith-based schools) and secular microsystems (public schools, families) across SGMY's social ecology. The language and ideology of "sin" and "conversion" were evidenced in direct religiously based bullying of SGMY in schools, and victimization in places of worship and family microsystems, as well as serving as a rationale for bullying and nonintervention by teachers, school staff, administrators, and family members. Multisectoral and multilevel influences of religiously based sexual prejudice on the bullying of SGMY suggest that existing individual-level and microsystem-level responses in schools should be augmented with institutional, policy, and legal interventions in SGMY's more distal social ecology in order to effectively prevent religiously based homophobic bullying.

Objectives: Moral distress is associated with adverse outcomes contributing to health-care professionals' worsened mental and physical well-being. Medical social workers have been frontline care providers throughout the COVID-19 pandemic, and those specializing in palliative and hospice care have been particularly affected by the overwhelming numbers of those seriously ill and dying. The main objectives of this study were (1) to assess palliative and hospice social workers' experiences of moral distress during COVID-19 and (2) to identify and describe participants' most morally distressing scenarios. Methods: Using a mixed-methods approach, participants completed an online survey consisting of the Moral Distress Thermometer (MDT) and open-ended text responses. Results: A total of 120 social work participants responded to the study, and the majority of participants (81.4%) had experienced moral distress with an average MDT score of 6.16. COVID-19 restrictions emerged as the main source of moral distress, and an overlap between the clinical and system levels was observed. Primary sources of moral distress were grounded in strict visitation policies and system-level standards that impacted best practices and personal obligations in navigating both work responsibilities and safety. Significance: In the first year of the COVID-19 pandemic, palliative and hospice social work participants indicated high levels of moral distress. Qualitative findings from this study promote awareness of the kinds of distressing situations palliative and hospice social workers may experience. This knowledge can have education, practice, and policy implications and supports the need for research to explore this aspect of professional social work. [ABSTRACT FROM AUTHOR]

Amid the ongoing pandemic, as overburdened and underfunded health systems are requiring health care social workers (HSWs) to assume responsibilities beyond their scope of practice, institutional constraints have undoubtedly heightened encounters of moral distress (MD). MD is the psychological disequilibrium that arises when institutional factors obligate an individual to carry out a task that violates their professional and/or personal ethics. Our qualitative study investigated HSWs' (n  = 43) MD in Texas during the 2019 COVID-19 pandemic. Findings from our study indicate that MD occurs across five levels: (i) patient care decisions; (ii) personal care decisions; (iii) team/unit decisions; (iv) organisational decisions; and (v) social justice decisions. MD is rooted in systems that disproportionately impact historically excluded populations, including social inequities such as financial instability, homelessness and substance use. Organisations need to explicitly consider social justice initiatives that seek to identify growing disparities in care that have been at the forefront of the pandemic; macro-level perspectives that expand MD must address social and health inequities that impede daily tasks of all health care workers. MD encounters that are rooted in social determinants of health can inform supervision, education and practice to ameliorate HSWs' value conflict. [ABSTRACT FROM AUTHOR]

The authors comment on an article by Laura Kolbe and Immaculada de Melo-Martin which give perspective on the challenge of measuring and defining the concept of moral distress (MD). Topics include factor that is further complicating measurement of clinician distress, results that provide guidance on how health systems may begin to address MD, and the need of leaders to reevaluate models of care delivery to prioritize clinician well-being as an end unto itself.

Information and Communication Technologies (ICTs) permeated social work practice before coronavirus disease 2019 (COVID-19). In addition to ICT-based formal services (e.g. e-counselling), social workers used ICTs informally as an adjunct to face-to-face practice. Building on our previous research, our cross-sectional online survey examined social workers' informal use of ICTs in four countries: Canada, the USA, Israel and the UK. The survey was administered through Qualtrics software among social workers across Canada (n  = 2,609), the USA (n  = 1,225), Israel (n  = 386) and the UK (n  = 134), and analysed using IBM SPSS Statistics version 26. The findings substantiate the ubiquitous use of informal ICTs in social work practice, as an adjunct to face-to-face treatment, across the four countries. Given the current, unprecedented context of COVID-19, we discuss the meaning of our findings related to access, ethical considerations (e.g. professional boundaries) and supervision in the context of restricted face-to-face practice. We discuss the implications for social work practice, education and research, and conclude that in the COVID-19 context, there is an even greater need for research, clinical discussion, supervision and policy on informal ICT use in social work practice. [ABSTRACT FROM AUTHOR]

This paper reports on findings from a qualitative study that examined how Canada's socio-political context influenced gestational surrogacy for same-sex male couples. Semi-structured interviews were conducted with gay fathers and gestational surrogates to investigate supports and barriers of pursuing surrogacy. Questions explored publicly available information, policies and practices of fertility clinics and hospitals, post-birth resources and cultural attitudes regarding same-sex parenthood. Findings suggest that in Canada, a global leader in LGBT rights and inclusive same-sex parenting legislation, participants encountered inadequate same-sex inclusive resources and insufficient provider competencies. The aim of this study was to inform individual and institutional recommendations to counteract biases in fertility care and post-birth services. Following interview analysis, five key strategies were identified: (1) more accessible information on paths to same-sex parenthood; (2) more inclusive fertility clinic and hospital practices; (3) recognition of same-sex fatherhood in formal documentation; (4) post-birth resources such as formula feeding, play groups and first aid courses intended for same-sex parent families; and (5) shifts in cultural attitudes of same-sex parenthood and, specifically, gay fatherhood. Approaches that subvert heteronormative discourses embedded in fertility and reproduction are required to legitimise and support same-sex parent families. [ABSTRACT FROM AUTHOR]

Objective: To retrospectively explore how gay fathers and gestational surrogates in Canada perceived their relationship at three distinct time points: prepregnancy, during pregnancy, and postbirth. Background: Canada has witnessed an increased number of gay men seeking fatherhood through surrogacy. However, there is limited empirical research on the experiences and perspectives of surrogacy for gay men, both in Canada and worldwide. Method: Qualitative in‐depth interviews (∼60–120 minutes) were conducted with (a) gestational surrogates implanted with one or more embryos from a donated egg and gay fathers' sperm, (b) gay men who pursued gestational surrogacy to have a biological child, and (c) single or partnered gay men and their paired surrogate. Participants who agreed to participate, who were willing to contact their third party, and whose matched party agreed resulted in a surrogate triad in which the intended parents and surrogate all participated. Interviews (n = 21) were recorded, transcribed, and analyzed using interpretive phenomenological analysis. Results: Findings from the present study draw attention to the intricacies of surrogacy relationships and demonstrate the variability of how gay men and surrogates identify and address their procreative roles and responsibilities through pregnancy and postbirth. Conclusion: Participant narratives challenge heteronormative experiences of pregnancy and childbirth, extending the two‐parent family paradigm to include families of choice and a close network of individuals and communities. Implications: Allied health professionals ought to provide competent, inclusive care that actively confronts a priori biases and assumptions regarding same‐sex parent families and surrogacy. [ABSTRACT FROM AUTHOR]

This teaching note presents the adaptation of four innovative pedagogical techniques from Boal's Theatre of the Oppressed (TO) to effectively teach ethics across the social work curriculum. Each of the four techniques (Forum Theatre, Newspaper Theatre, Image Theatre, and Legislative Theatre) will be described in general and then modeled as an activity to use across four social work curricular areas, respectively: clinical practice, research, field education, and organizational policy. Teaching preparation/tips will be provided to guide educators on how to successfully employ these techniques to enhance student competencies to identify and address ethical issues and to participate in moral dialog. The teaching note will conclude with an analysis of the advantages and limitations of using TO techniques in the classroom. [ABSTRACT FROM AUTHOR]

The bullying of sexual and gender minority youth (SGMY) is pervasive, with documented negative impacts on health. We explored the social ecology of bullying of SGMY, with a focus on religion as a source or context of bullying. Semistructured interviews with service providers, educators, and administrators in Toronto, Canada, who work with SGMY explored perspectives on the bullying of SGMY, focusing on religiously based bullying and strategies for intervention. Interviews (45-60 minutes) were recorded, transcribed, and analyzed using thematic content analysis. The data revealed religiously based homophobic discourse that permeates religious (places of worship, faith-based schools) and secular microsystems (public schools, families) across SGMY’s social ecology. The language and ideology of “sin” and “conversion” were evidenced in direct religiously based bullying of SGMY in schools, and victimization in places of worship and family microsystems, as well as serving as a rationale for bullying and nonintervention by teachers, school staff, administrators, and family members. Multisectoral and multilevel influences of religiously based sexual prejudice on the bullying of SGMY suggest that existing individual-level and microsystem-level responses in schools should be augmented with institutional, policy, and legal interventions in SGMY’s more distal social ecology in order to effectively prevent religiously based homophobic bullying. [ABSTRACT FROM AUTHOR]