Over the course of my career, I have experienced at least 15 leadership changes, and the atmosphere before the new leader arrives is always the same. Each time, employees or members are hoping for a leader that will take their concerns seriously, improve conditions, and overall make the organization function better. However, the one consistency from one leader to another is change. Recently, I had the opportunity to interview Dr. McClain, and he succeeds Elizabeth Clark who held the position from 2001 until May 2013.
As a macro social work practitioner, I have always expressed concerns regarding clinical social work and licensure laws eliminating traditional social work roles and its focus on social justice. In the interview, I ask Dr. McClain some tough questions regarding his thoughts and assessment on the current state of the profession.
Dr. McClain joins NASW after serving six years as Commissioner for the Massachusetts Department of Children and Families, a position appointed by Governor Deval Patrick. While there, he oversaw a budget of $850 million and a workforce of 3,500 employees to address reports of abuse and neglect for the state’s most vulnerable children, partnering with families to help them better nurture and protect their children.
Prior to that position, Dr. McClain was Vice President and Executive Director of Value Options New Jersey where he built and oversaw administrative, clinical and quality management program infrastructures that increased access to behavioral health services for children and youth, including those in the juvenile justice system. via NASW
I must admit that he is off to an excellent start just by making himself reachable. Since being in his new role, the NASW’s website has been updated with email addresses to executive leadership, and he agreed to answer questions for Social Work Helper about his vision for leading the organization into the future. NASW has seen declining memberships in recent years for various reasons. Will he be able to convince current members to stay with the NASW, and will he be able to re-engage members who have left as well other social workers? Here is what Dr. McClain had to say:
SWH: Can you tell us about your background, and what led you to choose social work as a profession?
CEO: When I was a child, my mother said that I ought to pick a job where I could help people. Throughout my youth, I benefited greatly from the kind, caring interventions from a number of professionals, which caused me to want to “give back” to others in similar need. When I was being recruited to play college football, one of the recruiters asked me what I would want to major in if I went to college. I told him that I wanted to help people, and he said that I could major in social work.
So began what has become a three-degree, thirty-year journey of helping people and helping social workers help people. Throughout my career I’ve worked with, and learned from, some very talented professionals; I say to them, “Thank you, very much!” My social work career journey has allowed me the pleasure of working in almost every field and method of social work practice, I bring all of those lessons and experiences to my CEO role here at NASW.
SWH: What will be some of your top priorities moving forward, and how do you plan to collaborate with other organizations in order to achieve your objectives and goals?
CEO: Our profession, and our society, is at a unique juncture. The world has changed a great deal and there are many opportunities and challenges facing NASW, and all professional associations. Thus, these times call for an ambitious grand vision. Our grand vision revolves around strengthening America’s social safety net, by ensuring that all individuals have the opportunity to improve their human well-being and are able to live free from social injustice.
We will do this by supporting social workers, advocating for the profession, and ultimately serving the millions of clients helped by social workers each day. NASW is strong—and when we speak, over 600,000 social workers have a voice for achieving our collective human well-being and social justice goals. Most importantly, we can use our influence to make sure that the vital social services and resources that millions of Americans depend on continue to be valued and funded appropriately.
Collaboration with all of our stakeholders and allies is critically important to our grand vision. I firmly believe that in order for us to provide the best services, products, and advocacy for our members, and social workers throughout the country, we must partner and collaborate whenever possible. There are over 40 sister social work organizations and each one fills an important role.
I look forward to continuing to work with, and learn from, them so that we can collectively represent the breadth of the profession as well as cater to the professional needs of each and every social worker. This includes working effectively with our sister social work organizations, allied professionals and groups, and the people, families, groups, and communities served by social workers.
I’ve spent my first three months at NASW meeting with numerous organizations, including the Council on Social Work Education, the Association of Social Work Boards, the North American Association of Christians in Social Work, the Association of Oncology Social Work, the Clinical Association of Social Work, Child Welfare League of America, National Alliance to End Homelessness, the National Council for Behavioral Health, and many others to determine how we can build on our collective strengths and work together in positive and meaningful ways.
I created the NASW CEO inbox (email@example.com) to hear from members, social workers, and other stakeholders regarding the issues that concern them the most. This has been important because in order for me to effectively provide the necessary leadership, I need to understand the professional landscape and the day-to-day challenges and opportunities facing our colleagues practicing within all the fields and methodologies of social work.
SWH: NASW membership is comprised mostly of clinical social workers, academics, and administrators. What is your vision for continued growth and expansion?
CEO: NASW is the practice association that welcomes all social workers. We will continue to facilitate a “big tent” approach, and welcome all of our colleagues, understanding that the social work profession is much stronger when we stand together. That being said, one of our main goals is to serve a dual purpose of being a large, influential national professional association, as well as providing exactly what our members need in terms of professional resources to practice at the highest levels, to advance their careers, and to maintain a sense of professional fulfillment and well-being.
We want to have conversations with our colleagues, provide materials and resources that are relevant to their experience and expertise, and make their membership experience unique and beneficial to their specific field and method of practice. Our goal is to delight our members, help them advance their social work practice with enhanced skills and knowledge, and ultimately to provide the best social work practice possible to the people, families, groups and communities they serve.
SWH: Many believe that social work has moved away from its social justice roots to only focusing on the clinical perspective as it relates to the individual and family. Do you agree with this assessment, and how do you plan to either expand it or create balance?
CEO: The strength of the social work profession is its breadth and depth; the profession has always, and still does today, focused on advancing human well-being and promoting social justice. When one looks closely at the work of social workers in every field and method of social work practice, there’s ample evidence that our grand vision of improving human well-being and promoting social justice is very much alive; however, much more needs to be done before we can fully realize our grandest vision. I see opportunities for enormous synergy when we approach our social justice and clinical practice goals with harmony and coordinated ethical responsibility.
The resulting synergy will help us achieve even better outcomes across these two perspectives—ultimately, we would do a disservice to the people, families, groups and communities we serve by artificially choosing between social justice and any particular field or method of social work practice. Social workers not only can live in harmony with one another, but have an ethical responsibility to do so—NASW is excited about the possibilities it has to help lead social work towards its grandest goals.
Clinical and direct practice social workers cannot do their jobs without the efforts of advocates, organizers, researchers, academics, policy practitioners, and administrators. Obviously, regardless of our field or method of social work practice; we are all in this together; each providing a valuable service to individuals, families, and communities in need and advancing the profession.
The NASW Code of Ethics outlines our primary mission as working to enhance human well-being and helping to meet the basic human needs of all people. We cannot realize that mission without an “all-hands-on-deck” approach of working together. The challenges facing our society are incredibly complex; thank goodness for the power of social work to define, address, and overcome societal injustices and strengthen the fabric of our great nation.
Photo Courtesy of www.fnsc.org
The Case for Ending the Anonymity of Egg & Sperm Donations in the United States
Egg and sperm donations in the United States have long proceeded under the cloak of secrecy. Twenty-five years ago, when I first started interviewing patients who used donors to conceive a child, many intended parents struggled with whether eventually to tell their child about the nature of his or her conception. While some professionals in the fertility industry advised that this was a parent’s personal decision, others encouraged disclosure, and still others recommended never telling a child how they were conceived. The last approach dovetailed with the industry standard that required donor anonymity. In subsequent years, my research has led me to conclude that mandatory donor anonymity is problematic – not only for the children conceived with donor help, but also for donors themselves and the people who created their families with donor assistance.
After a boom in the late 1980s and 1990s, the use of donor sperm and eggs continues to expand in the United States – and increasing numbers of donor-conceived adults are going to want access to their biological information, including access to the identities of the people who helped create them. The United Kingdom has abolished donor anonymity. Why has the United States not followed suit?
How Does Anonymity Affect Donors and Donor-Conceived Children?
Many professionals in the fertility industry maintain that mandatory open donor identity would reduce the number of people willing to come forward to provide eggs and sperm. In countries that have national registries and have abolished donor anonymity, these fears have not borne out. In the United Kingdom, the Human Fertilisation and Embryology Authority reports that the number of sperm donors has increased since anonymity was banned; and since ending donor anonymity, Australia and Sweden have also seen increases in donors volunteering.
In the United States, given that donors are compensated – indeed, egg donors are substantially compensated – the financial incentive alone is enough to ensure that people will still come forward to provide gametes for other people’s children, even if their identity is revealed to the children born from their gametes. Many donors prefer an end to anonymity. In my current research project, I have to date interviewed over 90 donors and collected 190 online surveys. Only a handful of egg donors, I find, want to remain anonymous in perpetuity – yet the majority reported they were told anonymity was their only option.
Many sperm and egg donors go to great lengths to meet their genetic children, turning to DNA tests, online registries, and ancestry websites in their searches. Meanwhile, the first generation of children conceived via banked sperm or donated eggs are now young adults, who have their own feelings about donor conception and their own desires for forging connection, or not, with their donors. Some experienced emotional fall-out from being told later in their childhood they were donor-conceived or discovering it themselves after having the truth was concealed for of their lives.
In my conversations with donor-conceived people, those who seemed most at ease were told at a young age and continued to hear their conception story as they matured. People who were told as adolescents or later, or discovered the “secret” on their own, report feeling a sense of betrayal at having been lied to by the parents they were supposed to be able to trust. For families who decided not to inform their donor-conceived children, the secrecy appears to have been largely rooted in the stigma and shame many people feel about infertility and the inability to have a biological child.
Dealing with the Downsides of Anonymity Falls to Individuals
In a quest for identity, many donor-conceived adults report using a combination of techniques to find their donors. Some sign up on registries, such as the Donor Sibling Registry. This service charges a $200 lifetime fee for donors and donor-conceived people to sign up and search for matches, using the donor identification numbers that clinics, sperm banks, or egg donation agencies assign. Others have turned to free online sites – such as donorconception.com – that help donors, donor-siblings, and donor-conceived children find each other by combining donor information, direct-to-consumer genetic tests, and ancestry registries.
Essentially, anonymity is already obsolete; U.S. policy simply has not caught up with modern technology. The rise of direct-to-consumer genetic testing increases the likelihood of donor-conceived children finding their genetic parents, whether the donor wants that to happen or not. If anyone in a donor’s family does a test and registers on a website like ancestry.com, chances are good a donor-conceived child can find them. While such consumer testing and ancestry sites do raise privacy concerns about the public availability of genetic information, they make it virtually assured that anyone can be found.
The Need for a Donor Registry
Many fertility industry professionals have voiced concerns about how a registry would function given U.S. patient privacy law. The industry’s fear that registries reduce donors has not borne out in other countries that have implemented them. And by now, offering anonymity as an option misleads prospective donors into believing that their privacy can be guaranteed, when it cannot. With anonymity increasingly a non-viable option, it is time to consider establishing a national registry for egg and sperm donors. Not only would such a registry make it easier for people to find biological kin, it could also provide other advantages:
- A registry could keep track of the number of live births per donor in the same geographic area, to reduce the risk of unions between donor-conceived biological siblings.
- For egg donors, a registry could track completed egg donation cycles to reduce the risk of donors going through more cycles than is considered safe.
- A registry would allow researchers to track egg donor health to better understand complications and give women considering egg donation more information for their decisions.
Partnering with Clergy to Prevent Domestic Violence
Domestic violence remains a serious and widespread problem in the U.S., particularly for women from racial or ethnic minorities, who experience higher rates of abuse than the national average. Now, a team of researchers from the University of Georgia have developed an online training that leverages the influence of religion to prevent intimate partner violence in Korean American communities.
The CDC defines intimate partner violence as physical or sexual violence, stalking, or psychological harm caused by a current or former partner or spouse.
“For many immigrant communities, the commonality that I witnessed, and that research bears out, is that religious organizations and religious leaders are a very important piece of the puzzle to prevent partner violence because they have so much power in the immigrant communities,” said project lead Y. Joon Choi, an associate professor in UGA’s School of Social Work.
While some religious traditions have at times reinforced gender inequity and norms that discourage women from seeking help, religious leaders have the power to shape attitudes and behaviors within their communities and promote new norms that support healthy relationships and reject partner violence.
Aware of this critical influence of religious leaders, Choi wanted to not only educate clergy on the problem, but empower them to speak out against violence and support parishioners who come to them for help.
Choi collaborated with Pamela Orpinas, professor of health promotion and behavior in UGA’s College of Public Health who also studies intimate partner violence, and instructional designer ChanMin Kim with Penn State University, to build a program comprised of four interactive case simulations that guide clergy through real-world scenarios. The program is called Religious Leaders for Healthy Families.
The researchers worked with domestic violence prevention groups and gathered feedback from Korean American faith leaders to present cases that were culturally appropriate and supported the clergy’s ability to be domestic violence prevention advocates.
“What we wanted to see was behavior change,” said Orpinas. “After this training, are faith leaders going to be able to help victims when they suspect abuse? Are they going to be involved in the prevention of partner violence within their congregation?”
The key, say the researchers, is to build confidence within faith leaders that they could take action to promote healthy relationships and connect domestic violence service providers to parishioners who need their support. The interactive case simulations allow clergy to practice responding to victims who are experiencing different types and degrees of partner violence in a safe space.
“We wanted to make sure that through this medium, they were able to practice how they are going to interact,” said Choi, “and also they are going to learn what are good responses versus dangerous, unsafe responses for the victims. We are hoping to increase their self-efficacy through this intervention.
Though this project is focused on Korean American clergy, the team designed the modules to be easily translated to other communities.
“Much of what they need is there,” said Orpinas, “in terms of asking open-ended questions and supporting and believing the survivor. The case simulation helps clergy practice how to talk about those things.”
The team is eager to see the program be adopted more broadly by immigrant communities or any community where faith leaders are trusted and influential resources.
The full development of the online program, including theoretical underpinnings, community feedback, and performance objectives, is described in a paper published in Health Promotion International. It is available here.
Challenging Assumptions About the Use of Contraception by U.S. Muslim Women
Contraception is complicated. Reproductive health scholars can comfortably weigh the protective benefits of condom use compared to the convenience of intrauterine devices. However, for most people, contraception continues to be a sensitive subject not appropriate for casual conversation – and consequently many Americans lack an adequate understanding of their contraception options. Likewise, even the best-intentioned clinicians know little about how minority communities engage with reproductive healthcare and utilize contraception. Due to these knowledge gaps, providers of contraceptive services often struggle with how to approach family planning with individuals from minority populations, particularly those belonging to highly stigmatized groups that are underrepresented in scientific research. This can be especially true for “culturally conservative” populations of clients, among whom sex itself is stigmatized and sexual health is not freely discussed in the home or the doctor’s office.
Knowledge gaps are especially prevalent about the reproductive health behaviors of Muslim women, arguably one of the most understudied populations in the United States. This dearth of research is not surprising, given that Muslim women are part of a religious minority group that experiences ongoing intersectional stigma and discrimination in American public life. Because past studied have sometimes taken advantage of minority and marginalized populations, groups such as Muslim women may be suspicious of researchers and wary of divulging personal information, particularly on sensitive topics like contraception use.
Nevertheless, good research is needed, because in its absence, pernicious assumptions can take the place of actual evidence – and myths can misinform clinicians and policymakers as well as the general public. Social scientists therefore have a pressing calling to conduct research that may ultimately dispel harmful myths and give voice to a group of women missing from academic discourse. Our work examines this set of issues, contraception use and reproductive health preferences, in Muslim women in the United States. We collected information from Muslim women themselves about their lives, and our findings refute presumptions that women in this population typically experience low bodily autonomy and high sexual risk factors.
Path-Breaking Research from the Muslim Women’s Health Project
In 2015, the Back of the Envelope mechanism at the University of Alabama at Birmingham School of Public Health funded a grant to collect exploratory data from Muslim women across the United States. Our research team developed an online survey that included measures of stigma, mental health, and contraceptive use among participants. Respondents were women who self-identified as Muslim and who were at least eighteen years old and current residents of the United States. To be sure, online surveys have limitations – for example, American Muslim women who did not have a computer in their home or did not regularly use the Internet would likely not have been exposed to the survey at all. Nevertheless, one major benefit of online surveys is their ability to engage difficult-to-reach populations, including respondents in stigmatized populations, minority enclaves, and groups fearing persecution. Data from our respondents, including participants from Muslim subgroups, were analyzed to identify notable barriers and facilitators to various kinds of contraception use – namely use of oral contraceptive pills, condoms, intrauterine devices, and reliance on withdrawal during sex.
In the United States as a whole, some national estimates suggest that 62% to 75% of women of reproductive age use contraceptives. Rates of contraception use by women in Muslim majority countries varies widely, from a low rate of use by 38.5% of reproductive-age women in Pakistan and to a high rate of use by 62.3% of such women in Indonesia. Because of these statistics, we assumed Muslim women in the United States would use contraceptives at a higher rate than their counterparts in Muslim majority countries, but at a lower rate than other women in the wider-population of Americans.
Results from our survey showed that our hypotheses were wrong. We found that almost 80% of eligible Muslim respondents used some form of contraception. As we delved further into characteristics of our sample, we realized that the women who responded to the survey tended to be highly educated (over half had completed graduate or professional school) and had relatively high incomes (43% had a household income of over $100,000 annually). They also had high rates of health insurance coverage, given that fewer than six percent were uninsured. A deeper investigation through multivariate analysis showed that education and income were more important to understanding contraception use than religion, ethnicity, or even immigrant status (whether a respondent was born in the United States or elsewhere).
Essentially, our inquiry found was that when the social playing field is leveled through higher education, increased income, and full access to health insurance, contraceptive utilization increases – even among populations that are predominantly foreign-born and where people may be religious or hail from culturally conservative communities where women hold a secondary social status. Such factors are typically associated with low contraception use, but in our study, we found these factors could be counteracted by positive social conditions associated with empowerment.
Why Policymakers and Advocates Should Further Overall Improvements
When officials or advocates aim to boost contraceptive use by racial and ethnic minorities in order to reduce unintended pregnancies and sexually transmitted infections, it may be valuable to address community conditions holistically. Working patient by patient in health care settings can be helpful, but this approach is limited in scope, costly in time, and influences only the identified, targeted health behaviors. The better approach may be to expand women’s overall access to advanced educational opportunities that can lead to socioeconomic success and improved quality of life – even for women who belong to culturally conservative communities. Overall empowerment, we conclude, is the best way to increase rates of contraceptive use and ensure better life choices and opportunities for women in all communities.
Connect With SWHELPER
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