Add digital skills to the many skill sets we wear as social workers. Our clients are carrying around devices that can serve as a secondary tool to support practice and our primary connections. Many practitioners feel that technology is taking away from the human interaction. However, technology can actually enhance our practice and empower our clients while scaling our efforts.
For instance, we can reach people in rural areas we weren’t able to reach before, empower clients to monitor their moods outside of sessions and have real time data to discuss in session, make connections with children on the autism spectrum that is difficult for a human to make, assess suicidal ideations, alert authorities/contact of domestic violence situations in real time, and the list goes on. We must not fear technology as it is here to stay. In fact, they are now moving into the world of the Internet of Things (IOT) such as wearable technology.
The social work practice will not progress by chance, we will have to embrace and educate ourselves on technology in order to most effectively advocate for our clients and the profession.
- “Most social workers have no access to data in the field, even though worldwide global mobile access is above 87%.” Northwoods Business Brief
- “Smartphone owners use an average of 24 apps per month but spend more than 80 percent of their [in app] time on just five apps.” Forrester Data
- “To date, 85.5 percent of the world subscribes to mobile phone services…” Technology for good: Innovative use of technology by charities
Mobile apps are a wonderful tool, however they are just that: a tool. They should not replace the relationship but rather enhance and augment the work you are doing.
1. PTSD Coach – “The PTSD Coach app can help you learn about and manage symptoms that often occur after trauma. Features include:
- Reliable information on PTSD and treatments that work
- Tools for screening and tracking your symptoms
- Convenient, easy-to-use tools to help you handle stress symptoms
- Direct links to support and help
- Always with you when you need it
Providing you with facts and self-help skills based on research.” (iTunes, Google Play)
Tags: Veterans, Mental Health
2. Northwoods Compass CoPilot – “It’s the ideal solution for mobile social workers at child and adult protective services agencies, and other workers who visit clients in their homes or other locations. Social workers in the field use Compass CoPilot to access all case and client information, forms, and documents, just as they would in the office. It’s the only social services software to ensure that social workers are never without the files and information they need while they’re on the road. During client visits, social workers can use Compass CoPilot to record interviews, take photos, document, and notate their findings — all while they are in the field. Being able to accomplish all of this with a tablet makes the information gathering less intrusive, which helps put clients at ease and allows for better interactions. Our innovative social service software syncs the new information with the agency’s Compass® system back at the office.” (iTunes)
Tags: Child Welfare, Case Mangement
3. Classdojo – “Easily encourage students on participation, perseverance, or something else? Customize ClassDojo to work for your classroom. See a timeline of students’ progress, share a beautiful timeline of all the wonderful things your students do. Students love how positive classrooms are and it saves teachers valuable class time, too.” (iTunes, Google Play)
Tags: School Social Work, Autism
4. TF-CBT Triangle of Life – “new [free] mobile game app helps children who have experienced trauma by letting them use their tablets or smartphones to practice life skills they have learned in the therapist’s office. With the tagline “Change how you think; change your life,” the TF-CBT Triangle of Life game is designed to help children age 8-12 better understand their thoughts, feelings and behaviors, and move toward a better quality of life. During this game, the player takes the role of the lion in a jungle story, guiding other animals toward more positive experiences and relationships.” (iTunes,Google Play)
Tags: Mental Health, Trauma, CBT, Therapist
5. Aspire News – “A domestic violence app is disguised as a normal icon and even has a decoy home page, so you’ll be safe if your abuser takes your phone. The most important feature of the Aspire News app is called the GO Button, which you can activate the moment you are in danger. Once activated, the GO Button will send a pre-typed or pre-recorded message to multiple trusted, preselected contacts, or even 911, saying that you are in trouble. Additionally, once the app is activated, your phone will begin recording audio of everything that is going on in the room, which can be used as evidence for any legal proceedings that may stem from the incident. Robin emphasizes that it’s important to always have your location services activated, as many of the app’s features require it. For example, the app can be used to locate the shelters and resources closest to you.” (iTunes, Google Play)
Tags: Domestic Violence
6. The Savvy Social Worker – “Trying to stay abreast of developments in social work and human services practice? Few practitioners have the time to identify all the key sources of information on the web. This app, developed by the University at Buffalo School of Social Work, will help you stay current with new developments in social work practice, especially evidence-based practices and best practices. We bring information about key practice resources and practice research findings to you all in one place, in an e-news reader format. You select the information providers (channels) that you would like to monitor, and we do the rest. Included in our list are key sources such as the Substance Abuse and Mental Health Services Administration (SAMHSA), the Cochrane Collaboration, the Campbell Collaboration, ad Information for Practice.” (Google Play)
Tags: Social Work, Resources
7. Suicide Safety – “Suicide Safe, SAMHSA’s new suicide prevention app for mobile devices and optimized for tablets, helps providers integrate suicide prevention strategies into their practice and address suicide risk among their patients. Suicide Safe is a free app based on SAMHSA’s Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) card.” (iTunes, Google Play)
Tags: Therapist, Suicide, Social Work
8. The DBT Diary Card – “DBT Diary Card is the only DBT iPhone app designed and created by a licensed and DBT intensively trained psychologist.” (iTunes)
Tags: Therapist, Social Work, DBT
9. Dialysis Finder – Dialysis Finder App quickly identifies your location and lets you choose the nearest Dialysis Clinic as well as get other information about the location. A convenient way to find a US Dialysis Clinic near you. (iTunes)
Trigger Warning: A Chinese Father Saved More Than 300 People at Nanjing Yangtze River Bridge
“I understand these people. I know they are tired of living here. They have had difficulties. They have no one to help them.” – Chen Si
Since the Nanjing Yangtze River Bridge was first built in 1968, an estimated 2,000 people have died from suicide involving the bridge. According to data from 1995-99, in China’s first national survey in 2002, death from suicide accounted for 3.6 percent of the country’s total deaths. During that period of time, 287,000 Chinese people died from suicide every year, putting the average suicide rate at 23 per 100,000 people.
Chen Si, also known as The Angel of Nanjing, has been patrolling this bridge every Saturday for more than 20 years and has managed to save more than 300 people from death by suicide. He is a 52-year-old father from Nanjing, the capital of Jiangsu province of the People’s Republic of China. Following the loss of a close relative to suicide, Chen Si has taken up this cause because someone needs to.
A Long History
The relationship between mental illness and suicide is controversial in China. Those who follow traditional Chinese philosophy are not encouraged to express their feelings, nor are they encouraged to expect their environment to change to suit their needs. Therefore, intense misery and feelings of despair may go unrecognized, and suicidal symptoms are not easily detected by Chinese medical professionals. In fact, many doctors working in rural areas do not understand the symptoms of depression and often receive low salaries, which discourages more doctors from entering the mental-health field.
According to the World Health Organization (WHO) statistics, China’s suicide rate in the 1990s was 20 per 100,000 people. In the 1990s, female suicides were higher than male suicides by a factor of three. While China remains one of the few countries with a higher suicide rate among women than men, recent data shows that these disparities have evened out. In 2016, suicide rates among Chinese men and women came up almost even at 9.1 per 100,000 men and 10.3 per 100,000 women. Overall, China’s suicide rate in 2016 was 9.7 per 100,000 people, which was among the lowest globally.
A 2002 survey also revealed that 88 percent of females who died from suicide used agricultural pesticides or rat poison. Although China initially eliminated highly toxic pesticides to improve the safety of its farm produce, the elimination also had a substantial impact on the reduction of deaths from suicide among women. Research shows that men tend to attempt suicide through violent means such as hanging, whereas women tend to attempt suicide with medication. Overall, most studies indicate a decline in suicide rates among all gender and regional categories in China. The studies also recommended targeted suicide prevention programs, particularly for people in rural areas.
Women’s freedom, urbanization, and decreased access to toxic pesticides are key reasons behind the decline in suicide rates. According to Jing Jun, a professor at Tsinghua University in Beijing, “female independence has saved a lot of women.” The founding of New China in 1949 in combination with the opening-up policy in the late 1970s and the continuous growth of China’s economy has led to more equitable opportunities for women. Additionally, urbanization removed certain social constraints leading to more freedom for women. For instance, escaping an abusive partner or household may be easier in a city than in a small village.
Despite a decline in death by suicide rates in China, this is an area that we should pay more attention to. Chen Si acts as an angel, but he cannot do this work alone. He hopes that officials consider building a net across the Nanjing Yangtze River Bridge to prevent deaths by suicide.
The Crisis Intervention Centre, the first of its kind in China, was established by Nanjing Brain Hospital to provide psychological advice and support to Chinese people. The Centre also has a hotline, which can be reached at 862583712977.
The Lifeline Shanghai at (400) 821 1215 is a free, confidential, and anonymous support service that is open 365 days a year from 10am-10pm GMT+8.
Facebook and other social media platforms also offer many virtual support groups for individuals experiencing hardship. The National Suicide Prevention Lifeline at 1-800-273-8255 is a 27/4, free and confidential resource to support people in distress, prevention, or in an active crisis. Users should utilize the translate function on these web pages to adjust for language barriers, if necessary.
Can I Ask My Therapist About My Diagnosis?
“I don’t know if I did the right thing. Maybe I shouldn’t have.”
Power differentials are present within the helping profession and may cause the helpee to feel inferior to the helper, particularly in a client-therapist relationship. Oftentimes, clients are in a position where they feel reliant on guidance from their therapist. If there is a significant power imbalance, clients may be hesitant to ask questions and unsure of their role in the reciprocal helping relationship.
On a Reddit social media post, a female client with obsessive-compulsive disorder (OCD) posed this question: “Can I ask my therapist about my diagnosis?” The client has been working with her therapist who is a psychiatrist. The relationship between the therapist and client is fairly new. During one of their sessions, the therapist mentioned that the client might be autistic but they were unsure. The client was previously tested as a child, but the results did not confirm autism or autistic traits. Because the therapist has not confirmed the client’s diagnosis, the lack of uncertainty is creating terrible chaos in the client’s head, as she would like to know if she is or is not autistic. The client is thinking about repeating this question in her next session but is unsure whether it would be rude, pointless, or wrong. Unsure whether or not her therapist is capable of diagnosing autism, the client has tried to persuade her therapist into revealing a diagnosis, but the therapist redirected the conversation.
“This is something I’ve brought up with reluctant therapists as well. I understand the reasons they may not want to disclose that info to a client, but at a certain point it’s like if you had to go to the doctor every week to get an MRI and they just told you they’re just concerned with working on your symptoms.” – u/HyaAlphard
An article on Informed Consent written by Annette Johns discusses how the Canadian Association of Social Workers (CASW) Code of Ethics (2005) defines informed consent as “a voluntary agreement reached by a capable client based on information about foreseeable risks and benefits associated with the agreement.” Social workers have an ethical responsibility to seek informed consent from their clients at the beginning of the therapist-client relationship. Clients also have the right to refuse or withdraw consent and to have an opportunity to ask questions.
It is also important for clients to be engaged in the decision-making processes throughout the duration of the therapist-client relationship. In fact, informed consent and full transparency are integral to the relationship between a client and therapist and ensures the client’s right to self-determination, autonomy, dignity, and confidentiality. Social workers should use clear and understandable language to inform clients of the purpose, risks, limits, and reasonable alternatives to services.
Receiving a Diagnosis
Clients should be a part of the decision about whether to be assessed for a diagnosis. If the client is willing, the therapist has a responsibility to disclose the advantages and disadvantages of receiving a diagnosis. One advantage is that receiving a diagnosis can be comforting to clients who have been struggling with symptoms. Some clients find relief and feelings of validation when they can put a name to it, as well as decreased guilt, shame, and feelings of isolation. Receiving a diagnosis can also open up resources for the client and strengthen the relationship between the therapist and the client. However, clients should also be informed that diagnoses can stick with people, following them to and beyond adulthood even if they were misdiagnosed.
Suggested Questions to Ask
The client should feel comfortable to ask their therapist questions and express their needs throughout the duration of the therapist-client relationship. When the therapist suggests a “working diagnosis,” it should also be understood that the client is the most important member of the diagnostic process and has the right to obtain clarity by asking questions, taking notes, and being actively involved. Although the questions below are based in the medical profession, they are relevant to all clients. Out of seven questions posed by Helene Epstein, here are four relatable key questions:
What kind of test(s) will I have?
It is important for the client to know what kind of tests the therapist plans to administer. There are many different types of tests and ways to identify the source of a client’s concern.
Why do you think I need this test?
It is important for the client to understand why their therapist is even recommending the test in the first place, as not every test is essential, and some may be invasive or expensive. The client has the right to ask whether there’s an alternative, if it is costly, or if the test is necessary.
What do I need to do to prepare for this test?
While not every test requires specific planning, some might. If this is not communicated in advance, the client may have to reschedule.
When will I get the results?
Depending on the test and other extenuating factors, waiting times for results may vary. Clients should consult with their therapist for more details.
Clients have the right to be fully informed and fully engaged. Although asking questions may seem rude or wrong, it is not. It is important for clients to be informed about decisions being made on their behalf.
Start with these questions and see if they help give you the answers you need. It’s important you use your voice in client-therapist relationships and prioritize your needs. At the end of the day, the treatment your seeking is for you, so do what feels right.
Trigger Warning: Holistic Public Policy Can Save Lives From Suicide
At the age of 17, I lost my older brother, David, to suicide. As a gay man in his early 20s, David struggled with mental health conditions and social isolation. His loss affected my family, his friends, and me forever. It was then that I decided to dedicate my life to suicide prevention.
His loss, and the loss of so many others, makes the 2020 data showing that the suicide rate in the United States has increased by 1.4 percent even more upsetting. Michigan’s suicide rate has increased by over 33 percent since 1999, and among young people ages 10 to 24, the rate has climbed by 56 percent since 2007, making it the second leading cause of death for that age group.
Despite these sobering statistics, I’m confident that we can prevent suicide.
In the past couple of years, Michigan has taken great steps toward suicide prevention and mental health promotion. In a past legislative session, Senate Bill 228 established the State Suicide Prevention Commission, and House Bill 4051 established a statewide mental health crisis line. The passage of each of these bills highlights our legislators’ commitment to saving lives – but there is more we can do.
We need a holistic set of public policies that works to promote well-being and ensure safety across all contexts in which our young people live, learn, and play.
For example, in 2019 Sen. Curtis Hertel, Jr. introduced Senate Bill 532 to mandate suicide prevention instruction for K-12 students and professional development training for public school teachers and staff. As of the start of 2020, Michigan was one of only 15 states that encourages such training but does not require it. In comparison, 18 states mandate suicide prevention training but do not specify if it must be annual. Whereas 13 states have mandated annual suicide prevention training for school personnel.
In addition to training, 22 states also mandate comprehensive school policies on implementing suicide prevention education, responding to students in crisis, and handling suicide deaths. Again, Michigan has no such mandated policies.
The American Foundation for Suicide Prevention (AFSP), in partnership with The Trevor Project, the American School Counselor Association, and the National Association of School Psychologists has developed a Model School District Policy on suicide prevention. The document outlines policies and best practices that school districts can follow to protect the health and safety of all students.
Outside of the school, numerous other policies can help save young lives. For example, while federally mandated, Michigan is among a staggering number of states that currently have no laws guaranteeing mental health parity — the assurance that insurance companies will cover mental health care in the same way they cover physical health care.
In addition, 20 states now have laws banning conversion therapy – the practice of counseling or psychotherapy that attempts to change one’s sexual orientation or gender identity. The negative effects of such practices are well documented and include increased suicide risk, decreased self-esteem and well-being, disrupted healthy identity development, and increased social isolation. As it stands, Michigan only partially bans conversion therapy for minors, along with four other states. In total, 20 states ban the practice for minors outright, 3 are still settling the issue in court, and 22 states have no policy or mandate regarding the practice.
As a researcher, advocate, and brother, I know we need policies that are proactive rather than reactive, address multiple contexts, and dismantle the stigma around suicide. We can and must do more to save lives and bring hope to those affected by suicide.
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