Ethical Dilemmas Facing Mental Health Social Workers

In practice, it is sometimes necessary for social workers to make a judgment call, and one needs to be sure they are choosing the best options to resolve issues wisely when encountering an ethical dilemma. The social work code of ethics are designed as a guide to follow in order to help aid you in finding the best resolution when possible. Circumstances will naturally be further defined or complicated as specific details arise from any number of given scenarios a social worker may face over the course of his/her practice.

Accounting-EthicsOne important key principle to emphasize is the client’s right to self-determination which means the client’s desire to make his or her own choices including finding resolutions takes priority. This is paramount whether or not the social worker personally believes it is the right decision.

Instead, it is the role of the social worker to present all of the options available, thus allowing the client to make an informed course of action. For instance, perhaps a client has a different set of personal beliefs, such as those regarding sexual orientation. The social worker will need to put any differing opinions regarding this aside as they work with the client.

This right to self-determination may come into conflict with the right of confidentiality if the subject display or express being a danger to themselves or others. If a client expresses a desire to commit suicide or seriously harm another person, the social worker has a right to disregard confidentiality, as this is now a matter of public safety. In any other cases, any personal details shared with a third-party must only occur after the client has signed a consent form. Confidentiality extends to the educational process, in which case a social worker may never use a client’s real name when recounting certain events in a learning environment. Also, social workers should remember to stay updated and educated about advancements made in the field, which will also help you maintain the continuing education credits needed for licensure each year.

When providing mental health services, it is important for social workers to make sure they have the client’s consent to treat them. Clients need to be aware of the extent of the services they will be offered as well as the obligations for payment. If the patient is a minor, then consent will need to be obtained from a parent or legal guardian. The client should also be made aware of any alternative treatment methods that may be available to them.

Another ethical consideration for social workers is to determine how long treatment is needed in order to be effective. The social worker should seek to terminate the relationship with the client if they believe that treatment is no longer in their best interest, and the social worker will also need to keep records of their work. However, you need to be sure that names of third parties are kept confidential, and they you do not violate HIPPA Laws. Social Workers should seek to protect the privacy of your clients at all times as well as maintaining a professional relationship with their client at all times.

Also, you want to ensure to limit treatment only to areas in which are trained  and officially licensed for. Leaving your own personal issues or biases out of the therapeutic process is paramount to your client’s success, and always seek additional consultation for a patient as it is needed. It’s important to acknowledge if additional guidance is needed.

Using Car Rides to Get Teenagers to Open Up

smartglass

For many years as a frontline practitioner and later as a respite foster carer, I have often driven children and young people to supervised contact visits with birth family members or to 1:1 session outside of the home. After talking to some workers the other day, we all agreed that these car rides provide opportunities for some of our most powerful conversations to take place with the young people in our care.

Many of us recognise the importance of this uninterrupted, private time with no risk of a direct gaze which often enables children to share and process their experiences and emotions. Then, I had a ‘light bulb’ moment and thought about it in the context of the child’s trauma and attachment needs, and these car conversations made even more sense.

Children who develop in homes where they experience stress and fear because adults are emotionally unavailable due to their own trauma, their mental illness, substance dependency, interpersonal violence, or are perpetrators of sexual or other abuse don’t get to internalise a sense of a safe person or place they can go to, either literally or metaphorically. They have more reactive survival brains and fear/threat responses that are easily triggered.

Daily life can be a brutal assault on their senses, triggering continual fight, flight, freeze, friend or flop responses in a random way so car journeys can feel more contained, predictable and less sensory stimulating. Hence why I have often arrived at the fast food outlet and the young person has preferred to carry on talking and it’s been my anxiety about feeding them which has eventually got us out and into McDonald’s!

Thinking of the children’s early childhood relationships which have often been largely unpredictable, chaotic and/or inconsistent then the time spent with a worker who offers a better attachment experience can be calming and reassuring. A car journey can become a non-threatening, attachment focused, time and space without too much sensory overload with a trusted adult to begin to explore, express and invite a reaction or response to complex, memories issues or concerns. The side of someone’s head who is slightly distracted by driving can offer a less intense interaction allowing a child to think and share what they feel the need too.

Of course, for some youngsters, cars may remind them of traumatic events. I remember a 6 year old telling me how Daddy had hit Mummy in the car, and he had tried to stop him. Then, he showed me how he had tried to wedge himself between them. We talked about how this had felt for him and our journeys gave him a different experience and memories. Other children may find being in a confined space with a relative stranger very frightening and triggering so they may not settle well, may fiddle with things and wriggle about as they get the urge to flee without the opportunity to fulfill this need.

As workers, hopefully we can see car journeys as potential opportunities to listen whilst taking the foot off the ‘find out information/fix it gas, so we can focus on relationship building and just ‘being’ emotionally available and present with the child or youngster in our care. Then, we can offer them a journey that’s not just getting from A to B, but a space that  is about them.

What Else Can I Do With My MSW?

se211029

They say unemployment is on the decline, but I can tell you as a recent graduate with a Master’s degree in Social Work (MSW) from a top rated school that it isn’t low enough! Many from my cohort are still unemployed, and many who expected to be employees by their second year practicum were disappointed!

The University of Southern California, my Alma Mater, spent a great deal of time asserting that your MSW was more than just a degree for therapy and could be used as training for multiple work force sectors. By receiving your MSW, you learned skills needed to go into consulting, human resources, and any number of nonprofit sectors. In addition, combing these skills with other talents will create a variety of new and interesting opportunities

Though I remain unemployed, I am still using my MSW, and the skills I have gained are being used in way I would never of expected. Here are a few ways I am using my MSW that might surprise you and more importantly might give you ideas on new ways to use yours!

Documentary Interviewer:

Every single MSW had to take classes on how to interview clients and most have done many interviews themselves. These skills lend themselves directly to interviewing people for documentaries. You can interview patients at a hospice, creating personal histories of these peoples lives so that their families have something to remember them by!

Consulting:

What is a needs assessment? A systematic process for determining and addressing needs, or “gaps” between current conditions and desired conditions or “wants”.  Doesn’t that sound like a skill that might be useful in the work place. Working as a consultant allows you to put those strong assessment skills into practice in combination with your other skills to better understand what your client needs rather than what they might want.

Not only will you have the necessary skills and abilities, but you will already have experience working directly with difficult populations. A hyped up lawyer in a suit is nothing compared to staring down someone who is suffering a psychotic episode, and sometimes you still have to deal with a hyped up law in a suit when you go to court. Most people have little idea that a MSW has a backbone made of steel!

Data analyst:

Though it may require that you have some experience with statistics, a MSW’s eye for detail is important. In addition, social workers have a strong knack for understand both Qualitative and Quantitative statistic after reading over the tides of research papers during your program.

Many of you who have “Macro”  specific MSW degrees concentrated your course work with data collection and program evaluation which are both skills data analysts use on a regular basis.

One challenge that social workers face is convincing others that their degree is for more than just a clinical position, I know because I face that challenge in showing others my skills translate. Unfortunately, to do this, we have to pick up other skills and certifications along the way.

If you are using your MSW in interesting ways, let us at Social Worker Helper know in the comments below.

Social Workers, Watch Your Language

How often do you stop to check the words you’re using with client groups, whether verbally or in writing? Are you sure that you’re using a commonly understood language? Or have you slipped into the comfort zone of everyday “colleague speak” when communicating with your clients? At the root of every social work intervention, micro or macro, is communication. Communication is an interesting mix of words and non-verbal cues.

JARGON PICThis is one of the most basic learning curves in our early social work training. We’re taught all sorts of aspects of effective communication such as how to establish rapport, how to structure a sentence so that the question is “open”, what active listening involves and even how to place seating arrangements to avoid barriers.

We spend months learning how to facilitate groups, identifying roles that participants take on, learning skills to redirect conversations, applying conflict resolution skills and ensuring we maintain a cohesive group where everyone benefits from participation.

We also learn how to gather interested stakeholders to lobby for community justice solutions, empower community groups to represent their views to significant bodies and write reports to further the cause and inspire collective action.

All these processes require effective communication skills. And most social workers pride themselves on their communication skills.

When reflecting on practice, how often do we focus on the actual words we’re using?  The words we string together when interacting with our clients. Somehow, through our social work education and consequent experience in the sector, we start to use words that the sector understands but can fail to convey meaning when it comes to many client groups. Not only do we use terminology that is foreign to our client groups, we actually forget how and when to use “plain speak”.

When someone speaks to us in a language we’re not totally familiar with, there is a shift in focus  on trying to understand the words, as opposed to listening to the message that is being conveyed. At best it’s a distraction, at worst a barrier to understanding.

SOCIAL WORK JARGON

What are some examples of social worker jargon?  For starters, there are so many acronyms in both service language and diagnostic language I’m surprised we understand each other: “Mr and Mrs Brown state they are having issues with parenting, mother has diagnosed BPD but no current treatment, eldest child diagnosed with ADHD. Recommend referral of mother to GP for a MHCP,  both parents advised to contact local C&FS for support and Triple P, and check possibility of vacancy in OOSH for eldest child.”

How many social workers have suggested in conversation to their client that they make an appointment with their GP ? What happened to the word “doctor”? Yes it’s easier and faster to abbreviate titles and labels in reports and in rushed conversations with colleagues. But isn’t it ironic that we express concerns at the social media trend of abbreviations such as LOL, OMG and ROFL yet continue to add more acronyms to our professional vocabulary?

Besides acronyms, what about some of those words that we use every day? Words that are part of daily life for us but confusing for client groups? Examples are   Intervention, advocacy, rapport, consumer, resilience, empower, auspicing  and engagement

Ask Joe Public what he thinks these things mean. Don’t be surprised if he  perceives “intervention” to mean “interfere”;  “to build rapport” is to write a report, “consumer” is someone who does the shopping, advocacy is a lawyer thing, resilience is about the strength of metal, community engagement is lots of couples planning a joint wedding, and auspicing is something to do with orphans. Yes, these are real responses!

THE NECESSITY OF JARGON

Jargon is expected in the formal realms of our profession. Report writing, funding submissions and academic reviews are just some examples.  Using complex language is almost a kind of intellectual segregation.  It says I’m educated, and additionally specifies my expertise in a certain realm. It’s a kind of “tribal speak” . My colleagues know exactly what I’m talking about, and by using this same “language”, I portray that I am worthy of being in this tribe called “social workers”. I prove my belonging by speaking native social work. It’s okay to mix in some native doctor speak if I work in a hospital setting, and some native psychiatrist speak if I work in a mental health setting.  I guess I could choose not to, but then I would not be taken seriously by these allied tribes.

But when I transfer this “social work native” language to those outside the profession, I have to remember that translation may well be required. After all, someone coming to me for support, who is already feeling vulnerable, does not need the added distraction of words they don’t understand.

BACK TO BASICS

In summary then, spend some time reflecting on the words you use when communicating with clients. Use language that most will understand. Keep it simple. By going back to basics, you will ensure that meaning is conveyed without doubt or misunderstanding.

Instead of building rapport, “get to know each other”; instead of talking about resilience let’s discuss “the ability to bounce back”; instead of engaging, we’ll “get together and work on some solutions” and instead of advocating let’s “chat to that person on your behalf”. For the sake of those we seek to support –  please mind your language!

The Social Work Internship Debate

The debate of social work internships is a hot topic right now, and I hear a complaint about field placements come up daily. People have been constantly arguing about what works and what should be implemented. It does not seem like there is a clear consensus on the issue, and who knows if there will ever be one. I thought of sharing my perspective, especially with the Summit on Field Education coming up in October.

unpaid internship
Photo Credit: Beatriz Albuquerque, 2005, Chicago, Work For Free Project. Beatriz Albuquerque www.beatrizalbuquerque.com

Before I begin, I will share some information on my background. I am currently a dual-degree master’s student in social work and public administration, and get the chance to be exposed in two different programs. I have a clear focus of what I want to do, but still open to new opportunities. I am 23 years old and will be beginning my TENTH internship at the end of this month.

Yes, I have completed ten internships ALL in the public sector, and I value each of their experiences. In addition to my internship experiences, I worked at the career center at my undergraduate school for over three years and currently work at the career services office at my current school for almost a year. I would say, that I have had my fair share experiences with internships and have observed and learned what works and what does not. That being said, I want to share my thoughts on this internship debate and offer my thoughts.

First of all, I believe there should be an internship requirement for social work programs. Internships are valuable experiences and complement the information learned in the classroom. The more internships a student completes, the more opportunities they get to develop their career goals as well as expand their network. I completely agree with the required mandate for all concentrations, but I certainly do not agree with mandates that are currently in place and some of the suggestions I have heard.

Here are some of my thoughts:

Strict Requirements do not work and making them stricter will not work make them better: The strict requirements that are currently in place for social work internships are harming the current generation of students. Anyone advocating for even stricter requirements is ignorant of what is like to be a student now. We want options, and we want to individualize. Students entering colleges now have grown up believing we are unique, and we constantly brag about it. We each have our own interests and skills, and we want to find experiences that compliment them. A universal approach does not work for every client, and it certainly does not work for every social work student. Enforcing strict requirements is harming social work programs and ultimately the field.

Internships are for Exploration: As I noted before, internships are a chance for students to explore opportunities in their desired field. Since social work is such a vast field, it is important for students to have the opportunity to explore the many options. Students should be able to explore things they like before they enter into a career. I am not positive, but I certainly believe that many students drop out of social work program, because they are forced to perform work they do not want to do. If students had the option to explore areas of interest to them, then maybe they would value their experience more in the program.

Disciplining Does Not Help: This should be an easy topic to conceptualize, but schools across the country are punishing their students for wanting something different. Students are kicked out of programs for horrible field placements at the fault of the school for placing them there. Students are deemed UNFIT social workers for pointing out flaws at their agencies. The director of field education at my school has told numerous students to DROP OUT of the program simply if they do not like the rules. Isn’t that ridiculous? Since when is punishment the way to address issues in social work? Shouldn’t we supporting students through their beginning stages of being a social worker instead of setting them up for failure?

Mandatory Social Work Credentials for Supervisors Limit Options: I understand the reason for requiring a supervisor to have a social work background, but this limits so many opportunities for social workers to get great experiences. If you think about it, there are social workers that understand the values of social work WITHOUT a social work degree. If someone without a social work degree is doing the exact same work job at a similar agency than someone with a social work degree, why can’t they supervise a social work student? If colleges are in need of more placements for students, this should be a rule that seriously needs to be reconsidered. Having a social work degree, does not qualify you to be the best social work supervisor.

Concurrent Course Requirements: I am not sure if all schools require this, but my school definitely does. They require students to be taking course at the same time as their placement, primarily meaning they can’t complete their internship hours at all over the summer. This rule is ignorant of the needs and schedules of current students. I do believe an internship should begin after the student begins coursework, but this rule just makes things harder for students. Taking a full course load and completing an internship that is most likely unpaid is already a lot, and add on top of that working somewhere to pay the bills. If schools were more flexible with this rule, then maybe students will be able to complete the program with less stress and more enjoyment.

Now that I’ve discussed addressed some of the issues I see. Here are some suggestions I have for improvement:

  • Students should be required to have an internship since social work programs are professional programs, but students should have flexibility and should be individualized to their interests, skills and needs.
  • Students should have option in the internships they obtain and should practice applying and obtaining these internships in preparation for job applying process. Students can obviously receive help and support from the school during this process.
  • Students should not be punished for bad internship experiences. They are learning experiences and should be taken treated as such.
  • Supervisors should be approved by the school, but should not have to have a social work degree. Mental Health counseling, advanced psychology, public administration, public policy, business administration, and other applicable degrees can be effective supervisors and provide the student a great perspective in their internship.
  • Students should be able to be flexible with their internships, as long as they are meeting the requirements.
  • Minimum hours requirements could be implemented to ensure students perform an adequate amount of applicable field experience.
  • Internships must be approved by the field office as applicable placements, and the student and supervisor should set a learning plan to ensure all the social work objectives are met in the internships.
  • Students should not have to be placed in internships outside of their career interests unless they desire.

I hope this article is a start for discussion, not an argument. I do not mean to cause problems or trouble, but merely offer a different perspective that could be helpful in this internship debate. Please share these thoughts, and I’d like to hear other opinions.

What is a Political Social Worker Anyway?

EinsteinAlbert-Politics800px

When people ask what I do, my reply is always, “I’m a political social worker.”  The response is usually, “what is that?”  There is a small but growing group of political social workers who work mostly in legislative offices.  I have the unbelievable opportunity to try to correct some of the social injustices that send many people to seek help from private practitioners and/or agency caseworkers.

When I was finishing up my M.S.W. and my fellow students were talking about what they wanted to do after graduation, I chimed in saying, “I want to work in a legislative office.”  “Your just saying that to start conversation, right?”, was the reaction.  “You’re not really going to work for them.”  “Oh yes I am”, I replied.  “When you start the revolution on the ground, you will be very happy to have a friend up there.”  Saying that  Martin Luther King could not have passed the Civil Rights Act without Lyndon B. Johnson is a favorite of mine when trying to help students make that connection.

I am the social worker in the Office of NYS Senator Liz Krueger.  My official title is Director of Community Outreach.  My portfolio of constituents consists only of seniors.  I develop and run programs for them as well as help them individually with issues around housing, health care, transportation, long term care, and end-of-life. This aspect of my job allows me hone my casework skills as I interact with constituents and their problems every day.

We need more social workers interested in doing the kind of work that I do.  Wouldn’t it be wonderful if our legislators were social workers rather than the attorneys that most of them are!  Right now there is a social work caucus in our federal legislature. A social worker’s world view is holistic and broad, while many of our legislators have a myopic view of the world where things are only black and white.

It would serve our profession well if all social work students were required to take courses in political advocacy.  When my social work interns leave this placement, I know that I have succeeded as their field advisor if they make the connection between the work that case workers do on the ground and the legislation that is proposed in the capital.  The root of many of the problems that our clients and/or constituents come for help with are a result of bad or non-existent legislation.

As an example, right now in New York City, I see many of our elderly constituents who are in jeopardy of losing their homes.  Most seniors live on a fixed income, yet their rent keeps going up.  For those who are struggling financially, there is a program that freezes their rent; but they have to be living in a rent regulated apartment to receive that benefit.  We now have 1000 seniors living in the NYC shelter system, a number that is growing every day.   Shame on us!  I am advocating for providing these older adults with a subsidy of no more than a couple of hundred dollars a month. This would keep them in their homes and is more economically prudent than the cost of keeping people in the shelter system. This is not to mention how inappropriate the shelter system is for the elderly.

I’m often invited to speak to social work classes about what I do and why social workers are uniquely trained for politics.  A number of years ago, NASW published an article entitled, “Putting the Profession in Public Office.”  I always hand this out for students to read.  It talks about how social workers in the political arena can have a huge impact on people’s lives.

Every staffer in our office takes constituent calls, regardless of their title; and we all have our niche knowledge of specific issues. My co-workers all use social work skills regardless of the fact that none of them are social workers.

When searching for a place to bring your social work skills and knowledge, consider putting some time in a legislative office.  You will be surprised at all the you can learn and all that you can contribute.  Those of us who do this work live with the hope that “moving one grain of sand can change the world”.  It is what gets us through even the roughest days.

Women Concerns as Social Workers in the Workplace

On June 17th, 2014, Social Work Helper Magazine co-hosted a Virtual Town Hall with National Association of Social Workers (NASW -NC) by simultaneously conducting a Live Twitter Chat and Facebook Forum to identify concerns of women as social workers in the workplace. The town hall was held in preparation for the upcoming White House Summit on Working Families on June 23rd, 2014. Participants were asked to host local events in order to help identify priorities for the summit, and  As Editor-in-Chief of Social Work Helper Magazine, I will be in attendance at the Summit with President Obama.

working_families_summit_social_inviteAs a female dominated profession, approximately 80 percent of social workers are women, yet men overwhelming hold key leadership, administrative, and executive positions. The virtual town hall explored issues such as gender pay equity, sick leave, maternity leave, promotion/retention, workplace discrimination, and workplace safety. 

The key issues arriving from the live twitter chat were pay equity and the need for national unionization comparable to teachers, nursing, and law enforcement. The Facebook Forum most active discussions were workplace safety and the ability to use sick leave for self-care when needed. However, the consensus from both platforms is that no one felt safe reporting issues of with pay equity, sick leave, maternity leave, promotion/retention or workplace safety.  Dr. Michael Wright a professor at Tennessee State University who participated in the live Twitter chat stated, “When your job is what stands between you and homelessness, you don’t rock the boat”.

One woman made a profound statement in which I hid her comment from public view to help prevent any retaliation whether real or perceived. She expressed concern about hoping her comment does not hurt her job, but she also expressed the need to share with people who may understand.

As a woman who was out in the field with another woman three weeks ago when I was assaulted by a client with a brick in the head, I’m really tired of having safety training on fire extinguishers (which there are none in my building and it’s been evacuated due to fire twice in six months), but none on what I could have done differently when faced with a psychotic child with a brick. I love my job, but don’t feel I can turn a blind eye this time. Something needs to change. #workplacesafety

Law enforcement officers which is a male dominated profession requires at minimum a high school diploma and are often paid higher than an entry level Master of Social Work graduate working in the public sector of a female dominated profession. Despite both jobs being classified as hazardous by local, state, and federal agencies, social workers are often denied comparable overtime, time off, and other benefits given to law enforcement officers. When social workers witness or experience trauma or fatalities, there is no mandatory counseling or fitness for duty assessment to ensure the social worker is emotionally prepared for duty.

Social workers have  been denied the additional workplace safety protections given to law enforcement officers despite both law enforcement and social workers operating under statutory authority and hazardous conditions in the public sector. Some agencies do not even provide social workers with an agency vehicle or cell phone, and social workers are often required to utilize personal assets in order to perform job duties. Social workers are not given any self-defense, no radios, have no weapons, no backup, are often alone, and have no communications center to call for help to know someone is coming.

According to a 2007 Hill Briefing on Social Work Safety Issues,

A disturbing trend of violence against social workers and other human service professionals was mentioned in a letter sent to legislators by the bill’s sponsors. In April 2005, a woman in Texas fired a shotgun at two social workers visiting her home. In March 2006, The New York Times reported that Sally Blackwell, a social worker, was found dead in a field just outside of Austin, Texas. Throughout the investigation, her family said that threats were a daily part of Sally’s life as a social worker investigating accusations of child abuse and neglect with the power to remove children from their homes.

Two surveys conducted by the National Association of Social Workers in the last few years have found that job-related violence and the threat of such violence are common. In a 2002 survey, among 800 social workers, 19 percent had been victims of violence, and 63 percent had been threatened. In a 2006 national study of the licensed social work labor force, 44% of 5,000 respondents said that they face personal safety issues in their primary employment practice.

The current bill, H.R. 2165, would establish a grant program to provide for safety measures such as GPS equipment, self-defense training, conflict prevention, facility safety and more. It would also help with educational resources and materials to train staff on safety and awareness measures. The bill calls for Congress to authorize $5 million per year for the next five years and require states to provide 50 percent matching funds.  Read Full Briefing

Unfortunately, this bill and many others to address the debt of becoming a social worker do not go anywhere in Congress. Social Workers are often under a mountain of student loan debt in order to provide services to those within the margins. The unfortunate part is that many social workers and  social work students working in mandatory unpaid internships are living in the margins along with their clients. Many are having to rely on public assistance and programs in order to make ends meet and take care of their families.

Last year in New Orleans, a social worker named Ashley Qualls was murdered on her way home. Social Work Helper did a story on Ashley Qualls’ death when A&E First 48 Hours aired an episode with the detectives who continue to look for those responsible for her death.

Tulane School of Social Work graduate, Ashley Qualls, was working at a substance abuse treatment center when she was gunned down while walking home from work. Although Ashley was from South Carolina, she moved her family to New Orleans believing they would have more opportunity in a larger city. Each day, she rode public transportation to work, but at night she was forced to walk the 3.5 miles home because public transportation had stopped running. Read Full Article

It is my hope that events such as the White House Summit for working families will begin to acknowledge the specific challenges women working as social workers face in the workplace in order to serve others and take care of their own families. To view the storify of the Virtual Town Hall, you can visit this link.

Taking the Social Work Licensure Exam

Social work licensure can be a dizzying experience for anyone who has graduated with a Bachelor or Master of Social Work. Preparing involves understanding the different requirements for each state, contacting the local state board that regulates licensure, and communicating with your local, state, and national NASW.  Grasping the educational provisions required by the CSWE and adhering to the procedures used by ASWB, it’s no wonder that of the 27,699 exams administered in 2013, there were 6,093 failed attempts.

social-workFor those of you who are quick with math, you’ve already figured out that number equates to a 78% pass rate for the five different licenses they offer, which may not sound too shabby.  But consider this, the pass rate only takes into account first time test takers for that calendar year.

So, no matter how many times someone has taken and failed the exam in previous years, if they passed in 2013, they were counted in that number.  The level of confusion only increases as social workers allow year after year to pass between graduation day and exam day.  This is enough to cause measurable anxiety.  So what do social workers do when it gets to this point?  We seek out help.

A few years ago one of the most intelligent social workers I have met passed her clinical social work exam and is now practicing in the state of Georgia. For her, passing meant not having to go through the process over again for her fifth time. As far as my personal experience, the social work clinical license exam was the hardest exam I’ve taken in my entire life!  I studied hard and thought I would walk right in and ace the test my first go around.  However, I missed the mark by more than 10 points.  I was devastated that I had to go through the painstaking process of retaking the exam.

After I was successful at passing, my goal became offering help to other social workers who are trying desperately to clear this hurdle.  I have been working with social work licensing ever since and while I have had the privilege of sharing in the joy of many success stories, I have also witnessed social workers fail the clinical exam by as little as a mere point.  Some give up while others only get hungrier to succeed.

One option is to get together with colleagues or fellow alumni to create study groups.  We dust off the old text books and pull out the faded notebooks and buckle down to help pull each other through the process.  This works for some, however, let’s say 2 of the 5 people in the study group pass the exam and the others don’t.  While the newly licensed social workers are celebrating their success, the others may be left back…disappearing in embarrassment.  So we want to ensure that we are sensitive to the needs of all in the group.

A different approach is to turn to outside resources to move us forward on our quest.  Online test preparation programs, face to face groups, individual tutors, DVD’s, CD’s, apps, podcasts, and handbooks are some of the widely used tools.  Some are endorsed by NASW on a national level and some are even offered at NASW local chapters.   There are also some companies who provide group study events all over the country and many schools of social work are now incorporating a test prep component into their curriculum.  Be mindful that some of these programs are created by people who are not social workers and others who offer all manners of exams ranging from the LSAT to the GRE.

Technology also plays a role in advancing many social workers towards passing their exams.  There are apps that are offered free, as well as ones that costs.  At this time there are only a handful available and they mainly offer flashcards and practice exam items.  Web camera products like Skype and Google Hangouts assist many social workers with connecting to others when we cannot meet face-to-face for a studying session.

Submit your social work licensure stories of success, struggle, and any questions you may have about the process.  This is the first of a series of articles on the topic and as the resident expert-you can expect a well researched and valuable response on the level of competence you have come to expect from Social Work Helper.   Future articles plan to have interviews with key players from organizations such as CSWE, NASW, state jurisdictions, ASWB, and various test prep providers.  We also plan to do feature stories with social workers who have faced the exam and lived to tell about it!

Did you know…

…that ASWB creates the exams for social workers in 49 states (except California), the US Virgin Islands, and all 10 of Canada’s provinces?

Another Harm Reduction Perspective: An Interview with Walter Cavalieri from the Canadian Harm Reduction Network

The Canadian Harm Reduction Network is a virtual meeting place for individuals and organizations committed to reducing the social, health and economic harms associated with drugs and drug policies. The network was established in 1999 by a group of activists committed to improving the lives of people struggling with drug use, and Walter Cavalieri is the director of the organization.

The Canadian Harm Reduction Network is a virtual meeting place for people to exchange ideas and information. The network has been engaged in recent research, presentations and the media. Essentially the Canadian Harm Reduction Network wants to change the world to make it better, kinder, and a more evidence-based place.

The Canadian Harm Reduction Network has a Facebook page and a Twitter account. The Canadian Harm Reduction Network has also taken part in media studies looking at what harm reduction looks like internationally, rather than only what it looks like in Vancouver, Toronto and Montreal.

Photo-Podcast-16-Walter-Cavalieri
Walter Cavalieri

Walter worked in professional and academic theatre for over 20 years. However, he eventually began to become more in touch with his pursuit to improve individuals’ lives and make the world a better place. Therefore, he began to volunteer at the LGBTTQA counseling centre at the time and his work with the counseling centre became more interesting than any area of theatre work that he engaged in. Walter then went back to school and obtained his Bachelor of Social Work degree and resided in Toronto. During his initial involvement in Toronto, he began to work with children living on the street, that were surviving through drug use.

His initial response to children using drugs was telling them to stop using drugs; however, he began to explore alternatives to this view on drug use. He began to work with the children and discovered the drugs were often used as a coping mechanism for trauma. Walter also began to work with adults and opportunities for a needle exchange were established. He then attended a harm reduction conference in Toronto and realized that harm reduction should be very important in reducing the harm of drug use in Toronto. Thus, Walter helped to establish the Canadian Harm Reduction Network in 1999.

SWH: What does harm reduction mean to you?

Harm reduction means very simply “ending suffering and saving lives”, which is a slogan from Chicago Recovery Alliance. Therefore, whatever harm reduction does, it helps individuals who may be engaging in harmful behaviour move forward and make small incremental changes and improvements in their lives. The client is considered to be the expert and the service provider learns just as much from the client as the client learns from the service provider in order to facilitate less harm in the client’s life.

SWH: How easy is it to get funding for research in harm reduction?

Funding for drug research is very hard to come by. Harm reduction has a very close relationship with AIDS, but drug research needs to be expanded. Much of the funding comes from pharmaceutical companies, as those companies are often interested in drug research. However, it is very difficult to get funding for the health of people on the street or the harm that is coming from injecting. It is also difficult to obtain funding for this research because the government is not interested in harm reduction’s effects on drug use. The government does not like people who take drugs because it isn’t fashionable and does not play to their base.

SWH: Why are harm reduction approaches so controversial?

Harm reduction is done naturally to protect society, children, loved ones, families and communities. For example, children are taught to look both ways before crossing the street. Harm reduction is very intuitive, but keeps humanity’s best interest at heart. The stigma against people who use illicit or licit drugs (ie. prescription or over-the-counter medication) is huge and it’s fostered in official propaganda. Drugs are a dangerous substance to use badly. Instead of raising awareness and educating people to reduce the harm of drug use, the world is trying to induce fear on drug users and potential drug users. However, fear doesn’t always work.

SWH: What is the difference between a harm reduction based program and a 12-step program?

Harm reduction is more than individual treatment. As Dr. Gabor Mate would say, ‘everyone who is addicted to drugs has a history of early trauma’, then we need to address early trauma. However, individuals who have been experiencing life on the street for two to three years are continually being re-traumatized on the street. Many people who live on the street for many years have a limited chance of leading a drug free life because the drugs work for them in hiding the physical and emotional pain and trauma that they must cope with in their lives. What right do we have to say to a person that they cannot take away a painkiller and leave them to suffer, we are not sure that we have that right.

There are many ethical dilemmas in working with people who are struggling with drug and alcohol use that are insoluble. Thus, harm reduction is different than an abstinence-based or 12-step program because there is not one way to reduce harm (ie. remaining abstinent) but many ways. Harm reduction is very much based on an individual’s needs, temperament and goals; therefore, it can include abstinence; however, abstinence does not work for everyone. Harm reduction may not witness the solution as quick; however, the solution will most likely become apparent over time. However, since substances are illegal, it is very difficult to receive support for harm reduction practices. Thus, it is much easier to gain support for moderation management with alcohol and/ or cocaine.

SWH: What stage is Canada at for receiving government support for harm reduction?

The federal government still opposes harm reduction. However, on a province-to-province basis, there is some hope. However, funding is always difficult even for the provinces, but at least the provinces are discussing and brainstorming ideas regarding how harm reduction can be implemented. However, it has become increasingly more difficult to get support for harm reduction at the provincial level as grant funding for harm reduction has become more difficult to acquire. Many organizations have relied on city grants to fund harm reduction outreach programs, which is an integral aspect of harm reduction.

SWH: Do you think Canada is further ahead than the United States in harm reduction?

Canada is ahead of the United States in terms of harm reduction; however, Canada should be much further ahead than it appears to be. If you take a close look at harm reduction in the United States, there are at least 17 states that have Good Samaritan laws. Therefore, in some ways Canada is further behind the United States. Canada has led needle exchange programs and crack kit distribution; however, these programs and resources need to be further administered in both Canada and the United States. In addition, the United States has very solid activist groups that are dedicated to making a difference and advocating for harm reduction, which do not exist in Canada.

For more information please visit the Canadian Harm Reduction Network’s website at .

NASW Technology Standards: How Do You Measure Up?

Social Worker 2

One thing that students and current working social workers are familiar with is the NASW, which has a huge influence over most of the standards set for social work practice and education.  They also have some clearly defined standards for technology as outlined in the NASW’s Code of Ethics.

The standards cover a wide variety of topics, and I know that my education as a social worker did not address more than a minimum number of the standards. As discussed in an earlier article by Deona Hooper, Social Work and Technology: Fails in Teaching Students Technology, even though in 2005 it was directly laid out that we should by the NASW!

Lets take a look at what the NASW’s standards are and we can see how we measure up:
I will be scoring myself on a 1-5 scale you should too!

Ethics: 4/5

“Social workers providing services via the telephone or other electronic means shall act ethically, ensure professional competence, protect clients, and uphold the values of the profession.”

Technology adds an entirely new dimension to the ethical standards social worker’s have to abide by. Not only do you have to know what can  and cannot be shared via communication on telephone and email. Technology has a way of blurring lines that are otherwise clear. If someone texts you something are  you still mandated to report that or is that something you keep private? What about if you hear something in the background of a Skype conversation?

Privacy: 4/5

“Social workers shall protect client privacy when using technology in their practice and document all services,taking special safeguards to protect client information in the electronic record.”

Do you know about HIPAA regulations? Do know about the many ways client confidentiality can be compromised in electronic means? More importantly do you know what you might be held liable for? To compound  the issue  most social workers need to know about how to maintain client privacy when using nonstandard means of communication. This is particularly relevant when looking at the recent development of teletherapy (therapy via video conferencing). Worse, what happens if you store your clients information on a personal computer and it gets lost?

Let me know in the comments section if you have ever had questions about client confidentiality and privacy related to technology!

Access: 3/5

 “Social workers shall have access to technology and appropriate support systems to ensure competent practice, and shall take action to ensure client access to technology.”

The NASW acknowledges that we work in organizations that often have obsolete software and equipment and they clearly state we should advocate for both ourselves and our clients when it comes to access to technology, something I agree with. Good job NASW! Do you have access to “appropriate technology”? Do you know what the technology you might need is? Let alone the technology that your clients might need. This is a gap in education for social workers that needs to addressed by schools across the country.

If you know of any schools that have classes that address technology and social work let me know in  the comment below!

Proficiency: 3/5

“Social workers shall be responsible for becoming proficient in the technological skills and tools required for competent and ethical practice and for seeking appropriate training and consultation to stay current with emerging technologies.”

This is where you can check where you measure up, do you know how to use the technology in your workplace? Does your workplace offer training in that technology so that you can better help your clients? What should social work programs offer in the way of technology?

Let me know in the comments below what you wish your social work program had taught you about using technology to help your clients!

Final Score: 14/20

Ouch  70%!  It is pretty obvious that this is an issue that still needs to be address, for right now you can keep visiting Social Work Helper to educate yourself about technology until social work education gets its act together!

And don’t forget to let me know your final score in the comments below!

The Business of Social Work Practice

Over the last decade, certainly in Australia, funding for human services organisations has undergone significant change.  The days of filling out an annual evaluation report and expecting to be automatically re-funded are gone. Simply ensuring you meet the objectives of last year’s funding is not enough. A competitive tendering process is now a harsh reality in the realm of community services. What implications does this have for social work practice?

CompetitionFirst of all, we need to get comfortable with the notion of “competition”. It’s a word that doesn’t seem to feel comfortable with most social workers.  And yet, in the tender process, that is exactly what we face.  May the “best” organisation win. No matter what your values and passions may be as a social worker, no matter how much you abhor the thought of competing with another well-meaning, non-profit agency, no matter how much you talk about collaboration and partnerships, the bottom line is that you have to provide evidence that your organisation deserves a portion of limited funding more than another.

Secondly, we need to become acquainted with the word “business”. Traditionally, funding in community organisations is prioritized to the grass-roots workers – those who deliver service to the client group. The rest of the “business” is expected to be run by volunteers. Or the coordinator of the service works double the paid hours to ensure everything is running smoothly at a business level. At times a small portion of funding is reluctantly allocated to a bookkeeper or administrative assistant or allocated to the social workers who are already overloaded meeting client needs. Besides being an unrealistic addition to workload, most social workers do not have an effective skills set in business practice.

This reluctance to allocate funds to the business side of the organisation exists because traditionally, community organisations are “supposed to” spend allocated money on client service delivery. This has been perceived to mean “direct service”.  But tell this story to any small business, or a corporate organisation and they’ll ask “how does your organisation (business) run effectively and professionally without business and marketing expertise? “ Every business knows, to compete effectively in the market place, you need people with both business and marketing skills. Private businesses are born in a tough, competitive market place so this notion is simply accepted as part of business life. Community services however, were born in a “charitable, gentle, cooperative” market place.

Time to wake up – things have changed. As many of the larger community organisations have proven, allocating funds to the “business” side of an organisation enables growth. These large community organisations have whole departments allocated to “operations”, “marketing and communications” and “fundraising”. Those employed to deliver client service are able to focus on just that – their clients. The business side of the organisation is fine-tuned by those with specific skills in those areas. The ultimate result for those organisations is that they’re highly competitive in the tender process. And the more tenders they win – the more their client needs are met.

So how would a small community organisation start the process of being competitive in a business sense when funding is so limited? First of all do what you’ve been taught to do as social workers: look at the big picture.  Empowering your clients is not just about casework and running groups. The stronger your organisation is, the more chance you have of gaining the funds you need to initiate or expand service provision. Then question the status quo. Just because it’s always been done this way, doesn’t mean that’s what works best.

Perhaps the well-meaning volunteer, or the overworked caseworker are not the best people to be focussing on business operations or communications strategies. Where there really is no funding to employ more people, start placing some priority on business practice. Think of ways existing staff and volunteers can be up-skilled so that they understand and possibly assist in strategic planning, fundraising, marketing and business operations. Talk to some of the larger organisations and ask them how they raised the funds to break away from the traditional charitable approach to a solid business approach. They also started out small.

Then ask yourself these questions: How many social workers know how to write up a business plan? Or understand that a marketing plan is an integral part of a business plan? How many social workers understand that innovation and creative thinking are essential elements of any successful and sustainable business?  Or at a smaller level, how many social workers understand how to promote their services to their client base?

Social workers traditionally are not business oriented. Social workers want to see all human services as affordable. But in a world where values change, where government priorities become unpredictable and outcomes are consistently measured according to standards set by external assessors, isn’t it time social workers took on some business sense?  We’re not the traditional “do-gooders” anymore. We’re agents of change. It’s time to look inward at our profession and take some responsibility for the lack of funding to critical operations funding in our organisations.

After all, we continue to accept and work under the premise that our organisations should only allocate funding to direct service, not to administration. Ironically we do this because we’re used to another kind of tender – being gentle.  Ultimately, this quiet acceptance significantly reduces the chances of community organisations gaining momentum and successfully competing for effective client services.  Which tender are you aiming for in your social work practice?

The Crisis of Identity: the First Year Out as a Social Worker

Four intense years are spent learning social work theories and attending practicums to put theories learned into practice. Our values are challenged, we get a feel of our area of interest, and we develop our professional identities by being thrown into the deep end of field practicums. We receive our own clients, we mingle with existing professionals, and  we are responsible for our load. In class, we are placed in role plays that depict social work dilemmas and our conflict skills are tested.

kassie graduateOur assignments involve creating realistic workshops for client groups and given to agencies to use. Then, we write our resumes and locate our professional selves in preparation for employment. Last, we present a conference for professionals in all fields sharing our insights, passion and skills, and we write a final academic paper pinpointing an area of interest and our ideas for positive change.

But at what point do we become social workers? At what point do we suddenly go from student to professional? Our final placement leads us to feel we are inches away from being true professionals – we have our own clients, we participate in staff meetings and discussions, we write client notes and case manage, we attend regular educational workshops.

When we have our final class, we are congratulated as social workers; our photograph is taken and hung in the University humanities foyer. Then, we are told see you ‘in the field’.  We relax for a few weeks…we feel OK to kick back from job searching instantly as we are burned out from the crazy hours and stress spent on our conference paper. Also, it is near the end of the year, and we are told jobs will roll out at the beginning of next year.

Next year comes. We start searching for jobs. But we find a lot of the criteria requires two years POST experience…despite our placements, our four years of study…we are suddenly not qualified enough. Some of us have had jobs in the field but not for two years. Does this mean we are not fully-equipped social workers? Are we now simply ‘newbies’ who still do not know enough to get a real job?

How did we go from being prepped for employment, bursting to the brim with anticipation to suddenly not being ready? Some job applications do not return our expressions of interest, yet we hear a massive need for social workers. We suddenly feel inept despite being told we are professionals, and we suddenly feel there are no jobs for us despite being primed for employment.

We start to fear losing our skills and becoming rusty…we start to doubt our ability. We go from calling ourselves social workers to saying we have no experience because the jobs we search for require this. What do we do? Volunteer? But what about those of us who need to earn a living? Must we begin again on at the bottom of the rung when we have done the hard yards of study and placements?

Despite gaining a degree, we feel as though we are back in Kindergarten. So what are we to do? Ride it out? Keep applying? Go for other jobs that do not spell ‘social work’ and get our foot in the door that way? Endlessly advertise ourselves in the hope we will be in the right place at the right time? How do you manage the huge ball of anticipation you’ve been building for four years to sink your teeth into employment to have to sit and wait…wait…wait.

Again, at what point do we graduates become recognised as social work professionals?

4 Pitfalls to Avoid When Using the Internet to Find a Job!

linkedin

Many of you reading this may be recent or soon to be graduates, and/or  you have been looking at the job market with abject terror. You might feel somewhat akin to how a deer must feel as they are staring at an oncoming car. You know that you need to find a job, but you also can’t seem to make any moves to do so. Well don’t let opportunity pass you by! Don’t fall into these technology pitfalls that can make finding a job even harder!

1. Searching websites like Idealist, Indeed, Craigslist

Yes, those websites are great, but they also create several problems:

  • They encourage you to apply for job with companies that you don’t know about. Which is fine, but you are far more likely to get a job with a company that you know and love.
  • Everyone else is seeing these same jobs, which means you have to stand out in an even bigger crowd
  • These websites can be outdated, there is no guarantee that you applying for a job that even exists!

Solution: Find organizations you know and love! Look for jobs on their website, even better call their HR department. Yes, they might just tell you to look at the website, but you have made an impression that you want the job. The person is even more likely to remember your name. You may also hear about a job before it is posted!

2. Not having a complete Linkedin profile

Good job, you made yourself a Linkedin! Oh, you didn’t complete the whole thing. I guess that is fine, I am sure the person hiring you for your dream job will fill in the blanks though it might not be with what you should expect.

If you are going to have a Linkedin you need to complete it and continue to update it.

  • A post once a week is good, once a month as a minimum.
  • You never really know who is going to look at your profile. You might be missing out on any number of opportunities.

Solution: Complete your Linkedin profile, for those who are not tech savvy and are having a hard time there are many guides out there, call a friend and you can even email me and I will look at your profile and give you some free advice!

3. Mixing Work and Play

  • I am all for people using their computers for fun! By all means have a Pinterest about your favorite band, cat pictures etc. Use your twitter to talk about the latest celebrity idiocy, but please, oh please….
  • Have separate accounts! The last thing you want an employer to see is your drunken, misspelled political rant on twitter.

Solution: Use an Alias for your personal accounts, or just your first name! Make sure they are not linked to the same email address. Setting things to private is not adequate, as nothing is really private on the internet.

4. Not promoting yourself

Again, we live in an age where you never know who might be looking at your online profile!

  • Put your best face on!
  • Make sure your contact information is up to date and most of all promote yourself. It is ok to shamelessly ask your friends to share, retweet, and pin your posts because you will do the same for them.
  • The point of this whole social media world is to have as many people as possible see your best face.

Solution: Share, share, share: make sure you post once a week at least and share it. If you are in a resume pool and the hiring manager has read your blog and loved it you are going to have a huge advantage over someone they have never heard of before!

Now, you know technology can help you find a job, but it can also hinder you.  Make sure you are using it right and remember nothing beats good old fashion legwork!

Harm Reduction Defined

Harm reduction seeks to maintain people’s safety and minimize death, disease and injury from high-risk behaviour. The reduction of harmful consequences can be associated with drug use or other risky health behaviours. Thus, harm reduction can be used to decrease harmful illicit drug use or prostitution. The main goals of harm reduction are supported by social justice and empowerment theory, as harm reduction allows people to make autonomous decisions, but it also addresses the inequalities and stigma that individuals who take part in risky behaviours experience in the community.

Harm reduction functions on a continuum with prevention and education on one side and enforcement on the other. The criminal justice apparatus cannot fix many health issues that result in risky behaviour; thus, harm reduction advocates for prevention, treatment and other healthcare services. However, critics of harm reduction often believe that tolerating these behaviours can represent an acceptance of these behaviours as acceptable in the community.

Drug Use

hr saves livesHarm reduction respects that people who use drugs will not always abstain from using drugs. Thus harm reduction strategies include needle and crack pipe distribution programs, supervised injection facilities, methadone replacement therapy, heroin maintenance programs and naloxone distribution. The primary function of needle and crack pipe distribution programs and supervised injection facilities is to provide clean needles to decrease the risk of abscesses, damage of veins, syringe sharing, HIV/HCV infections and fatal overdoses.

Methadone replacement therapy reduces harmful effects of opiates by substituting an opiate drug with an oral prescription, which eliminates the need to inject. In addition, if administered properly, individuals will not experience withdrawal symptoms and cravings. In heroin maintenance programs, people are provided with medical prescriptions for pharmaceutical heroin so that heroin-dependent individuals can use heroin in controlled environments.

Evidence has suggested that these programs can improve the health and social circumstances of participants, while also reducing costs incurred by criminalization, incarceration and health interventions. Naloxone distribution is used to counter overdose effects of opioids such as heroin or morphine overdose. The World Health Organization indicates that naloxone is one the most “essential medicines” and recommends its availability and usage. Harm reduction programs and practices help drug users develop awareness and education regarding safer drug use practices. Harm reduction programs also provide easy access to addiction counselling as drug addicts are often in contact with drug programs, social workers and healthcare staff, which can evidently lead to discontinuation of drug use as well.

Alcohol-Related Programs

The HAMS harm reduction network encourages goals for safer drinking, reduced drinking, moderate drinking and abstinence. Thus, harm reduction provides education to individuals on alcohol consumption, but allows individuals to make their own choices. In addition, the dangers of drinking and driving have also been analyzed and designated drivers or free taxi programs are used to reduce the occurrences of drunk driving accidents.

Tobacco

Harm reduction to reduce tobacco consumption takes action to lower the health risks associated with using tobacco, without engaging in abstinence from tobacco and nicotine. Such methods may include switching to lower tar cigarettes or using a non-tobacco nicotine delivery system. In addition, although discontinuing the usage of all tobacco products is encouraged, many individuals are unable or unwilling to be abstinent; thus, harm reduction can provide many benefits to these individuals.

Sex

Safe Sex
Many schools have committed to pre-teen and teen students who may be sexually active. Since teenagers may have sex, a harm reduction approach seeks to provide adolescents with the education to have safe sex such as use of birth control and condoms to prevent sexually transmitted diseases and unwanted pregnancy. These programs differ from abstinence-only education, which assumes that educating teenagers about sex will encourage them to engage in it.

Prostitution
Harm reduction provides education and advocacy for the human rights of both voluntary and coerced prostitution. Harm reduction strives to end the marginalization, isolation, powerlessness and oppression of sex works by promoting development of a critical and social consciousness. Since much disapproved behaviour from sex workers is often criminalized (ie. sex trafficking), the disproportionate amount of violence that they endure makes them increasingly vulnerable. Thus, sex workers are considered to be addicts, incompetent, diseased and desperate despite their likely circumstances of not having any other income options. Thus, instead of victimizing and infantilizing sex workers, harm reduction promotes the health, rights, and dignity of individuals impacted by sexual exchange and provides respectful and non-judgmental affirmation of power and control in society.

Photo Credit: Courtesy of Youth Rising

References

BC Centre for Disease Control. (2013). Harm Reduction. Retrieved March 24, 2014,from BC Centre for Disease Control :

Canadian Harm Reduction Network. (2014). What is harm reduction? Retrieved March 24, 2014, from Canadian Harm Reduction :

Canadian Paediatric Society. (2014, Feb 1). Harm reduction: An approach to reducing risky health behaviours in adolescents. Retrieved March 24, 2014, from Canadian Paediatric Society: health-behaviours

Harm Reduction Coalition. (2014). Sex workers without boarders. Retrieved March 24, 2014, from

OHRDP. (2014). Harm Reduction. Retrieved March 24, 2014, from Ontario Harm Reduction Distribution Program : http://www.ohrdp.ca/about-us/harm-reduction/

Rhodes, T., Kimber, J., Small, W., Fitzgerald, J.,Kerr, T. et al. (2006). Public injecting and the need for ‘safer environment interventions’ in the reduction of drug-related harm. Society of the Study of Addiction, 1384-1393.

Wikepedia Encyclopedia. (2014). Harm reduction. Retrieved March 24, 2014 from

It’s Time for Social Work Internship Reform

On March 14, 2013, the Council for Social Work Education opened the public commenting period for individuals, schools, and organizations to make recommendations to help improve the social work degree. Social Work Helper conducted a focus group via twitter with educators, practitioners, and students to help identify the most important issues to the social work community.

devilwearspradaInternship reform was the primary concern for focus group participants. Participants overwhelming believed that social work students should be able to customize their degree based on need and work experience. In my article, Suffering in Silence: Identifying the Oppressed, I go in more detail about why I believe this policy change is needed.

If students can’t be trusted to come to the best conclusion on the number of internship hours they need under counsel of their advisor, how can we entrust them as social workers to problem solve someone else’s life with no stake in the outcome?

Currently, the Council for Social Work Education has instituted a 400 hour (12 credit hours) minimum internship requirement for BSW and over 900 hours (18 credit hours) for MSW students. Most people believe it’s the NASW or individual institutions that have the power to reform the internship requirement, but the CSWE is the accrediting body who instituted this policy. Macro MSWs and BSWs are often competing in the job market against other generalist degrees in which the social work degree is not even listed as an acceptable degree.

These mandatory minimums prevent schools from innovating generalist and macro programs to be competitive against the degrees generalist students are facing in the job market, and they prevent students/consumers from tailoring a social work degree to fit their needs, projected goals, and desired career paths. Removing a mandatory minimum structure does not prevent students from continuing to take the same internship credit hours if that is their desire, but it does also allow for flexibility for those who want to specialize and/or who are already working in the field.

We understand that eliminating the 960 hour mandatory minimum internship requirement for the Clinical track MSW degree may be problematic since it’s the only master level degree that has the ability to conduct psychological assessments and/or treat mental health disorders. However, the Department of Psychology already uses the desired model for their Generalist and Clinical Psychology degree which can be viewed at  http://www.ecu.edu/cs-acad/grcat/programpsyc.cfm.

Although my petition does not specifically request changes for clinical practice, there are many fact based reasons for changes. The generalist Master of Psychology degree does not require an internship, but instead uses a thesis  and/or internship based model. Additionally, the clinical masters psychology degree requires only 10 credit hours in paid internships while the MSW requires 18 credit hours in unpaid internships. Social Workers always want to compare ourselves to Psychologist, what about in these instances.

For the generalist track MSW and for all BSW programs, we want the mandatory minimums for internships removed, so students can customized their social work degree based on need and work experience.

* For Students with Work Experience or Working Practitioners, senior seminar or Capstone projects are both acceptable standards to demonstrate knowledge. Currently, the social work degree is the only degree that requires double or quadruple internship credit hours out of all disciplines.

  • BSW Student who plan to take advantage of the Advance Standing Status and seek a Clinical MSW, they should be able to reduced internship credits and add more psychology course work. However, BSW Students with no work experience should be encouraged to continue incorporating internship hours in their plan of study.
  • BSW Students and Nonclinical MSW Students should have the opportunity to customize their degree based on need, work experience, and desired career path whether this means taking more technology, business, clinical or political sciences courses in lieu of more internship credit hours.
  • Traditional BSW Students and Non-Clinical MSW Students with demonstrated work experience should have Capstone projects as an alternative to demonstrate knowledge which is an acceptable standard across disciplines. Students should not have to pay college tuition to work for free when it creates a hardship and does not add value to the social work degree.

The purpose of the internship is to provide work experience and to prepare students for the work force, but these mandatory minimums retard student’s ability to tailor a social work degree to the individual instead of using a cookie cutter approach.

Eliminate the mandatory minimums for all BSW programs and the nonclinical/generalist MSW degree for 2015, and make it retro-active for current students. Let’s also use this as an exercise to show the power of social media. Public commenting ends May 4, 2014.

According to CSWE President Darla Coffey, “CSWE does not require programs to allow students to earn field credit through their employment – accrediting bodies are not that prescriptive. CSWE does require that they programs have policies in place in order to ensure consistency and transparently.” However, there is no enforcement to ensure students have the same opportunities available per institution. Removing the mandatory minimum internship requirements will provide students with more autonomy in choosing the best options available to them while still having counsel from their Advisors.

Before this solution is easily dismissed as a radical departure from the way things have been traditionally done, as social scientist we should be asking our schools of social work to analyze the demographics and trends of incoming students. What are the financial needs of students who enroll, have BSW enrollment declined into graduate schools, what does the make of the student enrolling look like?

If there is a skew towards traditional students versus non-traditional students, this is an indicator of a larger problem especially when recent studies report only 16 percent of students are traditional students. How is social work measuring up and what are the barriers to obtaining a social work degree.

EmailbyDarlaCoffey

Licensed Social Workers Do Not Mean More Qualified

Recently, I came across a Boston Herald article questioning why 34 percent of the Boston Division of Children and Families (DCF) were unlicensed social workers. The tone of the article suggests that unlicensed workers are not qualified to perform their duties while indicating that licensed social workers equated to a higher standard.

As a former Child Welfare Investigator, those who follow Social Work Helper is well aware that I am a strong advocate against the Licensed Clinical Social Worker (LCSW or equivalent) becoming the standard for all social workers especially in the public sector and child welfare. Many hear the word licensed and assume it means in compliance or adherence to a certain standard, and it does if you are providing mental health services. Until the LCSW, a doctorate in psychology was needed for diagnosing and treatment. Social Work Licensure Advocates for the LCSW changed that dynamic and have helped to make mental healthcare services more accessible. However, each state develops their own licensing requirements which often varies from state to state.

As it relates to the Licensed Clinical Social Worker (LCSW) or the Licensed Independent Clinical Social Worker (LICSW) under Massachusetts’ licensing law, it means the individual social worker has a master degree in social work, and he/she is licensed to diagnosis clients with a mental health disorder and/or provide treatment to help improve their outcomes after being diagnosed with a mental health disorder. Additionally, Massachusetts provides licensing for Bachelors level social workers. However, this is not the standard in North Carolina or the majority of states.

Currently, most Child Welfare Agencies require at minimum a bachelors degree in Social Work or related field. However, by requiring social work licensure, I believe it places additional financial burdens on social workers working in traditional social work roles while the Council for Social Work Education fails to address the barriers and challenges those in the public sector face in pursing a social work education.

Both Child Welfare Social Workers and Police Officers are given powers by statutory law. However, child welfare agencies are not required to be accredited and maintain minimum training and standards certifications like police departments despite recommendations by the United States Government Accounting Office (GAO). Although studies show a social work degree is the recommended degree for a child welfare setting, studies also recommend accreditation as the best course of action to improve outcomes for children and families. Having licensed social workers do not guarantee their course work was specifically for working in child welfare nor does it institute transparency, accountability, program evaluation, and minimum standards of care as well as creating standards for the Agency’s administration of policy.

Many social workers are deterred from pursing a social work education due to the barriers and oppressive polices against older, working practitioners, and/or the underpriviledged. Although I had a BSW degree and working as a Child Welfare Investigator, I had to quit my job and work for free at another human service agency in order to be in compliance with the internship requirements. Social Workers are finding themselves without health insurance and in economic turmoil in order to comply with a licensing standard that is geared towards clinical practice and not macro/public service.

The Division of Child and Family Services and other child welfare agencies act under the authority of federal, state, and local statutory laws to investigate allegations of abuse, neglect, and dependency. These agencies are also charged with making recommendations and monitoring the fitness of parents once a determination has been made following a family assessment or investigation. As a result of this statutory authority, licensing law advocates have been unsuccessful in eliminating the licensing public sector exemption for child welfare and human service agencies. However, they have been successful in creating this mandate in the private sector.

Governor Deval Patrick Addressing the Media on DCF
Governor Deval Patrick Addressing the Media on Division of Children and Families

As a Child Welfare Investigator, I brought a knowledge base of almost 14 years of interview and interrogation experience in addition to a Bachelor of Social Work. Later, I pursued a Master degree in Social Work with a concentration in management and community practice.

However, without doing an additional two years in post graduate doing therapy, I am not eligible for licensing in the State of North Carolina. Because someone can go straight to undergrad, then to graduate school, and then work an additional two years post graduate doing therapy for less than minimal wages to get a LCSW in the State of North Carolina, it does not make them more qualified as a child welfare social worker. It makes them more privileged.

Child Welfare social workers act as brokers when treatment services are needed or recommended. We connect families with community providers and resources who are trained to provide those services and make expert recommendations on their progress or lack of progress.

Child Welfare Services must coordinate between schools, police department, hospitals, and other community providers in order to obtain information and coordinate services while maintaining case documentation and hourly billing for reimbursement from the federal government. Unlike private sector project managers, child welfare social workers must complete this high wire act with limited resources and access to technology while dealing with a load of bureaucracies in poor work environments. Child Welfare Social Workers live and work in fear because the bulk of your time doing triage and cases with low activity often get re-prioritized due to high caseloads and staff shortages.

When I investigated cases, the police investigators relied on my evidence and case gathering to determine whether charges should be filed because social workers are more educated and are the experts in these cases. Social worker have both education and training in many aspects police investigators do not. Yet, often the police investigators that I interacted with had higher salaries than I did, received over-time pay or comp time in excess of a 40 hour week, and most only a high school diploma or at best a bachelor’s degree despite our jobs being classified as hazardous by both the county and the State.

If there is a tragedy, the media is asking the wrong questions, and Agencies are not going to steer you into asking the right questions. Child Welfare and Human Services Directors answer only to their Board of Directors, and they operate independently of the county or State unless State legislation has addressed this. State oversight is limited because Child Welfare Agencies predominately operate by mandate of Federal law as adopted by State law.

If you want to know why something happened, find out the case number ratios for each social worker and the amount of hours each worked. See how many children a social worker has on his/her caseload and their risk level which determines the amount of times each social worker must visit each child monthly. Look at the administrative time logged for each social worker which provides insight into actual days work,  time in meetings, time spent in case supervision, and training records. You will find the numbers won’t add up to what is humanly possible.

Do you automatically assume that each case only has one or two children in the same household or go to the same school? Eight-teen cases don’t sound like a lot, but you could easily have over 55 children with moderate to high risk levels. Moderate risk requires bi-monthly visits and high-risk requires weekly visits. Low risks require monthly visits, but they are often not enough to keep a case open for services.  No matter how many children on your caseload, you don’t stop getting cases. 

It is not uncommon for kids to leave for summer camp or go visit relatives especially when they are not in school, and a courtesy request home visit made to another Agency in another state could take months to occur. States are not connected, and sending out an alert on a missing child equates to an email and a report to law enforcement which often don’t go anywhere due to being out of their jurisdiction for investigation.  I believe the cases in Boston will expose systems failures if the right questions are answered. 

Ask for the same records and standard operating procedures, you would seek if you want to know if a police officer or police department was malfeasance and whether proper in-service training was up to date. Under current federal mandates, it is statistically impossible for the best qualified social worker to adhere to every standard and best practices. Front-line staff often take the fall while policy and system failures are not being properly identified.

Where are the supervisory case notes by each supervisor who is suppose to meet weekly with their subordinates to discuss all the children on their caseload? Are the checks and balances clearly defined by supervision and the administration to account for the whereabouts of children falling under the scope of child welfare services, and how is it monitored? 

I challenge the media to ask the right questions. In the video below, the Governor addressed allegations relayed by the school superintendent after the fact. I could write another article on the improvements needed between child welfare social workers and teachers. Social Work investigators’ caseloads are tremendously exacerbated because teachers are not trained on the differences between abuse/neglect and poverty. However, I will have to address that at another time.

[youtube]http://www.youtube.com/watch?v=Y6H638unwi0[/youtube]

Myths and Facts about Social Work

“All of us are born for a reason, but all of us don’t discover why. Success has nothing to do with what you gain in life or accomplish for yourself. It’s what you do for others,” said Danny Thomas, the founder of St. Jude Children’s Research Hospital. People who are passionate about helping others might want to consider a career in the field of social work.

According to the Bureau of Labor Statistics, those interested in this career would be joining a large and ever-growing professional community, in 2010, there were 650, 500 social workers in the United States. What exactly do social work professionals do? The answer to this question is more complicated than it may seem. To begin the discussion about what the role of a social worker is let’s start by dispelling some common myths about the profession.

factormythMyth: “Social workers do not make much money.”

Fact: Salaries can vary based on several factors, including educational background, qualifications, geographic location, and specialization. According to the Bureau of Labor Statistics, a social worker employed in the field of individual and family services earns a median salary of $39,310 per year while the median salary of a social worker employed in an elementary or secondary school is to $54,260 per year.

Myth: “Social workers work primarily with the poor.”

Fact: It is true that the practice of social work was rooted in helping individuals living in poverty, when the profession first originated in the 19th century which is also why social work is often mistakenly only viewed as charity work. However, in modern times, social workers provide services to individuals with all backgrounds, ages and socio-economic status.

Myth: “The majority of social workers are employed either in social services or child welfare.”

Fact: Social workers work in a variety of venues, including hospitals, emergency rooms, nursing homes, rehabilitation facilities, mental health clinics, substance abuse divisions (like me!), prisons, private practices, schools, nonprofit agencies, welfare agencies, children and family services, government offices, policy divisions, etc.

Myth: “Social work is depressing because you are always involved with individuals’ problems.”

Fact: It is true that social workers try to improve others’ lives by helping those in need cope with and solve personal problems and other issues. Social workers may also work to assist those who face disabilities, life-threatening illnesses, homelessness, unemployment, domestic violence or substance abuse. Yet, the job of a social worker is not always depressing. Social workers aim to enhance others’ well-being with a focus on empowering individuals and recognizing their needs, strengths and abilities, and social workers are often rewarded when they are able to witness their clients personal victories. Additionally, there are also special trainings to help social workers manage their feelings of stress or sadness.

It is surprising how little people know about the field of social work. Once you get past the myths, you will realize what an important role a social worker plays in society and that it takes a very special kind of a person to do social work.

Reducing the Risk of Developing Dementia: Is Freedom 55 Really Attainable?

Dementia is a debilitating illness that is characterized by degeneration of memory, cognition, behaviour and the ability to perform activities of daily living. Approximately 35.6 million people worldwide have dementia and there are 7.7 million new cases every year, given the projected increase of the aging population. In addition, although dementia mainly affects older adults, it is not a normal component of aging because it has led to much disability and lack of independence among older adults throughout the world.

Elderly Woman Smiling Wearing a Swimming Cap in a Swimming PoolAlthough incidences of dementia, the most common being Alzheimer’s disease, have been rapidly increasing, no treatment has been developed to cure the disease or reverse its deterioration of the brain and individuals’ functioning capacity. Therefore, research needs to take place to establish inexpensive ways to help individuals reduce their risk of dementia and maintain cognitive function.

Recent studies suggest that people who delay retirement have a decreased risk of developing Alzheimer’s disease or a related dementia. However, researchers believe that the age of onset of Alzheimer’s disease and dementia is affected by many more complex risk factors and protective factors that extend beyond simply delaying retirement, which makes this topic relevant to the future health of older adults.

Although, many individuals enter into a pursuit of attaining Freedom 55, this may not be the healthiest option for older adults. A recent study lead by Carole Dufouil concluded that every additional year of work could reduce the risk of developing dementia by 3.2 percent, decreasing the risk of developing Alzheimer’s disease or a related dementia. However, the findings of the study are reliant on many more complex protective factors than only retirement such factors include education, occupation and retirement age.

Firstly, education produces health and well-being, which thus lowers an individual’s risk of developing dementia. In addition, each year of education may decreased the risk of developing dementia by 12 percent. Secondly, employment can be both mentally and socially stimulating, thus helping an individual maintain cognitive abilities. Thirdly, level of occupation, retirement age and education may have greater cognitive reserve capacity that may delay onset of dementia. Other protective factors may include a healthy diet, exercise and continued cognitive stimulation activities later in life.

Therefore, since the amount of people with dementia is expected to double by 2040, it is evident that a means to reduce the risk of dementia needs to be developed. However, older adults must decide what activities will be the most effective in helping them maintain cognitive and mental health throughout old age. For some this may be continuing to work or retirement, depending on their current occupation and job satisfaction. It does not make sense for an individual to continue working if they hate their job; therefore, an older adult must choose unique ways of exercising their brains that will work for them. Freedom 55 may be attainable for some; however, not for all.

References

Basu, R. (2013). Education and dementia risk: results from the aging demographics memory study. Research on Aging, 35, 7-31.

Lupton, M.K., Stahl, D., Artcher, N., Foy, C., Poppe, M., Lovestone, S. et al. (2009). Education, occupation and retirement age effects on age of onset of Alzheimer’s disease. International Journal of Geriatric Psychiatry, 25, 30-36.

Marchione, M. (2013, July 15). Delaying retirement can delay dementia, large study finds. The Associated Press. Retrieved from .

World Health Organization (2012).Dementia Retrieved November 15, 2013 from .

Photo Credit:

Multidisciplinary vs. Interdisciplinary Teamwork: Becoming a More Effective Practitioner

thumb-experience

Both multidisciplinary and interdisciplinary teamwork have been used in healthcare in the past. However, although there is a clear difference between the two approaches to care, many educational researchers and practitioners use these terms interchangeably. The fundamental difference lies in the collaborative care plan that is only developed in interdisciplinary patient interventions, as multidisciplinary care does not emphasize an integrated approach to care.

Multidisciplinary teams are unable to develop a cohesive care plan as each team member uses his or her own expertise to develop individual care goals. In contrast, each team member in an interdisciplinary team build on each other’s expertise to achieve common, shared goals. Therefore, it is crucial to indicate that multidisciplinary teams work in a team; whereas, interdisciplinary teams engage in teamwork.

An interdisciplinary care plan is developed by answering these questions:
1. What are the issues?
2. Who will be involved?
3. What will the interventions be?
4. What are the goals of the intervention?
5. When will re-evaluation occur?

Therefore, interdisciplinary care must occur to bring about improved patient outcomes such as more efficient practice, an increased individualized and patient-centred approach and improved quality in care. If healthcare professionals do not have the same intervention goals, patients may suffer. Therefore, if practitioners focus on a single, shared goal, a patient will be more successful in receiving the care that they require.

In addition, the need for interdisciplinary care is increasing as a result of:
• A growing aging population with chronic and complex needs
• The increasing knowledge and skill required to provide comprehensive care to patients
• The increasing specialization in healthcare fields
• The growing encouragement to develop multi-faceted teams in healthcare, and
• The increased emphasis on continuity in care planning.

Therefore, changes in practice approaches and interventions need to take place to advocate for the use of integrated care plans. With a growing aging demographic and the development of more complex health problems, it is crucial that interdisciplinary care is used in all areas of the healthcare field. Interdisciplinary care aims to be an all-inclusive resort to meet the unique care needs of individuals. It is considered to be the “Hallmark of Geriatrics”; therefore, it must be represented in practice to improve quality and efficiency of care to all individuals.

References:

Walter C. Chop Regular H. Robnett, ed., Gerontology for the Health Care Professional, ed. (Boston: Jones and Bartlett Publishers, 2010).

Andrew Booth, Steven Ariss,Tony Smith, Pam Enderby,and Alison Roots4 Susan A Nancarrow, “Ten principles of good interdisciplinary team work,” Human Resource Health, 2013: 1-11.

Big Cities Need Social Workers

New York City-NY
New York City-NY

According to researchers working on the American Cities Project, a study sponsored by the PEW Charitable Trust, many cities across the United States are experiencing significant population growth. This population boom is a contributing factor in increasing the availability of social services and the need for social workers within these cities.

Urban populations often face poverty, unemployment, and job insecurity; and an increasing number of people have been affected by a lack of adequate or affordable housing, limited access to quality health care, and poorly performing education systems. The combination of these problems and an expanding population may indicate the need to increase the number of social work professionals working with populations in larger cities.

According to the Bureau of Labor Statistics, the social work profession is expected to grow by 25% by 2020, and new social work education programs are popping up all over the country to try to keep up with the demand. Helping those in need within the urban population requires social work professionals who are able to work with diverse populations. In many cases, it is expected that social workers working in cities acquire special skills such as second language in order to be culturally close to the populations they must serve.

In many cities, gaining access to needed social services requires individuals to navigate complex bureaucratic systems. Social workers who are able to utilize their advanced problem solving and advocacy skills are key factors to successfully connecting at risk members of the population to the resources they need to survive. Combating bureaucracy has become almost common place when working to ensure that people with little or no resources have access to assistance.

A common benefit of working in metropolitan areas is that larger cities often support a greater number of social service agencies and providers. Social workers in bigger cities are fortunate to have many resources at their disposal and frequently have access to specialized services, which may not necessarily be available in smaller locations and settings. More importantly, clients have access to a broader range of services and support.

Social workers may rely on many of these resources to provide direct care to clients in need, but can also work to collaborate between agencies to ensure a more comprehensive and holistic plan of care. Advocacy and utilization of existing networks may be beneficial when seeking resources to help with individual and family needs.

Further, it is essential for social workers to keep up to date and have knowledge of community resources such as non- profits organizations, secular services, and faith based programs and their ability to address the crucial needs of those seeking help.

Social workers in large cities face many unique challenges, but they also have access to unique resources. As large cities become increasingly populated with individuals in need of a diverse array of assistance, social workers may become in greater demand in these areas.

These professionals will need to know how to take advantage of the social services available within large urban areas, understand how to work with diverse populations, and find creative ways to ensure the large numbers of clients they work with are able to get the help that they need.

Exit mobile version