Understanding the Code of Ethics in Social Work Practice

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Social workers are required to consider the code of ethics when working with clients in a therapeutic or direct practice relationship. However, we want to examine and discuss the implications of utilizing the code of ethics while working along the full continuum of social work practice from micro to macro. Most have heard about ethical issues relating confidentiality, dual relationships, and sexual relationships, but what do ethical dilemmas look like when working in communities, advocacy, or public policy? What ethical obligations do social workers when working in social justice versus working in one on one relationships with clients?

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Heather McCabe

We will explore how practitioners and students view ethical obligations around macro practice and social justice issues. Our guest expert is Heather McCabe, Assistant Professor of Social Work at Indiana University. She served as a medical social worker at a pediatric tertiary care hospital for several years before returning to school for her law degree.

She also served as the Director of the Public Health Law Program  and then Executive Director for the Hall Center for Law and Health at the IU School of Law – Indianapolis before coming to her current position.  Professor McCabe’s research is primarily in the areas of public health, health policy, health disparities, health reform, and disability related policy.  She is particularly interested in exploring the effects of multidisciplinary education and collaboration in her work.

Questions to be explored:

  1. Do you think about the NASW Code of Ethics applying to community organizing, policy practice, advocacy? If so, how?
  2. If you see multiple clients with the same systemic issue, do you have any ethical obligation to address the issue?
  3. What types of bills do you see as impacting your clients? What responsibility to you have to advocate for/educate about them?
  4. Do you advocate for policy in your day to day work? Give an example.
  5. How do we continue encouraging social workers to see practice as a continuum, which includes macro practice?

Resources:

  • Reisch, M. & Lowe, J.I. (2000). “Of means and ends” revisited: Teaching ethical community organizing in an unethical society. Journal of Community Practice, 7(1), 19-38.
  • Hardina, D. (2000). Guidelines for ethical practice in community organization. Social Work, 49(4), 595-604.
  • Harrington, D., & Dolgoff, R. (2008). Hierarchies of Ethical Principles for Ethical Decision Making in Social Work. Ethics and Social Welfare, 2(2), 183–196. doi:10.1080/17496530802117680
  • National Association of Social Workers. (2008).  Code of ethics of the National Association of Social Workers. Washington, DC: NASW Press.
  • Rome, S.H.,Hoechstetter, S., and Wolf-Branigin, M. (2010). Pushing the envelope: Empowering clients through political action. Journal of Policy Practice, 9(3-4), 201-219.
  • Rome, S.H. (2009). Value inventory for policy advocacy. In E.P Congress, P.N. Black, and K. Strom-Gottfried (Eds.) Teaching Social Work Values and Ethics. Alexandria, VA: Council on Social Work Education.

About us:

#MacroSW is a collaboration of social workers, organizations, social work schools, and individuals working to promote macro social work practice. Macro social work practice focuses on changing larger systems, such as communities and organizations. It encompasses a broad spectrum of actions and ideas, ranging from community organizing and education to legislative advocacy and policy analysis. The chats are held bimonthly on Twitter on the second and fourth Thursday of each month at 9 p.m. EST (6 p.m. PST).

Social Work for a New Generation

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Social work is at a crossroads. As a new generation of social workers move towards graduation and entrance into the profession, we face a unique conundrum. Millennials overall are earning less despite being the best educated generation in history. We are struggling to pay student loans and are widely expected to be the first generation to fare worse than our parents. We know from our own struggles this is not for lack of effort.

Injustices have been allowed to fester and grow unchecked. The social work profession must choose how to address the concerns of this new generation–dedicated to meeting the needs of others, but who are also struggling to meet their own.

For millennials, there is little choice. We will lead for a better tomorrow.

Millennial social workers are recognizing the importance of clinical, community, and political practitioners working in tandem for change at all levels, and the foundations to support this philosophy are being laid down at this moment. Recognizing the unique perspectives of our generation, YSocialWork is launching as a millennial-driven organization that will apply social work methods to the profession itself.

YSocialWork, originally launched as a hashtag for the inaugural Student Advocacy Day platform for social work students in the United States,  is a socially conscious, grassroots start-up based in Washington, DC.  It seeks to provide training and education to youth and young professionals in the areas of innovation, leadership development, and political engagement.  Since its inception in 2014, as the driving force behind creating new opportunities for students in policy-entrepreneurial engagement, YSocialWork continues to empower its members to transform ideas into sustainable solutions in the classroom, community , and government.

Examples of policy-entrepreneurial activities led by YSocialWork will include (but not be limited to): idea generation activities, problem framing activities, dissemination activities, strategic activities, demonstration project activities, activities cultivating bureaucratic insiders and advocates, activities enlisting support from elected officials, lobbying activities, and administrative and evaluative activities (Roberts & King, 1991).

I’m a millennial who became politically conscious under the second Bush Administration–tainted as it was with an air of corruption and illegitimacy. My entire adult life, the United States has been at war. I’ve only experienced an economic recession, despite the alleged recovery. My political reality has been shaped by seeing advocates who stood against the conservative Bush agenda all but disappear as a new Democratic administration came to power–but the injustices remain.

I saw a political system change but go unchanged.

I changed. What might have been the making of partisan loyalty eroded. The belief that good politicians could change the system from the inside dissipated. Because every good politician must confront a system fueled by money and seniority–two things that have a way of influencing political thought and behavior.

I cheered the Arab Spring, the occupation of the Wisconsin capitol, and of course Occupy Wall Street.

In the midst of it all, I became a social worker, drawn by its values–so simple yet essential–a belief in the inherent value and worth of all people and the pursuit of social justice. It is the only profession that carries such a mandate. Social work seemed like the obvious answer to our fragmented systems for social good with micro, mezzo, and macro practice united by a common mission to enhance human well-being.

Unfortunately, our profession has become unbalanced, with an emphasis on clinical practice that comes at the expense of organizing and political work. This is not unlike my own generation. No matter how idealistic we may once have been, we have disengaged from the political in favor of individual impact. We are a generation undeniably invested in social good, but we have not yet mastered how to maximize our impact.

To be sure, this is changing. The vestiges of Occupy–once apolitical–have found a candidate in Bernie Sanders. The historic Black Lives Matter movement has grown to engage not only in street protests, but the political sphere through its strategic confrontations with presidential candidates and the launch of a policy agenda–Campaign Zero. We are learning quickly how to use all the tools at our disposal and to attack the ills of our world from multiple angles.

We must recommit to our core values. We need social workers helping communities to stand up and force systemic change. We need social workers to be political leaders who will listen and take action with the interests of society’s most vulnerable at heart. We need front-line social workers to help individuals overcome their personal struggles and navigate existing systems. We need a united front of social workers for social justice.

Hillary Clinton Can Do Better on Race

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Hillary Clinton is currently using a rhetorical device otherwise known as an attempt to be “honest”, and it’s a call for us to be reflective about our own indifference to the racial divide. The problem is, former Secretary of State Clinton reinforces an irrational fear, masked in a logical fallacy, to justify an unsustainable ego defense. She meant well in the context of a larger discussion on race.

But, she could have engaged the same discussion by demonstrating the fear as irrational rather than leveraging the fear to elicit an emotional connection. Let’s apply the Social Work Next perspective to evaluate the rhetorical device. Our central question is one of Politics. How can policy and politics support empathy?

Exploring the Rhetoric
This speech was delivered July 23, 3015 in South Carolina. Some are attempting to use the clip without context to manufacture a Clinton gaffe. Presenting this as a gaffe, it would set up a narrative pitting open-minded Whites against other Whites using Black lives as the key factor in the decision point. Many may fall into that pit, but Social workers cannot.

If you took this position, it argues for Whites to advocate for and acknowledge that Blacks deserve to be treated as equals. Then, the other Whites should join the open-minded Whites and their action in creating a more tolerant United States. What this does is maintain the privilege of Whites as the center of the debate—the decision makers and the one group whose advocacy and opinion matters.

It also limits the debate to an individual level debate, one where each person needs to step up. The danger is to ignore mezzo and macro levels that also need attention. The danger is to miss the opportunity to ask a presidential candidate how he/she will legislate with the empathy necessary to create change. Policy should be the center of this debate leveraged by Justice for all, informed by Appreciation for all.

Clinton states in multiple events over the past month, some version of the following:

“Let’s be honest, for a lot of well-meaning, open-minded white people, the sight of a young black man in a hoodie still evokes a twinge of fear. And news reports that poverty, crime, and discrimination evoke sympathy, even empathy, but too rarely do they spur us to action or prompt us to question our own assumptions and privilege” (June 20, 2015 speech to US Conference of Mayors).

It’s still an inappropriate line. It could have been better. It serves to justify fear of Black males even while highlighting privilege.

Breaking down the Conceptual Semantics

The Social Work Next approach to this begins with the awareness of multiple systems levels: micro, mezzo, and macro. The individual or micro level is where much of this rhetoric resides. Rather than justifying the fear as a reminder to reflect with empathy and action, let us explore the fear as irrational.

The individual assessment would ask what biopsychosocial-spiritual-meaning experiences support the fear of Blacks. Only by addressing those fears at their origin, can the individual address the fallacy (most often) or the trauma (less likely) that supports the fear. The point at the individual level is that YOU have a choice regardless of the past or fear of the future. The risk in this moment is equal to the risk is all other moments.

At the mezzo level, we deal with institutions. What institutions support the idea that being Black is somehow threatening or precursor to harm? The solution is to move away from prejudice and determine the content of a person’s character no matter their race or clothing. The number of Blacks has no impact on your level of fear during a board meeting even if they all wore hoodies.

Let’s be clear, alley ways are scary no matter who is standing around in them. Anyone walking into a convenience store with a hoodie pulled over their head is going to raise your fear level. Remove the “being Black” offense from the evaluation of safety in context. Let us promote institutions that utilize the best in social engineering to support collaborative outcomes. You do that by moving away from social control and toward social capital. You know what I mean. “Protect and Serve” community policing versus “Stop and Frisk” raids and harassment.

At the macro level, we discuss environmental practice—the home for our discussion of politics. This is where we get into the depth of empathy. Empathy can begin with guilt. The problem here is that the guilt-to-empathy construct works at the individual level. The task is to expand the construct to the macro level, to collectively reflect, then politically act. What Clinton got wrong is that we don’t make this choice because of our guilt about our privilege or our fear of Blacks. We make the choice to create a politic of justice and appreciation because it serves our ends. The first level of empathy is to see ourselves or our children as the potential victim of unjust policy. The second level is to care that any other person would be subjected to such unjust policy without our ability to successfully navigate the system.

Policy-JusticeANDAppreciationPolitics of Change
As citizens, we are counting on our politicians to advance policy solutions. As social workers, we must educate a populous addressing a politic that lacks empathy. Clinton discusses empathy that leads to action, but only after justifying irrational thoughts. Reflection on assumptions and privilege is not enough. Many well-meaning people don’t have the energy and commitment for true empathy–understanding how my history makes my choices reasonable. And, how your insistence on my conformity criminalizes my existence. That is the point of #BlackLivesMatter. Not a redress to your privilege, but the assertion of my right to exist, under my own terms.

Use policy to grant me that right. Structure institutions that promote and bolster that right. Make equitably available the tools to defend myself and navigate the system.

In your speeches, structure your rhetoric to ensure a movement of justice and appreciation leading to empathy. Go beyond the guilt of having more, living outside stop-and-frisk zones, and living within successful school districts. Create, support, and enforce policies that provide equity of opportunity without asking me to become like you or more safe for you. I can’t change my color, but WE can change policy.

Afterward to the Social Worker
If you want to explore rhetoric and semantics further, may I suggest the following article as a starting point.

Complex speeches aren’t better speeches. In fact, they’re worse.

The most memorable lines in modern rhetoric—”Ask not what your country can do for you, ask what you can do for your country”; “The only thing we have to fear is fear itself”; —are remembered precisely because they’re simple enough to understand, memorize, and talk about. Practically every modern sage of language—George Orwell, Steven Pinker, William Safire, Strunk & White—advises non-fiction writers to express themselves with simple language. Even if you like purple prose in your long-form narrative non-fiction, you’ll agree that it’s pleasing to hear complex policy points in clear sentences and parallelisms. (It’s hard to rule out that the dense language of the 19th century was pleasing and cogent in its own time.)

Read More

If you would like to explore the implications and the next steps for social work thought, keep reading this site, or you can do both.

Find the Perfect Internship: Interview with Nathan Parcells CEO of InternMatch

I often hear from social work students and professionals who wished better internship opportunities were available to them. Many social work degreed students are finding that they are competing with communication and journalism majors, women’s studies, political science, public administration, and law students for social justice positions that have been traditionally social work roles.

Employers are beginning to view social workers from a child welfare or mental health professional lens which is preventing social work students from interning as social media community managers, community organizers,  grassroots activism, digital strategist, and public policy positions.

I had the opportunity to engage in a lengthy conversation with Nathan Parcells, CEO of InternMatch, who appears sympathetic to the plight of the social work student in creating expanded opportunities. We also discussed how the social work skill set is transferable and may be highly desired by some of the companies he works with.

Nathan appeared open to new possibilities, and here is our conversation below:

SWH: Tell us a bit about your background, and what led you to create InternMatch.com?

Nathan: We started InternMatch when I was a senior at the University of Pennsylvania. I remember attending career fairs, searching online and seeing the same big brands names posting internships again and again. I quickly realized that there was no internship resource that reflected the diverse range of positions that truly interested my peers and myself.  Beyond this internships had become the most critical gateway for students to break into new industries but most students were still relying on family and friend connections rather than having a tool that helped them apply to roles they wanted.  We felt this had to change and decided to start InternMatch to create an easier place for students to search, find and apply to roles.

Nathan ParcellsSWH: What types of companies take advantage of the services you provide at InternMatch, and is it expensive?

Nathan: We have all kinds of employers on our site from leading tech companies like GoogleFacebook, Not For Profits like DoSomething, and DonorsChoose small startups like MindSnacksand Udemy to small businesses. Thousands of companies post with InternMatch.  The cost for posting a 60-day internship is $99 and a 60-day entry-level job is $199 .

Ultimately, this is not very expensive because we focus on helping companies find students who truly fit their culture and role.  We do this through our large community of millions of students, but also by working with 850+ universities at the department, club and even professor level.  This deep focus on sourcing candidates helps ensure companies find quality matches, which ultimately far outweigh the cost of the posting itself.

SWH: How do students learn about the opportunities available at Internmatch?

Nathan: Students discover InternMatch in a variety of ways.  As I mentioned we work with over 850 schools that directly promote InternMatch. In addition, over 42% of students start their internship search through a Google search and we are easily found this way by students.  Lastly, students really like the clean and easy user experience our site offers.  Because of this we see a huge amount of students coming to InternMatch via word of mouth and returning for many years as they find the site useful.

SWH: Are you willing or interested in being a broker with these companies to foster field placement opportunities for social work students? 

Nathan: InternMatch is setup like a broker already. Companies are able to easily post roles and we currently have over 500 social work positions available all across the country.  Meanwhile, students can easily save roles and searches they are interested in and apply for free.  Our goal is to make all these positions easily findable and open to all students regardless of connections.

SWH: Would you be willing to make contact with the career coordinators at Schools of Social Work, in addition to the career centers with the university? Often those opportunities are not in the pool of field placements available to social work students.

Nathan: We are always excited to connect with career centers of various kinds and find the best way for us to share internships that are helpful for their students.  We also are always happy to craft resources for career centers that are specific to challenges their students face.  Students, employers and career centers can contact me at any time at nathan@internmatch.com.

Capacity Building for Communities of Color: The Paradigm Shift and Why I Left My Job

When I first got out of grad school with my Master in Social Work, I was a bright-eyed kid full of hopes and dreams of doing my part to make the world better. Completely broke and desperate to find work before the student loans people released their hounds, I applied to countless jobs and found that no one would hire me because I had no experience, a vicious “Experience Paradox” that many young grads go through each year.

Frustrated and dejected, I secluded myself in my room (in my parents’ house), sending out my resume all day, coming out at night to raise my clenched fist to the dark skies and screaming “I may be inexperienced, but I am still a human being! A human being!!!” Then I would eat some ramen and watch Spanish soap operas on Univision.

building-capacityWhat is the point of that story? The point is that communities of color, and the organizations led by these communities, often feel like these recent grads. We are stuck in this debilitating and demoralizing “Capacity Paradox” where funders do not invest sufficient funds in our organizations to build capacity because we don’t have enough capacity. Yet, we are constantly asked to do stuff, to sit at various tables, to help with outreach, to rally our community members to attend various summits and support various policies.

Everyone seems to be in agreement that major efforts to effect systemic change are missing the voices of communities of color and would benefit from having those voices. Everyone also seems to be in agreement that communities of color that have strong organizations behind them are much more involved and effective at all levels of service and policies. Building the capacity of these organizations, then, is critical to all systems-change efforts: Housing, homelessness, climate change, education, neighborhood safety, etc.

What many of us fail to recognize is that the current efforts to increase the capacity of nonprofits led by immigrant, refugee, or other communities of color, which I call “nonprofits of color,” are not sufficient. Funders who provide significant, multi-year, general operating funds—the holy grail of funding and the thing that will help any organization develop its capacity the fastest—operate under systems that leave most nonprofits of color behind. These significant capacity building grants are almost impossible for nonprofits of color to attain. We usually don’t have the same relationships. Or grantwriting skills. Or board members who can strongly articulate the vision. Because we don’t have capacity, we can’t get support to develop capacity.

With significant, catalytic funding out of the question, funders provide small grants to nonprofits of color so they can do things like hire a consultant to facilitate a strategic planning retreat, or to send them to workshops on board development, fundraising, personnel policies, or myriad other capacity building topics. These grants can be very helpful to keep an organization going. But in the long run it doesn’t work because there is a critical missing element. Staffing.

You can send an organization to a thousand workshops and do a thousand strategic planning processes, but if they do not have staff to implement their learnings, they are not going to build significant capacity. We have many, many nonprofits that are doing good and much-needed work, that are constantly asked to do more work for free, without receiving any of the trust and support to hire qualified staff to sustain and grow their operations.

The paradigm has to shift. I don’t say this lightly, because there are few things I hate more than jargons like “shifting the paradigm.” But the reality is that what we are doing is not working, and we have to change our mindset completely and do things differently. If we value the voice of our diverse communities, we must build the capacity of organizations led by those communities. But we must do it differently than how we’ve been doing it. We must invest strategically and sufficiently. We must take some risks. It to society’s benefit to help these nonprofits break out of the Capacity Paradox.

For the past couple of years I have been working with a group of brilliant and passionate people on a project called the Rainier Valley Corps (RVC), a model designed to increase the capacity of immigrant/refugee-led nonprofits by providing this critical missing element of staffing. The project recruits emerging leaders of color from within immigrant/refugee communities, trains them in a cohort on capacity building and nonprofit management, and sends them to work full-time at nonprofits of color to help those nonprofits develop their infrastructure and effectiveness.

Now, we can send these nonprofits to workshops and do strategic plans, because now there is staffing to implement stuff. These emerging leaders get a stipend, healthcare, and a bonus to support paying back student loans or furthering their education. They will get mentorship and support and encouragement to stay in the nonprofit field and rise up to become leaders within their communities.

RVC addresses several needs, among them the vital staffing that is required for capacity building to be successful. But it also addresses a scary challenge that many of us are not even talking about: The gap in leadership among the immigrant/refugee communities will widen further because kids are not entering the nonprofit field. Most immigrant/refugee kids are pressured by their families to go into jobs with higher pay and prestige.

Many nonprofits of color are currently led by elders, who will in 10 or 15 years retire, and if we don’t start to develop the pipeline for new generations of leaders of color soon, we may not have many in the future. This will jeopardize all sorts of systemic-change efforts.

So, Rainier Valley Corps will increase capacity of nonprofits of color, improve services to immigrant/refugee communities, build up new generations of leaders of color in the nonprofit field, and foster collaboration between diverse ethnic groups to address inequities. If we do a good job, lessons can be learned that can be applied to diverse communities all over the US.

The project itself is ambitious with nearly $700,000 per year for seven years to support cohorts of 10 to 18 emerging leaders/organizations each year, but if we genuinely want to build the capacity of nonprofits of color, then we must be willing to invest sufficient funds to make it work.

This year, RVC received some start-up funding, enough to hire a full-time Project Director who will focus on raising the $700K/year, develop the infrastructure and curriculum, and strengthen relationships among the various nonprofits, funders, and capacity-building organizations. I firmly believe this model holds promise to greatly increase our immigrant/refugee communities’ effectiveness and voice which is why I left my job as executive director of the Vietnamese Friendship Association (VFA) to become RVC’s project director.

It was bittersweet leaving an organization that I love and one that has given me so much in terms of skills and connections as well as relieved some existential angst about the meaning of life. But, VFA is doing great, with an incredible board, amazing staff, and dedicated supporters. I have nothing but gratitude and pride for VFA and all we achieved over the last nine years. I still remember when we had an operating budget less than $20,000, no staff, and one program. I remember staying at the office until midnight to get work done, and then come to my car to find it had been broken into. VFA have grown a lot. We strengthened our capacity. We now have several staff, many great programs serving thousands each year, and we’re being more and more involved in cool stuff like working with other ethnic groups to push for education equity.

VFA is why I so strongly believe that Rainier Valley Corps holds the key to capacity building for immigrant/refugee communities. Ten years ago, when I could not find a job because I had all this passion and no experience, I was accepted into a unique program. It recruited us emerging leaders, trained us in a cohort on capacity building and nonprofit management.

Then, it sent us to work full-time in small Vietnamese-led nonprofits across the US to help those nonprofits develop their infrastructure and effectiveness, and I was sent to VFA. I know this RVC model and how effective it can be because I personally went through it and have seen the results. The program drew us inexperienced-but-passionate grads into the field, and many of us stayed and continue to contribute. Several of us became leaders of our organizations and within our communities, which is great.

Without this program that kept me in the nonprofit field and inspired Rainier Valley Corps, I probably would have ended up on another career path: Writing for Spanish soap operas.

Is Politics Failing Social Work or is Social Work Failing at Politics?

Mahatma-Gandhi-Politic-Quotes

Current news events seem to be rife with stories relevant to social work while continuing to highlight our lack of presence in those conversations. Suicide, police shootings, more school shootings, corporal punishment, and domestic violence are issues that stick out on a very long list . Various articles on this website have challenged us to think about social worker’s role in these mainstream stories.

The ultimate gauntlet was thrown by Dr. Steven Perry and his speech on C-SPAN that we are “too silent” on issues of access and social justice.  We are in the trenches on the frontline, and we need to increase public awareness on the efforts of social workers in order to affect public policy making decisions.

Prior to listening to Dr. Perry’s speech, I honestly thought the answer to this question was that politics has been failing social workers, but Dr. Perry calls us out on how we can do more and should be doing a lot more. As social workers, we are interested in making a change, but it is how we go about it that is coming into question. What the above speech and article do (excellently) is get us to think about where and how we want to be involved. Social Workers need to be involved more in politics.

Where I struggle with politics is the much talked about notion of “Policy to Practice”. As people in the helping profession, we all have a notion of what helping others entails. We have the power to help heal individuals, families, schools, and communities yet our voice is not always heard by policy makers. Similar to Dr. Perry, I wondered why our expertise and knowledge continues to not inform policy. What gets in the way?

Social work is becoming more and more about the bottom line. We get messages to use programs that are “evidence based”, “increase productivity”, and “reduce cost”. Interventions that accomplishes all three of these things may get the funding or not. However, despite meeting this criterion, these programs don’t always appear to “make the cut.”  Here are some examples to illustrate this further.

First, lumping together both foster care and juvenile justice together to discuss prevention programs and increasing outcomes. There appears to be a lot of concern about the money we are spending on foster care, out of home placement, and juvenile justice centers. As someone who coordinates care with young people who are at risk for out of home placement, there is a lack of intensive preventive services. There are huge waiting lists for the small amount of slots available. We know prevention services work, however my observation is that these programs are actually getting cut. Are politicians aware of this?

Another example of failed policies and lack of evidence based interventions being funded can be seen in how homelessness is being addressed. According to a press release by The U.S. Housing and Urban development in 2010,

“When an individual or a family becomes homeless for the first time, the cost of providing them housing and services can vary widely, from $581 a month for an individual’s stay in an emergency shelter in Des Moines, Iowa to as much as $3,530 for a family’s monthly stay in emergency shelter in Washington, D.C. The U.S. Department of Housing and Urban Development today released three studies on the cost of ‘first-time’ homelessness; life after transitional housing for homeless families; and strategies for improving access to mainstream benefits programs”

Services to prevent homelessness seem few and far between. For a homeless family, $3,000 per month can go a long way to finding someone permanent, stable housing. Social Workers are on the frontline, and we see what works as well as what our clients need. We apparently need to demonstrate to policy makers that what we do has “return on investment.”  Investing $3,000 a month to teach families to be more self-sufficient, knock down barriers to unemployment, and access to substance abuse and/or mental health treatment will save more money so individuals and families don’t need to become homeless in order to get services.

Are we ensuring policy makers know that we are fighting for the poor, marginalized, and oppressed on a daily basis to help improve their quality of life and to reduce dependency on government services? This is the challenge that we need to take head on, and Dr. Perry reminds us of how powerful social workers can be at the policy making level. To truly serve our clients, we have to address and engage on a policy level because helping one client at a time is only temporary fix which may be impeded further without proper funding.

To truly serve our clients, we have to address and engage on a policy level because helping one client at a time is only a temporary fix which may be impeded further without proper funding. Social Work has power and let’s take up the challenge to find new ways to use it. Dr. Perry has called us out and please find your way to answer the call.

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!

2014 NC Short Session: That’s Hardly a Wrap!

Senators wrapped up the 2014 short session shortly after a midnight on Friday when they finally approved a state budget. House members  followed by issuing their final votes on Saturday. But there’s a catch, legislators will return this week to agree on an actual adjournment date as the House made more changes to the Senate’s original plan.

On August 14th, legislators will return for a brief additional session to take up any bills that might get vetoed by the Governor, wrap up any bills that got assigned to a conference committee, and attempt to complete nine different other provisions held over in adjournment resolutions. There’s still one more catch, legislators will return again on November 17th for a special session to discuss Medicaid Reform and possibly Coal Ash, and there is no word on how long this session will last.

So, while legislators have adjourned, they have not technically finished working. We should have a better idea of  their plan to meet again in August by the later part of this week.

Relevant Bills with Action:

SB 744 Appropriations Act of 2014: This bill has been in the works since session started. When legislators couldn’t agree, they turned to appointing a 42 member conference committee. Last weekend, they reported that they had come to an agreement. The conference committee budget highlights are below. With the Governor’s signature, this will be the state budget for the 2014 fiscal year. View the Money Report for further explanation on the spending plan with accompanying page numbers listed after each highlight. Please note, it is difficult to capture all the provisions in the budget due to the amazing variety of the social work profession so information below is only a snapshot of changes.

  • Provides funds to support the costs related to the education of children in private psychiatric residential treatment facilities (F-6).
  • Provides funding for one year for group home residents who were determined to be ineligible for Medicaid personal care services on or after January 1, 2013. The maximum monthly payment is set at $464.30 and is based on providing 33 hours of service per eligible recipient (G-3).
  • Reduces General Fund appropriation for the Home and Community Care Block Grant (HCCBG) by 3%, leaving a balance of $31,808,889. Cuts are $969,549 (G-4).
  • Changes the income eligibility for the State-County Special Assistance (SA) Program from a method that bases income eligibility on the payment rate for the facility type where the recipient resides, to a method based on the federal poverty level for all recipients regardless of where they reside. The SA eligibility level is set at 100% of the Federal Poverty Level. Current recipients of SA are grandfathered in and will continue to receive SA. (G-8).
  • Provides funding to replace $4.5 million in federal block grant funds that counties lost in 2013-14 that was utilized to pay for Child Protective Services (CPS) workers. An additional $2.8 million in funding is provided effective October 1, 2014 to reduce county departments of social services caseloads to an average of 10 families per worker performing Child Protective Services assessments (G-9).
  • Provides $4.5 million for Child Welfare In-Home Services to serve at-risk families (G-9).
  • Provides $218,538 recurring and $125,750 nonrecurring funds for the implementation of drug screening for Work First Benefits applicants (G-10).
  • Provides funding through incentives and rebates to end the waiting list of the Aids Drug Assistance Program (G-11).
  • Provides $2.2 million for community-based crisis services (G-15).
  • Provider rates are cut, once again, by 1% (G-18).
  • Mental Health Drug Management: Authorizes DHHS to impose controls including prior authorization, utilization review criteria, and any other restrictions on mental health drugs (G-18 and pg 87 of the budget).
  • Provision to hold special session in November to discuss Medicaid Reform (pg 87, budget).

Other Bills of Interest with Action:

HB 884 Dropout Prevention/Recovery Pilot Charter School: This bill establishes a two year pilot program for one charter school who has had students drop out. The purpose is to increase graduation rates and reengage students. The bill passed the House and Senate and was presented to the Governor for signature.

SJR 881 Adjournment: This bill directs legislators to adjourn but to return on August 14th and November 17th. As mentioned above, the November special legislative session will be focused on Medicaid Reform.

HJR 1276 Adjournment: The House version of the adjournment resolution. While the dates to return are the same as the Senate, the House has a few more issues to keep alive including any bills related to autism insurance reform. The House gives the Senate until Wednesday, August 6th to take up the new adjournment resolution.

2014 NC Legislative Short Session Nears End But No Deal on Budget

Last week, the General Assembly saw more action from the Senate than the House, and Senators have been meeting in Rules Committee the past couple of weeks to pass a few pressing bills. On Thursday, while discussing Medicaid Reform on the Senate floor, Senator Bryant sought an amendment to expand Medicaid. Unfortunately, but not surprisingly, the amendment failed.

Senators commented that this was the fourth time they voted down to expand Medicaid in the state. The House did meet on Thursday and Friday of last week, but they had little committee activity during the week. Despite filing an adjournment resolution for Friday, July 25th, the House does plan to meet this week. Rumors started over the weekend that legislators have reached another deal on the budget, so we hope to see the proposal this week.

Relevant bills with action:

short sessionHB 1181 Medicaid Modernization: This is the bill that would create a new department to oversee the operation of Medicaid and NC Health Choice run by a seven member appointed board, create full capitation by 2018 (instead of fee for service), integrate physical and behavioral health by 2016, and much more to reform Medicaid in our state. The bill went to committee to push back a few dates in the bill including the creation of the new department from August 1, 2014 to September 1, 2014. Senators will take a third, and final, vote on Monday night. The bill then has to get approval from the House before it is made law. No word yet on the House’s position on the bill.

HB 369 Criminal Law Changes: This bill passed out of the Senate last week and is scheduled to be heard on the House floor on Tuesday. The bill will allow NASW-NC and other partners to work with the Human Trafficking Commission on age appropriate sexual abuse education for students and teachers. The bill also makes several changes to various criminal laws such as expungement for certain offenses and higher penalties for providing inmates with cell phones.

HB 1133 Technical and Other Corrections: A bill that normally marks the end of the legislative session, the House and Senate have been working on a technical corrections bill to tie up loose ends of the session. Usually very technical in nature (spelling errors, corrections to previous bills, etc), the bill had a surprise section that would eliminate the Child Fatality Task Force that makes statewide recommendations to prevent unnecessary deaths of children.

During the existence of the Task Force, childhood death has decreased by as much as 32% in the past three decades. During floor debate, Representative Grier Martin (D-Wake), ran an amendment to eliminate this section of the bill and it passed overwhelmingly. The bill passed out of committee and passed the floor Friday. The bill will now go to the Senate.

2014 NC Short Session, Week 10: The Newest Medicaid Reform Plan

Bay Area Activists Protest Cuts To Medicaid

What a week at the General Assembly! The Senate decided to work on bills that were sitting in the Senate Rules Committee all last week and move them to the floor for votes.The most controversial was Medicaid Reform which the Senate proposes to create a completely new Department. The House did not meet last week and have nothing on their calendar for tonight, but it is possible that they meet later in the week to work on the bills the Senate is working through their Rules Committee.

Relevant Bills with Action:

HB 369 Criminal Law Changes: This is the omnibus bill that will expunge certain drug offenses and includes language on Erin’s Law. Under Section 4(a), the bill directs the Human Trafficking Commission to study the inclusion of age appropriate sexual abuse education in the classroom as well as gather information on sexual abuse in NC. Under the bill, the Commission is directed to work with several organizations to do this, including NASW-NC. The bill will be heard a third time tonight and, if it passes the Senate, will be sent to the House for concurrence.

HB 1181 North Carolina Medicaid Modernization: Last week, the Senate came up with an entirely new Medicaid plan. Under the new plan, the Division of Medical Assistance (DMA) would become an independent agency called the Department of Medical Benefits which would manage behavioral, physical and other specialized care for Medicaid and NC Health Choice recipients under a Managed Care Organization (MCO) or Accountable Care Organization (ACO) model.

The Senate scheduled this new Department to be created by August 1, 2014 and governed by a 7 member Board of Directors. The Senate plan also directs the Department of Health and Human Services to immediately cease any activities related to Medicaid reform. This plan is certainly fast-moving in the Senate and controversial among many. The bill is scheduled for a floor vote in the Senate tonight. If it passes, it will need to go to the House for concurrence. The Governor has already stated opposition to the new plan but the House has not spoken much for or against the bill.

Relevant Bills Filed:

HB 1276 Adjournment Sine Die: Yes, you read that correctly. The House bill filed last week sets adjournment for this Friday, July 25th. Keep in mind, the Senate filed an adjournment bill on June 27th, and legislators are still in session.

Looking at Labeling and Diversity: Interview with Philip Patston

Recently, I had to the opportunity to catch up with Philip Patston who is a phenomenal speaker, advocate, and expert on diversity and labeling. Philip is also one of Social Work Helper’s expert columnists who offer readers a global perspective hailing from Auckland, New Zealand. Although he is located on the other side of the world, Philip helped me to realize through his writing and speaking the symmetry we all (human kind) share versus focusing on our differences.

Philip has traveled an interesting path and has seen the world from different lenses such as a counselor, comedian, and advocate to name a few. After viewing his Ted Talk with over 30,000 views, I wanted to learn more about Philip. We had an interesting conversation, and now I am going to share it with you.

SWH: Tell us a bit about your background and what led you into the field of social work?
Philip Patston at Tedx Auckland
Philip Patston at Tedx Auckland

I began a Bachelor of Arts degree majoring in Psychology and Sociology aged 18, but hated the University environment, so I quit early in my second year. I then trained to be a phone counsellor and ended up counselling by phone for nine years. I had also been a member of a youth group since my mid-teens and had been “dropped” into leadership roles (e.g. turning up at youth work meetings and being told to get up and speak about the youth group). So I did a lot of youth development work in my late teens and early 20s as well.

Then in 1990, when I was 22, I was accepted onto a two-year Social Work programme which gave me a Certificate of Qualification in Social Work and a Diploma in Applied Social Studies. The programme was known to be quite radical. There were only 40 students per year, half of whom were Maori (the indigenous people of NZ or Tangata Whenua, literally “people of the land”), a quarter Pacific people, and a quarter “other” (known as Pakeha in the Maori language).

It was an immersive bi-cultural programme, deliberately making Maori culture dominant. There were huge conflicts, particularly among the Pakeha group, who felt aggrieved by many processes in which they were not the majority. Being gay and disabled, I was fairly used to not being in the majority, so I was quite comfortable and amused by some of my colleagues’ inability to step outside of the process and learn from the experience of the tables being turned.

During my first year, I did a placement in a government care and protection agency and realised it wasn’t my thing. My second year placement was doing social research on the needs of disabled people for the Auckland Health Board. That turned into a two or three year job. After that I worked for the Human Rights Commission for four years, after which I became self-employed, raising awareness of diversity and doing comedy professionally.

So, I never really got to actually be a social worker! But the Diploma programme gave me a great grounding in radical social theory and direct action. If anything, I was an activist. Running awareness workshops as well as doing comedy, which led me to have a very high profile in New Zealand through television in the 1990s and 2000s, were a great combination of vehicles to create change.

SWH: Would you identify your work as being macro and/or mezzo focused, and what advice would you give other social workers who would like to do the work you are doing?

People have likened me to Nietzsche over the years so, yes, I do work in the macro/mezzo realms, I guess! I think it’s a hard place to feel effective because like any leadership or social change activity, it’s a long game and hard to see any tangible evidence of success. My suggestions for others working in similar spaces? Find like minds and check in regularly. Drink wine. Celebrate any success however small and, every now and then, pretend you’ve had a huge success and celebrate that! Finally, read Getting to Maybe: How the World Is Changed — the best book on social entrepreneurship and social change ever written.

SWH: Who are some of your biggest influencers in how you filter, provide and give information/advice to others?

Some of my favourite thinkers in the work I do are the authors of Getting to Maybe, Sir Ken Robinson, Brene Brown, Peter Block, Kathryn Schulz, and Adam Kahane. I also love Onora O’Neill’s definition of trust. Another fave is Prof. Brian Cox – he’s a cute, English educational physicist and I’ve used his layperson explanations of entropy and physics to explain diversity and relationship dynamics to school students. Finally, Sue Davidoff and Allan Kaplan, from The Proteus Initiative in South Africa. I’ve worked with them on living social practice twice now and they’ve had a profound influence on the way I work with people about diversity.

SWH: Your Tedx Talk on Labeling was a huge success. What was that experience like and what has life been like after your Tedx Talk?

It was surprisingly intimidating and nerve-wracking. Being a regular viewer of TED Talks, it really felt like I was wheeling into a TED video! Those big red letters and the round red carpet are quite iconic. I had refused to rehearse because as a comedian I would only ever rehearse mentally, so the guys running it (who hadn’t seen me perform) were a bit nervous and told my PA, Wai, who was backstage. Wai said, “Nah. he’ll be fine,” and halfway through they apparently said, “He’s killing.” Wai: “Told you so!”

Probably the most significant thing though was being able to present what I would call my soul work to 2,000 people live, in a funny, entertaining way, and have it videoed and put online under the TED brand so that it’s had over 30,000 views. That’s a great privilege.

Life after TED? Well, I did a conference call with the Diversity Group of IBM in California, which was a bit of a fizzer, and I’ve had a few speaking and facilitation jobs as a result. Not life-changing on the big scale of things, but definitely a highlight

SWH: Are you further developing your work on labeling, and do you have any other projects you are working on or have recently finished?

I recently made a music video about labelling that I’ve used a lot in diversity workshops. Music is a powerful way to simplify topics that can be quite complex, in order to have a conversation about the complexity. I was really lucky to work with an extremely talented musician, Arli Liberman, who put my words to music; and then some friends who run a superb creative agency, Borderless Productions, came up with the concept and produced the video. I’ve also recently finished some work on diversity in the media and co-wrote and published a children’s book.

Right now, I’m in an interesting space of limbo. Apart from running a leadership programme, which I love and is in its fourth year, a lot of my projects have either come to an end or have lost funding (we’re in an election year in NZ so Government funders have become super risk averse, unfortunately). So I’m in a space of seeing where I will be taken next. I’d love to make some more music videos, but they’re quite expensive and hard to get funded, even via crowdsourcing. I funded the first one myself, which meant I had a complete creative license and no accountability — that was extremely liberating!

So what’s next on the bucket list…oh and I started writing a book earlier this year and I am stuck big time. I need to give myself a good talking to and hopefully, I’ll get back into that soon too!

Good News for Macro Practice?

There may be good news on the horizon for social workers who appreciate the need for our profession to be more involved with influencing institutions and policies. The Association for Community Organizing and Social Administration’s (ACOSA) Special Commission to Advance Macro Practice in Social Work expects to release a report and proposals this year on ways to strengthen social work macro practice. The formation of the commission was spurred by a report, Education for Macro Intervention: A Survey of Problems and Prospects, by the venerable Dr. Jack Rothman. The Rothman report garnered a great deal of attention because it documented how little attention has been given to macro practice in social work. And that macro practice instructors often felt marginalized in social work programs. Social work leaders coalesced around the critical and timely need to address these issues and created the special commission.

St Thomas Univ. at Social Work Day at the Capital
St Thomas Univ. at Social Work Day at the Capital

Once again, social work is wrestling with the tension between cause and function—how much resources and energy should be devoted to addressing the structural causes of what ails society’s most vulnerable citizens versus efforts to help these citizens cope with their various sets of circumstances. What is encouraging is this appears to a credible effort to systematically examine the state of macro practice and arrive at some proposals for real change.

The special commission is being co-chaired by Dr. Darlyne Bailey, dean of the Graduate School of Social Work and Social Research at Bryn Mawr College, and Dr. Terry Mizrahi, professor and chair of Community Organizing and Program Development, Silberman School of Social Work at Hunter College and former president of the National Association of Social Workers (NASW). To date, it has received financial support from 40 schools and departments of social work and two organizations.

At issue is how much attention and resources can be devoted to macro social work practice given the overwhelming emphasis on licensing and direct services in most schools and departments of social work? Social work schools value instructors who teach courses that prepare students for licensing exams. Rothman found in his research that schools will use adjunct instructors for macro courses and reserve the bulk of their tenured positions for micro practice educators. As a result, students gravitate to micro practice because they believe this area of focus gives them the best chance for employment after graduation.

Another concern for macro practitioners is the issue of licensing. If macro practice were to grow as a share of social work there would undoubtedly be increased pressure to professionalize this specialization. Dr. Linda Plitt Donaldson and colleagues wrote in Social Work that licensing macro practice is a complicated enterprise because of the current state of variations in licensing requirements among states. Currently only three states (Michigan, Missouri, and Oklahoma) offer licenses in advanced macro practice. Given the broad range of macro practice would there be different standards for administration, community organizing, and policy? Licensing is generally seen as a means to protect the public from poorly trained practitioners. Would the same concern apply to a policy analyst who rarely interacts with the general public?

These are some of the tough issues the special commission will be grappling with going forward. What is clear in this ever changing society we live in—new technologies, graying population, transforming demographics, growing inequalities—decisions are being made in various policy deliberations and social workers need to be at the table. Gentrification and immigration are reorganizing communities and social workers need to be in the mix. We are not going to be able to “fix” people to deal with their environments, we need to be fully engaged in helping to shape their environments.

This is not a zero sum proposition. Expanding macro practice does not mean reducing the emphasis on micro practice. There will still be a need to improve the image of the profession generally and increase compensation to attract more direct service providers. By expanding macro practice, we may expand the pool and some who enter for macro practice will find micro practice more to their liking as well.

Photo Credit: Courtesy of St. Thomas University

Macro Community Practice: Why It Can’t Be Separated From Politics

What is macro community practice, and what does it have to do with politics? Anyone who follows me on Twitter knows that I often engage in political discussions with my @swhelpercom Twitter account. Most people outside of social work are often glad to see a social worker engaged in the conversation because these discussions involve Medicare, Social Security, Mental Health, and Welfare programs. They view us as the experts in these areas because we are the implementers and providers within those programs.

Social workers are the largest provider of mental health services in the United States, yet we are not at the table when experts are gathered by the government to reform these various systems. Who is the blame for social workers being absent from the policy making table which will overwhelmingly affect our ability to provide services to the people we serve? Macro community practice by definition is instituting programs and policies to increase the outcomes of the service community. Macro community practice focuses on using program evaluation and evidence based practices to gather essential data to identify areas for improvement.

Unfortunately, many social workers in both the US and abroad do not believe social workers should engage in politics. On several occasions, I have been told by other social workers that it’s inappropriate for me to engage in political conversations or advocate from a political point-of-view because social work is not political or it must be engaged in a nonpartisan way. Social Work is a profession much like teaching and law enforcement in the respect that our jobs are intrinsically linked to government funding.

Our Human Services system is in desperate need of reform, resources, and funding. However, is it reasonable to expect politicians with no human service or social work experience to see these systems as a priority especially without a union to protect our interests?

Recently, I had a brief conversation with a social carer in the United Kingdom (UK) on Twitter, and I responded in 140 characters of course. My main point in the conversation is that legislative policy dictates practice, and we must have advocates in public offices who are sympathetic to the plight of social workers/social carers in order to get system changes that are supportive of social workers.

I don’t know a single social worker who won’t agree that the system is broken and changes are needed to improve the quality of services to clients, work conditions, and pay for social workers. Macro community practice is designed to look at system changes that will impact service delivery at all levels. However, macro community practice is not a concept that should be viewed from the top down rather than the inside out. No matter our specialty or the demographics we serve, micro/direct practice should never be separated from macro practice.

For a macro community practitioner to be effective we must challenge systematic oppression as well as oppressive policy and laws creating barriers and limiting our clients’ ability to improve their outcomes. When can still help one client at a time, but how we vote and who will be put in office will determine the fate of our profession.

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