To Support Others, Social Workers Must Advocate for Themselves Amidst Covid-19 Outbreak

As a profession, social workers are advocates. We’re led by values of social justice, the advancement of the vulnerable, and promotion of dignity and basic rights for all. In the wake of the COVID-19 outbreak, there is an immediate risk to social workers’ lives, and we must also focus on advocating for ourselves.

It seems no small coincidence that in the United States, a profession of human dignity and equal rights is held in the lowest esteem of professionals across measures which also includes pay scale and representation in management, leadership, and politics. This is an important time to declare our commitment to defending the most vulnerable and establish our expertise as the profession of social justice.

As the pandemic begins to take effect in the United States, the inequities woven into the structure of our society are increasingly laid bare. As states are mandated to shelter in place, who among us are excluded from shelter at its most basic? As we adhere to mandates to maintain social distance and self isolation in the interest of public health, which communities are more likely than others to be targeted and harmed?

Social workers sit adjacent to and alongside societally marginalized groups through our daily work, personal histories, and professional passions. We demand a voice at the table as decisions are made that will impact the fabric of our society for generations to come. Indeed, by virtue of our profession’s holistic lens, social workers have a critical perspective on the current crisis facing our country and our world. We have long been unsung heroes of multidisciplinary solutions to large-scale problems, and are advocating now for an amplified role in formulating the response to COVID-19.

Social workers have been organizing in protest of the increased risk of exposure to COVID-19, largely due to our employers’ negligence in acknowledging the full scope of the problem and accommodating the unique needs that have arisen in light of the pandemic. In Maryland, the government has closed schools, restaurants and non-essential businesses. Even with these precautions our hospitals may become overwhelmed by acute need and do not have the personal protective equipment or plans in place to support the health and safety of social worker staff. While social workers have been deemed essential by the state, we are underutilized by our organizations. We have not been asked how our key clinical and critical thinking skill sets can best be applied in healthcare settings, to the detriment of ourselves and our patient populations.

The primary conflict facing our profession now is that the cacophony of social work voices, often overlooked frontline responders, are somehow still not valued highly enough to warrant support and advancement from the very organizations that are meant to be championing our cause and working alongside us to inform change. As social workers we know we are only as strong a voice for our client and patient populations as we can be for ourselves. Our profession of advocacy and organizing is only as good as what we advocate and organize for. If our boards and associations will not stand up for us and our communities then we will find other ways to make our voices heard. This is the story of a rallying cry. Social workers are fed up.

We require elevation as a profession, acknowledgment of our function reflected through representation in leadership and pay scale, and the respect that we have earned as essential staff at the frontlines of this crisis. It is only when social workers and our representative bodies advocate successfully for ourselves that we can effectively advocate for the communities our profession has committed to serve.

In such times of uncertainty, we are first demanding that social workers be protected appropriately in order to be both physically and emotionally prepared for the tasks at hand and ahead. We believe this advocacy will impact other communities as well, at macro levels of society. The recommendations for immediate action below are meant to guide organizations employing social workers as well as policy makers and political leaders at the local, state, and national levels:

  1. Provide protective equipment to all client-facing social workers, regardless of the limited nature of in-person services.
  2. Allow pregnant, elder, and otherwise immunosuppressed staff to stay home or work from home with pay and health benefits.
  3. Encourage social work services to occur remotely as possible. Indeed, non-medical personnel should be able to work from home if they so desire, and the social work role in “essential” settings such as healthcare should be carefully examined for opportunities to rotate remote and in-person services to limit exposure for the individual and community. A lack of teletherapeutic infrastructure is not an appropriate reason to require in-person client contact (see public school systems for example).
  4. Make clear organizational policies emphasizing that clients stay home and practice social distancing as much as possible. Trust social workers to utilize their clinical skill set to appropriately assess for their clients’ safety and needs.
  5. Hold all organizational meetings online and prohibit in-person meetings.
  6. For Healthcare organizations, encourage coordinated care in service of clients and families having preemptive discussions regarding treatment, including the designation of healthcare decision-makers and completion of advance directives.

All social inequalities are magnified in this crisis. We urge elected officials and health care organizational leaders to respond to this pandemic on a scale comparable to the threat, and make sure that we are protecting working people, low-income people, and poor and societally marginalized people, many of whom may be social workers.

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About Anti-Racist Social Workers Baltimore

Template: Social Work Organizational Action Letter

6 Recommendations for Social Workers During COVID-19

Social Workers Against Solitary Confinement (SWASC) seeks to abolish the use of solitary confinement and supports social workers in its fight against this social injustice.

This Educator|Resource offers a comprehensive overview of solitary confinement that includes voices of those who have been affected by it, the ethical dilemma of health and social service providers who work in criminal justice facilities, and humane alternatives. A resource database provides an extensive set of more than 300 teaching resources that can be used in a range of social work courses. This includes courses in criminal justice and practice courses in mental health, policy, community organizing and advocacy, and social justice and human rights.

We thank the Council on Social Work Education for acknowledging the contributions of SWASC and to Yolanda Padilla for their help and support in launching this project.

Getting Stuff Done

I used to manage a wonderful multidisciplinary team in East London, who prided themselves on going the extra mile for families on their teamwork and joined-up support. I remember an imposing senior manager visiting, and the staff sharing with her descriptions of their casework.

As she listened intently and I idly read the screen-saver on the computer behind where she was seated, I realised with dawning horror that it was repeatedly scrolling across the monitor “The East Welford Team* gets S*!%T done!!” It didn’t take long for me to find an excuse to show her another part of the office, making dagger-eyes at my team to get them to change the message to something more positively corporate-sounding pronto!

But I was very proud of that team, and I was reminded of them last week when I walked into the Project Room at work to offer to make a round of tea. I found Marianne (one of our team co-ordinators) talking excitedly with Emma and Theresa (two of our Family Workers).

The subject of the discussion was the intensive afternoon-into-early evening they had had the day before, “holed” up in an office at a GP surgery with a parent, supporting her and making phone call after phone call to get the various agencies to respond to the crisis she and her children were dealing with. The excitement didn’t arise from anger or triumphalism related to the battle with other services; it certainly wasn’t taking satisfaction in or credit from someone else’s misfortunes.

But what those team members were remembering and celebrating was a job well done and achieved through team work and partnership. Just for those 15 minutes, Emma and Theresa deserved their place under the spotlight, although to be honest most of their weeks are filled with unheralded skill and hard work to help parents, children and even other professionals achieve their potential. Marianne said that from this point on she would call them Starsky and Hutch because of their partnership, dynamism and commitment to getting the job done – even under intense pressure.

That made me smile, but also reflect on at what point we in the voluntary sector stopped talking about the “work”? And by the ‘work’ I mean the hands on engagement with and support given to our service users and beneficiaries. Don’t get me wrong – I know there are lots of people involved with charities whose work is little acknowledged and often not recognised.

A voluntary sector bulletin recently dropped into my inbox from a major national newspaper, and to judge from its contents, charities like mine are increasingly effective in our campaigning about what we do, striving to identify outcomes for what we do, tweeting and blogging about it, and of course fundraising for what we do. All the people who undertake those tasks and who support the aims and values of their charities deserve to be appreciated and applauded. But lately, it doesn’t seem (purely a hunch – no hard research was undertaken) that we explain what it is we do exactly “to help”. Or that we celebrate that work.

Yes, we do talk about outcomes – but rarely about how those outcomes were achieved, even if it was only by simple but vital acts such as providing a space to talk, enabling respite for carers by finding children a holiday scheme, or setting up an awards ceremony and disco for young disabled volunteers so they can party and have fun like many of their non-disabled peers.

Under the stress and pressure, our wonderful staff carry on talking the talk and walking the walk. Sometimes in the face of hostility, but also receiving more gratitude and thanks from our service users than people would ever expect was expressed. Last month I conducted the final observation of our social work student on a visit to a parent and family she had supported during her placement.

Amongst lots of really concrete outcomes achieved by the student, including getting the children into an afterschool club and linking the family with advice around a child’s special educational needs, the parent told me that “you couldn’t wish for a better person to work with you”. When I passed it on I saw how my student positively glowed at that piece of feedback. And what could be a stronger endorsement than that someone is willing to open up some of the most private areas of their own or their family’s life to you?

If something is not talked about it is effectively unseen and unacknowledged. What we do – the day job – is a big part of our identity and people need to feel able to be proud of it. They may not look or act like Starsky and Hutch, but every day voluntary sector staff contribute to thousands of supportive conversations in bedsits, flats, living rooms, hostels, interview rooms, and group work sessions to create the opportunity for positive changes in people’s lives. And we shouldn’t be afraid to talk about how they are getting sh…I mean STUFF! done.

Engaging Fathers in Parenting Intervention Improves Outcomes for Both Kids and Fathers

A parenting program where fathers engage with their children through reading was found to boost the fathers’ parenting skills while also improving the preschoolers’ school readiness and behavior, finds a study led by NYU’s Steinhardt School of Culture, Education, and Human Development.

“Unlike earlier research, our study finds that it is possible to engage fathers from low-income communities in parenting interventions, which benefits both the fathers and their children,” said Anil Chacko, associate professor of counseling psychology at NYU Steinhardt and the lead author of the study, published in the Journal of Clinical Child & Adolescent Psychology.

Fathers play a significant role in the social, emotional, and behavioral development of children. However, working with fathers to improve their parenting — and, in turn, outcomes for their children — has been understudied, as most parenting research focuses on mothers. In addition, earlier studies of parenting interventions for fathers have issues with high rates of fathers dropping out of the studies.

This study evaluated the effects of Fathers Supporting Success in Preschoolers, an intervention that focuses on integrating parent training with shared book reading to improve outcomes among fathers and their preschool children.

Shared book reading is an interactive and dynamic activity in which an adult uses prompts and feedback to allow a child to become an active storyteller. It relies heavily on using pictures, and supports parents giving children praise and encouragement. Shared book reading fosters father-child interactions, but also aligns with a priority of early education programs to develop school readiness.

“Rather than a goal of increasing father involvement, which implies a deficit approach, a program that uses shared book reading targets a specific parenting skill set and represents a valued activity for parents and children,” Chacko said.

In the study, 126 low-income fathers and their preschool-aged children were recruited across three Head Start centers in New York City. The families, a majority of whom spoke Spanish, were randomly assigned to either participate in the program or were put on a waitlist (which acted as the control condition).

The short-term intervention included eight weekly sessions lasting 90 minutes each. In these sessions, small groups of fathers watched videos showing fathers reading with children but with exaggerated errors. The fathers then identified and, in small and large groups, discussed better approaches to these interactions. Fathers were then encouraged to practice the strategies they identified at home with their child during shared book reading.

The program sought to improve parenting behaviors such as establishing routines, encouraging child-centered time, using attention and incentives to promote good behavior, using distraction and ignoring to reduce attention-seeking behavior, and resorting to time-outs sparingly.

The study evaluated the effects of the program on parenting skills, child behavior and language, and outcomes for fathers, including stress and depression. These factors were measured before and immediately after participation in the program, and included both observations by the researchers, standardized assessments of language, and information reported by the fathers. Attendance data was also collected as a measure of engagement.

The researchers found that parenting behaviors, child behaviors, and language development of the children who participated in the program improved significantly relative to those on the wait-list.

More specifically, fathers reported improved discipline approaches and promotion of their children’s psychological growth. This held true in the researchers’ observations, who after the intervention, saw that fathers made fewer critical statements to their children and used more positive parenting behaviors like praise and affection. The researchers also measured a moderate effect on language outcomes among the children. Overall, the data suggest more than a 30 percent improvement in parenting and school readiness outcomes.

Importantly, the average attendance rate for the weekly sessions was 79 percent, which was substantially higher than past parenting programs for fathers.

“Unlike other parenting programs, fathers in this program were not recruited to work on parenting or reduce child behavior problems, but to learn — with other fathers — skills to support their children’s school readiness, which may remove stigma and support openness among fathers in supporting their children,” Chacko said. “The findings are particularly noteworthy given the study’s population of low-income, Spanish-speaking, immigrant fathers.”

The researchers noted that shared book reading may not be the best approach for all fathers and children, so interventions should be tailored to the preferences of communities and parents in order to increase the likelihood of success.

“Ultimately, we believe that developing a program that is both focused on the parent and child, and one that is not deficit-driven or focused on improving problematic parenting but is focusing on skill development, would be appealing and engaging for fathers,” Chacko said.

In addition to Chacko, study authors include Gregory Fabiano of the University of Buffalo, Greta Doctoroff of Yeshiva University, and Beverly Fortson of the Centers for Disease Control and Prevention.

Defining “The Value” of Care

Price-and-Value

Social Media is a place to interact and network with fellow professionals. However, it is also a place to problem solve and create dialogue between multiple disciplines. Through my twitter account, I had a chance encounter with a great community called #medpsych which is the brainchild of Dr. Anne Becker-Schutte and Dr. Susan Guirleo. What’s interesting about #medpsych is their focus on “whole-person care”.

The mission of the #medpsych community is to make the connection between physical and brain health. The connection between mental health and physical health can’t be disputed. The more interaction with this healthcare community and others, the link between social work and healthcare is becoming more and more evident.

I want to bring attention to #medpsych chat discussing how one defines value in healthcare. Members of the open #medpsych twitter community include doctors, psychologists, healthcare policy advocates, nurses, social workers, and patient advocates to name a few. As a group, they set out how to determine which healthcare services have value.  These can be powerful interactions across disciplines to help practitioners and service providers to identify what working and help identify areas for more investigation. The question “What does ‘value in healthcare’ mean to you, and how can we make this more than a buzzword”? Here are some of the following answers:

https://twitter.com/mattbc/status/532363839837577216

Defining value started out about the financial value. Does the money we put into the healthcare service yield a cost saving result?  As a group, we started to question whether it is not always about the fiscal value.  If valuable healthcare is not about the money then what is it about?  Insurance companies certainly want to demonstrate programs have “value” in terms of money. In helping make change, “throwing money at the problem” does not always work.

Value seemed to become about the quality of the interaction between the patient and the healthcare provider. This went across the entire spectrum of care and it depends on the point of view. As Scott Strange said in the chat, the provider might think  “I went home fine but I might think I was better off before I came”.

This conversation about value and healthcare can easily be transferred to social work, and how you define value in your work?  Clearly, the interventions we provide have value, but how to we define it? Is it measured by income generated for your program? Is it positive outcome to demonstrate to funders? Asking these purely fiscal and outcome questions are an important part of value, but we must constantly define and redefine value for both service providers and service users.

There needs more interactions across practice areas in the profession in order to better help us define and determine value. It worked for the #medpsych community, and it will work for the social work community. Let’s work together with all stakeholders to better define value in your community. If you are interested in reading the #medpsych transcript, you can read it here.

How do you believe we can better define value of the persons we care for?

Pregnant and Parenting Youth in Foster Care Epidemic

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Possibly one of the few things more challenging than being a teenage parent is being a teenage parent in foster care.  While the adverse effects of teen pregnancy have been well studied, researchers and social service providers are only recently coming to terms with the growing epidemic of pregnant and parenting youth in foster care.

According to a 2009 Chapin Hall Study  adolescents in foster care are at a significantly higher risk for pregnancy than the general adolescent population:

  • At ages 17 and 18, one third or 33% of young women in foster care were pregnant or parenting  
  • By age 19, more than half or 51 % of young women currently or formerly in foster care were pregnant or parenting, and nearly half of those young women had more than one child
  • 60% of 21-year-old former foster males report impregnating a female partner as compared to 28 % of the general population

To be clear, foster youth are children who have been removed from their families and are in the legal custody of the state. Another way to think of this is, the government is their parents. If that is the reality, than foster youth are basically “our children” and we are doing a pretty shabby job at being their parents.

What is possibly even more troubling than a 50% pregnancy rate is the experiences of these young parents while in foster care:

  • 1 in 5 pregnant teens in foster care received NO prenatal care
  • 22% of teen foster care mothers were investigated for child maltreatment
    (this is way above the 12% of teenage parent in general)
  • 11% of teen foster care mothers had their children removed from their custody 
  • 44% of foster care mothers graduated from high school; 27% for parenting foster fathers
  • Having a child while in foster care was the largest predictor of homelessness after exiting care

Teen pregnancy and parenting is only one of the indicators of poor foster care outcomes. Very few programs and policies address the needs of pregnant and parenting youth in foster care or work to prevent initial or repeat pregnancy.  Other critical foster care outcomes include a significant  increase in the risk of homelessness, incarceration, poor educational attainment, and poverty for foster youth ages 14-18 . But there is something uniquely disturbing about the fact that the children of foster youth are at-risk for entering foster care while their parents are still in foster care.

Though I am in no way suggesting that the U.S. do away with child protective services or foster care, circumstances such as these do beg the question, “Is the government any better at being a parent than the very caregivers these children are removed from?” This is a scary question to ask, but one that social workers must constantly be appraising.  The answer is not “no” but it is not a resounding “yes” either.

By definition, children in foster care come into care from troubled circumstances, putting them at greater risk for a number of poor outcomes. But we must make a guarantee to these children that the new environments we provide for them will make them better off than the environments we took them from. We must transition child welfare into a place where safety and permanency are not our only goals.  Well-being and a better future are essential.

As a child welfare systems change analyst, I applaud the tireless work of child welfare workers and administrations and recognize it is one of the most difficult, yet rewarding, jobs to do. There are so many forces beyond our control and endless administrative hurdles to overcome. But we must still do better. We have to do better or what is the point of the entire system?

References & Resources: 

Boonstra, H.D. (2011). Teen pregnancy among young women in foster care: A primer. Guttermacher Policy Review, 14 (11) pp.8-19.

Center for the Study of Social Policy: Pregnant and Parenting Youth in Foster Care

Children’s Bureau, Administration of Children, Youth, and Families. The AFCARS Report: Preliminary FY 2012 as of July 2013.

Children’s Defense Fund. (2010). Fostering Connections to Success and Increasing Adoptions Act Summary.

When Processes Become Part of Outcomes: Collaboration, Creativity, Community

As social workers involved in community development, we all know and understand that funding bodies, sponsors and management committees wish to see “objectives and outcomes”, but how much valuable information gets lost when these are the only areas of focus for reporting? And how much do we restrict ourselves when planning programs purely based on stated initial objectives and outcomes?

A recent experience highlights the need to be flexible in the planning and implementation of projects as well as in the final evaluation phase. Had the focus for this particular project remained inflexibly on the initial “objectives and planned outcomes”, we may well have missed valuable opportunities and failed to report valid information in the outcomes section of any final evaluation.

The key is to spend a little bit of time thinking about the impact of “processes”. You may be pleasantly surprised that processes can actually add to the outcomes.

The Canopy Family Community Exhibition

The Canopy at Cameron Park Community Centre is a community organisation (in NSW Australia) that provides services to families, children and communities.  To celebrate 25 years of supporting families it was decided to hold an event that involved other organisations who provide family services.

The objectives of the Canopy Family Community Exhibition were to:

  • Give local groups and/or agencies the opportunity to promote what they are doing in the community to support families
  • Spread awareness of services to the local community
  • Provide an opportunity for networking
  • Provide a forum to positively model relationships and family

With objectives such as this, it would be all too easy to simply send out an invitation to participate, and wait for the bookings to roll in. The end result would be similar to a kind of “expo” where organisations have a stall with various pamphlets and information.

The trouble with that concept is that it’s been done before. Not too much thought or preparation needs to go into the event. In other words, the process for staff and/or volunteers from each agency would simply be to nominate one person to gather promotional items from the agency’s cupboards and set up a standard table of information.

How do we expand on this concept?

  • What processes could we set in motion to encourage communication around the meaning of “family”?
  • How could we engage clients of some of these services into a process that ultimately portrays and promotes the function of the service?
  • How can we take some of the projected outcomes beyond just the planned “one day” of exhibits?
  • How do we foster collaborative efforts?
  • How do we encourage agencies to do something innovative so that others are inspired by their presentations? (yes this means encouraging people to move out of their comfort zone)

What we came up with was to ask agencies to submit a creative representation of “family” as it related to their group. Creative representations allow participation from all ages, backgrounds and skills levels.  Each agency was asked to enter a collaborative effort involving staff, volunteers and if possible, clients of the service. They were asked to explain their “creation” and also provide information about their service. For those who felt stuck for ideas and/or time, we offered consultation and assistance with brainstorming and/or assistance with the creation.

The results were 17 entries, all depicting “family” from their agency/group perspective, with an explanation of the services that their agency provides to the community. The making of each entry had become a “mini” project with outcomes of its own. Subsequent conversations between agencies revolved around the process of making their creation. Who took part, how they made decisions, sharing stories about what “family” meant to them, which contributions were made by staff, volunteers and clients of the service, and the feeling of teamwork the process inspired.

The following statements from agencies involved explain this:

Our communities are from various cultural backgrounds coming together to develop new relationships that redefine family in Australia, after their loss through migration of close loved ones. This project has been very important as a way for  parents, children, siblings and community coming together as family. We have had over 20 participants inclusive of children involved + 5 staff and 4  volunteers.  ~Northern Settlement Services

We started out with the idea of having a hat stand…to represent where the family members ‘hang their hat’….So…one of the ladies from the craft group who meet here on Tuesdays said she had an old plant hanger which may suffice as a hat stand. When I picked it up and brought it into my office the staff, volunteers and visitors all started contributing ideas and somehow it turned into a family tree instead of a hat stand. It ‘grew’ from there…at one stage it was going to have photos of our various ‘family members’ hanging from it but then the leaves seemed to work better.  ~ Woodrising Neighbourhood Rising

A lot of our tiles came from donations of staff and families old tiles which also added a special element of family and  togetherness. Many wonderful conversations and reminiscing came with our “labour of love”, family and friends and times gone by. ~Domain Macquarie Place

Would these results have eventuated if we only implement a cookie cutter approach? Next time, you’re involved in planning a community project, don’t lock in the goals. Don’t restrict yourself to preconceived outcomes. Remain flexible, get out of your comfort zone, and try a little innovation! Check out some of the photos on https://www.facebook.com/cameronparkcommunitycentre

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