Thursday, 1 March 2012

10 Dedicated and Deserving Social Workers

10 Dedicated and Deserving Social Workers
By Lindsey Getz
Since National Professional Social Work Month will be observed in March, we devote this space to some of the wonderful and committed social workers in the field. With the second annual “10 Dedicated and Deserving Social Workers” recognition, we asked you, our readers, to nominate your colleagues, coworkers, and mentors by writing essays about the people you believe should be recognized. So many of you deserve recognition, but 10 finalists were selected, and we are honored to share their stories with you here.
Stacey Krueger Barton, MSW, LCSW
Clinical Social Worker at Washington University School of Medicine in St. Louis
Prior to working in the Washington University School of Medicine Movement Disorders Center, Stacey Krueger Barton spent almost 10 years working in hospice. She says that background prepared her for working with patients with Huntington’s disease, a progressive and incurable movement disorder that often strikes people in the prime of their life, destroying their ability to move, talk, and reason and eventually leading to their death. Barton was hand-picked for her current position by its former holder—someone who was told she could find her own replacement and knew Barton was the perfect fit.
“Once I learned more about the position, I knew she had pegged me well,” says Barton. “About 60% of my time is clinical, and the rest is doing research.”
Barton’s responsibilities include counseling patients, helping them and their families adjust to future changes related to Huntington’s disease, and heading up numerous research projects for the disease. Patients have a 50% chance of transferring the gene that causes Huntington’s disease to their offspring, so Barton says it’s quite common for her to work with more than one family member. But she says it’s a “family disease” whether the gene has been passed or not.
“The patient’s actions have a ripple effect on the whole family,” she explains. “The disease causes cognitive and psychiatric changes that are tough to deal with. For example, sometimes Huntington’s patients do things that cause them to get in trouble with law enforcement, and that’s an area where we have to intervene.”
While these difficult cases can take a toll on health professionals, Barton says her training helps her deal with the weight of her work. “I learned to measure my goals differently,” she explains. “My goal in hospice wasn’t that the patient would live—it was that they have a good death and that the family was prepared. Maybe I helped get them on Social Security or ensured the patient had good care in their final days.”
In addition to setting realistic goals, Barton says she’s also learned to create boundaries that she keeps in the forefront of her mind at all times. “That’s something else I learned in hospice,” she says. “I became good at letting go of the person I just left prior to walking into the next house. And at the end of the day, I have to let go of that last patient so I can be present for my own family. It can be challenging, and when I mentor students, I try to discuss this with them because I think letting go of patients is something social workers struggle with.
“As engaged as I may be with the patient, at the end of the day it’s their life, not mine,” she continues. “The truth is that I’m not living with what they’re going through. Perspective is one of the best job perks. I’m constantly inspired by my patients.”
Bill Wertman, MSW
CEO of the Alzheimer’s Project, Inc. and an adjunct instructor at Florida State University
Bill Wertman’s grandmother was diagnosed with Alzheimer’s disease while he was working on a degree in nutrition and dietetics. She came to live with him and his family. Wertman says that move had a huge impact on his career path.
“I saw how much of a struggle it was for my mom to provide a certain level of care for her,” he says. “I was working on my degree, and there just weren’t a lot of resources available in the rural county we lived in, so my mom was often on her own.” 
After finishing his degree, Wertman went back to school get a master’s degree in social work, a decision influenced by witnessing his mother’s struggles as his grandmother’s primary caregiver. In 2006, Wertman joined the staff of Alzheimer’s Project, Inc., an organization that provides much-needed respite for caregivers by placing volunteers in patients’ homes. The organization has also incorporated support groups, counseling, educational opportunities, and much more into the local communities.
And while Wertman loves this job, he says his true passion is teaching. He believes numerous social work programs are based heavily on a textbook methodology for teaching, but as an adjunct professor, he brings some real-world perspective into the classroom. “You can read a textbook example of how XYZ looks, but it’s nice to be able to talk about how XYZ goes in real life—it’s not always picture perfect,” he says. “Students appreciate that honesty, even though it can be scary at times.”
Wertman says he sees a future for social work students in which there are numerous possibilities. “The training social work students receive prepares them to do any number of functions once they graduate,” he says. “They can work in administration, be advocates across any practice level, create their own environments, or even partner with other social workers. They can even have their own practice. The most important message I want to convey to my students is to think outside of the box that has contained us for so many years. We’ve been taught to think that as social workers, we can only become case managers or earn X amount of dollars, but that’s not how I see it. I see a future that is much brighter than that for today’s students.”
Seth Berkowitz, LCSW, CCLS
Patient Services Manager for The Leukemia & Lymphoma Society Southern Florida Chapter
Seth Berkowitz was involved in the healthcare field prior to joining The Leukemia & Lymphoma Society (LLS). He worked for Gilda’s Club South Florida running support groups and sold safety training to corporations and businesses for the American Red Cross. And prior to moving to Florida, he worked as a child life specialist at Children’s Hospital of Michigan.
But when a position became available at LLS for a full-time social worker, he knew it was his calling. “It’s such a great organization and a place I’d been working part time even before this full-time opportunity became available,” he says. “We are the frontline of support for newly diagnosed patients with leukemia, lymphoma, and other blood cancers.”
Berkowitz isn’t just a clock-in, clock-out kind of employee at LLS. He has taken on numerous leadership roles both locally and statewide within many social work organizations, including the National Association of Social Workers and the Florida Society of Oncology Social Workers. “I wanted to get more involved with those organizations because I feel like they’re making a true impact on society and moving things in the right direction,” he says. “You start to realize the impact you can have once you get more involved.”
While he’s remained involved in the healthcare field with his LLS work he says that, as a social worker, he enjoys working a bit outside the medical model. “I’ve worked with patients that have died, but I can at least walk away feeling that I know I did something to help with the process and make life better in some way for that patient and their family,” Berkowitz explains. “We are often able to make the patient’s life better or even helped them live even longer by providing interventions and support. That allows me to walk away from tough cases and still feel some sense of reward. Since the medical model is so focused on the patient outcome, I think it’s hard for the medical team to walk away from those cases where they lost a patient. We’re focused more on the journey of the patient and doing everything we can for them in terms of support.”
Christa Albert-Watson, BA, MSW, LCSW-BACS
School Social Worker Specialist for Recovery School District in New Orleans
When Hurricane Katrina struck the Gulf Coast in 2005, Christa Albert-Watson was among thousands who had to leave New Orleans. Upon returning, she found that the children’s psychiatric hospital she’d worked at had closed its doors. But she also found that there were many new opportunities where she could provide service—the greatest of which was in the school system.
“The biggest need was helping get kids back into school and also helping them adjust to all the changes that had taken place since Katrina,” says Albert-Watson. “In the beginning, a lot of my work had to do with the basics we take for granted—helping kids get clothes for school or even their birth certificates so they could enroll in school. Sometimes it was helping schedule their bus routes because the places they were living could change daily. Those early days were tough times, as everyone was starting all over again.”
Even today, Albert-Watson says there are daily struggles. Students are still returning to the area, having been away since Katrina, and Albert-Watson says many are shocked at the changes. So her job still has much to do with helping kids adjust. “There are still a lot of logistics to work out,” says Albert-Watson. “We also have a population of homeless kids whose needs we’re helping meet.”
It’s Albert-Watson’s positive attitude that helps her continue to make a difference in the lives of these children. She always looks for the bright side of a situation—even in trying times.
“I think that every day there’s at least one bright spot,” she says. “Even if it’s a day full of challenges, I always look for the moment that makes it a good day. And I’ve always found something, even if it’s just a tiny fleeting moment. I grab on to that, and it helps me get to a new day. The sign outside my door says, ‘Every day is a new beginning,’ and I really believe in that philosophy—starting fresh each and every day, no matter what happened in the past.”
Susan Signorino, MSW
Senior Living Counselor at Brooking Park in Chesterfield, MO
As a teenager, Susan Signorino realized she wanted to go into a helping profession. She was working as a candy striper at a local hospital and says she loved the atmosphere and enjoyed the sense of fulfillment from helping others. So she followed that path. In her first 17 years as a social worker, Signorino worked in home care and hospice through a rural hospital.
While Signorino interacted daily with patients at the hospital, she began to feel isolated because there weren’t many other master’s level-prepared social workers around. Seeking some support from and connection with her peers, Signorino launched an e-mail listserv to reach out to other social workers in the area. “Many organizations only have one social worker on staff, so this was a great way for all of us to communicate,” she says. “Then in the ‘90s, we went through a time when a lot of social workers lost their jobs and were in need of work, so the listserv became an opportunity to help one another by posting résumés and sharing job openings. From there, it has evolved.”
Four years ago, Signorino began working in the St. Louis area, and with the move to a larger community, the listserv truly blossomed. Today there are more than 700 social workers who use it, yet Signorino continues to manage it on her own and also keeps it free of charge despite the huge amount of time she invests in it. “This is never something I’ll charge for because it’s meant to be a community service to my fellow colleagues,” she says. “Connecting is something that benefits us both personally and professionally.”
Signorino has seen these benefits from the listserv herself. Since the recession, Signorino has been let go from three jobs in just three years because of issues such as downsized departments.
“Psychologically, it’s been devastating,” she admits. “But then I get an outpouring from other social workers who have shared their own stories of lost jobs or are sharing job opportunities with me, and it helps remind me what I love about this profession. Today I’m settled in a long-term care community doing marketing and admissions, and I feel that things have worked out great even though it’s been a roller coaster ride to get here. All along, the connection with other colleagues out there through this listserv has reminded me that I’m not alone.”
Leta Meerman, BSW, MS
Emergency Department Social Worker at Holmes Regional Trauma Center in Melbourne, FL
As an emergency department social worker at Holmes Regional Trauma Center, Leta Meerman provides crisis intervention for patients and their families during some of the most traumatic times in their life. She deals with trauma cases, homeless patients, child and elder abuse victims, and many other difficult scenarios, yet she comes to work every day ready to make a difference.      
“We deal with a lot of horrible things—gunshots, stabbings, drownings, murder attempts, domestic violence, abuse and, of course, any vehicle or motorcycle crashes,” says Meerman. “But even though it can be difficult, it’s also wonderful to be able to help someone at their worst moment in life. I’ve always had an interest in making a difference and being in a place where I can help people, and this is certainly one of those places.”
Meerman has even extended that helping hand in her free time, having volunteered to be on the board of directors at a local adoption agency. “There are so many people looking to adopt internationally, but there are a lot of kids here in our own community that need homes. That fact has driven me to help.” 
In fact, it even led Meerman to adopt a special needs child of her own. “A therapist I work with showed me a picture of this little girl and said she looked a lot like me and expressed that she needed a home,” says Meerman. “That’s something I’ve always wanted to do personally because I believe every child needs a family. Today, she’s 11 and doing very well. I’ve also helped place at least 10 other special needs children into loving families.”       
Whether it’s working with families looking to adopt or in her current position in the emergency department, Meerman says her guiding philosophy has always been the old proverb that if you give a man a fish, you feed him for a day, but if you teach him to fish, you feed him for a lifetime.
“That’s my approach to social work,” she says. “I aim to empower my patients to help themselves. That proverb reminds me that I need to ensure these patients and their families have all the resources they’ll need to be OK after they leave these horrible traumas and my service.”
Brandy Johnson, MSW, LCSW
Senior Oncology Social Worker for Cancer Care at Saint Clare’s in Denville, NJ
Brandy Johnson says she was always intrigued by cancer cases, so when she became a social worker, it was obvious that working with patients who have cancer was her calling. She later realized her grandmother, a 25-year breast cancer survivor, likely sparked the passion.
“She had breast cancer at a time when the treatment was a radical mastectomy and radiation that left you with burns all over,” recalls Johnson, who says she’s also been a cancer caregiver to her aunt. “But that never stopped her from doing anything. She was always dressed to the hilt and never let cancer get in the way of her life. Looking back at her strength has helped me go into this field and has helped me realize that cancer doesn’t have to be something to be scared of. It’s a part of life. The question is how to deal with it, and that’s where I want to help.”           
As an oncology social worker, Johnson helps ensure her patients and their families get the support and resources they need. As a tireless advocate, she’s also frequently involved in community events such as the Breast Cancer Walk and Survivor’s Day. “I find strength in participating in these additional community activities,” she says. “I may collapse at the end of the day from being tired, but I also really enjoy it.”
Additionally, Johnson sits on the board of the Operation Bling Foundation, which provides free jewelry to cancer patients. She says asking patients or their caregivers if they’ve been “blinged” is sometimes a great conversation starter, especially with a family that has been resistant to a social worker’s help. “Once they open up, they start talking about how they’ve been poked and prodded and just feel like a piece of meat,” Johnson says. “To get a piece of jewelry as a gift makes them feel human and loved.”
Johnson says she’d like to see the greater community become better educated on the value of social workers so that more conversations can be started. “We really need to strut our stuff and show the world that we’re not just people that take babies away,” she says. “I’d love to see the community educated on what we as social workers can do and how we are there to help.”
Mark Rogalsky, BASW, MSW
Unit Manager for Prevention Services at Mercy Behavioral Health, part of the Pittsburgh Mercy Health System
“It all goes back to the summer of 1974,” says Mark Rogalsky, describing what led him to the field of social work and, more specifically, to working with kids.
Though only a kid himself at the time, during the Pittsburgh Jewish Community Centers overnight camp, he had a calling—literally. One of the program’s youth workers called Rogalsky after he returned to the city from camp and asked if Rogalsky wanted to help plan another weekend-at-camp event. “I think from that point on, I was hooked on group work with kids,” Rogalsky says.
In his first job out of graduate school, Rogalsky went to Houston, but he says it wasn’t long before he got a call for a position that brought him back to Pittsburgh. From there, he has held several different positions. But ultimately an opportunity came up to be a school-based therapist. The more “normal” business hours plus time working with kids appealed to Rogalsky, plus he was in an excellent position to make a huge impact on kids’ lives. But how he did it might be a surprise—it was through dance.
Rogalsky was instrumental in bringing “dancing classrooms” into some of Pittsburgh’s highest risk schools. Coordinating the program, he works within the schools, plans competitive events, and markets the program to the community. “I had seen Mad Hot Ballroom and Take the Lead, and I began to realize how wonderfully it fit in with the idea of prevention,” says Rogalsky. “It’s like The Karate Kid in the sense that there’s a bigger picture. Kids don’t realize that dance is keeping them from getting in trouble or giving them a place to connect. They think they’re just learning to dance.”
Rogalsky says Janice Pringle, PhD, from the University of Pittsburgh, School of Pharmacy is in the process of working on hard data to determine the program’s impact in areas such as behavior and academics, but preliminary reports are “phenomenal.” Personally, he says participating in the dancing classrooms has been the greatest part of his time as a social worker. Rogalsky says it’s obvious just by watching the kids the positive impact the program has on their lives.
“I get to go from school to school and talk to the kids and watch them dance, and it’s been wonderful to see how excited they all are,” Rogalsky adds. “It’s amazing how much we can accomplish with school-based prevention. There are just some things kids will remember forever, and that’s pretty powerful. It’s the realization that you helped them look at things with a different perspective and made a positive impact on their lives in some way.”
Hanan K. Bilal, BSW
Social Service Coordinator for Gardenia Gardens Neighborhood Network Center at Gardenia Gardens Apartments, Inc. in Gainesville, FL
Hanan Bilal says her passion for “connecting people with resources and making a difference in the community” comes from growing up with activist parents. “They were concerned about education, poverty, and racial and social inequalities,” she says. “Growing up with parents that had such passion, it was automatic that I picked it up myself.”
While Bilal has traveled the world, she ultimately wound up back in the town she grew up in. “I went to school here. My daughter’s grandparents live here, and I just have background here,” she says. “It makes you want to do your best for the people that live here when it’s your own community.”            
But Bilal has truly gone above and beyond. She began working six years ago with an affordable housing community subsidized by the Department of Housing and Urban Development as a social service coordinator. Though she was told it would eventually be a funded position, that hasn’t happened, so even though she took on a full-time job as a director of volunteers for the Ronald McDonald House Charities of North Central Florida, she has continued to provide her social work services to the housing community, often going door to door to see her clients. “I have found that a lot of times, people just don’t come to you, so if you want to be effective as a social worker, sometimes you have to go that extra mile,” she says.
With the little amount of spare time she has, Bilal also founded the group Muslims That Want to Marry as a resource that would help Muslims connect with one another. “I was raised in a Muslim family that was surrounded by Christians,” says Bilal. “Most of our family is Christian, and while I love and respect Christians, as a divorced woman, I’ve realized how hard it is to meet other Muslims. As a social worker, I naturally wanted to find a solution. While people told me I could make money off of the site the way a site like Match.com does, I felt that would defeat the purpose. I understand not everyone would be able to afford it, and I want this service to be available to anyone that needs it.”            
Just like Bilal was inspired by her own parents, she says she hopes to be an inspiration to her 14-year-old daughter. “In everything I do, I realize that my child is watching me, and that always reminds me to do the right thing,” she says. “I believe in volunteering and helping people, but it has to be more than a belief—you have to actually do something about it.”
Nancy Calhoun, LMSW
Retired Social Worker for SUNY Upstate Medical University, University Hospital in Syracuse, NY
Years ago, Nancy Calhoun became a single parent and needed to pursue a new career. Her next-door neighbor, who was the dean of Syracuse University’s School of Human Development, suggested pursuing an MSW because it could be the “key to multiple careers.”
Calhoun says that’s exactly what social work has been for her, and since obtaining her degree, she’s used it for service, teaching, applied research, advocacy, and counseling. Now retired, Calhoun provided decades of dedication to the social work field and says if it weren’t for her current battle against breast cancer, she’d be doing even more.
Though she’s held various positions, for the last 15 years, Calhoun worked at SUNY Upstate Medical University, providing care to older adults with dementia and supporting their caregivers. She says she’s become accustomed to looking at the big picture and always asking herself, “How can I make this happen?” She never gets discouraged and is always looking for solutions. In fact, Calhoun says that even today the “ideas are there, just not the energy to follow through,” as she fights cancer.
Along the way, Calhoun has taught and developed a gerontology curriculum and a course on aging. “I taught until I realized I was approaching the aging population myself,” she says while laughing. “I always saw myself as the link between the younger generation of up-and-coming social workers and the older generation, but once I realized I was part of the latter group, I decided that wasn’t the role I wanted. I was no longer the middle-aged person that could interpret for both groups.”
Calhoun says that even in retirement, she can’t stop herself from always looking for a solution. That’s the life-long social worker in her.
“There’s always a way through a problem. I’m an eternal optimist,” she says. “Along with that, I have the ability not to dwell on the things that don’t turn out so well. I can move on and accept the next challenge. That’s part of how I live my life. If it weren’t for my health situation, I’d be out there now. But I’ll never stop looking around and seeing opportunities to help.”

Facebook and Suicide Prevention

Facebook and Suicide Prevention -Written by Linda May Grobman, MSW, LSW, ACSW  

Facebook announced in December 2011 a new partnership with the Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Suicide Prevention Lifeline 1-800-273-TALK. Through the new service, Facebook users who see a suicidal comment posted by a friend can report this to Facebook using the “Report Suicidal Content” link or the report links found throughout Facebook. Facebook will then send an e-mail to the person who posted the suicidal comment, encouraging him or her to call the National Suicide Prevention Lifeline or to click on a link to begin a confidential chat session with a crisis worker.

    With 800 million active users, Facebook has the potential to make an enormous impact with this new service.
    “Facebook and the Lifeline are to be commended for addressing one of this nation’s most tragic public health problems,” says Surgeon General Regina M. Benjamin, MD, MBA. “Nearly 100 Americans die by suicide every day—36,035 lives every year. These deaths are even more tragic because they are preventable.”
    Social worker Brad A. Palmertree, BSW, who is co-chair of the Gay, Lesbian, and Straight Education Network (GLSEN) of Middle Tennessee, says of the partnership, “[It] is a natural progression of social service professionals meeting the clients where they are. Social media has become a place where individuality and personal expression is not just accepted but expected and embraced. So it’s only natural that life’s troubles show up alongside its triumphs.”
    He adds, “I think it’s a wonderful step in the right direction. As someone who works daily on creating and maintaining safe spaces for lesbian, gay, bisexual, transgender, or questioning (LGBTQ) youth, social media has been a double-edged sword. It allows young people to freely express themselves while building community with others who are navigating the murky waters of adolescence with an identity that is not always easily accepted or understood. But it also allows for a space where the bullies come at full force, often anonymously. Those who self-identify as LGBTQ, or even those who do not but are labeled as such because of preconceived gender norms, are bullied and harassed at a rate much higher than their heterosexual and cisgender counterparts. When school is not a safe haven and neither is home, LGBTQ youth turn to the Internet to seek answers, counseling, or simply validation.”
    The Lifeline has actually partnered with Facebook since 2006, but the new partnership adds the option of chatting online with a crisis counselor. John Draper, Ph.D., the Lifeline’s project director, says, “We have heard from our Facebook fans and others that there are many people in crisis who don’t feel comfortable picking up the phone. This...provides a way for them to get the help they need in the way they want it.”
    Ellen Fink-Samnick, MSW, ACSW, LCSW, of EFS Supervision Strategies LLC, believes the new collaboration, “on face value alone...is a promising means to enhance suicide intervention.” However, like others, she thinks that related ethical concerns warrant equal attention.  “Courtesy of rapidly emerging technology innovation, the framing of professional ethics has changed from ‘what one does while nobody watches,’  to ‘what one does while everyone watches, 24/7 in cyber-space,’ ” she points out.
    For social workers and other clinical professionals who may be involved in these efforts, Fink-Samnick says ethical concerns include:

State-to-state licensure: It would seem  there is a high likelihood that professionals will find themselves practicing across state lines as they assess clients in cyberspace. Will the professionals be appropriately licensed, credentialed in all jurisdictions?
With respect to “duty to warn,” what will the turn-around time be from identification to assessment to intervention?
How will professional liability be addressed?

    Others have brought up concerns about privacy and “Big Brother”-like worries. What happens when Facebook sends an e-mail to a suicidal user, and that e-mail address is a shared address with the user’s spouse, parents, children,  or co-workers? Is this a violation of the person’s health information privacy? And if so, is it excusable, given that it is for the purpose of saving the person’s life? Does the answer to this question depend on who is employed by Facebook to perform this task? And while we’re at it, what is a social worker’s responsibility when he or she comes across suicidal content, on Facebook or elsewhere online?
    Any effort to prevent suicide is commendable. At the same time, the best way to implement this plan is yet to be seen. The suicide reporting tool may be hard to find. There is no obvious “Report Suicidal Content” button in big red letters.

How My Field Placement Showed Me Why I Wanted To Be a Social Worker


People often ask, “Why social work?” It is almost inevitable that a social work student will be asked to answer this question multiple times during his or her social work education. Of course, many people will answer with something along the lines of “wanting to help people.” Personally, I have always hated this question. I knew I wanted a career in social work, but I could never find the words to fully explain why. Becoming a social worker was something that just seemed right, an unexplainable feeling that this is what I am supposed to do. Having a feeling is great (especially in this field), but I needed a more definite answer. I needed a universal answer I could tell to salesclerks, my 80-year-old grandfather, and potential employers. So how do you capture your passion for social work in words? I struggled with this question for a long time, and it wasn’t until the end of my field placement that I finally understood what social work actually means to me.My first official field placement was at Families Moving Forward, a supportive program to assist families experiencing homelessness. This field placement was everything I could have hoped for: an amazing field instructor, friendly staff, meaningful work, support, independence, and my very own caseload. The abundance of knowledge I obtained during my placement was something for which I will forever be grateful.
    As my hours were coming to an end, I began to invest less of myself at my internship. As many social work students understand, I was juggling far too many things to finish school. Papers, tests, work, field placement, family, friends were taking a toll on me. I was on a race to the finish line, counting hours until I could breathe again. It was in the midst of this chaos that I finally began to answer the infamous question, “Why social work?”
    My last case started out seeming ordinary. Little did I know Mary would have such an influence me. Mary was a hardworking single mother who came to Families Moving Forward seeking shelter. She was a delight to be around and was a breath of fresh air to the emergency shelter program. Mary had an associate’s degree and was considered highly employable. I would often find her diligently working on the computer to find housing programs and applying to new jobs.
    In one of our case management meetings, Mary shared with me the devastating news—she had been diagnosed with cancer and needed to be treated with chemotherapy and radiation immediately. My heart broke for this woman; being homeless is one thing, but having to go through a serious illness while being in a shelter seemed like cruel and unusual punishment. As social workers know, when it rains it pours. A series of unfortunate events followed as Mary began treatment. As her case manager, I felt completely powerless. What could a social work student such as myself have to offer someone facing cancer in a homeless shelter?
    My internship was coming to an end. I only had a few more appointments scheduled with Mary, and I did the average things that needed to be done. Mostly, I just listened to Mary share her experience. I felt bad for not having any profound resources for her and didn’t think she would bat an eyelash when I told her a new case manager would be taking over for me because my field placement was coming to an end.
    The day I told Mary I was leaving completely shocked me. She cried hysterically and disclosed that I was the only person who had taken the time to just let her talk about the cancer. She didn’t want me to go, because in the midst of all the pain, our weekly meetings were what held her together. Knowing that someone would just be sad with her made the week bearable. All of these weeks, I had been feeling bad about myself for not knowing what to do, and in the end just sitting with her was the most influential thing I was able to do for her.
    Mary’s response to my leaving was sadness and anger. This makes perfect sense when I look back on the situation, but in the moment I truly thought Mary barely even knew my name, let alone would be angry at me for leaving (oh the joy of being a student!). I felt horrible that I had to leave her and hated that I had to add another piece of sadness to her already fragile plate.
    This experience hit something inside me, and for the first time, I finally understood what being a social worker looks like to me. In all of my scrambling to get to the finish line, I finally knew in a logical way, not just an “it feels right” way, why social work is the right profession for me. Social work is acting out of love for strangers in tangible ways. We are made to represent love so that all people we encounter have a more profound sense of hope and faith within themselves. We do the hard, intimate, sometimes painful work, and in return bring a little more of the divine into daily life. We get to remind one another about the bigger, more beautiful picture that we can’t always see from where we are.
    Sometimes the bottom just falls out, and nobody is exempt. Everything is not okay. And one of the most profound gifts we can give to our clients is the willingness to hunt down tissues or offer a safe place to be upset. Because in the end, what else is there to do? I can’t take away the cancer, although I would if I could. I can’t buy my client a house, although I would if I could. I can’t say that it’s never going to happen again and everything will be okay. But I can be there, and I can listen to their stories, of funny things the doctors said, and the strange and annoying things that people think are helpful to say in these situations. I can sit in silence in the moments of rage, knowing that everything is not okay, but that this tiny moment is.
    Thanks to my field placement, I now feel confident as to why I am dedicating my career to social work, and I couldn’t be more grateful for the amazing people who allowed me to be a part of their journey.

Katie Ullman is a student in the University of St. Thomas/St Catherine University School of Social Work. Her field placement for 2010-2011 was at Families Moving Forward, a faith-based program in Minneapolis that provides temporary housing and supportive services to children and families. Katie recently became a volunteer at the Angel Foundation where she provides support to adults facing cancer. Her favorite activities are yoga and watching movies with friends. She plans on attending graduate school next year to become an LICSW

How My Field Placement Showed Me Why I Wanted To Be a Social Worker

Written by Katie Ullman  


Duty to Warn, Duty to Protect
Since the Tarasoff case in l974, duty to warn and duty to protect have become important as concepts in the field of social work and other helping disciplines. Being able to protect potential victims from harm and protecting clients from self-harm have become ethical obligations in social work practice. This area needs to be explored and understood by social work practitioners, educators, and social work students. Duty to warn and duty to protect have ethical implications for all social workers Walcott, Cerundolo, and Beck (2001) describe the facts of the Tarasoff case. Prosenjit Poddar and Tatiana Tarasoff were students at UCLA. Poddar stated to the university health science psychologist that he intended to kill an unnamed woman, who was identified as Tatiana Tarasoff. Although the psychotherapist did not directly warn Tarasoff or the family, the psychologist notified the police, who interviewed Poddar for commitment. The police only warned Tarasoff to stay away. After Poddar returned for the summer from Brazil, he murdered Tatiana with a knife. Tarasoff’s family sued the campus police and the university health service for negligence. Walcott, Cerundolo, and Beck (2001) cite the second Tarasoff case When a therapist determines, or pursuant to the standards of his profession should determine, that his patient presents a serious danger of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger. The discharge of the duty may require the therapist to take one or more various steps, depending on the nature of the case. Thus, it may call for him to warn the intended victim or others likely to appraise the victims of that danger, to notify the police or take whatever steps are reasonably necessary under the circumstances (p. 340).

    The Tarasoff case imposed a liability on all mental health professionals to protect a victim from violent acts. The first Tarasoff case imposed a duty to warn the victim, whereas the second Tarasoff case implies a duty to protect (Kopels & Kagle, 1993). There are many concerns about the implications of the Tarasoff case, especially around the confidentiality of the client-social worker relationship and violent clients avoiding treatment.
    Since the second Tarasoff decision in 1976, there has been argument and debate as to the applicability of this judgment to the client-social worker relationship. The environment has changed for social work and confidentiality, as social workers now divulge confidential information to third-party payers. Tarasoff is an important decision with legal implications, and only 13 states in the U.S. lacked Tarasoff-like provisions at the time of Herbert’s report in 2002.
    Duty to warn means that the social worker must verbally tell the intended victim that there is a foreseeable danger of violence. Duty to protect implies a therapist determining that his or her patient presents a serious danger of violence to another and an obligation to use reasonable care to protect the intended victim against danger (Harvard Mental Health Letter, 2008, January). This may entail a warning, police notification, or other necessary steps.
    Duty to warn and duty to protect have implications for social work practitioners in the fields of mental health, HIV/AIDS, domestic violence, and medical social work. There are also serious implications for malpractice and unethical behavior. What began as a mental health issue has been expanded to other fields of social work practice.

Duty to Warn and Duty to Protect in Mental Health  

    In the field of mental health, it is difficult to actually make predictions of client violence. The Harvard Mental Health Letter (2006, January) makes recommendations for handling duty to protect with homicidal and suicidal patients.
  
The principles for managing a threat of violence are generally the same as those for dealing with a suicidal threat. Therapists should find out whether a patient has ever seriously injured or thought about seriously injuring another person. Especially with new patients or any patients whose symptoms are becoming worse, it is important to know whether they are dangerous to others and whether the danger is due to mental illness. Is the patient losing the capacity to control violent impulses? (p.4)

    Duty to protect can involve warning the potential victim, notifying the police, starting a commitment hearing, informing mental health evaluators of the threat, and utilizing professional supervision. Duty to protect involves working with homicidal and suicidal clients. The obligation of duty to protect varies from state to state (Dolgoff, Loewenberg, & Harrington, 2009).
    Failure to protect potential victims of violence can result in losing one’s job at an agency. Consider the following hypothetical example.
  
A professional social worker conducted an intake interview with a client with a history of mental health problems and violence toward his father. The client was somewhat delusional and stated that he might hurt his father that evening. The social worker made no effort to commit the patient for hospitalization. That evening, the patient became violent and broke his father’s leg. The next day, the social worker was fired for negligence.   

    Protecting the well being of homicidal and suicidal clients is the obligation of professional social workers. Social workers should frequently utilize supervision and consultation when working on this issue of duty to protect, because it has ethical and malpractice considerations.
    
Duty to Warn and Protect in HIV/AIDS Cases  

    Social workers often work with clients who are HIV-positive or have AIDS. Confidentiality is very important to such clients, because of the stigma attached. Huprich, Fuller, and Schneider (2003) consider the question as to whether the therapist has the obligation to warn a third party of risk of transmission of HIV if his or her client is actually putting another party at risk. Stanard and Hazler (1995) report a case in which duty to protect seems important.
  
Brian is a 24-year-old married bisexual man entering counseling to deal with grief and depression associated with a recent diagnosis of HIV infection. During the course of counseling, Brian discloses that he continues to be sexually active with his wife and also occasionally with anonymous male partners. Brian has not disclosed his diagnosis to anyone and maintains that it is not necessary to do so because he practices “safe sex.” (p. 397)

    Melchert and Patterson (1999) discuss how being HIV-positive may pose a different situation from that of the Tarasoff case. Mental health professionals do not have the legal right to disclose that a person is HIV-positive to another person. This is at the discretion of physicians in many states. However, social workers and mental health professionals must struggle with this legal situation if a client insists on potentially harming another person through risk of transmission of HIV.

Domestic Violence

    In domestic violence situations, there can be an identified threat of harm to a victim. Domestic violence is a cross cutting issue that affects the daily lives of many people receiving social services (Danis, 2003). People who commit domestic violence will often commit criminal acts such as homicide, assault and battery, criminal trespass, terroristic threats, stalking, and sexual assault. Depending on the state, social workers have a legal obligation to report threats of violence and to warn the potential victims. Attorneys sometimes play a similar role to that of social workers and are privy to information about potential violence. Different states have varying levels of obligation to report specific threats of violence or intention to act (Buel & Drew, 2007).
    In working with clients who have a history of domestic violence, it is important to do a risk assessment of the situation to determine if there is a potential for harm. Also, the social worker needs to make every effort to try to defuse any potentially violent situation. Good clinical practice encourages social workers to send battering partners to groups to work on issues of anger management. Social workers also need to protect potential victims by referring them to safe places where they are not exposed to violence. Couples therapy can work when each person has contracted for no further incidents of violence.
    Consider this hypothetical case vignette, in which duty to warn a potential domestic violence victim presents a dilemma for a social worker.

A social worker is counseling a couple around issues of domestic violence. The husband reports that he has made threatening comments to his wife in the past. The wife has threatened to divorce her husband. The husband has stated that he would hurt his wife if they divorced.

    The social worker must make a decision. Should she report the case to the police as a threat? Is this threat serious? How is she going to assess the situation to possibly carry out a duty to warn?

Duty to Warn and Protect in Medical Social Work

    Social workers practice in the medical field, where many ethical dilemmas may arise with respect to duty to warn and duty to protect. With an increasing population of older clients in the United States, there are issues around caring for the frail elderly. Their children may not be willing to accept the recommendations that social workers make for their parents’ care. Following is a hypothetical vignette of just such a situation.

A social worker has recommended that an 88-year-old woman receive home health care. The family refuses this request, feeling that the 88-year-old woman can care for herself in her home. There is extreme danger of falling, missing meals, and not remembering to take medication at scheduled times. The social worker considers reporting this situation to Adult Protective Services.

    Social workers may be consulted by medical personnel to help resolve issues in genetic counseling. Issues of duty to warn and duty to protect may come into play, for example, if a patient refuses to disclose genetic information or test results to a relative. A physician may need to consult a medical social worker to work with the family on this critical issue, because sharing the information may save the relative’s life.
    Following is a hypothetical situation:

A 34-year-old woman receives the results of testing for cystic fibrosis, showing the probability of transmission of the disease through genetics. She wants to become pregnant but does not want to tell her husband about the test results. This presents a dilemma for the social worker who is counseling her.

    Pullman and Hodgkinson (2006) discuss the issue of whether duty to warn in situations of genetics overrides considerations of confidentiality. In the United States, case law is expanding the responsibility of clinicians beyond patients to include family members.

Ethical Concerns and the Duty to Warn and Duty to Protect

    Since the first Tarasoff decision in 1974, there has been an expansion of the debate around duty to warn and duty to protect, in that the social work literature has expanded to include mental health, HIV/AIDS, domestic violence, and medical issues. Social workers are confronted every day with difficult ethical concerns around duty to warn and duty to protect beyond the mental health field. Social work educators, practitioners, and students need to become knowledgeable about these concepts and their application in various specialties of social work.
    A social worker must assess whether and when to apply duty to warn or protect and when to protect confidentiality, and this is not an easy decision. Appelbaum (1985) states that since the time of Tarasoff, mental health professionals have been concerned about confidentiality and the prediction of dangerousness. He sees three stages to making this decision: (1) gather relevant data to evaluate dangerousness and make a determination based on this data, (2) once determining a situation to be dangerous a course of action must be taken, and (3) the therapist must implement this decision.   
    Borum and Reddy (2001) believe that a fact-based deductive approach is effective in dealing with the issue of duty to warn and duty to protect. They posit that the challenges to making a decision about duty to warn and to protect are based on whether the client poses a serious risk of violence to another and what steps are necessary to protect an intended victim. The question for the clinician is whether in this situation something should be done and then what to do. The ethical obligation of confidentiality may conflict with the objective of preventing harm to others. To make this determination, Borum and Reddy (2001) state that the clinician must distinguish between making a threat and posing a threat, inquire into attack-related behavior, and conceptualize and gauge the client’s risk as a dynamic pathway to action.
    Two hypothetical cases illustrate the duty to warn and duty to protect as they relate to confidentiality.

Case 1

John is a 35-year-old delusional mental health client who has been hospitalized numerous times. He states that he does not like his brother who lives in California and states that he has threatened him in the past. Today, the client has made a phone call to his brother again and threatened to beat him up. The social worker in assessing the dangerousness of the situation decides that there is no duty to protect or warn. The social worker determines that the threat posed is not serious. The social worker refers him to his psychiatrist for a medication check.

Case 2

David is a 35-year-old male who has a history of domestic violence toward his wife. Both David and his wife are in counseling separately for David’s violence toward his wife. In the counseling session, David insists that he is going to hurt his wife tonight at the house. He says that he is going to use a club or hurt her if she does not straighten up.The social worker questions further and determines that this threat is very serious. David has hurt his wife three times with moderate injury each time. The social worker decides that there is a duty to warn based on the threat posed to David’s wife.
 
    A social worker failing to become knowledgeable about these critical issues can be subject to ethical and legal problems, including malpractice and ethical complaints before licensing boards. Social workers need to seek out knowledge in this area to be effective practitioners and educators. NASW provides a valuable Web site (http://www.naswdc.org/ldf/legal_issue/2008/200802.asp?back=yes ) on duty to warn laws in different states (NASW, 2011)

Happiness and Positive Psychology

Positive Psychology sheds light on how and what can make us happy. It is concerned with the pursuit of happiness, as well as how we can lead more enriching, fulfilling and satisfying lives. Since the beginning, psychology has concentrated on mental illness but ever since the landmark book – “Authentic Happiness” by Martin Seligman, psychology has been striving towards focusing on well-being, happiness, and how can we successfully lead a better life. The science of positive psychology lays emphasis on investigating the potential concepts with statistically sound experiments and the research results are subject to stringent scientific standards, previous literature and critical peer review. This makes the concepts and findings of positive psychology more helpful.
Some people are naturally happier than others and there are people who have the ability to be happy most of the time and are optimistic looking at the brighter side of things and can bounce back from setbacks of life with greater ease and equanimity. Research shows as how we can do the things which elevate our natural level of happiness farther up the happiness scale as well as how we can stay happy. In fact, it is believed that we have control over a great part of opportunity for our total happiness, which gives us enough space to grow toward greater and more consistent happiness.
Here you may try the “Good Things” activity for a week. Each night before you sleep, recall three good things that happened to you that day. The good things don’t have to be dramatic or some earth-shattering events, just simple satisfying events such as finishing some delayed household chore, submitting some project before deadline, reading a good book, listening to some good uplifting music, meeting with some long lost friend or enjoying a happy meal – simple daily life events that made you feel gratified and happy. Now savour each moment – let it swirl around in your mind for some as you “taste” its goodness and enjoy the good vibes and feelings embrace you. Positive Psychology indicates that indulging in such an activity correlates with greater feelings of well-being and happiness.

Gut – The Backup Brain

While we have always believed that our brains influenced every aspect of our lives, latest research points out there is actually a “second brain” in our stomachs, which influences our moods, decision-making, our eating habits and even the diseases that inflict us. This is known as intestinal intelligence which can explain away why we binge when depressed or stressed, why we get anxious or how we rely on our “gut instincts” when it comes to taking some decisions.
According to Michael Gershon, professor and chair of pathology and cell biology at Columbia, the gut is another independent center of integrative neural activity which can work independently of any control by the brain. Thus, it functions as a second brain. Five decades of groundbreaking work has led to the discovery of the gut’s brain, known as the enteric nervous system (ENS). When a person is under stress, he/she feels twisting of intestines and aware of the signals that the gut can send to the brain.
It is now established that the Enteric Nervous System (ENS) has about 100 million neurons; which are more than the neurons in the spinal cord but less than in the brain, are spread over an intricately folded surface area which is hundred times greater than that of skin. According to Gershon, the ENS is independent in its working as it does not need any input or signal from brain to control the movement and absorption of food through intestines. It is quite a feat since no organ in our body can work without the direction of the brain.
Research shows that the ENS holds its own and it does more than just controlling itself. It sends signals to the brain which affect feelings of stress and sadness as well as influence learning, decision-making and memory. It functions on the basis of neurotransmitters, identical to those in the brain, numbering more than 30. The ENS even manufactures them in some cases. Research studies have shown that the second brain in the gut may hold potent solutions to autism as well as providing relief from depression.
There is a close connection between emotions and the gut and the nervous system actually started out in the gut yet neuroscientists fail to comprehend the complexity of the gut or enteric nervous system and its link to the brain. The gut has a nexus of sensors to gather information and like brain; it also connects and interacts with the external stimuli. The ENS does it by way of food, which it breaks down into simpler forms and sends off to different internal organs to sustain us that helps us survive.

HAVING SEX DURING ADOLESCENT YEARS COULD HAVE FAR-REACHING CONSEQUENCES ON THE MOOD AND BRAIN DEVELOPMENT DURING ADULTHOOD

HAVING SEX DURING ADOLESCENT YEARS COULD HAVE FAR-REACHING CONSEQUENCES ON THE MOOD AND BRAIN DEVELOPMENT DURING ADULTHOOD
There is time for everything: A time to love and a time to grieve.
A new study conducted by the researchers at Ohio State University College of Medicines has claimed that having sex during adolescent years could have far-reaching consequences on the mood and brain development during adulthood. They have reasoned that during adolescence the nervous system is still in the developing phase which can have broad consequences.
The research study conducted on hamsters found that the animals that mated earlier in life had higher levels of depressive behaviours, changes in the brain and smaller reproductive tissues compared to those that had intercourse later in life or not at all. According to the co-author of the study, John Morris, sexual experience at an early age, during adolescence or in early period of life, is not without consequence. The study was carried our on three groups of hamsters. The first group comprised of 40-day old male hamsters (the equivalent of human teens); who were allowed to mate with adult females in heat. The second group comprised of 80-day old adult males who mated in adulthood, while the control group was not exposed to any females.
The results revealed that the first group of animals who mated in adolescence did not swim vigorously when placed in water, rather stopped swimming – a condition understood to be a symptom of depression. It was concluded that the group allowed to mate in adolescence further showed less complexity in the brain’s dendrites – the branching extensions of neurons that receive messages from other nerve cells, and also showed a higher expression of the a gene associated with inflammation.
However, the researchers have cautioned against using the study from propagating teenage abstinence or believing that a similar study on human beings will also yield similar concluding results