Interesting Times

It's that time of year again when students start thinking about their courses for the next semester. Last year I didn't struggle figuring out what to take because it was mostly planned out for me. For second semester I was put with the same Practice professor (as is the style), I chose the same Human Behavior professor, and I just needed to figure out who to take for Groups and for my elective (I tested out of research one). I asked around about Groups professors and heard that one of them in particular does not run her class like a group. This is what I wanted. I had no desire to be immersed in a group to learn group therapy. For my elective I had been planning all year to take Object Relations, and I chose my professor because I heard him speak at orientation. It was easy to figure out, and I must say that it turned out to be a fantastic semester.

Now I have to choose classes for my final semester. I only have two electives remaining, and four courses remaining overall. I feel the pressure of making sure I continue to have wonderful professors while taking the electives that appeal most to me. I'm torn in many ways, and my ambivalence places me clearly in the "contemplation" stage of change. No, I am not ready to change to new professors and new classes. No, I am not ready to decide on what that change will look like. I am preparing, but my plan is not concrete.

I'm pretty certain of what electives I want to take: Feminist Theories & Practice and Community Organization. I hesitate, however, because I don't know anything about the instructors. I've tried researching the Feminist Theories & Practice instructor, but haven't learned much about her. I don't have any idea who the CO instructor will be. I'm also interested in the following electives: Grief, Loss and Bereavement; Comparative Short Term Therapies: Crisis Dynamic & CBT; Spirituality and Psychotherapy; Critical Analysis of Psychotherapy Theories; and lastly Ending Poverty (which wasn't even on the list the last time I checked!).

There are an awful lot of electives to choose from. I didn't even begin to consider the 1-credit courses, and I immediately excluded courses involving families or children, even though they all seem to be taught by fantastic professors. How do I make this choice?

NYU's Silver School of Social Work proudly advertises itself as a "clinical" program. I interpret this to mean that it focuses on working with individuals, groups and families on micro level needs. A lot of people come to school here to become therapists or to develop more direct practice skills and knowledge. That's why I came here, and I think it's doing a pretty good job (better than some other schools in the area).

I also care deeply about macro level issues, and issues that pervade all aspects of social work. I care deeply for social justice and I think NYU could do a better job of focusing on social justice as a core value in social work, especially micro-level clinical work. I also think they're improving on this, and some of the electives available next semester show that the faculty also care deeply for social justice. Here's a list of some of the courses that are less "clinical" and might appeal more to an NYU student more focused on justice:

Social Work and the Law - not only does this class sound very interesting, it's taught by a professor that I've only heard outstanding things about.

Feminist Theories & Practice - okay, I realize this is a clinical course, as evidenced by the word "practice", but it's the type of course that inevitably spans all aspects of social work from micro to mezzo to macro. Taking this course seems like a great way to develop direct practice skills to assist people oppressed by major forces (like hegemonic masculinity).

Social Work Foundation for Leadership - what better way to save the world than by joining with the forces destroying it? I'm sure some clinical skills will come in handy when dealing with the nearly psychotic members of congress (I don't mean all members of congress are nearly psychotic, just that some seem to have very little connection with reality).

Community Organization - I think we all know what this class is about. Thank you Mr. President.

Ending Poverty - The name really sums it up, right? Let's get to work.

At some point recently I checked my email and read that one of my classes was cancelled. It was the only class I had on that particular day and so I thought I might celebrate. "What better way to celebrate," I thought to myself, "than to go to campus and spend the day at the library!". So I decided to prepare myself for a few hours in the Bobst basement.

As it turns out, I wasn't destined for long hours of reading or day dreaming or napping in the library. I had gotten another email that stated that Dean Videka would be presenting research on moms with severe mental illness. Feeling thankful that I go to a school with professors doing a lot of cool research, I changed my plans and headed off to the presentation.

I must say that, as I write this, I barely remember any of the content of the presentation. I was not even very moved by much of the data. But what blew my mind was how little information has been collected on mothers with smi. A bunch of the consumers I work with are parents, with most of the mothers still taking care of their children. What a tremendous stressor that must be on the family! This population seems very under-researched.

Hopefully more people start researching specific interventions that can be used to help mothers with smi keep their stress levels low and develop the coping skills and support structures needed to move towards recovery while maintaing responsibility for their child.

I really appreciate that NYU SSSW offers these opportunities for students to learn about faculty research. It adds an extra dimension to the educational experience, and it seems to help gratify the decision to go to school by seeing first hand how passionate the professors are about their fields.

I just read an article linked to on Information for Practice. I was drawn to read it by the image from one of my favorite movies: One Flew Over the Cuckoo's Nest. The article is about Daniel Fisher, a psychiatrist in Massachusetts who has been a strong advocate and activist for client's rights in mental health settings.

The author calls him radical, and I think a lot of people would assume that his ideas are radical. I don't think they are. Thanks to a fantastic class in evidence-based interventions for people suffering from severe mental illness, I've been reading about recovery all semester. People do recover, and longitudinal studies support this. The studies cited by this website were all completed by the mid 1990's, when we had less effective medications and less knowledge about how to facilitate recovery than we do today.

Unfortunately, it's hard to know if the social work profession is helping facilitate recovery any better now than in the 1970's and 1980's. I'm sure a lot of people would say, "yeah, sure we're doing better", but when the treatment is dictated by private insurance companies it's hard to know if the techniques that have been shown to be effective are actually in use in programs.

Service providers have some fantastic evidence-based interventions available to them that have loads of supporting research. But they still have to focus more on making money to stay afloat. This means that instead of 8 people in an Illness Management and Recovery group, you have 30 people, making the group much less effective and limiting the group's ability to promote recovery. Organizations pretend to use evidence-based practices, but fail to maintain fidelity to the model that produces results.

Fortunately (maybe), some changes are afoot. In New York, the Office of Mental Health is phasing out "continuing day treatment" programs for a new style of programming: PROS. What's wrong with continuing day treatment? You might ask. Here is a report from the Commission on Quality of Care and Advocacy. Beware, it is a Word document and will download to your computer.

It's nice that some people are trying to move forward and improve treatment, but with everything we know about recovery and treatment, why aren't we doing better? Why aren't we implementing effective programs? Why do we just sit with the status quo and let people get abused? Why don't we learn more about advocacy and activism at NYU?