Social Quirk

One of the most interesting things I've come across as a social work student and intern are the creative ways to engage clients and assist them in dealing with their presenting problem(s).

Here's one of my favorites:

Decorating a box with clients with eating disorders: designing the exterior as the way you think others see you and the interior as how you see yourself (via writing and pictures)

An idea I think would be useful with people in recovery (addiction, mental illness, etc.) would be to do a brief audio recording with them that could be them simply exploring what brought them to the clinical setting they're receiving services for, what they hope to achieve, etc.

Clients could do one recording each week, after reviewing their previous recording. Ultimately, they'd get to keep all the recordings after they left treatment.

The idea behind this is to have something concrete and real that clients can review. Something that calls for self-reflection and does so in an easy format.

This could be useful for clients who aren't able to journal or who wouldn't be prone to reviewing all their past journals. Also, it provides some basic tid bits that a journal does not - you can hear where the person is at and (as I'm thinking about drug treatment), hear the change in their health and clarity of thought.

As clients terminate, they can quickly see where five weeks has taken them. As clients relapse, they may not be able to see the work they've done or deny the progress they made - feeling like they hit back to bottom. A review of their CD could provide some of the lessons they learned from someone who everyone like to hear from...themselves.

Finally, people are essentially interviewing themselves - something that culturally holds a certain level of prestige as many would associate it with reality shows with their video booth "confessionals" or radio disc jockeys.

In contrast, journaling in a composition book can feel like a return to grade school - not something people necessarily enjoyed or would want to revisit.

There's my idea. Readers, what do you think?

And more importantly, what superfunkycool ideas and techniques are you using/thinking of using whether in clinical work or at a policy or research level?

UPDATE: I read after writing this post, I found out that such recordings are sometimes used with folks experiencing manic episodes.

I guess what is informing my ideas of late is the overriding thought that the folks we work with (a.k.a. clients/consumers/patients) benefit from and are respected by giving up some of our privileged status and providing them with a sense of control, reflection and ownership over their work with us (a.k.a. treatment).

So I came across a bunch more amazing resources for social work training!

Counseling and Therapy in Video claims they provide "the largest and richest online collection of video available for the study of social work, psychotherapy, psychology, and psychiatric counseling." It's 285 videos or 314 hours, from Psychotherapy.net.

Example: This full 1 hour 40 minute video on group therapy by Irwin Yalom is streamed for free. If you purchased it on Psychotherapy.net you'd have to pay $89. Here's a clip.

The neat thing about that site is the videos are organized by therapy type and subject, including full length videos by Microtraining Associates, Psychotherapy.net, and the University of Manchester Department of Psychiatry.

The catch, it looks like it's only for a limited time. In their "About" page they share that all the videos will be available as part of an annual subscription.

I wonder why the NASW doesn't just host the videos they support in the name of accessible continuing education and just have an advertisement roll before, with gratuities going to the producers of the video - like other online video how-to websites.

I also discovered a wealth of free training via online grand rounds available at medical schools, hospitals and university psychiatry departments. It's curious why social work schools don't feature this or hold their own grand rounds. If I'm wrong about this, please send the link my way.

In response to a comment from the last post (Harriet), we do make use of some of these clips in our classes sometimes. The Irwin Yalom videos got featured several times in my group therapy class.

This is what I've found (please let me know if you discover anything else):

- New York Psychiatric Institute -- Video is available for 2 weeks of the months 4 grand rounds.
- National Institute of Health -- Hosts full-length video and podcasts from a variety of agencies, hospitals, universities, etc.
- UCLA Psychiatry Department's Semel Institute -- Provides video & podcasts of their grand rounds since 2007
- Yale Psychiatry Department -- Features videos of their grand rounds since 2002
- OHSU Department of Psychiatry -- Find videos since May 2008

It's challenging to enter social work school without any background in psychology. My first weeks at NYU's School of Social Work were tough because many folks were already familiar with a lot of the theory professors discussed. To boot, I'm supposed to start as a social work intern a couple weeks in, when I'm not entirely clear what that role entails and how to engage a client.

It's great to be on the other side of that. I worked through that experience and saw the other side of it, gaining a certain level of confidence. But I still often wished this summer that I could sit in on some individual and group work that I could reflect on and emulate (rather than just critique, as I'm prone to).

There are videos around, but any social work student will tell you, it seems like there was a boom in training videos for psychologist and social workers in the 80s that finished in the early 90s. You're hard pressed to find a video that doesn't include big hair.

I got lucky this year with my field placement, though I did advocate pretty hard to get a placement of that kind after last year. I wanted a clinical placement (in contrast to my case management placement last year), with an interdisciplinary team and like case conferencing and psychopharmalogical training. I not only got that (interning at Montefiore Medical Center), but we also have groups in front of a two way mirror. My first few weeks, I watched a bunch of groups held by to psychiatric residents, discussing issues with the clinical director during the groups and with the residents after the groups.

But still, many concepts are hard to get a grasp on. One neat website I came across, that seems very useful is The Psych Files where a clearly eccentric doctor of psychology provides basic tutorials in concepts, theory and practice in clear, understandable language.

Here's a sample:

One my favorite parts of the site is the Audio Psychology Test Prep Tool which gives basic explanations of psychotherapeutic concepts and disorders. It's simplified and clear. While that means it's incredibly limited, it does make it easy to learn the language and then build from there.

Another place to look is the YouTube pages for Psychotherapy.net (here) which has 45 training videos and the National Alliance on Mental Illness (here) which has 56 videos.

Other interesting places to look - the Minds on the Edge, a program that started airing on PBS this month, provides a full-length, online program on issues around severe mental illness in America.

Readers, have any of you found good resources that are publicly available?

A prospective student wrote asking: Question: I am slaving away at this Personal Statement of Purpose... got any suggestions on what to say.. or what NOT to say? Would love your input!

The briefest advice I could give I think applies to both writing and social work (can you tell I'm a social work student with a journalism background?)

Pick what seems to be the main issue going on and develop that as well as you can, as clearly as you can and as creatively as you can.

If there's no direction in your work with clients, no focus on any central issue(s), it may be interesting for you, but that seems to be an overwhelming task placed on the client. Similarly, when you write, pick a direction and stick with it. Often people name all their accomplishments when they write applications, building themselves up. They forget that they are sending their application to someone who has to sift through multiple applications and would love to read something interesting.

Great stories, and great storytellers, have a clear, thoughtful voice and develop complicated, interesting characters. I'd aim for sharing that - i.e. core experiences and issues that have driven you to the place of wanting to be a social worker - and how you hope to integrate it.

Some of the traits of desired MSW students according to the application are self-awareness, empathy, objectivity as well as a value for diversity and the biopsychosocial approach. If you can communicate that you value and practice these traits - through a story, not just saying that you value them, I'm sure that can't hurt.

Again, I'll emphasize this one point, make sure you keep it concise and interesting. You can write up to six pages. That doesn't mean you have to. If you're going to take someone through six pages of material, make sure you give them an incentive to by giving them a gripping story not the cookie cutter listing of everything about you.

Contacting the admissions office wouldn't be a bad idea either. If you want a sample of what I wrote (hey I got in, so it can't be so bad), you can download a draft of my MSW essay here.

Q: I am coming up to NYC for a couple days and wanted to scope out the campus/ Silver buildings. I also thought I might try to make an appointment with a professor as to get some one-on-one time exploring the program further. Do you have a suggestion for this? Who would be good to talk to on short notice?

Thanks for the question. I asked around and was told that you should contact the admissions office at the School of Social Work at (ssw.admissions@nyu.edu, 212 998 5910, or meet with an admissions counselor 11am-2pm on Tuesdays & Fridays ). They've apparently met requests like that before.

Depending on when you visit the school, you could go to one of the upcoming informational events (which includes faculty, current students and alum).

I went to the gay rights march in D.C. on Sunday and, among other things, it got me thinking about the role of social workers as activists.

There is a clear role that social workers can play and historically have played. But it doesn't seem like there is much of a media presence by social workers and groups like the NASW. There were a bunch of groups there, and I did bump into quite a few social work friends, but no NASW banner.

There also isn't a clear sense of what things we will get active about on behalf of our clients. For example, the DSM-V is due to come out in 2012 and one question is whether it will continue to deem people who identify as transgender and who cross dress as mentally ill.

A lot of folks don't think the prospects are great given Dr. Kenneth Zucker is the head of the working group on Sexual and Gender Identity Disorders in the DSM-V. He believes in reparative therapy for transgender children. Under that methodology, when a clinician thinks a kid identifies as transgender, they assume the child is wrong and encourage the kid to act different...more of what traditional Western culture associated as distinctly male and female in the 1950s. You can read more about efforts to reform the GID diagnosis here. And if you'd like, I wrote a paper on working with transgender kids and their families here.

Readers, what do you think about the social workers role as activists?

Here's some interesting clips I recorded from the gay rights march.

"Hey Obama! Let Mama Marry Mama."


"Barney Frank. Fuck You. Back of the Bus? Hell No!" (Here's why folks said they were screaming that about the first openly gay person elected to congress)

"Hey Obama, We Won't Wait. Equal Rights for Gay and Straight."

"Get up. Get Down. There's a Gay Right's Movement in this Town."

"What do we want? Equal Rights. When do we want it? Now!"

UPDATE: I just got this from a fellow member of the NASW LGBT committee:

Kinky is NOT a Diagnosis

Help make history by signing the DSM Revision Petition now! The diagnoses in the DSM-IV-TR still subject people who practice BDSM, fetishes and cross-dressing to bias, discrimination and social sanctions without any scientific basis.

We need 3,000 signatures, but we only have 2,200 now. If you don't speak up and call on the American Psychiatric Association to adhere to empirical research when revising the diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (DSM V), then the Sexual and Gender Identity Disorders Work Group won't make a meaningful change.

To sign, go to: www.thepetitionsite.com/1/DSMrevisionpetition

You can make your signature anonymous on this secure petition site so it doesn't appear on the Internet or when the petition is delivered to the APA.

Petition:
"We, the undersigned, support the American Psychiatric Association's (APA) own goal of making its Diagnostic and Statistical Manual (DSM) a scientific document, based on empirical research and devoid of cultural bias. A diagnosis of a mental disorder can have a severe adverse impact on employment opportunities, child custody determinations, an individual's well-being, and other areas of functioning. Therefore we urge the APA to remove all diagnoses that are not based upon peer-reviewed, empirical research, demonstrating distress or dysfunction, from the DSM. The APA specifically should not promote current social norms or values as a basis for clinical judgments."

To find out more about the DSM and the Paraphilias section, read the NCSF & ITCR: The Foundation for NCSF's "White Paper on the DSM Revision" at www.ncsfreedom.org

My evidence-based practice class provided a pretty neat exercise for working with folks with auditory hallucinations.

To do this exercise you will need:
- 2 cardboard pieces of toilet paper rolls
- 4 people

Choose one person to be "the clinician" and the other to be "the client" with auditory hallucinations, sitting across from each other.

Meanwhile, the other two people sit facing opposing sides of "the client" and provide the auditory hallucinations by speaking to the client through the cardboard rolls - so that "the clinician" can't hear.

Ultimately, as the social worker tries to do an assessment, the two voices can ultimately say whatever they want, relevant or not.

Rotate rolls and repeat.

I'll take any opportunity to showcase my talents in MS Paint.

This exercise proved really helpful in my being able to better empathize with people with auditory hallucinations and recognize how my own feelings as a clinician in these situations may mirror my client - that is, feeling overwhelmed, helpless and frustrated.

As my field placement this year is working on an in-patient psychiatric unit with severely mentally ill folks, I've been able to apply the lessons of this exercise already. Observing some of the psychiatric residents in group therapy, I've seen how it's hard to not get frustrated with particularly paranoid clients who isolate themselves and completely reject the idea that they need supportive relationships in their lives.

At the same time, and with some credit to this exercise, I've been able to see how that isolation may be beyond that client's control at times - where the client is really struggling to cope and process the information being told to them (against the volume of the "voices" they may hear).

Many professors have been talking lately about the need for our profession to improve its media skills and professionalize itself.

To that end, I'm working on two projects.

1. Video Explaining the NYC Family Shelter Process
Hurray! After months of preparation, I've completed a basic Powerpoint-style video that explains the family shelter process at the NYC Department of Homeless Services PATH office in the Bronx.

The 20 minute video aims to benefit homeless clients, social service providers and advocates who serve them by explaining the PATH process in a clear and detailed manner.

The idea for it came to me while I was a social work intern at the PATH office's Resource Room from 2008-2009. I discovered that many of our clients and the majority of DHS staff (myself included) didn't understand the process families were going through at PATH, as well as the resources and rights available to them along the way. I hope that by creating and sharing the information in this video, families can have an improved, better informed experience either directly from this video or indirectly with more knowledgeable social service providers.

2. An Online Database of Social Service Resources
This project is a bit more ambitious. Essentially, it aims to create an online 311 database of social service resources that includes documents (i.e. applications for public assistance, birth certificates, etc.) that are easy to find, a listing of social service programs (so you can search by service/eligibility/peer reviews/client reviews) all in one place. Social workers, as well as the public they serve, would be able to comment on agencies for improved referrals by all in the social service field, as well as improve the client/worker engagement with a sense that something concrete is easily accessible.

I met with Professor Helle Thorning, the head of field learning, who seems to like the idea and shared it with professors and the SSW Graduate Student Association. I'll update folks on the progress of this. Woo-hoo.

Let me know if you have any ideas for a project like this or if you're interested in being involved in any way (especially tech-saavy folks who can help me construct a database of this kind).

This is the final part in a series of questions I received from a prospective social work student.

Q: I am not your NYU prototype. Financially, Socially, and probably not academically. I am a 5th year senior at Auburn University in Alabama (I graduate this December). I am currently in Sociology: Marriage and Family, but also have a concentration in Human Development. My GPA is barely a 3.0, and I haven't attempted the GRE***. I know that NYU encourages those with lower than a 3.0 to apply, yet I read online and have consistently found that it's very unlikely that those scores could get me in to Silver. I have very strong volunteer/extracurricular activities and have proof of my commitment to social justice around the world. After spending 2 summers in Africa, 1 in Guatemala, and 2 in Brazil, I am confident that my time in the field makes me more than qualified to learn at such a high caliber school. Since you are in the school now, do you have any insight on this? Should I even bother applying?

A: I think you should apply if you're interested in going to NYU's Silver School of Social Work. What have you got to lose (except for the $50 application fee)?

Not everyone here is academically inclined. I'd say my biggest concern with some students I met my first year was not their academic abilities but their clarity on whether social work was something they wanted to do, understanding that lifelong learning/training is required.

More than a few seemed to indicate that they signed up for a MSW to handle issues going on in their life or because they imagined working in a private practice directly after graduate school as saw a MSW as a shortcut over a Ph.D. in psychology.

Those are concerning. But as long as you're clear about it, hell ya. Apply away.

It sounds like you have a lot of experiences that could serve you in your application essay for schools of social work, AND as a social worker later on.

If you want to test the waters at Silver, one route you could go is taking a class or two as a non-matriculating student after you move to NYC. More info on that here.

***You don't need to take the GRE to get into schools of social work.

OVERHEARD IN SOCIAL WORK

Prof: We're talking mucho cells here."

Discussing how each brain cell makes about 10,000 connections [through synapses]to other brain cells.