DCF’s Stars amid a Cloudy Sky

I just returned from a meeting of the Department of Children and Families State-Wide Advisory Council, where Commissioner Angelo McLain and his staff updated the group of advocates, providers, foster parents, birth parents, community volunteers, and professional societies the latest happenings at the Department.  A lot of time was spent on the budget and the impact of budget cuts on the critical services that the Department provides or contracts to community groups to provide.  The cuts that the Legislature is proposing are heart rending and will certainly mean that services will have to be cut and that social workers may be laid off.  We talked about prioritizing budget line items that we could directly advocate for given the across the board reductions. I marveled at the tenacity of the Commissioner and his staff to ‘soldier on’ with their commitment to continue to provide the valuable services they offer to our vulnerable families and children.

There was one very telling piece of information that was presented and that was the poor record MA holds in the number of foster home placements that Department of Children and Families (DCF) kids experience.  MA ranks 43^rd out of 51 states on placement stability. Commissioner McLain, instead of being defensive, directly conveyed that the state must do better. His staff shared with us all the actions they are taking to improve the situation and then they urged those present to add our ideas about what the Department could do.

It is this kind of genuine acknowledgement of failing grades and disappointing facts without any excuses that distinguishes Angelo McLain as a leader of integrity and inspiration.  I worked for DCF years ago and remember the impossible situations that the child welfare staff faced but I don’t recall this level of authenticity and candor displayed.  I am glad that Angelo is at the helm and we should do all we can to support him and his staff.

Carol J. Trust

PRACTICE SAFE SOCIAL WORK

It seems that every couple of weeks or so either I or my staff get a call from a worried and sometimes frantic member with an ethical dilemma that needs immediate attention.  Usually the person identifies himself or herself as someone who has been practicing for many years, has experience with tough clinical issues and has never had a problem like the one they are presenting.  'What do I do?' is the question posed to us.

Now, the MA Chapter has a wonderful service for its members who are faced with potential and real ethical dilemmas.  The Chapter's Ethics Hotline committee members, composed of social workers, highly trained in identifying and addressing ethical issues. They do an exemplary job helping callers with their ethical dilemmas.  What I want to stress is that social workers have an opportunity and a responsibility to be aware of potential ethical pitfalls BEFORE they occur.  As professionals, we must be totally aware of, trained in and knowledgeable about these unexpected situations that can occur in anyone's practice; regardless of the number of years one has practiced.  We cannot be arrogant about our knowledge of social work practice.

With this in mind, I want to remind all social workers to look for opportunities to become fully trained in 'avoiding' and 'addressing' ethical dilemmas.  One of these opportunities is coming up on June 10, when the MA Chapter holds a Continuing Education program specifically geared to raising social workers awareness, not only of the potential pitfalls but also of how to deal with them.

This program titled, “Protect Your Clients and Yourself” is particularly relevant now, as it will focus on the problems associated with the use of social media in one's professional AND personal life. The MA Chapter President, Betty Morningstar and I will be attending as we view this training as crucial to our professional lives.

The workshop will take place at Lantana in Randolph, MA on the morning of June 10^th (9-12:30) with registration starting at 8:30am. To learn more or sign up for workshop Click Here.

 Carol J. Trust

Power & Corruption *Updated

This has been quite a week with news items ranging from President Obama's speech on the Middle East, to Newt Gingrich's turbulent comments on his entry into the Republican Presidential campaign, to the annoyingly prevalent news coverage of the sexual misdeeds and alleged assaults of powerful men on women.

I am going to focus on the latter issue as it comes up so often, persistently gets people's attention and from my perspective continually astounds me.  The issue of powerful men factually and/or allegedly having liaison's with or attacking women in their personal and professional lives.  What is this about?  Of course, the clinicians, the anthropologists, the historians and the mavens among us have their views. The clinicians may give it a CPT code labeling the dysfunction with a variety of diagnostic categories.  The anthropologists may say that the behavior is primal and has to do with the male of the species declaring their territoriality for survival purposes.  The historians just may say that it is part of the human historical experience.  And the mavens?  Well, their unempirical view may range from "Ladies, watch out.  Proceed with caution.  Pay attention. Be on guard" to "It all goes back to the relationship with Mommy and Daddy."

I imagine that the answer to this 'phenomenon' may contain elements of all the above.  And what do we do about this reoccurring violation?  I am interested in your ideas and your responses.  I will be watching the responses to this blog, closely, and will be sharing some of the responses next week.

My own response is incredulous whenever I hear of powerful men who in their public lives have contributed in highly meaningful and valuable ways and who then behave in harmful and often illegal ways.

Standing by for your thoughts.


I am attaching the following article written by a clinical social worker who takes a clinical look at the issue of ‘sexual misbehaviors’ vs. “sex addiction.”  I would take a harder view and call those sexual actions by men or women who are in more powerful positions than the partner they ‘connect’ with, misguided from the most benign perspective to felonious, for those that exert physical and psychological force on the victim.
Sex Addict? 

Carol J. Trust

Weathering The Storm

If you are having trouble figuring out how the proposal for Health Care (Payment) Reform will effect your practice of social work, you are in good company.  Everyone is struggling, wondering and obsessing.

I am not just talking about social workers who have clinical practices, or to the majority of NASW members who practice their trade in the dozens of other social work settings but to all.  If you are a clinician providing mental health services to clients you need to be particularly vigilant as the changes will impact your livelihood and your personal health care needs.  If you are practicing social work in any other setting, you need to be aware of the changes for the population and communities that you are working in, as well as for yourselves and your families.

There are a number of the key issues that we are looking at from the social work perspective :  First, is the place of mental health services and specifically social work services in the proposed reform.  Social workers are in an excellent position to play key roles in the new Accountable Care Organizations (ACO) models.  We are expertly trained for the case management or care coordination roles that are integral parts of the Health Reform proposal. (Keep in mind that there are numerous phrases that describe this 'coordination' function and care management, care coordination, case management, etc. are just a sampling of the job functions.)  From our theoretical and practice training  we know that a client/patient/individual needs to be seen from the perspective of 'person in environment' which basically means being aware of all the influences on a client's life and not just one medical or emotional symptom that the individual may present at the doctor's office. Besides this expertise in coordination, social work clinicians are highly trained to provide therapy services to those individuals with mental health and emotional needs. 

Social workers provide over 60% of mental health services delivered in the country.

We need to make sure that social work is the profession of choice in the new system. There are job opportunities that we need to be vigilant about and promoting amongst our colleagues and the schools of social work.

Second, we are wondering, where mental health is going to fit? If the ACO's are going to be given a certain amount of money to provide for all the health needs of its clients, how can we be sure that the ACO (headed by a medical/PCP person) will deploy some of that money to the mental health needs of its patients when mental health treatment is indicated? NASW is working hard to get to the bottom of these questions.

The MA Chapter is paying close attention to these two major concerns of our members and the clients they serve.

Besides having established a work group made of NASW members who are knowledgeable about systems, health care, advocacy and practice, THE CHAPTER WILL TESTIFY ON MONDAY MAY 16^th at the State House about our concerns.  We are on the 'case' in the State House, with the administrative bodies that are charged with implementing the new Health reform proposal and with our colleagues in the other mental health and patient advocacy groups.

We ask that you keep abreast of the proposed changes in health reform by reading the accounts in the newspapers and other media, talking with your elected officials and continually bringing your questions and concerns to the Chapter.  We need to get feedback from you and take full advantage of your wisdom.  You can reach me at trust@naswma.org

Carol J. Trust

Ms. Trust goes to Washington

Each year the NASW Annual Leadership Meeting (ALM) brings together all the Executive Directors, the Presidents or the President Elects of the Chapters (there are 55 chapters), the National NASW Board of Directors and the National staff to receive training on issues common to the Leadership of the Association.  It is an extraordinary experience being in among all this brain power, exuberance, leadership and passion for the profession. One day is spent on building strong relationships between elected volunteers, leaders and staff so that this team can go home and recreate the powerful voice of social work in its local Chapter.  The training that our President, Betty Morningstar, and I received will be passed on to our Board of Directors and other Committee and Shared Interest Group Chairs as we increase the strength of leadership in the Chapter.

President Morningstar and I had the opportunity to visit the offices of our two Massachusetts Senators, John Kerry and Scott Brown, as well as each of our Congressmen, Barney Frank and Michael Capuano.  Our main objective was to lobby our Congress people to sign on to the Dorothy I. Height and Whitney M. Young Jr. Social Work Reinvestment Act (HR 1106/S.584.  This Act will not only strengthen the social work profession by giving it National Visibility, but it will also provide demonstration grants advancing the implementation of social work practice models in agencies and organizations throughout the country.  Senator Kerry has just signed on as a co-sponsor, as a result of our visit. You can count on President Morningstar and me to lobby the other three Congress people to a favorable decision.

A highlight of the 3 day event was the awarding of National Awards to exemplary social workers and public citizens.  The Massachusetts Chapter’s nominee for Public Citizen of the Year, Clementina Chery won the award with her exceptional vision and passion for creating the Louis D. Brown Peace Institute in Dorchester , MA.   In 1993, Ms. Chery’s son, Louse, was shot and killed while on his way to a Christmas party given by a group called Teens Against Gang Violence- a violence prevention, intervention and peer leadership development program. The Institute is dedicated to carrying on their son’s legacy of preventing violence in their community. The audience of National leaders and citizens were spell bound by the work of NASW-MA Chapter’s Ms. Chery.

So that’s a short round up  of what your Executive Director is up to on these yearly trips.  I am proud and grateful to represent the Massachusetts Social Work Community in the Nation’s Capital.

Carol J. Trust

When I'm 64...

Will you still need me?  Will you still feed me…….?  So the 1960’s lyrics of the Beatles song go and I still smile every time I hear that tune.  Decades old it may be, but the concern still prevails. How will life be as I get older, as my clients age, as we see the demographics shift such that there are more older folks in our lives than younger ones.  The subject has been getting more pressing as these topics are brought up in the media, and I become aware of my own aging. 

So what is NASW and the Chapter, in particular, doing about this?  How can we support our members who are dealing with these issues personally and professionally?  The news is good.  When you are an NASW member you can be sure to get all kinds of acknowledgment, support and resources in the area of aging.

For starters, in the area of acknowledgment, just take a look at the award winners at the 2011 Chapter Award event.  3 out of 7  work in the area of aging; Kathy Kuhn  recipient for the Greatest Contribution to Social Work Practice is on staff at the Institute of Geriatric Social Work; Chet Jakubiak, recipient of the Award for Social Policy and Change is  a leader at the  Massachusetts Association of Older Americans,  and Kathleen McInnis-Dittrich, recipient of the Greatest Contribution to Social Work Practice is Chairperson of the Boston College Graduate School of Social Work, Older Adults and Families Concentration.  We applaud these outstanding NASW members for their contributions to the field of Geriatric Social Work.

Then we have all the Continuing Education Events on the subject of working with the Elderly  held this past year, including: Love, Sex and Aging: Intimacy and Older Adults; the film Beaches of Agnes that focused on successful and creative aging.  And the Major CE event of the  year for folks working with the Elderly-The Annual Nursing Home Conference.

Further, the Chapter has two wonderful Shared Interest Groups (SIGS) that concentrate on issues related to working with the elderly:  The Nursing Home SIG and the Elder Issues SIG.  Both of these groups keep us well abreast of the issues that relate to the aging population. And when you go on the National NASW webpage you’ll find loads of resources related to working with the Elderly, in particular the Aging Section which takes a look at Aging issues from a National perspective.

So, when I hear questions from members regarding what NASW is doing to support social workers working with the geriatric population, a big smile of pride crosses my face.  And I am sure there is more that can be done.  As always, let me hear from you about this or any other topic.

And lastly, for those of you who are wondering why does Carol have a particular interest in the aging subject and how old is she, anyways?  I want you to know that I have no interest whatsoever, in your age and, I appreciate your showing the same indifference to me.

With Best Regards,

Carol Trust (trust@naswma.org.)

WHEN AN APOLOGY IS NOT ENOUGH

Every now and then we find out about program/service that is so extraordinary, either because it is so focused on a population that has not been visibly served or so potentially controversial that folks may be worried about its implications, that it deserves some special coverage with the social work community.  This recently happened when I was visited in the office by Ms. Linda Kenney, President/Executive Director of MITSS. She had been directed my way by one of the Directors of Social Work at a major teaching hospital in Boston who ongoing continually uses the MITSS services.  The MITSS (Medically Induced Trauma Support Services) program is one such program.

Every social worker should know about this service, not only for their professional practice but also for their family’s’, friends’ and neighbors’ well- being.   I will take some language from the program’s written materials to adequately convey the purpose and value of this service.

Medically induced trauma is an unexpected outcome that occurs during medical and/or surgical care. These events may affect the emotional well- being of the patient and/or family members.  It is different from other types of traumas for several reasons: patients and their families may feel isolated because hospitals often are not set up to provide emotional support beyond the hospital stay; the trust between the care giver and the patient has been breached or, patients may feel vulnerable because they will need continued care within the same system that harmed them.

As a result of the medically induced trauma, patients can experience a whole range of serious emotional effects, immediately or even weeks or months later after the harmed experience.

This is where the MITSS program comes in by offering extensive therapeutic educational support groups for patients and their families as well as hotline availability where support and encouragement are always available.  In addition, the program works with medical organizations to provide education and process improvement.

This is truly a valuable niche service- especially during those times when an apology from the medical and surgical team is not enough.

You can find out more about the program at: www.mitss.org

Carol J. Trust