So what can you do? The NASW Illinois Chapter is currently stepping up its advocacy to help avert many of these cuts. On April 30, 2012, we e-mailed the first of several legislative alerts (http://www.naswil.org/advocacy/advocacy-alerts/) regarding the budget. This is a crucial decision-making time in Springfield, so you will be receiving numerous legislative alerts as the Illinois General Assembly winds down during the month of May.

NASW Illinois Chapter President Yolanda Jordan and I were in Washington, DC, from April 11 through 14, 2012, for the national NASW annual leadership meeting, a gathering of NASW Chapter Presidents and Executive Directors. In addition to the wide range of trainings and a briefing on strengthening social work’s response to reducing poverty with the Congressional Social Work Caucus, National NASW Director Betsy Clark, in her state of the association presentation, announced her transition to retirement at the end of this calendar year. As national director since 2001, Betsy has been an exemplary leader, helping to navigate the association and the profession during very challenging economic times. A search committee will be led by immediate past National NASW President James Kelley.

I am sure you will find this month’s feature article by Ellen Carbonell to be very interesting, “The Alzheimer’s Epidemic: How an Exponentially-Growing Disease Will Affect Your Social Work Practice, and What You Can Do.” Ellen is associate director of Family Programs for the Alzheimer’s Association’s national office and recently presented at the NASW Illinois Chapter’s Older Adults Shared Interest Group (SIG) CEU series. The Older Adults SIG is one of the chapter’s most active SIGs. In March, they presented, “Your Hidden Clients: Clinical Issues with Older Adults and Their Families, an Intergenerational Approach,” and in April, over 40 people attended the second in the series, “Social Work Careers in Aging.” The third in the SIG’s series, “Navigating the New Millennium Maze of Aging,” will take place on May 31, 2012. More information about the SIG can be found at here: http://www.naswil.org/naswil/sigs/older-adults-sig/.

The NASW Illinois Chapter has several active SIGs: http://www.naswil.org/naswil/sigs/. Our International Activities Network SIG will once again will be participating in a social services exchange this summer, to take place in Hamburg, Germany, from August 30 through September 9, 2012. If you are interested in participating go to the IAN SIG page for more information: http://www.naswil.org/news/chapter-update/late-summer-international-social-work-conference-planned/.

Voting in 2012 NASW Illinois Chapter elections ended on April 30, 1012. Thanks to all of you who voted. Results of the elections will be posted on the chapter website later in the month.

In the upcoming weeks, please look for more information on the emerging Private Practice Shared Interest Group (SIG), job summit working groups, and other new events and programs.

Lastly, congratulations to all of the 2012 graduates of Illinois social work programs. On behalf of the NASW Illinois Chapter, I wish you much success and hope you will connect with the association as your career evolves. In the days approaching graduation, please be reminded that this is the most economical time to join the NASW. Join before graduation at 75% of the regular member cost: http://www.naswil.org/naswil/join-renewmembership/.

Joel L. Rubin, MSW, CAE, has served as executive director of the 7,000 member Illinois Chapter of the National Association of Social Workers (NASW) since October 1999. He has over twenty-five years of nonprofit management and fundraising experience including extensive work with boards of directors, committees and volunteers, and advocacy around a wide variety of social work, human service, and international political issues. Joel is a graduate of the Wexner Heritage Fellowship Leadership Program and a current adjunct professor at the University of Illinois at Chicago Jane Addams College of Social Work as well as Loyola University Chicago School of Social Work.
 

Here are the facts:

• There are 5.3 million people diagnosed with Alzheimer’s disease in the United States
• One in eight older Americans has the disease
• Alzheimer’s is the sixth leading cause of death in the United States and is the only one with no treatment, no cure, and no disease-modifying medications available
• Half of people over the age of 85 have signs of the disease
• Over 15 million Americans provide unpaid care for a person with Alzheimer’s or a related dementia
• Caregivers experience high levels of depression and emotional stress, financial drain, increased need to adjust work to meet their caregiving needs, and physical health deterioration as a direct result of their caregiving

Alzheimer’s disease is growing exponentially as baby boomers are aging into the years associated with high risk for dementia. Of the six leading causes of death, the rates of the other five decreased by 3 to 29% between 2000 and 2008. During that same period, on the other hand, the rate of Alzheimer’s disease increased by 66%. Unless some treatments are developed that can moderate this rate of growth within the next five years, the impact of this disease will bankrupt the medical care system as we know it.

These are the facts. As a result of what we are up against because of this disease, the public face of Alzheimer’s disease has begun to change. Articles appear in the press far more now than even five years ago, and people are beginning to see Alzheimer’s disease as something that starts with stages in which the person with the disease can talk about what’s happening to them and inform the public. Businesses are responding by learning about the impact of caregiving on their employees and are helping to educate them in record numbers. Awareness is in motion.

But are we as social workers prepared for the impact?

There are two ways in which I believe that social workers need to make adjustments in order to keep current with the needs that are being generated by Alzheimer’s disease.

First, we need to recognize even if our work is not directly with those who are this nation’s growing number of seniors, every area of our clients’ lives may be dramatically impacted by Alzheimer’s at some point. Any person who has parents in the high risk age category may find him or herself providing hands-on care or managing care provided by others along with adjusting to the changes that the disease brings over a number of years. These family caregivers are at the age in which they may be raising children or grandchildren in their homes. The current financial climate increases the need for these caregivers to also be providing an income for their families which adds work schedules onto their list of issues to manage and juggle.

Children, grandchildren, and even great-grandchildren are also affected by the adults in their lives who struggle with the disease themselves or as caregivers.The stressed adults who are providing care may be less available to these children in many ways, and when they live together, the impact may be felt daily. Social workers in child welfare and school settings recognize the impact that this stress has on their clients. Regardless of who our clients are, we as social workers need to recognize that Alzheimer’s disease and other related dementias may be touching the lives of our clients in ways that we have not yet recognized or addressed. We need to begin asking questions about this of our clients, and to learn as much as we can about the disease, its progression, and the effects on those around them.

There are practical ways to begin to address the unmet and often unidentified needs that increasingly affect our clients. Consider doing the following:

• Add questions about whether anyone is providing care for another adult on registration and intake forms, and begin to think of caregiving as a potential stressor on family systems.
• Because caregivers may not identify themselves as such, ask questions about whether anyone in the family lives with a diagnosis of any disorder. Include questions about what role your client has in providing care in intake interviews.
• Continue to explore this impact as treatment unfolds, asking about the impact of caregiving in sessions or meetings with clients and family caregivers.
• When your clients are children, include a series of questions about who in the family needs extra care attention from the parents, and help both your clients and parents understand the impact on the entire family.
• Assist caregivers with recognizing the need for additional help as the person’s disease progresses, and help them with locating quality resources.

The other way social workers need to adjust is to alter our thinking about our work with seniors, cognitive disorders, and end-of-life issues. Our field has made these changes in the past, as we have addressed the needs of those affected by cancer, substance abuse, HIV/AIDS, and sexual abuse. All of these issues have required that we look at ourselves and those around us with open minds, ready to learn and put our learning to use. Many times, social work has led the charge to help the public address difficult issues and think in new ways. The same is required of us now regarding the Alzheimer’s epidemic.

Working with seniors has long been seen as working primarily with issues of grief, loss, and custodial care. The end of life has been seen in this country as something to be avoided at all costs, and our medical community has been built around this premise. The hospice movement, however, has allowed us to begin looking at the end of life differently, as a time to come full circle and provide the dying with physical and emotional comfort. However, I believe that we have tended to see that process as somewhat disconnected from aging itself. Work with the aging is about loss, just as all of life touches this issue. But it is also about living life to the fullest, finding meaning and moments of joy, and helping people connect with the core of who they are. This is not just about loss; it’s about fulfillment and interconnection. It’s about facing the fact that we are all mortal, and that life is about experiences, learning, and using what we learn as we develop over time, and letting go of that which is beyond our power to understand or control.

So who better prepared than social workers to take this work head on? This is what we do, and the need for social workers to reassess work with the field of aging and take it on has never been more critical. Here are a few things to consider doing to prepare yourself as a professional whose work will be touched by the oncoming wave of aging Americans:

• Get educated about the facts of aging, caregiving, and dementia by attending programs and conferences on these topics. Many offer CEUs, and some are available online.
• Conduct a thorough exploration of your own feelings about aging and death and how they affect your work.
• Push yourself to move beyond outmoded ways of viewing aging which focus exclusively on loss; actively engage in a viewpoint that incorporates seniors taking on new challenges that have the potential for emotional growth and invigoration.
• Armed with a new understanding about how issues of aging and caregiving affect entire family systems, begin to incorporate this perspective directly into your work.
• Consider that the field of aging is one of the few areas of our work guaranteed to grow in the next few decades.

The aging of the American population is happening now, it is exponential, and the need for social workers in the field of aging has never been greater. We need to prepare to meet this need, and we can begin now by making some simple changes to our practices. By doing so, we enrich the lives of our clients and ourselves as professionals.

The rewards of working thoughtfully and intentionally with those affected by Alzheimer’s disease are there for the taking, full of both joy and sorrow, reflecting the essence of life itself.

Ellen Leon Carbonell, MSW, LCSW, is associate director of family programs for the Alzheimer’s Association’s national office. She is responsible for developing and producing dementia-related family programs for chapter implementation nationwide, and oversees caregiver and early-stage support group programs for the association. Trained as a clinical social worker, Ellen has thirty years of experience working with individual and family programs in mental health, vocational, educational, clergy, and voluntary health care settings. She is a Licensed Clinical Social Worker in the state of Illinois and is a member of the American Society on Aging.
 

Nominations are now being accepted for the annual NASW Illinois Chapter Emerging Leader Awards! This year, we are looking for outstanding individuals whose work has supported and promoted the social work profession and the people it serves. Nominations will be accepted through Thursday, May 31, 2012.

SELECTION CRITERIA

• Be a current NASW member
• Work in Illinois
• MSW degree from an accredited graduate school of social work
• Minimum three years post-masters experience (Consideration will be given to full- or part-time employment and/or volunteer work)
• 40 years of age or younger (Consideration will be given to individuals irrespective of age for whom social work is a second or later career)
• Demonstrated excellence in the following areas, including but not limited to: Public or nonprofit agency-based practice; policy/legislative advocacy and/or academia; contributions to services, programs, resource development, management, political efficacy, cross-cultural and anti-racist practices, teaching, research, and/or the development of practice knowledge

NOMINATION FORM
To nominate someone for the Emerging Leaders Award, please fill out the online nomination form (LINK) before Thursday, May 31, 2012. Please be prepared to provide a letter of endorsement for the nominee.

DEADLINE
The deadline for submitting a nomination is Thursday, May 31, 2012.

PAST AWARD RECIPIENTS
For a list of past award recipients, click here (LINK).

Marital affairs are always in the news and are a common problem that is treated in clinical practice. Lifetime rates for infidelity are around 25% for men and 15% for women. Rates for men and women under 35 have increased substantially. There are a number of reasons for this increase including a loosening of cultural mores, women’s increasing economic independence (as recently highlighted as the cover story in the March 26, 2012, issue of Time magazine), and digital technology (including Facebook, Craigslist, cell phones, the internet, and message boards). Google the words “infidelity” and “discussion group” and there are approximately 10,000 hits where people reveal their marital issues and receive support and advice.

Infidelity, however, has always been present. Historical figures such as Benjamin Franklin, former president John F. Kennedy, Albert Einstein, and more recently former governors James McGreevey, Arnold Schwarzenegger, and Mark Stanford were all involved in extramarital relationships. Other public figures such as presidential candidate Newt Gingrich, David Letterman, and Barbara Walters have been involved in affairs.

An affair is a relationship with another person that is based on deception. The essence of an affair is establishing a secret intimacy that must be defended with dishonesty. Betrayal can occur with people who are in committed relationships, such as a committed couple, whether they are heterosexual or gay/lesbian.

There are myths about infidelity: that it helps rekindle a troubled marital relationship, or that only troubled marriages experience this problem. One night stands and emotional affairs can be considered “not really cheating.”

There are various types of affairs, including sexual, which involves ongoing sexual contacts, one night stands, prostitutes, and emotional affairs. The most harmful affair to a relationship, however, is the sexual/emotional infidelity.

The reason men and women cheat is often very similar. Men often feel dissatisfied sexually and emotionally. Women often feel marginalized emotionally, and younger women can be attracted to men they feel have power. The stereotype of men drawn to sex is not always true. There are other similarities between men and women including body image problems, poor communication of needs, faulty problem management skills, and family background as a model of behavior.

Cultural mores often encourage cheating (such as television shows such as Desperate Housewives) as well as personality traits/disorders like narcissism and histrionic and antisocial behavior. Some psychiatric disorders may also contribute to infidelity like bipolar disorder, generalized anxiety, and substance abuse.

There are often warning signs such as disinterest, excessive criticism, and change in appearance that is not congruent with the family situation, as well as a lack of transparency in the relationship, especially with e-mails, cell phones, and internet usage. The best protective elements in a relationship are emotional bonds, sharing life experiences, conflict management skills, and sexual intimacy.

The impact of discovery is a crises for the betrayed spouse/partner. Psychiatric issues, such as severe anxiety and depression (including all of its manifestations such as crying, loss of appetite, insomnia, concentration issues, anger, and suicidal ideation) may be present. There also can be homicidal thoughts. Impact of discovery is a major trauma that has many similar symptoms to post traumatic stress disorder (PTSD). The offending spouse may become extremely symptomatic too. Children are also often severely impacted as well as other family members.

The dynamics of the third party often has an impact too. Whether the person married, single, a relative, is pregnant, carries the possibility of STDs, or refuses to break off contact can all be factors that exacerbate the conflict.

Treatment for infidelity is often complicated and difficult. There first has to be an assessment to determine if there is a commitment to work on the relationship and to explore the ambivalence that is frequently involved. The psychiatric impact must be treated too, including possible treatment for severe anxiety, depression, and trauma.

Interventions include conjoint therapy, individual therapy, a combination of both modalities, and medication management when indicated. Treatment has broadly three stages: the impact of the affair, finding meaning why the affair occurred, and forgiving, re-establishing trust, and moving on. This does not mean that the trauma of the affair is forgotten. The memory of the affair is placed in the background of the couples’ lives but remains, from my experience, in a compartmentalized form. There can be triggers years later that reactivate feelings.

The couple has to set their own agenda, and it is noteworthy that approximately 75% of marriages survive infidelity. However, for repeated infidelity, the survival rate is much less. There has to be guidelines for dealing with the third party, and the offending spouse has to agree to break off all contact including e-mails and texting. This can be problematic if there is a co-worker involved. The offending spouse has to take full responsibly for the pain that was caused and to allow the hurt partner to ask any questions. The inquisition usually evolves into information seeking. There has to be shared responsibility for change that would enhance the relationship.

Self-soothing and time-outs have to be implemented to de-escalate tension, as well as instructing the couple not to discuss the affair outside of the therapy session. Anger is often a defense for being hurt. Rituals have to be devised that promote relationship healing and symbolize moving forward. Safety net plans have to be implemented if the third party tries to re-establish contact. Individual therapy may focus on family of origin issues as well as specific personality issues.

Treatment guidelines need to be clarified when therapy starts, including contact between sessions. Individual session guidelines need to be discussed at the start of treatment. If another therapist for individual sessions is preferred, there needs to be coordination of care. No matter what choice is made, there can often be problems that have to be managed.

In summary, treatment and recovery from affairs can be very difficult for the couples, individuals, and children. Treatment is oftentimes consuming and has periodic crises. The therapist should have a treatment strategy and be nonjudgmental, not hesitating to seek consultation in difficult cases.

REFERENCES

1. Gurman, A. (Ed.). (2008). Clinical handbook of couples therapy. New York, NY: Guilford Press.
2. Black, C. (2009). Facing sexual betrayal, lies and secrets. Center City, Minnesota: Hazelden.
3. MacDonald, J. (2008). How to help your spouse heal from your affair: A compact manual for the unfaithful. Gig Harbor, WA: Healing Council Press. 
4. Glass, S., & Staeheli, J. (2004). Not just friends: Rebuilding trust and recovering your sanity after infidelity. New York, NY: Simon and Schuster.
5. Subotnik, R., & Harris, G. (2008). Surviving infidelity: Making decisions, recovering from the pain. Halbrook, MA: Healing Council Press.

Phillip L. Elbaum, LCSW, CADC, is in private practice in Deerfield, Illinois, a consultant to Hines VA Hospital, and is assistant professor in the Department of Psychiatry and Behavioral Neurosciences at Loyola University Medical School. He is a retired social work clinical manager and former coordinator of the Hines VA Hospital Employee Assistance Program. In addition, he has presented numerous workshops and has many publications.

School social workers have a unique type of knowledge in the school setting; they are clinical professionals. What do we mean when we talk about clinical knowledge? The term comes through the French clinique and from the Greek kline (a couch or bed). Clinical medicine was (and is) practiced at the bedside. This means that clinical work is direct—it directly touches the persons for whom it is intended, and it is healing. It is intended to benefit and restore the people it touches. So how does this apply to social work in schools? How is this a clinical occupation?

Teachers teach, administrators administer, psychologists test. And social workers work on the social; in other words, relationships. We make a caregiving relationship with the student for the benefit of the student, and we help the student with his or her relationships with friends, teachers, and parents.We are trained to be therapeutic—that is, healing—with students. We support the major educational function of schools, but what we provide is different from other professionals.

The unique caregiving relationship formed between a school social worker and a student is based on deep understanding. We understand distress, and we provide care. There are two types of distress, and so there are two types of caregiving: interpersonal (outer) and intrapsychic (inner).

Interpersonal distress is the most visible form of unhappiness in children. In addition to educating children, much school involvement with a student focuses on interpersonal distress. Interpersonal distress includes feelings, thoughts, behaviors, and cultural and developmental stresses. This type of distress may be shown in action or the student may tell us about it, but this distress is between the student and the outer world. Because student distress can interfere with learning, schools create a variety of responses to expressions of student distress.

Intrapsychic (inner) distress is more subtle and indirect, although equally damaging. As a result of our clinical training, we know that people are habituated to seek pleasure in certain characteristic ways and also to seek pain in certain habituated ways. We see people do things that are bad for them, and we understand they have misdirected inner motives. In our work, we see students create pain for themselves in several ways.

One of the ways that students create inner pain is through dysfunctional responses to losses. Everyone has losses, big and little. A loss is any unwanted experience in our lives. We may misplace our car keys or a beloved pet may die. Both are losses, but of different magnitude. The ways that people respond to these unwanted experiences affect how their lives unfold over time.

Students respond to losses in one of four ways: outer destructiveness (toward others or the environment), self-destructiveness (hurting themselves directly or indirectly), avoidance (such as burying themselves in computer games, running away, or becoming dissociated), or mourning (bringing the loss to a caring relationship). The first three responses are dysfunctional because the inner pain of the loss remains and continues to be harmful. The fourth response, mourning, is the act of turning to a trusted relationship to process (talk and think about) the loss. When a student is able to mourn losses, the losses become felt, accepted, and understood, allowing the student to truly move on.

A second way students create pain for themselves is perhaps the most counterintuitive aspect of people’s inner distress, namely, aversive reactions to pleasure. When a student has a gain of any kind, such as a good grade, a play date with a friend, or a family vacation, he or she may celebrate by sharing with friends and adults at the school and talking about the pleasure of that gain. But paradoxically, sometimes when children feel good, they instantly engage in some undoing reaction to try to return to a familiar inner state of unhappiness. This is because the familiar is more comfortable than the unfamiliar, even when the familiar feels bad. (For a fuller explanation of aversive reactions, see Pieper and Pieper, Smart Love, Harvard Common Press, 2001.)

For example, a child may do well on a test and then go out for recess and fight with a friend. As soon as the fight happens, the child and everyone else forgets what the child has done well and focuses on the “problem.” When we understand that this is an aversive reaction, we can help the child and the adults understand that without intending to, the child has tried to undo the unexpectedly good feeling. And we can remind them of what the child has done well.

We often see children engage in behaviors at school that seem to make no sense. These behaviors are unnecessarily harmful to the child or to others. It is sometimes difficult to understand why a child would be troubled or make trouble, especially when things are going well. The concept of aversive reactions to gains helps us make sense of these moments.

Because of our clinical understanding, school social workers are uniquely positioned to provide intrapsychic caregiving to help students with these ways they create inner pain. Intrapsychic caregiving involves offering empathic understanding, respecting that the child is in charge of his or her inner life, helping the child distinguish between healthy and unhealthy motives, and explaining that even though you cannot control the outcomes, you can do your best to make choices that are good for you. We can help children and the adults in the school understand that when a child gets off track there are reasons—even if we do not understand them—and we can help the child get back on track. That process of learning to get back to healthier motives over and over again is what strengthens the child’s capacity to make better and better choices.

Sometimes we experience pressure from the other school professionals to control outcomes. We are asked to make the child behave in class, get his or her grades up, stop missing school, or stop bullying peers. We can respect the goals of the school while helping colleagues understand that the benefits of building inner self-care and self-regulation will ultimately lead to better longterm outcomes than simply managing a child’s behavior.

Our understanding of the complexity of students’ behaviors and our clinical judgment about how we can best help the whole child are a vital resource for both the school and the children we care for. We can be respectful of the unique roles of each of the professionals in our school while at the same time articulating and demonstrating the clinical perspective that is a unique expertise of school social workers.

Nora L. Ishibashi, PhD, is a clinical social worker in private practice in Chicago and Northbrook, IL. She practices psychodynamic psychotherapy incorporating the newest research in neurobiology, attachment theory, philosophy of psychotherapy, and depth psychologies. She received training in medical hypnosis at Loyola University of Chicago Stritch School of Medicine. She is certified as a yoga instructor by the Kriya Temple of Chicago and as a public health fitness educator by the University of California at San Diego. Nora provides individual and couples psychotherapy; consultation to psychotherapists, teachers, school administrators, parents, and agencies; in-service and training; and public lectures. Nora is founder of the North Shore Alliance of Psychotherapists, a network of 150 therapists who practice in the suburbs north of Chicago.

With the projected growth in the aging population, the needs of older adults and their families are receiving increasing attention from the social work profession. One area that should be of particular importance to social workers is the quality of long-term care. As growing numbers of older persons and their families turn to long-term care facilities for care, it is imperative that we address how best to provide comfort care to nursing home residents at the end of their lives. While many disciplines are involved in the care of nursing home residents, social workers can assume a unique and important role as advocates for the provision of quality, comfort care in long-term care settings.

Mercedes Bern-Klug’s fine book outlines her belief that nursing homes can and should support the physical, psychological, and social needs of residents, and that residents can thrive in nursing homes when their needs are met. Bern-Klug and the book’s contributors explore the role that palliative or comfort care plays in enhancing the quality of life of nursing home residents as well as the medical, familial, psychological, cultural, and financial issues that influence decision-making about end-of-life care.

Each of the eleven chapters in Bern-Klug’s book focuses on a different aspect of end-of-life care in nursing homes while providing a broad overview of the issues affecting this complex area of practice. The book is designed to be a tool to prepare social workers to advocate for a greater incorporation of palliative care and psychosocial care into the culture of nursing home care, but it has relevance for other areas of health care as well. The book chapters include discussions of the psychosocial needs of nursing home residents and families, the financing of long-term care and end-of-life care, ethical issues in chronic care and end of life, trends and characteristics in nursing home care, rituals and grief at end-of-life, and considerations for the future. All of the contributors discuss the social work role in supporting and educating families and nursing home staff about the benefits of comfort care and planning for end-of-life. Each chapter includes case examples to further illustrate points made.

While the chapters build on each other, several are of particular interest. Chapter 5 focuses on physical and medical conditions that arise later in life, and the use of medication and other modalities to provide pain and symptom management. Chapter 7 includes an excellent discussion of the social work role in supporting the family through the placement and end-of-life process. This chapter reviews the importance of assessing the meaning of illness, dependence, caregiving, nursing home placement, and death to the patient and the family, and the implications for care-giving by facility staff. The book’s appendices include excellent examples of assessment questions. Chapter 8 discusses the importance of advance planning and health care directives and uses a case example to illustrate the ethical issues that can arise when an impaired individual does not have a legal decision-maker. Chapter 9 focuses on grief and rituals related to resident death in a nursing home. Many nursing homes are uncertain about how best to acknowledge the death of a resident; this chapter illustrates some of the industry best practices and highlights the social work role in supporting families and other nursing home residents when death occurs.

As the aging population grows in proportion to the rest of the population, every clinician can anticipate having contact with someone affected by chronic health issues and the need for nursing home care. Bern-Klug and her colleagues argue that these individuals have every right to expect good care and nursing homes, with support and education, can provide a level of care that enhances the quality of life of its residents. Bern-Klug and her colleagues further assert that social workers should be a driving force in ensuring that this goal is met and through this book provide the tools to enable clinicians to assume this role. Her final chapter asks the question whether society will accept old age as a stage of life and discusses the implications if we do not. This is a book worth reading and referencing, regardless of your practice area.

Nancy Flowers, LCSW, is social work manager at Rainbow Hospice and Palliative Care, a thirty-one-year-old nonprofit hospice located in Mount Prospect, Illinois.
 

We are now about to enter the final scheduled month of the Illinois state legislative session. This means that the state budget will start coming together in greater detail. The governor has proposed a budget that makes substantial cuts in human services programs and closes a number of state-operated facilities including the Tinley Park and Singer Mental Health Centers and the Murray Developmental Center in Centralia, IL. The governor also announced a plan to cut $2.7 billion from the state's Medicaid program.

The Department of Human Services (DHS) budget proposal, for example, makes significant cuts to mental health and disability programs. It also proposes to reduce lifetime limits for the Temporary Assistance for Needy Families Program (TANF) from five years to three years, and to make it more difficult for low-income working parents to secure subsidized child care. It would also tighten eligibility standards for the Home Services Program by requiring a higher score on the needs assessment instrument used to determine eligibility. This is a Medicaid Waiver program that provides individuals with disabilities personal attendants to assist with homemaking, meals, and other tasks. Further complicating matters is the fact that an Illinois House resolution allocating funds to its Appropriations Committees would require $230 million in additional cuts in human services, on top of those proposed by the governor. We do not know where these cuts will be made.

One pressing DHS budget issue in the current fiscal year is a $73 million shortfall in TANF, which would have to be addressed by taking funds already allocated for child care services, or funding the shortfall with a supplemental appropriation. A supplemental funding bill seems highly unlikely at this time. Taking the money from child care would result in a delayed payment cycle for child care providers. Many of the providers are either in-home day care program operators or center-based providers who only serve low-income communities and would not be able to survive delayed payments.

In the area of Medicaid, last week the governor issued a proposed plan to cut $2.7 billion. It includes a cigarette tax increase that has some opposition in the Illinois General Assembly. It also includes cuts to the Family Care program, elimination of medical coverage for General Assistance recipients, termination of the Illinois Cares Rx program, and elimination of adult dental care coverage.

The issue now is whether advocacy efforts can convince the governor and the legislature to restore some of these safety net cuts by finding other places to cut and creating additonal revenues. It will take a great deal of public pressure, and the time to start is now.

The legislation we are following includes the bills listed below:

HB 5290 (Cassidy and Luechtefeld) would require all school districts and non-sectarian private schools to adopt policies to address complaints of bullying. The bill is a follow-up to legislation passed two years ago that created a statewide task force on school bullying prevention. The bill is assigned to the Senate Education Committee and an amendment is being negotiated.

HB 3887 (Kay and McCarter) would add personnel of institutions of higher education, athletic personnel, and early intervention services providers to the list of mandated reporters of child abuse or neglect. The bill has passed the Illinois House, was approved by the Senate Judiciary Committee, and is now on the Illinois Senate floor.

SB 3824 (Sullivan and Cassidy) would amend the Criminal Code by including in the offense of threatening a public official specific threats to the person, family, or property of a social worker, caseworker, or investigator employed by the Departments of Human Services, Children and Family Services, or Healthcare and Family Services. The bill has passed the Illinois Senate and this week was approved by the Illinois House Judiciary-Criminal Law Committee.

SB 3773 (Sandoval) started out as a bill to require nonprofits that receive state grants and contracts to comply with requests under the Freedom of Information Act. After strong opposition, the sponsor asked for comments and suggestions. He has now filed a new amendment, Senate Amendment #2, which has been assigned to the Illinois Senate Executive Committee. The amendment removes the FOIA piece from the bill but would now require comprehensive and detailed reporting on each grant from any grantee, including for-profit companies. The amendment has not been posted for a hearing as yet. NASW Illinois would continue to oppose the bill with the most recent amendment.

HB 5278 (Cassidy and J. Collins) would amend the Criminal Code to allow a prosecution for involuntary servitude, involuntary servitude of a minor, or trafficking in persons and related offenses when the victim is under 18 years of age to be commenced within one year after the victim's eighteenth birthday, but the statute of limitations shall not expire sooner than three years after the commission of the offense. The bill makes additional changes with respect to such prosecutions, and with respect to the impoundment of a vehicle used in certain human trafficking and prostitution-related offenses. The bill has passed the Illinois House and has been approved by the Illinois Senate Criminal Law Committee.

As the population ages, more social workers find themselves intervening with older adults. As with any other population, ethical practice involves the ongoing commitment to developing cultural competence. The NASW Standards for Cultural Competence define culture as, “the integrated pattern of human behavior that includes thoughts, communications, actions, customs, beliefs, values, and institutions of a racial, ethnic, religious, or social group” (NASW, 2000b, p.61).

Competence is defined as “having the capacity to function effectively within the context of culturally integrated patterns of human behavior defined by the group.” Cultural Competence “refers to the process by which individuals and systems respond respectfully and effectively to people of all cultures, languages, classes, races, ethnic backgrounds, religions, and other diversity factors in a manner that recognizes, affirms, and values the worth of individuals, families, and communities and protects and preserves the dignity of each” (NASW, 2000b,p.61).

Standard 1. Ethics and Values
Social workers shall function in accordance with the values, ethics, and standards of the profession, recognizing how personal and professional values may conflict with or accommodate the needs of diverse clients.

Cultural competence requires social workers to live into the standards of the NASW Code of Ethics. Older adults and their families may present issues and challenges unique to that population and phase of life. This standard also recognizes the relationship between professional skills and knowledge, and personal values, beliefs, and family history. How does my age and health impact my practice of social work? What past or present family issues are impacting my values and beliefs? How much do I know or understand about the unique aging issues of lesbian, gay, and transgender clients?

1.04 Competence
(a) Social workers should provide services and represent themselves as competent only within the boundaries of their education, training, license, certification, consultation received, supervised experience, or other relevant professional experience.

An aspect of work with any population, but particularly older adults, may involve educating and support in completing wills and advance directives (Five wishes, medical/financial power of attorney, etc.). Competency requires a level of knowledge and personal comfort in addressing issues of illness, incapacity, and mortality. If social workers have not gone through the process of creating their own documents, it is important to ask ourselves, Why? What feelings and beliefs come up around this topic? A social worker’s personal experience will influence professional practice.

Five Wishes is a document to help people plan for the care they choose to receive in the event of a serious illness or injury. Aging with Dignity, a national nonprofit association that created Five Wishes, is an excellent resource for information. The document is now available in 20 different languages at http://www.agingwithdignity.org/translations.html.

NASW and the National Hospice and Palliative Care Organization (NHPCO) developed the premier credential for social workers who specialize in hospice and palliative care—NASW Advanced Practice Specialty Credentials in Hospice and Palliative Care. In addition, NASW offers NASW Standards for Social Work Practice in Palliative & End of Life Care and the NASW Social Work Hospice & Palliative Care Network.

Standard 2. Self-Awareness
Social workers shall develop an understanding of their own personal and cultural values and beliefs as a first step in appreciating the importance of multicultural identities in the lives of people. Cultural competence includes knowing and acknowledging how fears, ignorance, and the “isms” (racism, sexism, ethnocentrism, heterosexism, ageism, classism) have influenced their attitudes, beliefs, and feelings.

Self-awareness is at the core of ethical practice. What are my beliefs/fears about aging? How have I been impacted by any of the “-isms”? What are my feelings and beliefs about my own ethnic, religious, class, or racial identity? What are my beliefs about end-of-life care?

Standard 3. Cross-Cultural Knowledge
Social workers shall have and continue to develop specialized knowledge and understanding about the history, traditions, values, family systems, and artistic expressions of major client groups served.

Standard 4. Cross-Cultural Skills
Social workers shall use appropriate methodological approaches, skills, and techniques that reflect the workers’ understanding of the role of culture in the helping process.

The Cultural Competence Standards state that “cultural competency is never fully realized, achieved, or completed…competency is a lifelong process.” The expectation is that social workers are engaged in an ongoing process of knowledge-building, skill development, and personal awareness. It requires an open mind and humble attitude that allows for self-reflection, self-honesty, and a willingness to challenge personal bias or previous beliefs. Additional resources for best practices include the following:

• Aging Practice Updates
• Guideline for Alzheimer’s Disease Management:
  • http://www.alz.org/californiasouthland/documents/professional_NATLguideline.pdf to download the national version of this valuable resource
  • http://www.alz.org/californiasouthland/in_my_community_professionals.asp#Clinical_guidelines for background information on the development of the Guideline.
• Support for Family Caregivers: The National Landscape and the Social Work Role (Practice Perspectives January 2011)
• Standards for Social Work Practice with Family Caregivers of Older Adults
• Standards for Social Work Practice in Health Care Settings
• Standards for Clinical Social Work in Social Work Practice
• Standards for Social Work Practice in Palliative and End-f-ife Care
• Standards for Social Work Services in Long-Term Care Facilities
• Standards For Cultural Competence in Social Work Practice
• Indicators For Cultural Competence in Social Work Practice
• Social Work and Transitions of Care (10/15/09 )
• Biopsychosocial Challenges Related to Transitions of Care (10/15/09)
• http://www.socialworkers.org/practice/aging/agingFlyer0508.pdf for resources from NASW on aging and mental health

Standard 5. Service Delivery
Social workers shall be knowledgeable about and skillful in the use of services available in the community and broader society and be able to make appropriate referrals for their diverse clients.

Ethical practice involves knowing both what resources are available and when to make referrals. What are the limits of my expertise? What additional services are needed? In situations where there are limited resources for financial or geographic reasons, how are dual relationships managed

Standard 6. Empowerment and Advocacy
Social workers shall be aware of the effect of social policies and programs on diverse client populations, advocating for and with clients whenever appropriate.

Standard 7. Diverse Workforce
Social workers shall support and advocate for recruitment, admissions and hiring, and retention efforts in social work programs and agencies that ensure diversity within the profession.

Standard 8. Professional Education
Social workers shall advocate for and participate in educational and training programs that help advance cultural competence within the profession.

Standard 9. Language Diversity
Social workers shall seek to provide and advocate for the provision of information, referrals, and services in the language appropriate to the client, which may include the use of interpreters.

Advocating for appropriate interpreters is crucial to ethical practice. Provision of services in the most accessible language becomes even more important when combined with potential hearing loss, cognitive confusion, memory impairment, or other issues that impact processing information. Social workers need to be able and willing to advocate for these services. Use of family members for interpreting is fraught with ethical problems and limitations.

Standard 10. Cross-Cultural Leadership
Social workers shall be able to communicate information about diverse client groups to other professionals.

Leadership can be defined as “the process of social influence in which one person can enlist the aid and support of others in the accomplishment of a common task; an attempt to persuade others to see something from a new perspective and to motivate them to take action on behalf of that perspective” (Jaime Chahin, PhD, Ethical Leadership and Values). Leadership derives how social workers embody their role, independent of job title. Leadership is demonstrated through advocacy, education, empowerment of others, conflict resolution skills, and honest self-awareness. Social workers are often in a unique position to serve clients through sharing critical information in an effective manner.

Ruth Lipschutz, LCSW, ACSW, is a licensed clinical social worker with postgraduate certification in ethics, mediation, Transformational Imagery, hypnotherapy, and Eye Movement Desensitization and Reprocessing (EMDR). She received her MSW from the University of Illinois in 1978 and went on to complete the two-year postgraduate training program of the Institute for Family Studies at Northwestern University. She has extensive experience in the areas of ethics, mental health, addictions, traumatology, program development and implementation, supervision, consultation and Alternative Dispute Resolution. She is the chairperson of NASW’s National Ethics Committee and has served as a panelist, consultant, mediator, and trainer for the NASW Illinois Chapter Ethics Committee. She is currently in private practice.
 

• OFFICE FOR RENT - Northbrook: Large,attractive, very comfortable office space in "condo- style" building with 24 hour access. Available for part time rental. Semi-private waiting area, excellent soundproofing, private washroom, handicap accessable. Fax, copier, shredder, refrigerator, and microwave available for use. On Dundee Rd, 1/3 mile west of Edens Expressway. Call Steve Field, MD (847) 564-5645.
• OFFICE FOR RENT - Joliet: Share office space in a nicely-decorated, comfortably furnished 2-office suite with welcoming waiting-room. Handicap accessible building. Easily located in lovely, business/residential area. Directly off I-55 or I-80 exits. Free parking. Days/Evenings/Weekends available. Extremely reasonable rent. Contact Julia (815) 545-3348.
• OFFICE FOR RENT - Oak Park: Sunny office available in 3 office suite located in medical arts building. This well-appointed vintage building is convenient to transportation (one block from Oak Park el stop on the green line, parking options). Waiting room, access to fax, copier. Part time sublet a possibility. Contact Tom Como LCSW (708-848-7536).
• OFFICE FOR RENT - Chicago/Loop: Sophisticated/lovely decorated office space large enough for groups in an immaculately well-maintained building. Seperate entrance and exit doors (sound controlled), working office space and reception area. In the heart of the Loop and close to all public transportation venues. Pedway access from the building makes this an extra advantageous space for rent. Evening and weekend availability. Please contact me at 312.965.9991
• OFFICE FOR RENT - Oak Park: 200 square feet of office space available! $385 a month, includes all utilities. 7'8"x6'9" reception area, 11'11"x9'10" main office, and 4'x5'10" storage closet (dimensions are approximate). Elevator building, redecorated common areas, restroom facilities for tenants and guests. Great downtown Oak Park location. Metra and Green Line across the street. Metered parking lot next door. For more information, contact LaVerne Collins, GLA Property Management, Inc., 708-763-9927. Broker owned.
• OFFICE FOR RENT - Oak Park: 770 square feet of office space available! $1475 a month, includes all utilities. 13'4"x11'8" reception area, 10'7"x9'9" private office, 29'6"x14'3" main office area, and 8'10"x8'9" kitchenette. Elevator building, redecorated common areas, shared restroom facilities for tenants and guests. Terrific downtown Oak Park location. Metra & Green Line across the street. Metered parking lot next door. For more information, call LaVerne Collins, GLA Property Management, Inc., 708-763-9927. Broker owned.
• OFFICE FOR RENT - Evanston: Lovely therapy office for rent in 3-suite space. Newly decorated, quiet, all-therapist suite. Modern amenities, 24-hour door person, handicapped accessible, mid-rise building. Easy street parking. Location: 1007 Church Street, Suite 515. Monday, Wednesday, and Thursday availability with flexibility. Rent by the hour or reserve blocks of time to save on rent. Please contact Mary Leopold, LCSW, at 847.309.9638.
• OFFICE FOR RENT - Chicago: Streeterville office for rent part-time. Hours are negotiable. Small or large blocks of time are possibilities. Days/evenings/weekends are available. Beautiful space with lake views. Reduced rate parking an option. Please call 312-670-9885 for further information.
• OFFICE FOR RENT - Buffalo Grove: Buffalo Grove/Long Grove area. 1 office suite left among 8 other Psychology/Psychiatry/LCSW offices. New paint, New carpet. Private waiting room. Possible share situations. Call Susan (847) 913-1400.
• OFFICE FOR RENT - Naperville: Lovely large sunny practice office in Naperville historic building in downtown Naperville. Private bathroom and separate waiting room. Easy parking. Available for weekend use and Fridays.
• OFFICE FOR RENT - Chicago: Beautiful, professionally decorated 16th flr. Michigan Ave. office overlooks Millennium Park. Available weekdays, evenings, and Sat. Discounted parking available. Call Antoinette at 312 719-8498.

NASW ILLINIOS CHAPTER JOB BOARD
For a complete and up-to-date list of job board postings, visit the NASW Illinois Chapter Job Board: http://www.naswil.org/education-career-development/association-job-board/.   

• Chief Program Officer - Hoyleton Ministries
• Integrated Care Manager - New Age Services Corporation
• President & CEO - Neumann Family Services
• Mental Health Therapist - Human Resources Center

April is National Child Abuse Prevention month, a time to recognize the roles that we as social workers play in promoting the social and emotional wellbeing of children and families in communities. As a social worker in the field of child welfare, I know how important our role is in protecting, assessing, and servicing children and families as well as how important the preservation of family connections are to children.

Nationally, many child welfare agencies are moving toward a protective model due to research findings on children and families. According to the Children’s Defense Fund, a full range of services and supports are needed in service provision in order to promote healthy social and emotional development and well-being of all children and families. It is important to strengthen and support children and families in order to keep crisis from occurring and to help ensure that children are safe.

In efforts to reduce the incidence of child maltreatment, the Center for the Study of Social Policy in conjunction with other agencies and programs spent two years investigating ways to protect children and keep them safe. They developed a strategy that involves working with children and families from the early stages in order to prevent incidents of abuse and neglect. The thought is that if we can strengthen families through education, social connections, and psychological support, we can make homes safer for children and maintain family connections. Six protective factors were developed:

1. Enhancing Parental Resilience: Teaching parents how to be strong and flexible in order to deal with the stress of life.
2. Develop Social Connections: Assisting parents in developing an informal network of trusted friends in their community so that they have a support system for meeting both practical and emotional needs
3. Build Knowledge of Parenting and Child Development: It is important to educate parents on normal child development so that they have reasonable expectations for their children and develop alternative strategies for dealing with challenging behavior and avoiding harsh punishment.
4. Offer Concrete Support in Times of Need: It is important to connect parents with services in the community to provide needed services.
5. Foster Social and Emotional Competence of Children: It is important to assist parents with helping their children to communicate effectively. Parents need to be able to be supported by providers in learning how to detect signs of trouble that parents are not trained to see.
6. Promote Healthy Parent-Child Relationships: When parents are in tune with their children, they can listen to them, understand them and perceive their needs. It is important to find programming that can provide parent-child activities.

These protective factors have become part of child welfare practices across the nation as agencies partner with various community programs and early childhood education programs to strengthen families while keeping children safe.

As I look back over my career in child welfare, I have found this field to be rewarding and a great opportunity to work with children and families while making a positive impact on communities. For students who are making decisions on careers in social work, consider child welfare, an area where you can impact children, families, and communities.

Yolanda Jordan, MSW, LCSW, has an extensive background in abuse/neglect issues in the field of child welfare. As a placement manager with the Illinois Department of Children and Family Services, she is responsible for managing supervisors who are responsible for children who are placed in the foster care system. Yolanda is also a practicing psychotherapist and has been in private practice for the past ten years. Services are provided to children, couples, and families with a special emphasis on relationship issues that African American women face.

Yolanda is a graduate of Western Illinois University where she received her bachelor of arts in mass communications and master of arts in public communications human relations with a minor in African American studies. Due to her extreme love for people and having the heart of a servant, she continued her education and received a masters in social work with an emphasis on child and family practice from the University of Illinois at Chicago’s Jane Addams College of Social Work. Yolanda has been an active member of the NASW Illinois since 1996 and enjoys the work of advocating for the profession of social work and the community that social workers serve.
 

I say all this not because I want to highlight my resume for you, but to trace a path that leaves me on many days wondering if I’m still in fact working as a social worker at all. I no longer have direct contact with families or community members, and I don’t do anything remotely therapeutic, though even as I write this, I am reminded that my grandfather. The son of a union organizer and himself a social worker, community organizer, and peace activist, this father of a therapist always said he didn’t consider therapy to be social work.

My mother, the therapist, politely disagreed with him, pointing out that they were both in the business of making change but that while he focused on community-level change, she was focused on change that came on the individual level. He wasn’t sold, and she was okay with this, but it does make me think about where I fall on the spectrum of social work as they defined it. What is my place? Does the work I do in fact create change? And more ideally, does it create any kind of transformation in individuals, communities, and society?

I tell people I am focused on healthy child development, that healthy child development begets community development, which begets economic development. I tell people that I work in child abuse prevention because I believe that child abuse and neglect undermines healthy child development and can lead to long-term adverse experiences for both the individual and society. I also know that we can do better and that there are solutions that prevent child abuse and neglect before it ever occurs. There are home visiting programs such as Prevent Child Abuse America’s signature program, Healthy Families America (healthyfamiliesamerica.org), and there are all kinds of innovative things being done around preventing Shaken Baby Syndrome and child sexual abuse.

But people don’t know about these solutions, and the media doesn’t necessarily communicate about them either. News stories tend to focus on the latest big case, how they feel the child welfare system has failed children, and the demonization of parents and caregivers. The ways these stories are told—with little focus on solutions or context and lots of focus on graphic images and negative statistics—keep the public at arm’s length or worse, so overwhelm them that prevention not only seems impossible, but that they themselves have no role in the prevention of child abuse and neglect.

We can argue that this is a communications failure. Why don’t people play a more active role in social causes in general, and in prevention more specifically? That is because we have failed to engage them in a story about what prevention can be, and we have failed to show them what their role in prevention might be. I would also argue that this is one of the great challenges for our field, and for any field—how do we activate the public to play a role in the work of prevention, much less recognize the fact that they already play a role?

This kind of dialogue fascinates me. What is the language and narrative necessary to engage our friends, neighbors, family members, etc., to play a role, join us, and actively work for the healthy child development of all children in their neighborhoods, communities, and society?

Prevent Child Abuse America has been actively trying to figure this out for several years, evaluating how to reframe our work and craft a “core story of development” that will engage the public in this conversation. I have personally had the opportunity to talk about this “new” story across Illinois and the country in a series of very cool, engaging, and dynamic conversations.

Language, however, is ultimately only a piece of the kind of transformation we seek. Language needs a platform and a means for reaching the very public we are hoping to engage, educate, and activate. It is on this front that Prevent Child Abuse America has become involved in two different strategies to not only change the conversation about prevention, but elevate it to address what all children and families need and how what they need can be implemented.

The first effort is called Pinwheels for Prevention. This is a campaign we are engaged in where we are seeking to move the field away from its historic focus on the blue ribbon and highlighting a child’s death to a focus on healthy child development, child births, and solutions. We visualize this as a year-round effort but target Child Abuse Prevention Month, which is held in April, as a substantive opportunity to get the pinwheels out there, which people do, building pinwheel gardens in communities across the country and holding events where communities are engaged, opportunities to support the field are discussed, and prevention is the focus.

The second effort is the National Movement for America’s Children of which Prevent Child Abuse America is one of thirteen founding partners. The national movement was created to develop a true national strategy for the healthy development of all children and has embraced two key approaches to make this happen. First, we have developed a movement organizing site where we are encouraging visitors to sign a pledge that they want to be part of the movement, connect with their neighbors, organize community events, and answer what we are calling the Big Question: How can we ensure that every child has an equal opportunity for healthy growth and development? Second, we have been holding town hall meetings in communities everywhere posing the same question to the participants and engaging them in a conversation about what’s possible—this, of course, is part of the challenge because people have to see that something can happen, and they also have to see how they can be part of it.

Which I suppose brings me back to whether I am a still social worker and whether my grandfather would say I am having any substantive impact on the world we live in. I think he’d be happy with my choices, and I think he would see there are possibilities in our work. He would have questions of course, but I also think he would believe we have the opportunity to transform the cultural norms around children and families in our society as well. Which I guess means I haven’t strayed too far.

Ben Tanzer is senior director of strategic communications at Prevent Child Abuse America, where he oversees all traditional and social media efforts as well as Prevent Child Abuse America’s role in the National Movement for America’s Children. Ben is also the author of a number of books including You Can Make Him Like You, My Father’s House, So Different Now, and This American Life, and can be found online at This Blog Will Change Your Life.
 

Being a social worker, I think that psychotherapy is an art. There is the science behind the schools of therapy, but the art pulls it all together with intuition, exploring boundaries, and sensitively bringing light, color, and words together to make it work with each individual client. On occasion, it does seem to be an artistic process to connect so perfectly with another human in an effort to aid in healing, explorations, and new possibilities. During these connections, the therapist also opens new pathways to improve skills and insight. 

In the past year, I was inspired in a lecture by a young artist in New Orleans who calls herself “Swoon”. Initially, there was a display of her spectacular sculpture symbolizing the city which hung suspended from the ceiling in the great hall of the New Orleans Museum of Art. She was talking about the connection between her art and the humanitarian work in Haiti after the earthquake. She concluded that each of us has some way to express our passion and to do something for the greater good.  

At the time, I was in transition in my professional career after being in a stable position for over twenty years. Exploring options in this economy has its limits, especially if you live in a rural area. As this young woman spoke so powerfully and passionately, I was inspired to express my art and contribution by setting up a private psychotherapy practice. Which brings me now to the question of art in psychotherapy. 

Having set up a social work practice a couple of times in my career, I have noticed things are very different this time around. I was under the impression that it would be 70% clinical work, 20% paper work, and 10% marketing to get the practice started. The enormous tangle of contracts with insurance companies, credentialing programs, employee assistance programs (EAPs), Medicare, health information networks, and regulatory issues feels overwhelming and takes up much time. I have many years of experience in healthcare administration, so this is not so new to me, but to be solely responsible for interpreting all of these contracts and regulations is both time-consuming and challenging. In this climate of healthcare changes, most physicians are choosing to work for hospitals over private practice, so how could setting up a practice be an inviting option? 

With each new endeavor there are challenges, and in the process we have the opportunity to learn more about ourselves. When you are a sole proprietor, all success and shortcomings point right back to you. It is always important to stay focused on your vision because the details can be undermining. 

Where is the art in psychotherapy? There have been colleagues debating and studying this topic for decades. We don’t have the freedom we once had if we adhere to the limits set by payors; however, we do have our unique style which is developed over a number of years and work with many clients. As stated by J. Bugental (1999): “Our fundamental assumptions have been that the most mature psychotherapists are more artists than technicians and that they bring to bear a wide variety of sensitivities and skills so their clients can release their latent potentials for fuller living” (p. 264). He then goes on to explain the seven “Characteristics of Art Forms” (p. 265) which are present in most art forms, and those include the following:

• Self as primary instrument
• Open-endedness
• Disciplined sensitivity
• Highly developed skills
• A product of some kind
• Self-determined standards
• Identification with the work

As the psychotherapist evolves, Bugental summarizes, “Mastery of the art of therapy is a continually evolving process rather than an end state, a matter of accepting—even welcoming—the constant challenge to move past where one is and to explore where one is becoming” (p. 266). In all forms of art there is a common skill set, then the artist builds upon that foundation to evolve to where they are today with questions and concepts that drive them to explore tomorrow. 

Some might think this is idealistic in today’s reality. It may be, but how can we be effective for our clients if we don’t identify with the art of psychotherapy and stay focused on the complexity and fascination of human behavior?  

The esteemed psychiatrist, Irvin Yalom, expresses in his video, “The Art of Psychotherapy” that the therapeutic process involves discovering and exploring with the client. He examines the different perceptions that the client and therapist have of each session in his book, Every Day Gets a Little Closer, which was written jointly by himself and a client. This openness and willingness to explore and grow as a therapist comes from a place of competence, humility, respect, and wonderment with the process and each individual with whom we work. 

The theoretical framework which provides a foundation for the concept of art in psychotherapy lies in the existential school. “An Existential perspective would focus on the idea of an empirically informed art. In other words, existential thought would not devalue the scientific knowledge, but neither would it elevate it too highly. Science and research is one way of knowing. There are still many other ways of knowing which exist. This includes phenomenological, spiritual, intuition and relational ways of knowing. While these are generally more abstract ways of knowing, they are equally as valid” (Hoffman, 2005).

When we approach psychotherapy as an art form, our cognitive framework is enhanced by our willingness to explore beyond the knowledge that is there now and expand possibilities as a partner with each client. Isn’t this the basis of social work practice? 

I will venture to say that psychotherapy is an art if one is willing to take the risk to become an artist using the “Seven Characteristics of Art Forms” as listed above and, in the process, be vulnerable enough to pursue and allow growth with each session.  

Arlene Tippy, MSW, has had a varied and interesting career, ranging from working with abused children, community mental health, school social work, private practice, several roles within a rural hospital, including Alzheimer’s Diagnosis Team, starting an EAP, developing and operating an affordable assisted living facility, being a faculty member of the Southern Illinois University Physician Assistant Program, and acting as program director of an adult inpatient psychiatric unit. She is currently developing a private practice Olney, IL, and may be contacted at tippylcsw@gmail.com.
 

REFERENCES

• Bugental, J. (1987). The art of the psychotherapist. New York: W.W. Norton & Company.  
• Yalom, Irvin. Art of Psychotherapy [Video file]. Retrieved from www.thinkingallowed.com/2iyalom.html
• Hoffman, L. (2005). Psychotherapy: An art or science? [Video file.] Retrieved from www.existential-therapy.com/existential_topics/art_or_science.htm

Access to health care should be a concern for all social workers. It affects them both personally and professionally. Regardless of your specialization, all clients need health care. Additionally, the National Association of Social Workers (NASW) has championed universal health care for over two decades, both at the national and state levels.

Paul Starr, professor of sociology and public affairs at Princeton University, has written a thoroughly readable book. Remedy and Reaction: The Peculiar American Struggle Over Health Care Reform covers the history of the American health care system. As an insider in the Clinton administration’s fight for universal health care, Starr makes no attempt to hide his bias as a supporter of health care reform. He is well qualified to cover the history of our country’s “peculiar,” as he puts it, struggle with health care. Paul Starr was a senior advisor to Clinton on health care policy. He is co-founder and editor of The American Prospect, and the 2011 winner of the Prose Award in Government and Politics given by the Association of American Publishers.

Starr divide’s his book into three parts. Part I: The Genealogy of Health Care Reform is a historical accounting of health insurance in America. This is an informative and easy read, covering America’s health care formation from 1915 to 1990. Part II: Frustrated Ambitions, Liberal and Conservative (1991–2006) is a thorough accounting of the failure of health care reform during the Clinton administration. This section also goes into the “Counterrevolution” under the Bush administration. It deals with Speaker Newt Gingrich’s failed ‘Contract with America’ and the threatened end of entitlements. Remedy and Reaction concludes with Part III: Rollercoaster (2006–2011), dealing with the lead up to and passage of the Patient Protection and Affordable Care Act, signed into law by President Obama on March 12, 2010. The role of the Tea Party is mentioned and Romney’s Massachusetts’s model is discussed.

With a declining economy, more and more citizens are falling between the cracks and struggling with health care costs. Obama pledged during his campaign for the presidency to do something about the health care crises if he was elected. The Affordable Care Act is a down payment on that pledge. The act provides the first major changes to the American health care system since the passage of Medicare in the 1960s. Major because the act attempts to provide all Americans with some level of affordable health care insurance, Starr offers a detailed accounting of the drama involved in passing the Affordable Care Act.

This extremely complicated act should be understood by all social workers. Our current health system leaves approximately 50 million Americans uninsured. Unlike other democratic countries which provide access to all citizens as a right or as a responsibility, America has for a century operated with a piecemeal system, covering entitled groups through governmental programs while most Americans gain health care access through their employer or purchase out-of-pocket insurance protection on their own in the free market. The Affordable Care Act is estimated to provide health care access to an additional 30 million Americans. However, the media and conservative naysayers have confused the details with both partial and misinformed coverage of the act, pieces of which go into effect in different years. Unfortunately, according to Starr, the Democrats may have hurt themselves by putting off implementation of some measures of the Affordable Care Act until future years. For example, among the health care changes that will not be fully in effect until 2020 is the closing of the Medicare prescription drug donut hole. Delay leaves the public in a position of not benefiting from many of the positive changes to our health care system until after the 2012 elections when a conservative majority, if elected, could overturn the act. As we've seen, the Supreme Court could also declare the Affordable Care Act unconstitutional.

A provision for an individual mandate is the flash point for conservatives who wish to repeal the act, although this was once a Republican recommendation. The later portions of Remedy and Reaction cover the Clinton and Obama administrations’ attempts to reform health care. These parts can be a laborious read, but the information is invaluable to social workers.

Starr, like all good academic writers, summarizes his thesis with a final chapter entitled, "The Peculiar Struggle." Unlike other democracies, America’s health care system is a series of pieces which never quite make a whole. Therefore gaps may always plague it as the era of political compromise seems to have slipped away, according to Paul Starr. Other peculiarities in the American health care system are due to the realities of American politics, the power of special interest groups, and the role of money in policy-making.

Sandra Mills, EdD, LCSW, is associate professor emeritus of social work at the University of Illinois at Springfield. During her fifteen years on the faculty, she taught macro practice, including social policy and community organization courses. She also served as department chair and field work director. Additionally, she managed and served as Legislative Affairs Consultant to the NASW Illinois chapter for seventeen years before retiring in 2007.

I will never forget the day I was subpoenaed to testify in a hearing regarding a call I made to the Illinois Department of Children and Family Services (DCFS). “Emily” came into my office and told me she had been sexually abused. I contacted the DCFS Child Abuse Hotline to make a report. DCFS responded by sending a worker out to investigate. I was well-trained in the DCFS procedures and confirmed the report in writing within forty-eight hours.

A year later, I received a subpoena to a court hearing. The subpoena stated that I must come to court to testify. If I did not testify in court, I would be subject to six months in prison and a $500 fine. Intimidated by the consequences of not testifying, I went to the hearing. I realized that despite my training, there were still things I did not know. I became curious about my rights as a mandated reporter and the laws that obligated me to testify in this court hearing.

Abused and Neglected Child Reporting Act

The Abused and Neglected Child Reporting Act (ANCRA) is perhaps the most important child protection and child welfare intervention in the state of Illinois. Through ANCRA, the state is granted authority to intervene in families in order to protect children. It requires mandated reporters to report suspicions of abuse and/or neglect to DCFS. It also obligates DCFS to protect the health and best interest children. In 2006, the list of mandated reporters was broadened and specified to include “school personnel (including administrators and both certified and non-certified school employees)” [325 ILCS 5/4].

First, a social worker or mandated reporter, as defined by the ANCRA, calls the DCFS Hotline intake number to report the details of the suspected abuse or neglect of a child to a DCFS Hotline intake worker. Next, the intake worker decides whether to take the call (agrees that a report should be made) or not. If the intake worker takes the call, they enter the report into the DCFS computer database system and send it to the DCFS field office. An investigator then attempts to contact the victim and their family within twenty-four hours. In emergency cases where the child is in immediate danger, an investigator begins immediately after the call is made.

I strongly suggest keeping progress notes on each report you make. In your progress notes, be sure to include details about what the student said about the time and place the incident took place. You can also note any marks you may have seen on the student’s body. Be sure to include only your observations, specifically what you heard and saw. It is important to differentiate between personal, reflective notes which may be more subjective than progress notes. However, keep in mind that personal notes can get subpoenaed as well.

Usually, DCFS child protective investigators will contact you to verify information and to obtain any additional information such as the student’s grades and their discipline record since the call was made. Any notes that you keep may also be helpful when talking to the child protective investigators or if you are ever subpoenaed to testify in a court hearing.

Notifying Parents

State law does not require that the mandated reporter notify parents of the report. There is some controversy about whether you should call parents to let them know that a DCFS call has been made on behalf of their child. The rationale for not calling is that “contacting the parents in advance may cause unnecessary anxiety leading to avoidant or hostile behavior. Telling the parents might give them time to cover up evidence of abuse or neglect and put pressure on the child to change the story or prevent further disclosures” (Mandated Reporting, 16).

In most situations where DCFS is involved, I call parents to explain to them the necessity to report on behalf of their child after a call to DCFS is made. In addition to making sure that students are physically, socially, and emotionally safe, my task as a school social worker is to effectively communicate with parents. At Perspectives, we make every effort to build positive relationships and communicate effectively with parents and families. In today’s society, it seems that schools, homes, and communities seem to be becoming more distant. This gap between the elements in some of our student’s ecological system call for the crucial role of the school social worker: to build and maintain relationships with not only children but their families and the community. In addition, school social workers should encourage teachers to build positive relationships with parents and families as well.

The Investigation

During a DCFS investigation, the DCFS child protective investigator gathers information about the specific allegation(s) of harm to the child. At the end of the investigation, the worker determines if the report is “indicated” or “unfounded” (Mandated Reported, 21). Most reports that school social workers or mandated reporters make to the DCFS hotline are unfounded due to lack of credible evidence. I have heard of cases where DCFS made a report because of numerous calls about the same person that lacked credible evidence. The high frequency of the alleged abuse warranted an investigation. Whether or not DCFS takes the call or not is beyond our control. It is our legal obligation, however, to call even if history has shown that many of our past calls appear to fall on death ears. Some of us may be able to cite incidences that we deemed alarming and DCFS did not take the call. Despite those incidences, it is in our best interest to call the DCFS hotline intake number when we suspect abuse because it is the law.

When the protective investigators find credible evidence of abuse or neglect, the case is “indicated.” This means that any “further inquiry or allegation involving either the victim or the perpetrator which comes into the Hotline will reference the indicated finding(s), unless the legally-established retention period for the indicated report has expired or the indicated finding has been overturned by an administrative hearing” (Mandated Reporting, 21).

The particular call that I mentioned earlier was indicated. It went to a DCFS hearing because the perpetrator appealed DCFS’s decision. When a perpetrator appeals the decision of DCFS, he or she has a right to a DCFS hearing before a judge. The purpose of this hearing is for the judge to listen to the testimonies of the child, the social worker or mandated reporter, and the DCFS protective investigator in order to determine whether the report should be amended or removed. The judge’s decision is usually made within forty-five days after the close of the hearing (See 325 ILCS 5/7.16 for details).

Testifying In Court

As I testified in court, I was interrupted by the judge who repeatedly told me that she was not interested in what I thought, how I felt, or my assumptions. She wanted to know what I observed. The sharp contrast between communicating in the clinical setting and in court became painfully apparent to me. In the clinical setting, I unconsciously use body language as cues to openly discuss emotions and feelings. Here, I was not being asked about emotions and feelings. The judge wanted observable evidence and facts. How could I prove that the student was embarrassed when she told me about being sexually abused? How could I prove that she was anxious when I could not cite any previous encounters of her showing anxiety? What evidence did I have to prove that the student’s body language communicated a feeling of defeat and fear?

I thought that there was going to be a huge sense of relief after I gave the testimony. There wasn’t. I was still bombarded with thoughts of the case and the situation at hand. I was concerned about whether or not my testimony helped justice prevail. I was concerned about my safety. Ultimately, I was concerned about Emily and how this hearing affected her and her family. After talking to one of the lawyers, I learned that this was not a criminal case. It was a civic case because it lacked credible evidence that sexual abuse had taken place. The perpetrator admitted to inappropriate sexual acts but not sexual abuse. Thus, if the perpetrator was found guilty, he would be required to attend counseling services to learn about sexually in appropriate behavior.

I have not learned about the judge’s ruling on this case. However, the case revealed gap in my own social work training. As I prepared for the court hearing, I consulted with colleagues and realized that no one I had talked to had been in this situation before. Some people offered general advice by telling me to be honest and that if I did not remember something to tell the truth. I decided to let my experience help someone else. In an attempt to help school social workers and other school personnel when they have been subpoenaed for court, I found this list of guidelines for testimony.

Guidelines for Testimony

• Expect to be nervous.
• Your records may be helpful. Bring originals (if you have them) and photocopies.
• Dress conservatively.
• Don’t try to memorize what to say.
• Speak slowly and clearly.
• Avoid tones or words that convey possessiveness toward the child or condemnation of the defendant.
• If any attorney asks you a question, answer ONLY the questions asked.
• Don’t guess. If you don’t know, say so.
• State only what you remember. If can’t remember details, you may be allowed to review your notes.
• If an attorney makes an objection to a questions being asked of you, do not answer – wait until the judge makes a ruling on the objection.
• If you don’t understand, ask to have the question repeated; don’t allow yourself to be rushed or intimidated.
• Be as descriptive as possible when testifying about the events or reactions of the child so that the judge has a clear picture of what occurred.

REFERENCES

• Abused and Neglected Child Reporting Act [325 ILCS 5/]. Retrieved from http://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1460&ChapterID=32
• Illinois Department of Children and Family Services. (2008). Manual for Mandated Reporters (Revised Edition.). Springfield, IL: Children’s Justice Task Force.
• Illinois Department of Children and Family Services. (2002). Guidelines for Testimony, Section 2: Page 8. Springfield, IL: Juvenile Court. Retrieved from
  http://www.state.il.us/dcfs/docs/fpChapter2.pdf

Chastity Rolling Owens, MA, serves as school social worker at Perspectives High School of Technology, a charter school in the Auburn Gresham neighborhood. A graduate of the Clinical School Social Work and Type 73 Certification program at The University of Chicago’s School of Social Service Administration, she has worked in the fields of mental health, HIV/AIDS counseling, and adolescent sexual behavior and health research, and has served in public high schools in Chicago prior to her current role at Perspectives. Her interests in school social work focus on clinical case management, developing community partnerships, and Response to Intervention (RTI).

CEU Opportunity for Reading This Article!
NASW Illinois members can earn one CEU by completing an online quiz (https://naswil.wufoo.com/forms/quiz-april-2012/) regarding this article! The free CEU opportunity is only valid until June 1, 2012, after which the CEU fee will change to $15.00. Nonmembers must pay the regular $10.00 rate for the CEU, which will increase to $15.00 after June 1, 2012.

In recognition of the 40th anniversary of the NASW Legal Defense Fund (LDF), this is the second in a series of three articles on the history of the NASW Legal Defense Fund (see, Morgan, S. and Polowy, C., 2012, for first article).   Unlike other forms of advocacy where the power of public opinion is paramount, litigation is a forum where the power of one individual or group can have tremendous influence on the course of future events or the development of public policy.  One social worker who challenges a discriminatory practice or who stands up to protect a client’s rights or vulnerable child and remains committed to pursuing the available legal remedies may become the vehicle for setting a legal precedent  affecting the rights of other social workers or clients who face similar situations.

For forty years, the Legal Defense Fund has provided NASW member social workers with financial and legal resources and peer support to move forward and make a strong case for their professional rights and ethical standards.  While litigation can be uncertain, time consuming and emotionally demanding, successful outcomes can change the course of history for one individual or a whole society. 

This article will review the financial assistance that LDF has authorized for legal expenses incurred by NASW members and chapters in their efforts to promote social work practice that meets appropriate ethical, legal and professional standards and protects the client groups served by social workers. 

 To read the rest of the article, click here. NOTE: NASW login required.

The timing of our arrival was perfect—with both the Illinois House and Senate in session, we had the opportunity to be an active part of the democratic process. The night before we arrived, HB 5290—a bill sponsored by Rep. Kelly Cassidy that required schools to implement anti-bullying measures—passed in the House and moved to the Senate for final vote. You could feel the buzz of activity throughout the Illinois Capitol Building. Advocacy Day attendees were able to sit in on active sessions, leave information with their legislators in support of the pending bills, and I even spoke with a few participants who were able to pull their rep off the floor to chat in person about the issues.

Unfortunately, one trip to Springfield a year is not enough to ensure that bills which strengthen social policy pass into law, nor can it protect against the drastic and persistent cuts to social service funding. Those in attendance at the Prairie Capital Convention Center heard from panelist about the five billion dollar budget deficit facing Illinois that continues to threaten the valuable services provided to children, families, and their communities. Faced with such a harsh reality, we must be motivated to do more, not sit contently with one day well done.

Advocacy Day is only a starting place for conversations about how policy impacts our individual practice of the profession. Whether you were able to attend or not, how can you move forward and make an impact? Will you begin to follow specific bills and call/write in to your legislators in their support? Or will you take advantage of this election year to work on the campaign of someone who cares about the issues? Will you be the next one to run for office? However advocacy takes shape in your life, build on to this momentum. Social workers are powerful, we vote, we volunteer, and we care about where is our state is headed. Last Thursday in Springfield our legislators knew it—what will YOU do to help them remember tomorrow?

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OFFICE FOR RENT - Naperville
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OFFICE FOR RENT - Chicago
Beautiful, professionally decorated 16th flr. Michigan Ave. office overlooks Millennium Park. Available weekdays, evenings, and Sat. Discounted parking available. Call Antoinette at 312 719-8498.

NASW ILLINIOS CHAPTER JOB BOARD
For a complete and up-to-date list of job board postings, visit the NASW Illinois Chapter Job Board: http://www.naswil.org/education-career-development/association-job-board/.   

• Care Navigator - Alzheimer’s Association - Greater Illinois Chapter
• Mental Health Care Advocate - OptumHealth
• Clinical Social Worker - Counseling & Wellness Innovations
• Associate Director of Quality and Advocacy - Aspire of Illinois
• Manager - Human Service Center/Fayette Companies
• Medical Social Consultant (Diagnostic Specialist in Developmental Disabilities) - UIC
• Out Patient Therapist - Herington Counseling and Learning Alternatives
• Outpatient Therapist - Carlsbad Mental Health Center

I couldn’t help but wonder as I listened to Governor Pat Quinn last week outline enormous human service cuts in his FY2013 budget speech what the impact would be on social work jobs and the vulnerable Illinois citizens we serve. Perhaps the governor should be made aware of this year’s Social Work Month theme: Social Work Matters.

This month’s March Networker is our Social Work Month edition (LINK). I hope you will read with interest the wide range of comments of why social work continues to matter in 2012 from several past presidents of the NASW Illinois Chapter as well as several of our recent emerging leader awardees.

You may also want to take advantage of expressing why social work matters to you. The following is a link to a sample letter you can send to media outlets in your communities about why what you do matters. Additional information around this year’s Social Work Month theme, “Social Work Matters,” can be found on the national NASW website (LINK).

We are coming off an incredibly busy February and going into one of the busiest months in the NASW Illinois social work calendar.

In late February, the chapter joined together with the Illinois Association of Deans and Directors and convened a jobs summit to initiate a discussion on the many challenges that the current economic downturn has had in our state and country, as well as its impact on the social work force and the future of social service delivery in the state of Illinois. A full summary of that meeting can be found at here (LINK).

Earlier in February, the chapter convened a private practice lunch focus group. NASW Illinois has been seeking a way to better respond to the needs of private practitioners. Participants responded to a set of questions about their practices, the NASW’s role in private practice, current use of resources, and the challenges ahead. The following is summary of these comments and some suggested next steps for this emerging group:

• Many participants are involved in networking groups that include a significant number of LCSWs, namely the Chicago Therapists listserv
• Feelings of isolation were noted as challenges for many practitioners—not having colleagues or a consultation group readily available to bounce ideas off and to seek support
• Frustration with social workers who don’t identify themselves as LCSWs
• Many of the participants were in private practice full-time and enjoyed the flexibility
• NASW needs to do more on issues related to reimbursement, e.g., Blue Cross Blue Shield of Illinois (BCBSIL)
• Positive contributions from NASW have included affordable liability insurance and expansion of licensure in most states
• The importance of letting people know the uniqueness of our clinical credentials as many people have little idea of what we (as social workers) do

A variety of suggestions regarding programming were suggested. They included the following:

• A private practice symposium
• Consultation groups
• Mentoring
• Training new practitioners just getting into private practice
• Trainings on the changing nature of health care in light of federal healthcare reform legislation
• A listserv for LCSWs

There was a consensus from the group to move forward to eventually establishing a type of support group or Shared Interest Group (SIG) within the NASW Illinois Chapter. The group felt it was important to initially survey all private practitioners in the membership in an online survey to be sent out in early march.

An interesting opportunity for promoting the social work profession presented itself to the chapter in late December. We were approached by WLS-AM radio in Chicago requesting language for public service announcements (PSA) that the station wanted to put together on a variety of issues regarding mental health and treatment issues. Together with the national NASW office (who helped prepare the language for the PSAs), the chapter has been working closely with the station to develop language for these PSAs. We just were informed that the station has been running five PSAs on anxiety, depression, eating disorders, relationships, and suicide during the 4:00pm time slot, five days a week, since January 16, 2012. The station secured sponsorship from Rogers Memorial Hospital in Wisconsin. The hospital purchased a thirteen-week run for the spot and our contact at WLS-AM was optimistic that they or another area hospital would purchase the ad spot after the initial thirteen weeks expired. This has been some great free publicity for NASW as well as the association’s Help Starts Here consumer website!

During March, Social Work Month celebrations will be taking place in the eight NASW Illinois Chapter districts. District social work awards will be presented at these events as well, which always provide a good reason to get out and network with colleagues. A full list of social work month events can be found on our website calendar (LINK).

SAVE THE DATE! Please reserve Monday evening on March 19, 2012, for the inagural NASW Illinois Chapter townhall meeting via teleconference.

Social Work Month activities will culminate with Social Work Advocacy Day scheduled for Thursday, March 29, 2012, in Springfield, IL. For updates, go to Advocacy Day tab on the chapter website (LINK).

Enjoy the month, and celebrate the fact the Social Work Matters!

Joel L. Rubin, MSW, CAE, has served as executive director of the 7,000 member Illinois Chapter of the National Association of Social Workers (NASW) since October 1999. He has over twenty-five years of nonprofit management and fundraising experience including extensive work with boards of directors, committees and volunteers, and advocacy around a wide variety of social work, human service, and international political issues. Joel is a graduate of the Wexner Heritage Fellowship Leadership Program and a current adjunct professor at the University of Illinois at Chicago Jane Addams College of Social Work as well as Loyola University Chicago School of Social Work.
 

As we look to celebrate this year’s 2012 Social Work Month theme of Social Work Matters, we spoke to NASW Illinois Chapter past presidents and some recent emerging leaders about why they believe social work still matters today. The following are their wise remarks on why the social work profession remains relevant today, and how the profession hopes to evolve in the future.

Joseph A. Walsh, PhD, LCSW, ACSW, Professor Emeritus and Former Dean, Loyola University Chicago School of Social Work
NASW Illinois Chapter Past President 1995–1997

“As I enter my forty-fifth year as a member of NASW, it is not hard to believe that social work still matters. All of these past decades for me have been involved in the practice of clinical social work, and many years have involved university teaching. One of my recommendations to new students each year is to join NASW. It is an organization which will both aid you in your area of practice and help you connect to the broader mission of our profession.

NASW helps remind its members of the wide array of roles in which social workers serve. It constantly beckons our attention to the needs in society and the numerous different ways that social workers can collaborate with others in responding to these needs. NASW sets high standards for the organization structure it uses, emphasizing the inclusivity and representation of all its diverse members.

I am extremely proud of the emphasis NASW places on ethical practice and applying this in all its educational programs. Respect for the individual and responding to the person in his/her biopsychosocial context are enduring principles that always make a meaningful difference in how our profession serves others.”

Andrew C. Teitelman, LCSW
NASW Illinois Chapter Past President 2001–2003

“The timing of my term as chapter president of NASW brought some unique experiences that have stayed with me. I was chapter president of NASW from 2001 to 2003. In 2001, we held a statewide conference from September 13 through September 15, 2001. More than 500 social workers were registered. Despite the horrific events of September 11, we made a decision to proceed with the conference, and almost all registrants attended. There were many poignant exchanges and stories shared at the conference that remain clear in my mind all these years later.

As social workers, we help people navigate toward achieving personal aspirations and advocate for better policies, regulations, and laws that shape the environment in which we all live. We understand how support and intervention—at the right time—can make a major difference to people grappling with a personal or systemic issue. I believe the 2001 conference was a timely intervention and source of support for us as professionals; it provided an opportunity to regroup around the necessity and importance of our work as social workers.

I am privileged to have the opportunity to serve as chapter president of our professional association. During my term, I also had the good fortune to meet many members living and working throughout the state and to see first-hand the great and dedicated work performed. Social workers should be justifiably proud of the help they give individuals and systems every day.”

Giesela Grumbach, LCSW
NASW Illinois Chapter Past President 2005–2007

"Social work is relevant perhaps now more than ever before. The profession, in my opinion, will always be relevant to society for it values the worth of all human life and believes in the dignity and right to self-determination of all citizens. Social workers are obliged to address issues of oppression and social justice in the world. We will always need dedicated practitioners who are committed to improving poor conditions and structural barriers for marginalized populations.

Social work provides important curiosity about the human condition and seeks ways to remediate societal ills in order to strengthen the world around us. In today’s tough economic times, social work remains relevant when growing disparities widen the gap among the classes. Social work matters because the profession has the collective power to make a difference.

When I was approached by one of my first mentors in the profession and asked if I would consider running for the office of president, I remember feeling a sense of panic. Next, I recall the voice of Barbara Bacon, one of my professor’s at Loyola University who had taught her students that if you wanted to make a difference, you had to be willing to take a seat at the table. Then I recalled my mother’s voice that also encouraged me to take on life’s tough challenges. However, I am aware that we need not be in the role of leadership to be change agents. We can all make a difference if we are willing to take a seat at the table—where decisions are made."

Marvin Johnson
NASW Illinois Chapter Past President 1987–1989

"My two years as chair of the NASW Illinois Chapter back in the early 1980s were very exciting and challenging. One of our main goals was to obtain Illinois licensing and then third party reimbursement. We hired a lobbyist, contacted numerous legislators, made trips to Springfield, convinced the psychologists to not oppose us, and stay neutral; and we got it done!

Now thirty years later, we are still going strong! Social workers in primary care settings have been impacted by the bad economy with some reductions in service and layoffs. This often occurs in settings where the need for social work services is high, and this is disappointing.

I think major changes have occurred in institutions where social work is in a secondary position. That would include hospitals, rehabilitation facilities, nursing homes, and more. Social workers in those settings are often able to only do direct services, such as patient discharge, with not much time to interact with patient or family. Others have been cross-trained and become care managers/coordinators, dealing with insurance companies and struggling to get continued days of care for patients. This function may also include utilization review.

All in all, I feel social workers continue to have a very strong role in providing services to persons in need and provide a strong voice for the poor, underprivileged, and those who often cannot speak or advocate for themselves.

I am now retired but am proud of my fifty-two years of service as a social worker."

Carol S. Goldbaum, MSW, PhD, LCSW
NASW Illinois Chapter Past President 1999–2001

I have been a professional social worker for forty-five years, yet I am still in awe at the range and depth of the issues in which our profession is engaged. We have truly mattered in the lives of individuals and influenced national and international policy. We have one of the broadest missions of any licensed profession. This has been both a blessing and a curse. We have such a broad array of client populations, of scope and type of practices, that we often don’t acknowledge each other’s or have a clear body of knowledge. Yet we clearly have opportunities for “enhancing human well-being and helping meet the basic needs of all people, especially the most vulnerable” (Preamble of the NASW Code of Ethics).

As child welfare has professionalized in some states to include more MSW and BSW staff, so has the quality of their work with clients and the reduction of harm. Our national office’s role in court rulings have influenced the civil rights and liberties of various populations and broadened the definition of privilege to include social workers. Some of our educators have helped establish or improve social work education and services in countries around the world.

One aspect that has not improved and needs political action is the funding of our services and the education of social workers. We need to strongly advocate for concern for all people and urge our various levels of government to pay less attention to the wealthiest and return to true democracy. I hope to see you join NASW for Advocacy Day 2012 on March 29, 2012, in Springfield, Illinois!

And for some words from our past Emerging Leader award recipients:

Amy Terpstra, MSW, Associate Director, Social IMPACT Research Center at Heartland Alliance
2011 Emerging Leader

"Our profession boasts an awe-inspiring legacy, replete with giants who faced unthinkable challenges yet had such vision and achieved such progress. Through this lens we can see the importance of settlement house workers starting kindergarten programs and offering job training programs in their immediate neighborhoods; but we also inherently understand the necessity of their working for broader social change by reforming city garbage pickup, advocating for child labor reform, and crusading for the right to vote, because how else would the people in the neighborhood stand a fighting chance?

Without the benefit of a century’s distance though, our view of contemporary social work tends to narrow. The connection between the lives of those we work with and what’s happening in the social and political arena seems more difficult to pinpoint. We tend to see ourselves as either trench workers or systems change agents, but often not both.

The fact of the matter is that that rarely—perhaps never—before have social workers needed to embrace and embody both approaches more. Poverty and hardship are at historic levels and are on the rise. And to the extent that social services have mitigated some of the worst effects of poverty, our work is being undone as systems of help are dismantled.

Social workers can bring a powerful voice to conversations on these issues, one that derives its legitimacy from on-the-ground experience. With the tools of a digital twenty-first century amplifying our message, social workers should be a collective force to be reckoned with. During this Social Work Month, let us recommit to our dual roles and begin to think of them as inextricable so that a hundred years from now, the social workers of the future will look back on our time as a source of inspiration and be awed by all we faced and all we were able to accomplish.

Mackenzi Huyser, Dean for Faculty Development and Academic Programs Department of Social Work, Trinity Christian College
2010 Emerging Leader

Our profession is rooted in advocacy and working for social justice for all, but especially those populations and people that are marginalized and vulnerable in our society. We are reminded of this need to work for social justice when we see how systems impact our practice. We hear the impact of discrimination in the criminal justice system and inequalities in our education system. We hear accounts of violence in our communities and abuses in the home. These things matter. And it matters that our profession is concerned with these things and works to create change in these systems.

Beyond this, social workers also matter. Each of us represents our profession as we work to uphold these standards. No matter what population we serve, we are all tasked with living out this call to advocate and work for social justice. We do this day in and day out with individual clients, and when we bring voice to client groups at legislative hearings. We ask the hard questions about the challenges we see clients face and what our society needs to change. We do this with limited budgets and amidst turbulent economic times.

I am proud of the impact social workers make in families and our communities. I am proud of the lives we touch and the systems we change. I hope we all are proud to celebrate our work and the work of our profession this month—our profession matters and social workers matter.

Chasity Wells-Armstrong, MSW, CADC, Consultant
2010 Emerging Leader

Through the many roles of social work professionals, we have the ability to influence every area of life. Our work is even more relevant today as it was almost a century ago when the country was faced with civil rights, work force, cultural, human rights, and political issues. Although we have witnessed progress on many levels, the recent election of the first African American to serve as president has fueled racism and a political divide that threatens the progress of our country. If we do not pull together and focus on our core values to advance the quality of life for all people, the hard work and sacrifices of our social work pioneers will have been in vain.

As an emerging leader in this field, I am compelled to urge our members to get involved and do their part. Doing one's part can entail a range of actions from writing letters to the editor regarding social work issues, to serving on advisory boards, to pursuing elections to political offices. As we close upon another month of black history acknowledgements and celebrations, I am reminded of a quote by the late Dr. Martin Luther King, Jr.: “The ultimate test of a man is not where he stands in moments of comfort and moments of convenience, but where he stands in moments of challenge and moments of controversy." Social workers, it is time to stand.
 

CALUMET DISTRICT

Public Citizen of the Year: James Rowe
Jim Rowe is attorney with The Law Firm of Rowe & Associates and a candidate for Kankakee County State’s Attorney. His practice is devoted to fighting for those who have no voice in the justice system: victims and children. As a former assistant state’s attorney, Rowe prosecuted cases involving child abuse and neglect, ensuring that children were reunited with their family whenever possible, but always safe. In addition to working as an attorney, Rowe sits on the board of numerous child welfare agencies, advises local charities in Kankakee County, and hosts free monthly legal clinics for the Kankakee community.

Social Worker of the Year: Lynn Bos

Lifetime Achievement Award: Billie Terrell, PhD, MSW
Billie Terrell (PhD, Institute for Clinical Social Work; MSW, University of Illinois at Chicago) is chair/director of the MSW program and past director of the BSW program at University of St. Francis. She has been an active member of NASW for thirty-five years where she was elected twice as regional district chair, served on the Mental Health Task Force, and published articles for the association Networker magazine. She also has published and presented numerous articles on behavioral health from a multicultural perspective. Nationally, she was elected to the Council of Social Work Education (CSWE) National Nominating Committee and represented CSWE on the National Veterans Task Force and Council on Racial, Ethnic, and Cultural Diversity.

CHICAGO DISTRICT

Public Citizen of the Year: Miriam Weinberger
Miriam Weinberger (MSA, Roosevelt University; MA, Northwestern University) is executive director of The ARK, a social service agency serving low-income individuals and families from throughout the Chicagoland Jewish community. The ARK relies on a small staff and over 2,000 professional and lay volunteers to provide a comprehensive array of free social, medical, and legal services. Miriam has been with The ARK since 1991 and has successfully led The ARK through continual growth and development, resulting in better service to clients, advancement of the professionalism of The ARK’s staff and operations, increased revenue, responsible fiscal management, and an enhancement of The ARK’s reputation in the community. She plans to retire in June 2012.

JANE ADDAMS DISTRICT

Public Citizen of the Year: Richard Kunnert

Social Worker of the Year: Lynn Cadmus, AM
Lynn Cadmus (AM, University of Chicago) has worked as therapist at Family Counseling Services in Rockford for nearly twenty-three years. Subsequently, she accepted a position at Janet Wattles Center (JWC) as therapist, and sixteen months accepted her current position as Trauma Therapist with the Therapeutic Intervention Program (TIP). TIP Court is Winnebago County’s mental health court, and Rosecrance Ware Center (formerly JWC) staffs the mental health part of the team.

Lifetime Achievement Award: Warren Heinke
Warren Heinke (MSSW; University of Wisconsin-Madison; LCSW, ACSW) assumed his first position in 1970 as a social worker and, later, supervisor with a Wisconsin direct services agency doing foster care, treatment foster care, and adoptions.  He became Regional Director of the Northern Region of Children's Home + Aid (Rockford, IL) in July 1982.  Program development was his special niche, and he expanded the region from a staff of 5 to 94 until his retirement in October 2009 as Regional VP.  He traveled with International Activities Network exchanges to Birmingham, England, and Hamburg, Germany, and People-to-People NASW trip to Soviet Union. He has been a member of NASW since 1971.

NORTHEASTERN DISTRICT

Public Citizen of the Year: Anthony Kopera
Anthony Kopera (PhD, Loyola University) has served as Chief Executive of the Community Counseling Centers of Chicago (C4) since 1980. Prior to C4, he was associate professor of psychology at Northeastern Illinois University. Anthony has served on a variety of task forces since 1980, working on special focus groups in the areas of community mental health, children’s services, family services for the office of the governor, and policy and advocacy groups.

Social Worker of the Year: Cheri Sinnott, LCSW
Cheri Sinnott (MSW, Washington University; LCSW) is director of the Illinois Service Resource Center, a statewide technical assistance center of the Illinois State Board of Education, serving the behavioral needs of students who are deaf and hard of hearing in Illinois. She is adjunct faculty instructor at College of Lake County and maintains a private therapy practice. From 2007 to 2011, Cheri also served on the board of directors as the Northeastern District Chair for the National Association of Social Workers Illinois Chapter.

Lifetime Achievement Award: Margaret Powers
Margaret Powers (MSW, Loyola University Chicago; MA, University of Connecticut; LCSW) has been a private practice divorce and family mediator for more than twenty-five years. An established clinical social worker, Margaret maintains her practice in downtown Arlington Heights, IL. She is a founding member of several local and national mediation and conflict resolution organizations, and has taught mediation internationally. Margaret is adjunct faculty at Northwestern University and the Chicago School of Professional Psychology where she teaches mediation. 

SOUTHERN DISTRICT

Public Citizen of the Year: Stanley Schlarman

Social Worker of the Year: Andrea Shaw
Andrea Shaw (MSW, State University of New York at Buffalo; LCSW) has experience as a clinical manager, therapist, and as a workplace employee assistance professional (EAP) provider. Her roles have included program development, psychotherapy, and administration of mental health and addictions services to adults and adolescents in a variety of settings. Her work with individuals who have attempted suicide and the family members of those who have lost a loved one due to suicide or a drug overdose prompted her to establish Prairie State Prevention Education, Inc., a nonprofit community education agency. Through use of volunteers and community members, Andrea hopes to educate individuals about the supports and resources available to prevent the negative consequences of suicide, addiction, or other behaviors that directly impact the individuals, families, and communities.

WEST CENTRAL DISTRICT

Public Citizen of the Year: David Leitch
Representative David R. Leitch (R-Peoria) is serving his eleventh term in the Illinois General Assembly. He has received numerous awards for his community service, responsiveness to his constituents, and his legislative service. When the local (Peoria) state hospital was closing in 2002, Rep. Leitch organized a meeting of mental health providers to plan for community-based treatment and ensure community agencies and hospitals were adequately funded to deliver treatment in the community.

Social Worker of the Year: Joseph Croegaert, MSW, LCSW
Joseph Croegaert (MSW, University of Illinois at Urbana-Champaign; LCSW) has worked thirty-seven years in the social work field. He has worked for the last seven years as a counselor with Chapin & Russell Associates, a private counseling practice in Peoria. Joe has also worked with the Illinois Department of Human Services Division of Mental Health for the last ten years, most recently as an Evidence-Based Supported Employment Trainer and Coordinator and Contract Manager, assisting community mental health centers in central Illinois. Prior to this, Joe worked for twenty-two years in the child welfare field, in the private sector.

Lifetime Achievement Award: Sandra Mills
Sandra J. Mills (EdD, Northern Illinois University; MSW, University of Illinois at Urbana-Champaign; LCSW) joined Sangamon State University (now University of Illinois at Springfield [UIS]) as a visiting professor in 1994 and achieved tenure in 2001. She taught both graduate and undergraduate levels in the Child, Family, and Community Services Program. Sandy retired as director of social work field education and associate professor of social work at UIS, where she taught courses in policy, advocacy, and community organizing. She has worked in direct practice work in Peoria for over sixteen years. Sandy was also the legislative affairs consultant for the National Association of Social Workers Illinois Chapter (NASW IL) for seventeen years until her retirement in December of 2007. 

THREE RIVERS DISTRICT

Social Worker of the Year: Sara Klaas
Sara Klaas (MSW, University of Illinois at Chicago) is director of the Spinal Cord Injury (SCI) Service at Shriners Hospital for Children, Chicago, and has worked at Shriners Hospital for over 22 years. Sara speaks nationally on pediatric SCI and is well published in the field. Sara co-founded a sports and conditioning camp and a scuba adventure travel program for adolescents with SCI as well as a self-esteem and body-image camp for adolescent girls and a wheelchair body-building camp for adolescent boys. She serves on the board of the Spinal Cord Injury Association of Illinois, the Illinois Governor’s Council for Brain and Spinal Cord Injury, the medical and scientific advisory board for the National Spinal Cord Injury Association, and is the chair of the prevention committee for the American Spinal Injury Association.

Lifetime Achievement Award: Daniel Kill, MSW, LCSW
Daniel Kill (MSW, Loyola University; LCSW) is currently semi-retired and has a private clinical and consulting practice in Oak Park, IL. Dan was the president/CEO at Thrive Counseling Center located in Oak Park from 1996 thru July 2011. Throughout his social work career, Dan has lived out his personal belief of giving back to the community. Dan has served as treasurer of the NASW Illinois Chapter Board of Directors and represented NASW Illinois Chapter members at two national NASW Delegate Assemblies.

EAST CENTRAL DISTRICT

Public Citizen of the Year: Jeffrey B. Ford, JD
Jeffrey B. Ford (JD, University of Illinois at Urbana-Champaign) was sworn in as judge on July 1, 1985, after eight-and-a-half years in the state’s attorney’s office and in private practice. In 1994, he was awarded the State of Illinois Outstanding Support Person by MADD. In 2010, the Illinois Traffic Safety Leaders presented Judge Ford with the Joanne Blair Award for exemplary leadership in the area of traffic safety in Illinois. The Department of Psychology at the University of Illinois recognized him as a Distinguished Alumni at its graduation in May 2011.

Social Worker of the Year: Sandra Kopels, JD, MSW
Sandra Kopels (JD, MSW, University of Illinois at Urbana-Champaign) is professor at the School of Social Work at the University of Illinois at Urbana-Champaign (UIUC) and also a licensed attorney. Prior to joining the UIUC faculty, she was director of the Legal Advocacy Service of the State of Illinois Guardianship and Advocacy Commission. Presently, Sandra serves as managing editor of School Social Work Journal and is a reviewer for numerous social work journals. She is a member of NASW and has served as a member of the State of Illinois Child Welfare Employee Licensure Board. Sandra has served as a trustee, vice-chair, and chair of the NASW Legal Defense Fund. She is coauthor of Social Work Records with Jill Doner Kagle.

Lifetime Achievement Award: Kathryn Conley Wehrmann, PhD, LSW
Kathryn Conley Wehrmann (PhD, University of Illinois at Urbana-Champaign; LSW), is associate professor at the Illinois State University School of Social Work where she teaches research and evaluation and serves as a field liaison for MSW students. Her professional experience includes a background in public child welfare. She has worked extensively with Romanian officials on child welfare reform efforts and has also been awarded Fulbright Senior Scholarships for research and teaching in Romania. She is a past president of The Crisis Nursery of Champaign and currently serves on the board of The Baby Fold in Normal, IL. She has also served as past-president of the NASW Illinois Chapter.

Over the last several years there has been an increase in the number of social workers leaving agency practice for the independence and flexibility of private practice. Social workers who wish to make this transition must navigate the many pitfalls of establishing an independent practice and business. One such pitfall that must be considered is developing effective risk management strategies. Successfully managing risk in a clinical practice can be the difference between a profitable and satisfying business enterprise and a nightmare of legal and ethical entanglements. Anyone engaged in private practice must consider the following “Ten Commandments”:

Thou Shall…

I.  Accept clients for whom you have expertise
Typically, social workers are trained and licensed (LCSW) to independently conduct assessments, develop treatment plans, evaluate their efforts, and deliver a variety of interventions designed to improve the psychosocial functioning of individuals, families, and groups. Section 1.04 of the NASW Code of Ethics (2008) requires that, 

“(a) Social workers should provide services and represent themselves as competent only within the boundaries of their education, training, license, certification, consultation received, supervised experience, or other relevant professional experience. (b) Social workers should provide services in substantive areas or use intervention techniques or approaches that are new to them only after engaging in appropriate study, training, consultation, and supervision from people who are competent in those interventions or techniques.”

II. Obtain consent
Obtaining consent is more than just the client showing up to your office. All consent for services or treatment should be “informed.” Informed consent is the process by which a fully informed client can participate in choices about the type, nature, and duration of services being provided (Reamer, 2000). Research clearly shows a correlation between the client’s active involvement in their treatment and positive therapy outcomes. Obtaining informed consent is the first step in soliciting a client’s active involvement. Best practices suggest that informed consent must first be in writing in the primary language of the client, be voluntarily, disclose any potential risks and benefits of the treatment, and that the client must be competent to give consent.

III. Know who is your client
Determining who your client is can be one of the most important elements of managing risk. What seems on the surface to be pretty clear is not always so. Failing to clearly identify who is your actual client can potentially have you in deep and rough waters. Knowing who your client is can be particularly tricky when working with children and adolescents. The child or adolescent may be the one in the room, but the parents are often the ones paying the bills. Court-ordered or mandated clients can also be difficult. Determining who your master is has implications for your compliance with provisions of both federal and state laws and regulations regarding privacy and confidentiality. At minimum, social workers should have on hand and be familiar with the Mental Health and Developmental Disabilities Code, Illinois Mental Health and Developmental Disabilities Confidentiality Act, and the Health Insurance Portability and Accountability Act (HIPAA). Additionally, many social workers are turning to electronic records; HIPAA and its newer provisions require additional protections including data encryption software and other methods to protect clients from the unauthorized access to client files (NASW, 2011).

IV. Maintain documentation
Effective clinical documentation that clearly demonstrates your assessment of the client’s strengths and weaknesses leading to a medically necessary and diagnosable disorder (for insurance reimbursement), a treatment plan that directly and actively addresses the issues described in your assessment, and regular progress notes that reflect the problem areas identified in the treatment plan, your attempts to address the problems, and the client’s response to your intervention. This coherent flow of clinical documentation provides for the protection of the social worker and is consistent with most models of therapeutic intervention. The old adage that “unless it is written in the record it didn’t happen” is still alive and well. Most third-party payers including Medicare require this minimum level of documentation.

V. Have transparent billing practices
Social workers must be very clear about their fees and billing procedures. It may be helpful to have clients sign-off that they have received and understand your policies and practices. Frequent review of client accounts will not only help with your cash flow but insure that high unpaid balances do not get out of hand. Any non-payment for services should be addressed in the treatment room as a part of the therapeutic process. If you take third-party payments, your contract often requires that you collect co-pays. It is considered best practices to collect cash fees and co-pays at the time services, as well as verifying the client’s mental health benefits, and obtain any needed pre-authorization approvals before starting treatment (NASW 2011).

VI. Make use of consultation
No one person can possibly know all of the treatment strategies for every client situation. Consultation provides a great opportunity to enhance our clinical skills and ensure that we maintain the appropriate professional boundaries. This is critically important for social workers who are in solo practices.

VII. Have emergency protocols
Unless you have a practice that specializes in working with high-risk clients, you are not required to be available 24/7/365, but you must make it clear to your clients what they can expect if they have a crisis (NASW, 2002). An answering service that tells your clients to go to the nearest emergency room is certainly acceptable. The bottom line is to make sure you and your clients are on the same page on what to do when there is a crisis.

VIII. Have access to legal consultation
Having access to a knowledgeable attorney is worth their weight in gold. Having someone to consult with when legal or ethical issues arise is a great comfort and insures a peaceful night’s sleep. Legal consultation can often prevent issues from becoming bigger problems.

IX. Maintain appropriate malpractice insurance coverage
According NASW, social workers have been sued because of alleged failure to prevent harm to a client or others, failure to warn another party, or failure report physical harm to a client (child/elder abuse) (NASW, 2011). Having adequate malpractice insurance provides legal consultation and defense when a complaint has been made. It is important to make sure that you keep the policy enforced whether you are actively practicing or not (NASW, 2011). Claims can be made years later.

X. Be an active member of NASW
NASW is the largest professional association for social workers. NASW provides a variety of practice resources including sample forms, practice updates, malpractice insurance, risk management services and trainings, and a variety of advocacy activities that enhances the overall public visibility of the profession.

Social workers who work in private practice will always have to find ways to contend with the risk associated with clinical practice; however, adhering to these “Ten Commandments” will help in managing the ever present risk of clinical social work practice.

REFERENCES

• National Association of Social Workers. (2008). Code of ethics. Washington, DC: Author.
• Practice Update NASW (Ed.). (2002, April). Minimizing Practice Risks with Suicidal Patients, 2(4).
• Reamer, F. G. (2000, July). The social work ethics audit: A risk-management strategy. Social Work, 45 (4), 355–366.
• Risk management in clinical practice. (2011, October). Washington, DC: NASW.

Reginald C. Richardson, PhD, ACSW, LCSW, is Vice President for Evaluation and Clinical Services at The Family Institute at Northwestern University. He is a clinical lecturer in psychology in the Center for Applied Psychological and Family Studies at Northwestern University and a frequent speaker and trainer in the area of child and family issues. His research has focused on understanding behavioral problems in children of color, parenting practices in kinship foster care, and evaluation of social service programs. He maintains a clinical practice that specializes in individual, couple, family therapy, and outreach to persons of color in under-resourced communities.
 

Advocating For the Needs of Families
When first meeting with a parent or guardian of a student, I make it a point to tell them about what specific services school social workers provide. I communicate that while I am a school district employee, I am also an advocate for children and families. Defining advocacy to parents paints a clear picture of the role a social worker within a school district. I encourage parents to ask questions or discuss concerns. I let them know that a school social worker can help with finding resources and information. Many specialized courses are required of administrators, teachers, social workers, and other school personnel in order to do our jobs. Knowing this, how can we expect parents to make informed decisions about their child’s education without helping guide them through the myriad of procedures in place that are already  part of the school personnel’s everyday language?

Advocating for the needs of children and families does not only have to involve direct communication on an individual basis. Seminars given by school social workers are an effective way to provide information while bringing together parents and family members who may share concerns or questions. Topics can be decided upon ahead of time, or by means of a needs assessment. Another way to provide information is to maintain a webpage on a school district website. There are abundant resources on the internet that parents can access for their specific concerns. Providing a list of links on a website adds another access point of information for parents.  School social workers must work with parents and empower them to participate in the education of their children.  Educating and advocating for children and families not only opens the line of communication between the community and the school, but helps build resiliency in the lives of children and families.

Working With the School District
As school district employees, we work within the procedures and guidelines set forth from the district level to the federal level. At the same time, we are in the unique position of building bridges between the school and community. This can lead to some dilemmas or conflict if we are viewed as being secretive or holding out on information.  I have found that if I can cultivate understanding of the social worker’s unique role within the system, I stand a better chance of gaining the trust of administrators and other school personnel.  School social workers need to educate administrators, teachers, and other school personnel about situations where help is provided to families who need to know what options or resources are available. I explain that my position is not to take sides with a family, but to be a resource so that parents can have a voice in the education of their children. Conflict often happens when there is a lack of communication or understanding. By clearly defining my role to the district, I have found that administrators and other staff understand when I have to walk this fine line.

Concerning Special Education
I am currently in the middle of my third year as a school social worker, and I have already been in what feels like hundreds of special education meetings. I know the paperwork so well I can almost recite full pages. But what I always keep in mind is that for some parents and families, this is the first time they are hearing words like “disability”.  In my school district, I am responsible for providing parents with a copy and explanation of their Procedural Safeguards, or parental rights, for special education. The information provided in the Procedural Safeguards is how parents will know what to expect of the school during evaluations and service delivery. It also outlines disciplinary procedures. If the parents disagree with the decision made by the Individualized Education Plan team, the Procedural Safeguards provide the steps to make this known to the school, and if it leads to it, mediation and due process hearings. When parents disagree with an educational decision made by the school, they may ask for help and guidance in navigating the highly confusing system. This is another area where I feel that school social workers hold unique positions compared to anyone else in the school setting. I let parents know that I can meet with them prior to a meeting, walk them through examples of agendas or paperwork, and then help them communicate their needs to the other participants.

Connecting with Others
Another way that I have found guidance and help in some tough situations is through becoming a member of a professional organization, such as the National Association of Social Work or the Illinois Association of School Social Workers. Through these organizations, I have been able to network and hear from others who may have been in similar situations. By utilizing these resources, I feel that this has enhanced my level of comfort in different situations that I have encountered. While we can’t always discuss specific issues within our school due to confidentiality, there can be a general dialogue about how to successfully manage the fine balance of our roles as advocates.

Walk the Line
As we strive to find the balance in our jobs, there is one thing for certain we can keep in mind. Our own NASW Code of Ethics tells us that we “strive to ensure access to needed information, services, and resources; equality of opportunity; and meaningful participation in decision making for all people” (National Association of Social Workers, 2008).  In doing so, school social workers join in a larger effort to help those who may not always have a voice.

REFERENCES
National Association of Social Workers. (2008). Ethical Principals to the code of ethics. Retrieved February 16, 2012, from http://www.socialworkers.org/pubs/Code/code.asp.

Lindsey Trout, MSW, LSW, is a 2009 graduate from the University of Illinois at Urbana-Champaign School of Social Work. She currently serves on the board of the Illinois Association of School Social Workers. She is a member of the National Association of Social Workers and the American Counsel for School Social Work. Lindsey is currently employed at Villa Grove CUSD #302 as the district-wide school social worker.

Graham Dozer’s My Girls: A Story of Survival and Togetherness in the Inner City gives voice to the lived experience of six inner-city, African American teenage girls who are referred to a counseling group co-facilitated by Dozer, a white graduate student. The book reads as a novel where we come to know each of the six girls as they navigate their way through life in community “X”. In the story Dozer refers to himself in the third person through a character named Shawn; this adds a refreshing dimension to the book as the reader is allowed to experience the growth and development of a compassionate emerging professional. He refers to himself in first person when he is in the clinical role and making assessments.

Dozer’s qualitative, ethnographic style enables the reader to gain insight into the girls’ inter-subjective exchanges which shape their world view. From this vantage point, we are able to understand how the girls’ behavior serves a function and, in many instances, a source of survival. When we view human behavior through this lens, we are less likely to stereotype and dehumanize what we may not fully understand. Most importantly, it enables the practitioner to learn from his or her own inter-subjective experience. It is this perspective that allows Shawn and the reader to connect with the girls in a most human way.

Through the eyes of each of the girls, we see how they make meaning of the messages they are given about what it means to be a female and what gives one status and control as a female in community X. We see the young girls honing and developing these skills of survival. We also see that what gives females status and control can also make them vulnerable and place them in dangerous situations. One of the most abused characters in the book has had enough of her mother’s physical and emotional abuse and has to get out of the house. She decides to take up with an older man in order to escape. She eventually returns home, but we see what this experience has done to her self-esteem. We see that “playing the game” is entrenched in the culture of community X. At times the girls are competitors in this game, and at other times they support one another in the game. At one point in the book, one of the characters is being preyed upon by a young man hanging out on the corner with his friends. Her girlfriend comes to her defense and tells the pursuer to “[G]et the f--- out of here.” The pursuer says, “[D]on’t hate the player hate the game.” The game played in community X is raw. However, a variation of the game is played in many communities, regardless of race and socioeconomic status; rules and script may differ and the game may be played with less intensity and is less dangerous in communities where teenage youth have resources, perceived opportunity, options, and hope for what they may become.

During week 21, about two-thirds of the way through the book, Shawn’s mother is giving him a ride to his internship.Up until this point Shawn had wondered whether or not he was reaching the girls; their problems appeared to be complex and insurmountable. His mother states, “It’s really good they have someone to talk to. They have you.” He comes to realize that giving the girls the space to be heard and validated was important to them. He states, “I would have killed to have someone to talk to when I was their age.” He doesn’t know where this comment comes from and immediately wishes he could retract the statement. The penetrating silence between Shawn and his mother comes through to the reader. Further along in the book, Shawn and his mother revisit this conversation. It is apparent Shawn has been processing his earlier comment to his mother. He comes to realize that his family’s difficulty in communicating with each other is generational. He says (paraphrasing) to his mother: “You need to work things out with grandmother, you should talk to her.” By sharing this personal reflection, Shawn “humanizes” the practitioner.

While Dozer does not name reflective practice as a framework that guides his work with the girls, he models the tenets of reflective practice through the character of Shawn. We see that Shawn is constantly reevaluating his world view, values, and beliefs as he interacts with community X and the girls. He questions the traditional therapeutic models that create clear boundaries (interpersonal and intrapersonal) between client and counselor. Shawn comes to learn, through improvisation, that it will be important for him to become engaged in the community if he is to develop a trusting relationship with the girls in his group and other members of community X.

In the beginning chapters, Dozer is explicit about his use of attachment and trauma theories to interpret the girls’ pattern of relating to self and others. While he acknowledges he is in no position to make an expert clinical diagnosis, he believes the girls’ behaviors are symptomatic of individuals who are experiencing Post Traumatic Stress Syndrome (PTSD). He notes the girls were always poised and ready to react to any perceived threat; they were often detached from their own emotions and the emotions of others. We see through the individual narratives that the girls have issues of trust—trust in themselves, the male figures in their lives, and trust in the adults responsible for their care. When we view this behavior through the lens of trauma, we understand this behavior serves a functional purpose in a hostile environment. We see the girls realizing that the group is a safe place and becoming more comfortable in the group. They gain insight to their behavior and to the emotions they are feeling. Most importantly, they learn their feelings are justified.

At the end of the semester on the last day, the girls come to meet Shawn for the group session. He does not have to go and collect a group of indifferent girls as he normally did. They admit that this show of apathy was their way of saving face with their classroom peers and perhaps also another way of protecting their feelings. After all, they had to keep the game face. They let Shawn know that amongst themselves they talked about how they looked forward to coming to group. The reader sees that growth is relative. Shawn has made a small difference in the lives of these young girls. For youth who have been traumatized, finding one’s voice and gaining insight to feelings and emotions is an important first step towards movement in their arrested development.

My Girls: A Story of Survival and Togetherness in the Inner City is a perfect complimentary text for graduate students in a human behavior or practice class. The seasoned practitioner working with urban youth of color will also find the book to be a useful guide. The qualitative style of the book facilitates transformative learning that moves beyond the mere intellectual absorption of knowledge to include the integration of thinking, feeling, and sensing. When we combine feeling along with the intellect, knowledge takes on a different level of meaning.

Have a question on ethics you’d like addressed in the Ethics Corner? Submit your question today to office@naswil.org. All questions will be anonymous.

Kathy is in her first job out of graduate school. She works at a community social service agency on the west side of Chicago. Here is her story.

I am sitting in a training on alcoholism and other addictions. I am fascinated and terrified at the same time. They define addiction: “physiological and psychological dependence on a behavior or substance.” They go on to describe two types of addiction, “behavioral addictions (for example, sex, gambling, spending, obsessive internet use) and consumptive addictions (for example, alcohol, drugs, food).” (Barker, 2003). I know they are describing me.

My rationalizations and denial have been quite creative. I only drink at night, so I tell myself it does not affect my work. I have an apartment, a graduate degree, a job. I rarely go to bars. Even more insidious and minimized has been my eating disorder. I have overeaten, binged, starved, and been bulimic. I have not missed a single aspect of this vicious addiction.

The light of awareness pours over me uninvited. But my powers of denial are not ready to give in. A seed has been planted, I am not the same, but acceptance and recovery are still many years away.

I have always been the helper, hero, support. Much of my self-esteem has come from this role. I learned early on I needed to take care of myself. There is shame and fear in acknowledging my need for help. Honesty has always been an important value. I have seen myself as an honest person. Yet in my addictions I have lied to myself, my friends, my family, and my therapist. I have wasted time and money. It takes the threat of illness and death to inspire my courage; to get honest and seek help.

Addictions are indeed, “cunning, baffling and powerful”. There is more widespread acceptance of the concept of addiction to a substance, particularly alcohol and drugs. Bulimia and anorexia are understood as being eating disorders. The literature focuses less on the equally damaging impact of compulsive overeating or binge eating. Process or behavioral addictions can be even easier to rationalize and deny. These include addictions to sex or sex and love, internet porn, internet surfing, shopping, gambling, or even workaholism. Society, job demands (including fear of job loss), and personal values often conspire to facilitate and reward work taking over in a manner that puts a social worker’s health and well-being at risk.

Section 5.01a (Integrity of the Profession) tells us that “social workers should work toward the  maintenance and promotion of high standards of practice.” The Preamble to the NASW Code of Ethics explains that the foundation essential to “high standards of practice” is an ability to practice ethically. “Social workers' ethical behavior should result from their personal commitment to engage in ethical practice. The NASW Code of Ethics reflects the commitment of all social workers to uphold the profession's values and to act ethically. Principles and standards must be applied by individuals of good character who discern moral questions and, in good faith, seek to make reliable ethical judgments.” (NASW Code of Ethics)

Making “reliable ethical judgments” involves awareness, insight, patience, and self-honesty. Successfully identifying and resolving ethical dilemmas requires a capacity for managing stressful situations and effective critical thinking skills. All of these abilities are impaired by active addiction. Challenging denial and seeking out appropriate help is itself an example of the willingness to “discern moral questions.” Kathy is well-meaning and hard-working. She is managing issues in her personal and professional life through the use of substances. Her focus, ability to concentrate, thinking process, and responses to clients are all affected.

Section 4.05 (Impairment) reads as follows:

(a) Social workers should not allow their own personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties to interfere with their professional judgment and performance or to jeopardize the best interests of people for whom they have a professional responsibility

(b) Social workers whose personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties interfere with their professional judgment and performance should immediately seek consultation and take appropriate remedial action by seeking professional help, making adjustments in workload, terminating practice, or taking any other steps necessary to protect clients and others.

The ethical obligation is to an ongoing, honest assessment of how issues in our personal life may be impacting our professional functioning. As a supervisor, I had to fire a social worker I had worked with for three years. He was bilingual, hard working, connected well with clients, and was open to learning. He started coming in late. I then learned he had stolen a check from the agency, forged a signature, and used the money to buy drugs. It was heart-breaking to lose him. What about less overt impacts? How does my addiction impact my beliefs, values, and interactions with clients dealing with similar issues? Am I overtired? How are my focus, concentration, memory, and energy levels affected? What about decisions around boundaries? Another social worker was getting prescription drugs through a client.

Here are some helpful self-assessment questions:

1. What is causing stress (anxiety, exhaustion, etc.) in my life?
2. How do I manage stress?
3. What do I do when I am angry, tired, anxious, or sad?
4. Do I have activities that are secret or that I am ashamed to reveal?
5. What is my support system?
6. What do I do to relax or for enjoyment?
7. What negative physical, emotional, or financial impact has my__________ (eating, drinking, shopping, gambling, etc.) had in my life?
8. Have I attempted to stop or decrease my __________ (eating, drinking, shopping, gambling, etc) or told myself I should?

What about experiences with addiction in our family of origin as we grew up or in family members in the present? Are we dealing with addiction in a parent, sibling, spouse, partner, or child? How is this impacting our functioning and beliefs about addiction and addicts? How has our role in our family of origin affected the decision to become a social worker or the way we define our role in practice settings? Boundaries with clients, colleagues, students, and staff will be informed by our beliefs about our role. Is it to facilitate, fix, rescue, resolve, or manage? What terms would apply?

Another ethical consideration relates to the issue of competence. Section 1.04a (Competence) states that “social workers should provide services and represent themselves as competent only within the boundaries of their education, training, license, certification, consultation received, supervised experience, or other relevant professional experience.” In addition to formal credentialing, social workers bring varying levels of professional and personal experience to addressing issues of addiction. Social workers in recovery can bring a wealth of knowledge to their practice. The ethical obligation is to be honest with ourselves and supervisors/employers about our level of expertise. A common problem that arises is with practitioners addressing addiction issues with clients, but failing to focus adequately on their own recovery process.

What if you are aware of a colleague who is struggling with addiction, but is in denial? The following code sections address different aspects of this scenario:

• 2.09 Impairment of Colleagues
• 2.10 Incompetence of Colleagues
• 2.11 Unethical Conduct of Colleagues

There are three overriding ethical guidelines elucidated in these sections.

1. Social workers have an ethical obligation to address circumstances in which we have direct knowledge of a colleague’s impairment, incompetence, or unethical behavior.
2. The first step in attempting to resolve these issues, when “feasible and likely to be productive”, should be to discuss the concerns with the colleague.
3. If the colleague does not take “adequate steps” to address the issues, the social worker has a responsibility to take further action “through appropriate channels.”

Fulfilling these steps often presents both social workers with ethical dilemmas. Seeking out appropriate consultation constitutes best practice in these situations.

We are human. Our physical, emotional, and spiritual state will always influence our practice. The influence can be positive, negative, or neutral. The ethical obligation is to reflect honestly on the role of addictions in our life, to treat ourselves with as much compassion and empathy as we would our clients or colleagues, and to recognize the strength, courage, and tremendous resiliency in seeking out the resources we need to create balance and well-being in our lives.

Ruth Lipschutz, LCSW, ACSW, is a licensed clinical social worker with postgraduate certification in ethics, mediation, Transformational Imagery, hypnotherapy, and Eye Movement Desensitization and Reprocessing (EMDR). She received her MSW from the University of Illinois in 1978 and went on to complete the two-year postgraduate training program of the Institute for Family Studies at Northwestern University. She has extensive experience in the areas of ethics, mental health, addictions, traumatology, program development and implementation, supervision, consultation and Alternative Dispute Resolution. She is the chairperson of NASW’s National Ethics Committee and has served as a panelist, consultant, mediator, and trainer for the NASW Illinois Chapter Ethics Committee. She is currently in private practice.
 

The governor gave a budget message on February 22, 2012, that provided very little detail as to how he plans to balance the state's budget for FY2013. He prominently mention the "big two": pension reform and Medicaid cuts. On a positive side, he wants to spend more money on early childhood education. The governor proposed closing more state facilities including the Tinley Park and Singer Mental Health Centers, the Murray Developmental Center in Centraila, and the Tamms "Super Max" Prison in Alexander County.

Following his address, the state's human services agencies briefed a packed Howlett Building Auditorium on specific cuts. In the case of the Department of Healthcare and Human Services, the discussion and written materials laid out a series of potential options for reducing Medicaid spending with no specific recommendations. Options include (1) Reducing eligibility for the All Kids Program to 200% of the poverty level, which would take about 19,000 children off the program; (2) Eliminate the Illinois Cares Rx Program; (3) Take all undocumented children off of All Kids; (4) Lower income eligibility threshold for the Family Care Program; (5) Eliminate medical care for torture victims; (6) Eliminate the renal dialysis program, serving 270 clients; (6) Raise the DON score for supported living facilities and nursing facilities; (7) Eliminate adult optional services such as hospice, pediatric palliative care, adult dental, adult chiropractic care, adult OT and PT, podiatric care, adult speech therapy, (8) Eliminating or limiting eligibility for the waiver for medically fragile/technology dependent children, etc.. Obviously, none of these are good options.

As for programs operated by the Department of Human Services, proposed cuts include reducing the lifetime limit for TANF from 60 months to 36 months; reducing employability development services; cutting Teach Reach by 20%; raising parent co-payments for child care; eliminating mental health non-Medicaid grants; reducing mental health capacity grants; making it harder to qualify for the Home Services Program; limiting Home Services to Medicaid eligible individuals prospectively; and much more.

Our work is cut out for us to preserve these important programs and services. The time is NOW to become active. There will be cuts, but our voices will contribute to the dialogue about what the State's funding priorities should be next year.

There are thousands of bills pending right now, and it really is not a good time to write a summary of pending legislation. However, I want to mention a couple of bills and resolutions.

First, HJR-CA 12 (Jakobsson) would put on the ballot a constitutional amendment that would allow Illinois to have a graduated state income tax rate. The chapter is supporting this measure which, if adopted and then voted upon favorably by the electorate, would give us an opportunity to revamp our tax code, something that is long overdue.

SB 3773 (Sandoval) would subject nonprofit organizations that receive state funding from any source and of any kind to the provisions of the Freedom of Information Act (FOIA). This bill, if enacted, would subject nonprofit agencies to a FOIA request from anyone. It would require huge amounts of staff time and legal services to deal with these requests. The bill is scheduled for the Senate Executive Committee next week. We oppose.

HB 5290 (Cassidy) would amend the School Code provisions regarding bullying prevention to require the Illinois State Board of Education to develop a template bullying prevention policy for school districts to use in developiong their own policies. The bill requires that certain basic elements of a policy (e.g., having a complaint process, identifying who the contact person in the district is, collecting basic data and reporting it to the state board, posting the policy on the district's website) by part of every district's policies. The bill was held in the House Elementary and Secondary Education Committee this week, but is expected to be heard again next week with an amendment that addresses concerns of school management groups. The NASW Illinois Chapter supports Rep. Cassidy's bill.

HB 5363 (Gabel) would transfer programs now in the Department of Human Services to the Department of Public Health. There will be an amendment to specify that certain programs such as youth services will stay at DHS. The bill will be heard in the House Human Services Committee next week. The chapter is neutral on this bill, but will continue to watch it.

OFFICE FOR RENT - Orland Park
Office rentals-new furniture/carpet, computer/internet, shared waiting area, restrooms & kitchenette, parking-utilities included, or unfurnished. 630-890-1907 & office pictures @ jamessimmerer.com.

OFFICE FOR RENT - Frankfort
3 furnished offices in 5 office suite available by hour, day or month. Includes kitchenette, reception, group and class room. Contact Rena Compaan, LCSW at rcompaan@comcast.net or 815-469-2654.

NASW ILLINIOS CHAPTER JOB BOARD
For a complete and up-to-date list of job board postings, visit the NASW Illinois Chapter Job Board: http://www.naswil.org/education-career-development/association-job-board/.

• Care Coordinator Medical Social Consultant - UIC Division of Specialized Care for Children
• Addiction Specialist - Human Service Center/Fayette Companies
• Executive Director - A Safe Place
• Director of Therapy Services - Family Service Association of Greater Elgin Area
• Social Work Intern (NASW Illinois)
• Licensed Clinical Social Work (Learning Through Play™ Center for Child Development)
• Out Patient Therapist - Herington Counseling and Learning Alternatives
• Director, Grief Center - Northern IL Hospice and Grief Center
• Outpatient Therapist - Carlsbad Mental Health Center
• Program Manager (Metropolitan Family Services)
• PT/FT Outpatient Therapist (Lake County Counseling for Seniors)

Governor Quinn gave his State of the State address to a joint session of the Illinois House and Senate today. The full text of his speech is available on the state of Illinois' website. The governor made every effort to emphasize the accomplishments during his tenure as governor since he took over for Rod Blagojevich following the 2009 impeachment. He highlighted legislation he has signed such as the legalization of civil unions, the repeal of the death penalty, major education reform, the expansion of the Earned Income Tax Credit, the Illinois DREAM Act, campaign finance reform, workers' compensation reform, and others. He also mentioned a number of infrastructure improvement projects completed or initiated while he has been in office including the CTA Red Line renovation, improved highways and bridges, and building projects at state universities.

He focused a great deal on job creation, mentioning the expanded working hours at the Ford Plant on the far southside of Chicago as well as touting the efforts of a recycling business in Romeoville. He also highlighted advancement in technology such as broadband upgrades and accessibility.

As for the future, he briefly mentioned the need for pension reform and Medicaid reform without going into any detail. He steered clear of any budget details, saving those for the budget message he will deliver later this month.  

He mentioned several new initiatives: (1) A new technology center at the Merchandise Mart for launching digital start-ups; (2) A $6 million statewide competition to build "ultra-high broadband" in neighborhoods across the state; (3) Abolishing the natural gas utility tax, which he called "unfair, regressive, and not based on the ability to pay"; (4) A new Child Tax Credit of up to $100 per year for a "typical family of four"; (5) A tax credit for hiring veterans; (5) An unspecified major investment in early childhood education;  (6) Raising the high school dropout age to 18; (7) Making more MAP Grants available to college students; (8) An investment in modernizing classrooms across the state; (9) Creation of the Illinois Foreclosure Protection Network and a major housing initiative jointly with Cook County Board President Toni Preckwinkle; and (9) A clean water initiative. He acknowledged that some of these initiatives will require legislative action. He also did not specify how the initiatives would be funded.

It will certainly be interesting to see what the governor proposes for his 2013 budget and what will come of efforts to reform the state's pension systems to reduce the state's liabilities. Medicaid—always a political hot button issue—will have very strict scrutiny in an election year.

The civil rights movement and learning about those who fought tirelessly for the rights of African Americans was the first of many introductions to social work that I can recall. I remember reading about so many individuals who found it necessary to fight, putting themselves in harm’s way so that African Americans could attain simple rights like sitting at a lunch counter in a Woolworth’s store, sharing the same water fountain, the freedom to choose any seat on a public bus, attending certain schools, and so forth. I would be in awe of the strength of these people and the tenacity that they showed in fighting for what they believed in. I must also say that there was another part of me that wondered if it was really worth it. Sadly, in my young mind, I felt that the price seemed too high to pay. I didn’t think that people should have to die so that I could have these rights.

As I grew older, I began to realize that if these courageous civil rights leaders and workers had not made the sacrifices that they made, I would not be afforded the rights that I have today and because of this, I will never forget those whose shoulders on which I stand. Although many gains were made over the years, it is very clear in the current political and social climate that there is still much work to be done. I am reminded of a Bible verse that says: “For unto whomsoever much is given, of him shall be much required: and to whom men have committed much, of him they will ask more” (Luke 12:48b KJV). I made the choice to go into the field of social work because I have a responsibility. I have been given opportunities because of those who have gone on before me, and I owe it to the next generation to continue in the struggle and to fight for social justice and civil liberties.

I make it my life’s work to educate young people on the importance of social advocacy and instilling in them how important it is to stand up for those who don’t believe that they have a voice. I work daily with children and families to ensure that they are provided with all of the tools that they need to keep their families strong and their children safe. Equal educational programs, employment opportunities, housing, and access to mental health treatment are still critical areas in which social advocacy continues to be needed, and I am encouraged by those leaders of the past that set such strong examples on what it means to advocate for change.

I salute you, Whitney M. Young, Jr., Dr. Dorothy I. Height, A. Philip Randolph, Mary Church Terrell, Ida B. Wells, Marian Wright Edelman, John Hope, Dr. Martin Luther King, Jr., Medgar Evers, Daisy Bates, Rosa Parks, the Little Rock nine, Ruthie Bridges, and all of those who made huge sacrifices so that I and others like me could live better lives.

Yolanda Jordan, MSW, LCSW, has an extensive background in abuse/neglect issues in the field of child welfare. As a placement manager with the Illinois Department of Children and Family Services, she is responsible for managing supervisors who are responsible for children who are placed in the foster care system. Yolanda is also a practicing psychotherapist and has been in private practice for the past ten years. Services are provided to children, couples, and families with a special emphasis on relationship issues that African American women face.

Yolanda is a graduate of Western Illinois University where she received her bachelor of arts in mass communications and master of arts in public communications human relations with a minor in African American studies. Due to her extreme love for people and having the heart of a servant, she continued her education and received a masters in social work with an emphasis on child and family practice from the University of Illinois at Chicago’s Jane Addams College of Social Work. Yolanda has been an active member of the NASW Illinois since 1996 and enjoys the work of advocating for the profession of social work and the community that social workers serve.

Proponents of history months view the tradition as an opportunity to remind some and educate others of the past. This practice is thought to be particularly important for our nation’s youth.

An aphorism I frequently heard during my adolescence was, “In order to know where you’re going, you have to know where you’ve been.” There are variations of this expression, each emphasizing the importance of viewing self within the context of one’s individual and collective history, and being knowledgeable of the intersect between the past and present.

For some, lacking contextual insight may have no consequences. For others, however, the adverse affect on performance may be noteworthy. This article focuses on how one institution’s understanding of the impact of history on goal attainment led to the formation of a successful program for adolescents.

Mercy Hospital & Medical Center in Chicago has a legacy as a medical facility that reaches beyond the boundaries of its campus to address the health and social needs of its neighboring community. One notable community service offered by Mercy is the program Health Professions for the Future (HPF).

The HPF program originated twenty years ago. Thoughtful administrators saw the need for children of low-income families to acquire meaningful work experiences. In turn, the hospital offered summer job opportunities for those residing in the public housing developments. Since that time, this innovative endeavor has evolved into a successful summer and year-round internship program for youth desiring careers in the medical profession.

Given the social and academic struggles many urban youth encounter, Mercy has decided to focus its attention on students of average academic abilities. Primary criterions for inclusion in the program are teens that are willing to work, are eager to learn, and determined to succeed.

In collaboration with area high schools, the interns gain awareness of the opportunities in the allied health fields, and receiving preparation for degree or certification programs. Over the course of the internship, students are able to bridge what is taught in the classroom with the work world through shadowing and in-service training.

Sponsoring this program is consistent with the hospital’s vision to be “lifetime community partners” and to “help shape the future of health care.” In addition to being mindful of local social needs, the program’s founders were cognizant of an important challenge confronting the healthcare community—expanding consumer needs for medical care paralleled by an increasing shortage of medical professionals.

Eighty-million baby-boomers are reaching retirement age. As this population ages, the need for medical services will increase. To meet the current and future demand for services, a greater focus is on the next generation of workforce professionals—today’s youth.

Unfortunately many teens are not adequately prepared to enter the work environment. Fewer teens are working today than at any point since World War II. Teen unemployment is disproportionally significant among minority youth, and the decline in employment numbers has sharply accelerated in the past seven years. Consequently, young people are restricted in their ability to acquire good work habits and necessary information to make informed educational and career choices.

As a result, Mercy’s HPF program conducts seminars on employability skills such as punctuality, professionalism, conflict management, and communication. On occasion it is necessary to engage parental support in the learning process to address behaviors that seem to have become commonplace in the views of the child and parent.

The program would be amiss if it overlooked the psychosocial support needs of young people. Some students in the program are confronting daily obstacles that can impede motivation or attainment of personal goals. These impediments include insufficient family support and/or peer-related problems. Group meetings are conducted to address the social ills students confront in their communities.

As indicated, viewing youth within the context of their experiences requires the program managers and staff members to develop approaches that extend beyond providing students with clinical experiences. Each adult frequently finds themselves also functioning as mentors.

The program’s success is largely attributed to the guidance and support provided by staff in the form of mentoring. Most are comfortable in this role. Staff members have expressed a desire to give back. Many reflect on the period of their youth and history, noting the benefits that could have been gain if they’d had a mentor during their teenage years.

HPF students do not hesitate to express their appreciation and note the positive influences their mentors have on motivating them to achieve:

“I would like to thank you for allowing me to have such an amazing learning experience. You gave me a chance to expand my horizon and to learn more than what is in books. Also, to meet people who care about your future. People who give you advice about your future. You gave what feels to me a chance of a lifetime, and for that I thank you very much.” - T. D., Intern

“Words cannot express the gratitude I feel. This experience has been exceptional. I was given opportunities to witness and do various things that I never thought would be possible for someone my age. The people I was introduced to were amazing. They were always willing to help and teach me. They also helped with my transition. Having come to Mercy a shy person, now I am able to speak to everyone I know . . . My internship at Mercy has surpassed my expectations.” - S. W., Intern

The significance of mentoring cannot be overemphasized. Former President Bill Clinton once stated, “People who grew up in difficult circumstances and yet are successful have one thing in common . . . at a critical junction in their early adolescence they had a positive relationship with a caring adult.”

On January 3, 2012, President Obama issued a proclamation designating January as National Mentoring Month. He is a strong advocate of adults volunteering their time and sharing their talents to benefit others. “There’s no doubt about the value of mentoring. And there is no doubt about the tremendous need for mentors in this country . . . Ask any successful person how they got to where they are today, chances are they’ll tell you about a mentor they had somewhere along the way.”

“The youth are our future,” is a common phrase frequently stated by educators, lawmakers, and others when speaking about the needs of young people, or their role in addressing the nation’s problems. As we reflect this month on the contributions of African Americans to this country, let us not only look backward to appreciate the road traveled, but also forward to determine the best path for the future of our youth.

Kenneth M. Horace, LCSW, is a clinical social worker at Mercy Hospital in Chicago where he provides behavioral health services to youth and families. He also manages the hospital’s internship program, Health Professions for the Future, which offers medical training to high school students aspiring careers in healthcare. Mr. Horace is a member of the Chicago Public Schools’ Medical & Health Career Advisory Board, and the UIC-Jane Addams College of Social Work Alumni Board.
 

Well, I did it again. I had done it before, some twelve or more years ago. The “it” I’m talking about is making another accommodation to my age. I just purchased hearing aids. The earlier accommodation was to obtain trifocals. (However, neither of these has helped my short-term memory very much. My wife wants me to get something for that.) What it has done though is to help me avoid asking the “What did s/he say?” question as frequently to her and others as I was wont to do. It has also helped me tremendously in working with my clients.

Let me back up a bit. I tried retirement nine years ago when I turned 65. That lasted six whole months. (I’m not sure who was going crazy the fastest with that, me or my wife.) Up until five years ago, I had always lived in fairly large, single-family homes with good-sized yards and garages. I loved to work in the yard and tinker in my shop in the garage. In fact, the home I lived in before moving to Chicago twelve years ago was on a half acre of landscaped property with a double garage that could accommodate two extended cab pickups while still having room for a workshop space besides.

That brick, Mediterranean-style house had four bedrooms, three baths, a full living room, a full dining room (with butler’s closet), and a full family room. The back porch was 15’x40’, under roof. That was in south Texas, about seven miles from Reynosa, Mexico. In Chicago, for the same money, you can get a 1,600-square foot condo with one tiny garage space. Not much yard and definitely no workshop space.

So what was I to do with retirement with no yard or shop to work in? And after two weeks of exploring the great vast wasteland of television, I was ready to run down Pratt Boulevard screaming, “Help!” Okay, definitely time to go back to work! So I revved up my private practice again: finding and furnishing an office, getting back on all those insurance panels, and developing a client base. And for the last sixteen months, I have been doing hospital consulting as well. This has certainly been better than vegetating in front of a television.

Now back to the personal accommodations I’ve talked about. The hearing aids have definitely helped me in my therapy sessions and my consulting work. I don’t have to constantly ask clients (or my wife) to repeat themselves.

However, I now find that there is one accommodation that I can make for my clients that cannot be accomplished by the use of bandages, canes, walkers, glasses, hearing aids, or any other prosthetic or supportive device. I’m talking about the thought that I frequently have when I ask my clients, “Do you remember when . . .” and they return my query with a completely blank stare. You know, that “What in the world are you talking about?” stare. I have to remember frequently that I am well into my seventy-fifth year. I was born in 1937 and finished high school in 1956. Almost three generations have now come onto the scene with totally different frames of reference. It has to do with history, music, social customs and norms, and inventions that could hardly be dreamed of in the 50s and 60s. I remember a Ma Bell educational touring bus that came to our high school to tell us about the big advance in telephone numbers. There were going to be area codes!

I have to admit that generational accommodations are harder for me to make than purchasing trifocals and hearing aids. How in the world do I know and/or remember what music was their’s? And I’ve got clients that don’t even know 80s music much less 50s music. What TV programs did they watch, what movies did they see (assuredly, not at the drive-in), what books did they read, what styles did they buy and wear? In my time I bought and wore zoot suit–style pants and one-button roll sport coats. The shirts and ties I wore were pinks and purples. I had enough Wildroot Hair Cream on my ducktail haircut to lubricate the wheels on a twenty car passenger train, enough that my head would slide off the pillow at night.

And heck, for my part, I know the names of more than a dozen makes of automobiles that most of my younger clients have never heard of. The weird ones were the ones my dad always bought: Kaisers, Frasers, Hudsons, Nashes, Packards, Studebakers. He even put money down on a Tucker! I guess it just seemed like the thing to do at the time.

However, these age cohorts are the kinds of things that I really do need to remember. All of my cohort stuff has nothing to do with these younger cohorts. I really do need to consider and remember to listen even more to them and let them build their own frame of reference for me.

My glasses and hearing aids help me a lot. But giving my clients the freedom to talk to me about their frames of reference is a tremendous aid both to them and to me. It helps me to remember that I am there to let therapy happen and not force it into place. I have to admit, there are times when I am inclined simply to meet therapeutic challenges with a bigger hammer. But truly understanding their cohort context often helps me to get rid of the hammer all together.

It is most helpful for me to remember that true meaning often comes from its own special context. This is true no matter what my or my client’s age may be. While my age can—and does—help me work with clients closer to my age, it is listening to the context of others that enables me to be a collaborator with them in their therapeutic journey. It is the only way the therapeutic alliance can be born.

Without this process, how can clients have any real expectations for a collaborative therapy and successful change? We both have to be working from the same page, but the client has to be allowed to show me the page. For me, this is the only way to find a treatment rationale and enhance the chances of a true, therapeutic impact. Without a useful frame of reference, how can we achieve the goals of a truly therapeutic context?

Now, where in the world did I put those progress notes?

Mark Hicks, LCSW, lives and works in Chicago with offices in Chicago and South Holland. Over the years he has been licensed in five different states. His work experience has been in hospital, outpatient, community, and partial hospital settings. Recently he helped Proctor Hospital in Peoria obtain a Certificate of Need to develop an 18-bed gero-psych inpatient unit which will open later this year. He has had a private practice since 1979 in Kansas, Wisconsin, Texas, and Illinois. Mark has been a member of NASW since 1979 and an ACSW since 1981.

Since its inception, the United States educational system has dealt with racism. Throughout history, certain people were denied access to a quality education. The American South dealt with educational racism in very specific ways (including the Brown vs. Board of Education decision, which is notable in history books), but that was not the case for schools in the north. Students in the north faced residential barriers that barred where blacks lived, a lack of funding in schools for needed resources, rejection of good teachers to work in certain school and areas, and a push into remedial education. Discrimination in the workplace also chipped away at blacks’ desires or motivation to go to school since there were few employment prospects after graduation. IQ assessments, tracking, and remedial classes caused further division. African-Americans and white allies understood that separate-but-equal schooling never meant equal (Fraser, 2001). Racial issues in education have been well documented if not addressed in different forms throughout the years. Little by little, these racial issues accumulated and laid the foundation of policies and rules in our education system that are still in place today. In Schools Betrayed, Neckerman (2010) stated, “beliefs and expectations and patterns of behavior grow up around the institution, so much so that other arrangements become unthinkable. The institution recedes into the realm of the taken-for-granted; it becomes invisible. It takes history to make institutions visible again—to uncover the decisions, made early on, that foreclosed alternatives and made the expedient seem inevitable” (p. 5).

As education as well as social work programs became more formalized, The National Association of Social Workers (NASW) and the Council of Social Work Education (CSWE) established policies designed to combat and eliminate racism within the profession as early as 1969. The cultural competence model was chosen to promote an understanding of different races and culture. It allowed the integration and transformation of knowledge about individual groups of people into specific standards, policies, practices, and attitudes to be used in appropriate cultural settings to increase the quality of service (Davis, 1997). “Within the last two decades, the profession has made a concerted effort to forge a professional identity through the training of practitioners in the skills and knowledge that allow them to achieve their goals with diverse race, ethnic, and social groups.” (Teasley, Baffour, & Tyson, 2005, p. 228). In many ways and for many years, the cultural competence model has been the cornerstone of social work. In spite of these efforts, the cultural competence model has been shown to exacerbate rather than challenge racism in schools. Critics charge that the cultural competence model is largely ineffective and that its tendency to equalize oppressions under a “multicultural umbrella” unintentionally promotes a color-blind mentality that eclipses the significance of institutionalized racism (Abrams & Moio, 2009). As school social workers, we must look for racial components as we deal with issues concerning students and families within our schools and critically examine what we are seeing.

Many school social workers were not taught the historical significance of race in the social work field and are not being critically trained to adequately deal with race and cultural issues while in their social work graduate programs. Once these workers enter school systems, they are often faced with a myriad of issues surrounding race and culture such as special education identification, tracking systems, and segregation through curriculum, extracurricular activities, and discipline. Racism overtly and covertly—and always insidiously—distorts our thinking, curriculum, teaching approaches, language, and even well-intentioned efforts to promote empowerment and justice.

So what can we do to continue to educate ourselves and grow in our profession, especially concerning race issues? As school social workers, we must start doing a few things to address race and racist practices in our school and employment settings in order to challenge these discriminatory educational policies successfully. The following is a list of what we must do:

• Find our voice.
• Be prepared to battle once we pick which battles we want to fight.
• Gain knowledge. Know our stuff.
• Interrupt racism no matter how uncomfortable it makes us and do not make exceptions for family, friends, or in the work place because we fear the consequences.
• Always confront racism, ignorance, and inappropriate behavior/language when we see, hear, read, or experience it.
• Find allies of all races to discuss these topics. We may be surprised at the people we thought got it who really don’t. We also may be surprised by some who get it but are afraid to speak up.
• Teach, learn, and practice coping strategies to staff and students.
• Train staff, form committees, identify speakers, and facilitate classroom presentations.
• Ask the school librarian to furnish the professional library with resources on topics related to race.
• Explore the tenets of Critical Race Theory.

Critical Race Theory (CRT) could help us critically examine race in our graduate programs and schools settings. Critical race studies must have a place in social work graduate programs and K-12 schools. It was introduced to education by Gloria Ladson-Billings and William F. Tate in 1995. Some basic tenets include the following:

• Racism is at the core of American life and should not be placed on the perimeter.
• Racism benefits those who are privileged and serves the interests of the powerful to maintain the status quo.
• CRT represents a challenge to the dominant social ideology of color-blindness.
• Assimilation and racial integration are not always in the best interests of all groups.
• CRT argues for the legitimacy and appropriateness of the lived experience of racial/ethnic minorities.
• Addressing social justice efforts and the elimination of racial oppression are the ultimate goals of critical race theory.

Though CRT has not been formally introduced in many social work arenas, it is a theory that should be explored. CRT suggests that deconstruction is a critical practice that aims to dismantle the structures at work; it is not about pointing out an error but about looking at how a structure has been constructed, what holds it together, and what it produces. To give an example, CRT theorists discussed the “right to exclude” as a critical race concept that highlights the educational system’s history as well as current practices. “In schooling, the absolute right to exclude was demonstrated initially by denying blacks access to schooling altogether. Later, it was demonstrated by the creation and maintenance of separate schools. More recently it has been demonstrated by white flight and the growing insistence on vouchers, public funding of private schools, and schools of choice. Within schools, absolute right to exclude is now demonstrated by re-segregation via tracking.(Ladson-Billings & Tate, 1995). To critically examine issues with a race lens is important as we look at policies in the school system, discipline handbooks, acceptable practices, and special education legislation and implementation as well as school programs, assemblies, and communication with parents.

School social workers are often in the position to make an impact on issues concerning the individual student, the classroom, the school, and the community. We abide by a code of ethics to support the most disadvantaged youth in our school settings, and yet we often ignore the race component that impacts so many of our students’ lives. In honor of Black History Month, we must acknowledge it, learn to challenge it, and associal workers and life-learners, we need to question our education and learning portals. As social workers, we need to be climate watchers; we must address race, treatment of disadvantaged populations, and inequalities; and we must teach, support, and provide resources as well. We must also know our history and learn from it to advocate and support all of our students. As Marian Wright Edelman stated: If we don’t stand up for children, we don’t stand for much.

REFERENCES

• Abrams, L., & Moio, J. (2009). Critical race theory and the cultural competence dilemma in social work education. Journal of Social Work Education , 45(2), 245–261.
• Council on Social Work Education. (2001). Educational policy and accreditation standards. Alexandria.
• Davis, K. (1997). Exploring the intersection between cultural competency and managed behavioral health care policy: implications for state and county mental health agencies. Alexandria, VA: National Technical Assistance Center for State Mental Health Planning.
• Fraser, J. W. (2001). The school in the United States: A documentary history. Boston: McGraw-Hill.
• Ladson-Billings, G., & Tate, W. (1995). Toward a critical race theory of education. Teacher's College Record.
• Neckerman, K. (2010). Schools betrayed: Roots of failure in inner-city education. Chicago: University of Chicago Press.
• School Social Work Association of America. (2009). Retrieved December 5, 2010, from www.sswaa.org.
• Teasley, M., Baffour, T., & Tyson, E. (2005). Perceptions of cultural competence among urban school social workers: Does experience make a difference? Children & Schools , 27(4), 227–237.

Tiffany Johnson, MSW, LCSW, has spent eleven years as an educator in elementary, middle, and high schools. She is a regional representative for the Illinois Association of School Social Workers (IASSW) and is currently is a doctoral student in educational policy at the University of Illinois at Champaign-Urbana. Besides her educational and career endeavors, Tiffany is active in her community. She has been a DCFS foster and adoptive parent for over eighteen years, a Girl Scouts leader, YMCA camp counselor, and mentor. She is also the mother of three teenagers.

CEU Opportunity for Reading This Article!
NASW Illinois members can earn one CEU by completing an online quiz (https://naswil.wufoo.com/forms/quiz-february-2012/) regarding this article! The free CEU opportunity is only valid until April 1, 2012, after which the CEU fee will change to $15.00. Nonmembers must pay the regular $10.00 rate for the CEU, which will increase to $15.00 after April 1, 2012.

As a professional social worker and amateur writer, I can honestly state that at first, I wasn’t really sure how to begin my review of this very emotionally-driven book. When I first read the title, Is Marriage for White People? How the African American Marriage Decline Affects Everyone, I was instantly offended as a married African American male; but I was also intrigued, and that's what motivated me to read this book in a course of two days—it's quite a page-turner!

Let me start off by giving you a synopsis: Stanford law professor Ralph Richard Banks (an African American middle-class family man) has spent recent years gathering in-person interviews, statistical information, and other resources to compile a nonfiction manuscript of how the “trend” of blacks not marrying and/or divorcing is on the rise. Throughout the entire book, Banks discusses how the future of happily married black men and women looks bleak. He covers a spectrum of issues that include interracial dating and marriages, arranged marriages, legalities of marriage, the effects on black children, middle class versus the poor, the (black) man shortage issue, and finally, how to save black marriage.

As I read each of the eleven chapters that make up this book, I was hoping to read data that would assist support ways in which black men and women could come together and create loving and strong family units. As I read some of the statistics in the book—that the highest earning black men are more than twice as likely as their white counterparts to never marry, or that black middle-class families are poorer than their white counterparts—I started to feel very uncomfortable and hopeless.

In my opinion, Professor Banks may have listened to too many disgruntled black women and not enough of happily married black women and men! It started to feel one-sided and for me, when you take on this subject matter, one should be as unbiased as possible. Now don't get me wrong: when reading the testimonies of his interviewees, I thought about the bad male/female relationships amongst my family and friends. But almost simultaneously, I thought about the successful relationships that I knew. I know that as a reviewer I should have stayed neutral, but how could I as a married black man myself? Especially as one who is doing his absolute best to raise a brilliant and beautiful black daughter to not only be able to hold her own in the world, but to also show her that when she does become a partner in a loving relationship, she needs to be able to find her place of balance—for me, that’s the key of a successful relationship!

In assessing the strengths of this book, Banks did a great job of looking at statistics to formulate his hypothesis. He showed evidence of the mixed marriage theory which entails a marriage based on class (i.e., a woman with one or two degrees and makes six figures who is married to a man without a higher education degree and makes considerably less). He showed how these types of mixed marriages are doomed from the get-go because it goes against the societal premise of gender roles.

However, as an optimistic reader who wants to know how to ensure that black men and women have successful relationships/marriages, this book left me feeling pessimistic. By the book’s end, Bank states: "If Black women don't marry because they have too few options, and some black men because they have too many, then black women, by opening themselves to interracial marriage, could address both problems at once. For black women, interracial marriage doesn't abandon the race, it serves the race."

I had to force myself to understand his point which, in laymen’s term, is this: Because black men feel that it's 10 (women) to 1 (us) out here, then we get to be arrogant fools and lead women on; but if black women become “extinct” by marrying non–black men, then this will make black men step up our game, and then too will black women marriage stats go up. I think Banks missed the mark on this assumption. My answer, if he would have interviewed me, would be that us black men and women need to assess and write treatment plans on ourselves, start healing, become whole people individually, and then when that happens, our relationships will be more progressive, positive, and purposeful. Happiness starts internally and works itself outwardly!

Khalid B. Scott, MSW, LCWS, QMHP, is an eighteen-year licensed case management/clinical social worker manager who work has provided mental health therapy to everyone from IDCFS-affiliated clients to foster and biological family members for over eleven years. Khalid is also a contractual trainer for CASA Cook County Juvenile Courts as well as a contractual college lecturer at Westwood College, Olive-Harvey College, Columbia College, Chicago State University, the University of Illinois at Chicago, and DePaul University.
 

• Am I allowed or required to release the client’s information?
• How much information must I disclose?
• What type of client information should be released?

This Legal Issue of the Month article will address questions related to making well-reasoned decisions when responding to requests for confidential client information.  This review does not address situations where the social worker is the target of a lawsuit or complaint.

To read the rest of the article, click here. NOTE: NASW login required.

At what point does a student in a social work program finally become a real social worker? This question was recently addressed among students during a review of internship experiences. One student felt that the qualification of a social worker was not fully obtained until a degree was physically in hand. This concept sparked much discussion. Another student posed the following scenario: If you were swimming where there was a lifeguard posted, would you be able to tell the difference between the lifeguard with six months of experience versus a lifeguard with six years of experience? The answer: probably not. The question then becomes whether a client can tell the difference between an intern or one who is recently graduated versus a social worker with more field time? When a client is meeting with a social worker, the reassurance that there are resources available can be the beginning of a sense of trust and the first step towards a professional rapport.

As most social work students have returned to their spring semester and inch closer towards their degree, I would like to propose my idea of when a student in a social work program becomes a “real” social worker. A real social worker evolves from the beginning stage of having the desire to help others at the micro, mezzo, and macro level. Social workers also become “real” when he or she advocate for an individual or a group of people without their own voice. Additionally, students may find that policy is what inspires them. No matter which method of involvement is best suited for a student, these stages are the initiation to the group of real social workers. Social workers also possess characteristics such as compassion, understanding, and empathy.

Students should feel they are indeed real social workers while working as an intern; however, this does not discredit those social workers who have paved the path with years of service. The social work student also needs to remember that although they are a real social worker, the process of learning never ends, and it is to their advantage to learn as much as possible from those who have worked for years in the field. Learn from your professors, learn from social workers you are on a committee with, and learn from your supervisor at your internship. Become involved outside the classroom—there are endless opportunities to explore. Take the time to look at the NASW Illinois Chapter website (www.naswil.org)—there are plenty of ways to become involved. The ability to continue learning only enhances your role as a social worker. Imagine the student that worked with Jane Addams, Frances Perkins, Whitney M. Young Jr., and many others. The potential for real social work students to become incredible social workers are definitely within the realm of possibilities.

So for the students who are knee-deep in writing papers, studying for tests, interning, and preparing for graduation, remain steadfast, keep an open mind, and know that each day you are working as a real social worker, and you are joining the ranks of a wonderful group of men and women.

The Student Network SIG provides support and networking opportunities to Illinois social work students. To find out more about the SIG and upcoming events, please visit the Student Network SIG website.

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OFFICE FOR RENT - Frankfort
3 furnished offices in 5 office suite available by hour, day or month. Includes kitchenette, reception, group and class room. Contact Rena Compaan, LCSW at rcompaan@comcast.net or 815-469-2654.

OFFICE FOR RENT - Evanston
Office hours available in attractive office,west of Northwestern campus. Hours open: day, evenings and weekends $10/hr. "Patients" love this office and neighborhood
Call Diane Fisher,1847-989-1745

OFFICE FOR RENT - Oak Park
Oak Park Lake Street Location. Atrtractively furnished office and wait room.
Large windows with eastern exposure. Seeking full or part-time renter.
Joel Sherr 708-214-8768. jsherr611@comcast.net

NASW ILLINIOS CHAPTER JOB BOARD
For a complete and up-to-date list of job board postings, visit the NASW Illinois Chapter Job Board: http://www.naswil.org/education-career-development/association-job-board/.

• Director, Grief Center - Northern IL Hospice and Grief Center
• Staff Pychologist - Yellowbrick
• Licensed Clinical Social Worker (LCSW) - Franciscan St. James Health
• Quality Administrator (LCSW or LCPC) - Human Service Center
• Outpatient Therapist - Carlsbad Mental Health Center
• IOP / Substance Abuse Therapist - Carlsbad Mental Health Center
• Program Manager (Metropolitan Family Services)
• PT/FT Outpatient Therapist (Lake County Counseling for Seniors)

Legislative Accomplishments
The 2011 year began with several legislative accomplishments including a state income task that was a start in solving the state’s current fiscal crisis as well a repeal of the death penalty in Illinois. NASW Illinois worked actively with the Responsible Budget Coalition to achieve this. During the same week, the Illinois General Assembly passed SB3539, a landmark legislation repealing the death penalty in Illinois. On March 9, 2011, Governor Pat Quinn signed Public Act 96-1543 into law (http://ilga.gov/legislation/publicacts/fulltext.asp?name=096-1543). Two Illinois legislators were vital in getting this historic piece of legislation passed: Illinois Senator Kwame Raoul (D-Chicago) and Illinois State Representative Karen Yarbrough (D-Maywood). They were both presented with the NASW Illinois Chapter’s 2011 Legislative Award at the statewide conference in November.

A record number 900 social workers and social work students descended upon Springfield, Illinois, to participate in the 2011 Social Work Advocacy Day. This year, we exceeded our numbers yet again and established a record for attendance. Our large numbers could not have come at a more important time. Illinois Lieutenant Governor Sheila Simon opened the morning session with an inspiring message regarding the importance of advocacy. She was followed by a panel comprised of experts and leaders in the human services arena: Michelle Saddler, secretary of the Illinois Department of Human Services; Michael McRaith, director of the Illinois Department of Insurance; Ralph Martire, executive director of the Center for Tax and Budget Accountability; and Stephanie Altman, programs and policy director of Health and Disabilities Advocates. NASW Illinois Legislative Consultant Phil Milsk moderated the panel. The panel represented the most knowledgeable professionals in our state about the challenges of the state budget, funding human services, and reforming healthcare and Medicaid. They provided even greater insights during the respective breakout sessions.

The NASW Illinois Chapter’s Licensure Task Force convened several times during the past fiscal year, developing two proposed rule changes regarding the addition of cultural competence training to be included in the 30 CEUs required for licensure renewal; they also discussed the cap on online CEUs. These proposed changes now have to make their way through the administrative process at the Illinois Department of Professional Regulation, the governor’s office, and Joint Committee on Administration Rules (JCAR). These proposed rule changes would not take effect until 2013 licensure cycle.

If you want to know more about the chapter’s legislative efforts, be sure to sign up for our NASW Illinois Legislative Action Alerts. Over 9,000 people received our many alerts this past year. You can help us advance our 2012 Legislative/Policy Agenda.

EAPrefer
In conjunction with NASW Assurance Services Inc., the chapter launched in November a new exciting benefit. EAPrefer, a program that helps Illinois members put their experience and expertise as social workers to use as an employee assistance program (EAP) professional, allows members to assist others as well as earn additional income. EAPrefer allows EAP network providers to easily match qualified social workers with clients who need them. Complete details can be found at http://eaprefer.org/ or calling a program representative at 1.866.307.2325.

Greater Content in Online Networker Magazine: Faster,Expanded Access to Social Work News and Information
2011 was the first full year that the Networker magazine appeared entirely online. Not only has this shift saved the chapter in printing costs, it also has allowed us to increase our publication frequency to monthly, as well enhance the magazine’s content. For example, the Networker has included eight private practice–related articles, eight school social work articles, seven book reviews, three articles on aging, one on mental health, six on ethics, and eight of our long-running ‘Since You Asked’ articles. The past year’s articles can be found in the Networker archives at: http://www.naswil.org/news/networker/archives.

We have also improved the NASW Illinois Weekly Update, our weekly, virtual social work newspaper this past June. The Weekly Update links members to news related to the social work profession and the human service sector. Still haven’t signed up for these updates? Sign up in three easy steps!

1. Go to: http://paper.li/NASWIL/1306282408.
2. Click on the blue square on the right-hand side of the screen that says 'Subscribe'.
3. Enter your e-mail address into the box.

Our revamped website continues to provide the most recent social work professional news.

The NASW Illinois Chapter’s social media presence in 2011 continued to grow. Our iPhone and Android app are extremely popular, and our number of followers on twitter (@naswil), our ‘likes’ on Facebook, and the numbers of members on LinkedIn continue to grow.

2011 NASW Illinois Chapter Statewide Conference
Over 600 attendees participated in this year’s statewide conference. They were treated to a conference that included over 70 workshops and an outstanding exhibit hall. Technology, the hard work of the NASW Illinois Chapter staff, and the many volunteer presenters who shared their expertise and knowledge with their colleagues made the 2011 conference our most successful in recent years. A full description of the conference can be found at: http://www.naswil.org/news/chapter-update/2011-nasw-illinois-chapter-statewide-conference-summary/.

CEU Trainings
During 2011, NASW Illinois Chapter districts held 49 district events around the state (both CEU and networking). A total of 29 events were held at the NASW Illinois Chapter office, which including 10 licensure reviews courses and seven ethics trainings.

During 2011, all NASW Illinois Chapter members continued to earn free CEUs for all in-house courses (ethics workshops excluded).

2011 Social Work Awards
In February, the chapter presented its 2011 Emerging Leaders Awards to four emerging leaders at a luncheon during the February 2011 Board of Directors meeting. The awardees included the following:

• Robert B. Campbell, MSW, LCSW, QCSW
• Shelley Milosevic, MSW, LSW
• Amy Terpstra, MSW
• Chasity Wells-Armstrong, MSW, CADC

At the 2011 NASW Illinois Chapter Statewide Conference in November, Candi Gray (NASW Illinois Chapter Vice President and chair of the 2011 NASW Illinois Chapter Awards Committee) presented the 2011 NASW Illinois Chapter Awards. Recipients included the following:

• Legislative Award: Illinois Senator Kwame Raoul and Illinois State Representative Karen Yarbrough
• Public Citizen of the Year – Benjamin S. Wolf, JD
• Social Worker of the Year – Mary Garrison, MSW, LCSW, ACSW
• Lifetime Achievement Award – Richard L. Jones, PhD

Shared Interest Groups (SIGs)
There are currently five active SIGs in the NASW Illinois Chapter, all of which have had significant programming during 2011:

• Older Adults
• Retired Social Workers (RSW)
• Mediators Network
• International Activities Network (IAN)
• Student Network
• Social Work Field Directors

Chapter SIGs are maintained and sustained by members. SIGs can be formed around a particular practice area or geographic area around the state. Over 30 SIG meetings took place this year. SIG activities have ranged from networking events to CEU programming to hosting a social service exchange between Hamburg, Germany, and Birmingham, England.

NASW Political Action Committee (PAC) Illinois
The NASW PAC Illinois, whose mission is to strengthen the involvement of social workers in the political process, has been enhanced with a new board and revised bylaws. The PAC now has its own website at http://naswilpac.org/. The PAC also played an important role in the aldermanic campaigns (both the primary and the runoff) of James Cappleman, LCSW, an NASW Illinois member who was elected to the Chicago City Council as alderman of the 46th ward. A reception of his behalf was held at the chapter offices back in February. NASW Illinois members volunteered for his campaign as well. Concerted effort is currently being made towards developing PAC leadership and conducting political organizing and training.

NASW Illinois 2011 Marketplace Guide
During this past fiscal year, the chapter produced the first ever 2011 Marketplace Guide, a comprehensive buyer’s guide of social work resources. The guide represents a variety of products and services used by social work professionals. We were able to attract many advertisers for this inaugural issue and hope to expand the guide in 2012.

Thanks to NASW Illinois Volunteer Leadership and Professional Staff
The NASW Illinois Chapter Board of Directors, which is elected by the membership, plays an important role in setting the direction and policy of the association. We thank chapter president Yolanda Jordan and her leadership team around the state for all of their hard work this past year.

We are a member association, but the day-to-day operations and successes we experience are due in large part to the chapter’s professional staff. Illinois is fortunate to have committed professionals serving the membership. They include in Chicago, Kyle Hillman, manager of financial services and conference-special events; Christina Polus, manager of events and education; Nina Nguyen, manager of membership and communications; as well as our public affairs consultant Phil Milsk.

Best wishes for the holidays and the New Year!

Joel L. Rubin, MSW, CAE, has served as executive director of the 7,000 member Illinois Chapter of the National Association of Social Workers (NASW) since October 1999. He has over twenty-five years of nonprofit management and fundraising experience including extensive work with boards of directors, committees and volunteers, and advocacy around a wide variety of social work, human service, and international political issues. Joel is a graduate of the Wexner Heritage Fellowship Leadership Program and a current adjunct professor at the University of Illinois at Chicago Jane Addams College of Social Work as well as Loyola University Chicago School of Social Work.

A Protocol to Consider When Working with Children and Parents in Private Practice: A Parental Presence in Therapy

There can be several challenges encountered when working with children in private practice. The foremost challenge is that when a clinician provides therapeutic services to a child, they are actually working with two clients: the child and the child’s parents. The therapy protocol I use in working with children has taken into consideration these challenges in an efficient and effective manner while creating positive growth for both parties.

When I first receive a call from parents seeking out services for their child, I always schedule the first appointment with just the parents. The reasons for this are as follows:

• To gather as much information as possible from the parents without causing the child further distress as s/he listens to someone talk about him/her in third person at a time when the child is already feeling nervous and uncomfortable
• To ask the parents questions that they can answer in full without using discretion so that I can attain the fullest picture possible from their perspective; also to acquire a full history on the child so that I can properly assess current issues
• To give the parents the chance to determine if they feel comfortable with me seeing their child prior to bringing their child into my office; also to have an opportunity to educate them on the various therapy styles, including my own.

During the first session, as well as on the first phone call with a parent, I inform parents that I require as a part of my practice a parent-only session after every fourth or fifth session with their child. This is not optional, and I need parents to commit to this protocol in order for my services to be an appropriate fit for them.

These parent-only sessions are used for checking on progress (or lack thereof) outside of my office, answering questions that parents have about the overall picture of how their child is doing, and providing parental coaching or strategies to help parents most effectively help their child. I do not use parent-only sessions to provide parents with verbatim accounting of my sessions with their child. Instead, I explain to parents the importance of their child's confidentiality along with the limits to confidentiality with children. I also explain that when there are issues that parents need to be informed about, I will find a way to include the parents in the overall discussion, whether it come directly from the child or from me with the child’s knowledge. Obviously when there are matters of urgency, I meet with parents in a timely manner and do not wait a month to discuss these types of situations with them.

Prior to meeting with parents for their parent-only session, I ask the child if there is anything they want me to share or not share with their parents. Generally speaking, children will say there is nothing they want kept private to our sessions only. However, it gives the children the option of exercising some control over what they want shared and when (or if) they are ready to share that information. This in turn helps to continue building a trusting therapeutic relationship with the child.

When children have little or no response to my asking them what they would like to have shared, I say to the child directly: “Here is what I am thinking about sharing with your parents when I meet with them. How does that sound?” Many kids I meet with are relieved to hear my summation of their experience; more often than not, they actually want me to share what I am suggesting with their parents. Children often looked relieved that their parent will be let in on their distress, which has been so difficult for them to put into words. Yet at the same time, they are not being forced to try to explain it to their parents, which is often a relief to the children.

When I meet with kids, I do a check-in on paper at the beginning of each session where they rate on a 1 to 10 scale how various aspects of their life are going (10 being the best and 1 being the worst). My scales are blank, and I fill them in at the beginning of each session with the child. Some of the items I might list in this part of my check-in include school, home, life, and friends. The child then fills in how each aspect of their life is going in each of these areas by filling in the numbers portion of the checklist.

The second half of the check-in is another blank scale set from 1 to 10 (with 10 being the most and 1 being the least). On this scale, I fill in the blanks with four to five feeling words, then ask the child to rate them based on how they felt over the past week. For instance if I put the word "worried", the child can identify for me if they are feeling very worried or not worried at all. I add in new feeling words as I work with them each week and help children increase their emotional language.

These check-ins are a good opportunity for children to give us a sense of how they are feeling when it can be very difficult for them to put their experiences into words. They also provide the therapist with information that is difficult for kids to discuss, thus offering an opportunity to tailor the sessions accordingly. For instance if a child ranks “friendships” as a 1, but he/she is uncomfortable discussing this, I would move on from that topic and continue to figure out how to help the child express what is feeling uncomfortable to him/her either through play therapy or talk therapy as we move forward. As we know, it is important to go at a client’s own pace.

These check-ins are helpful in monitoring progress as well as understanding areas of distress for a child. The check-ins, combined with parent-only sessions, give a much clearer picture of what a child is experiencing which is crucial to providing effective therapy services. Therapists need to have an accurate assessment of a child’s world on an ongoing basis to truly be able to help them.

This protocol addresses including parents into their child's therapy while still building and maintaining trust from all parties involved. It is a means to answer parents’ questions without rushing them on phone calls because parents know they will always get a chance to talk more thoroughly with the therapist in the near future and get all of their questions answered on a regularly basis.

Collaborating with parents is important to a child’s well-being and making progress in therapy because we cannot impact true change while only working in our offices; there has to be a team approach that includes parents. Additionally, therapists cannot always determine if there is progress occurring from a child’s self-report; clinicians need parents to give us regular feedback on what they are seeing outside our office in order for us to know if we are making gains for children that translate into to their whole world, not just in the therapist’s office.

Tami Stieber, LCSW, has worked in the field of social services for the past sixteen years. Her past clinical experience includes working in both therapeutic and mainstream schools, residential settings, and for the private health insurance industry. In 2008, she transitioned to owning a private practice where she meets with both adults and children. Tami specializes in working with clients who are experiencing symptoms of anxiety, children who are having difficulties at school, and families who are dealing with issues related to divorce or other significant life changes. She has provided consultation to schools and clinical supervision to other mental health professionals. 

The Changing Role of the School Social Worker: Becoming a Visionary Practitioner

School social work as a profession (now celebrating its 105th year) emerged out of the settlement house movement and was initially known as visiting teachers. Simultaneously, school social work originated in Boston, Hartford, and New York in the early 1900s. The Chicago Public Schools employed their first school social workers in 1919 (Morrison, 2006). School social work grew out of the policies around compulsory attendance. The initial focus centered on the school social worker providing the link between home, school, and community, utilizing their skills to understand the social ills of the community. These individuals served as advocates for the child and family, ensuring that students received the maximum benefit from public education. Although our world is a very different place than it was over a century ago, policies that support the needs of children and their families in the educational setting have played a major role in the evolution of school social work. This article builds upon the historical context of school social work and identifies strategies that can be utilized with two current policies—response to Intervention (RTI) and social and emotional learning (SEL)—to expand school social work practices to new heights.

From a historical perspective, two major policy decisions that promoted the growth of the profession were the federal Rehabilitation Act and Section 504 (1973) and the Individual with Disabilities Education Act (1975). The Rehabilitation Act and Section 504 were important to school social workers because these policies helped to define the role of school social workers in education. With the simple act of prohibiting discrimination against anyone with a disability, Section 504 identified 20% of the school-age population as legally protected from discrimination and potentially requiring the provision of school social work services at some point in their educational career. The federal Individual with Disabilities Education Act marked the first time that school social work was defined in federal legislation requirements and currently delineates some of the services that school social workers provide.

Due to the need for students to be competitive in this global society, our educational system places great emphasis on student achievement, common core standards, and the correlation between academic achievement and social and emotional development. The school social worker can play a unique role in utilizing current policies to expand the role of the profession. Two recent mandates—response to intervention (RTI) and social and emotional learning (SEL)—provide an opportunity for the school social worker to intervene in the educational process at multiple levels, utilizing the systems perspective and offering prevention and intervention. Rather than viewing them as challenges, these new mandates can be viewed as an opportunity for school social workers to closely align school social work practices to impact academic achievement.

The National Center on Response to Intervention indicates that RTI includes rigorous implementation of a combination of high-quality, culturally and linguistically responsive instruction, assessment, and evidence-based intervention to address the needs of all students (American Institute of Research). Comprehensive RTI implementation contributes to more meaningful identification of learning and behavioral problems, improves instructional quality, provides all students with the best opportunities to succeed in school, and assists with the identification of learning disabilities and other disabilities.

Response to intervention is a system-wide approach used in general education to prevent or resolve issues around the lack of student success. It allows for early identification and prevention activities for all students. It was developed out of a concern for the growing number of students that were placed in special education (In particular, the over-representation of African American and Latino boys in restrictive special education settings), and the lack of success for many of the students receiving special education services.

Social and emotional learning (SEL) is a process for helping children (and even adults) develop the fundamental social and emotional competencies needed for success in life. SEL teaches the skills we all need to handle ourselves, our relationships, and our work both effectively and ethically. These skills include recognizing and managing our emotions, developing caring and concern for others, establishing positive relationships, making responsible decisions, and handling challenging situations constructively and ethically. SEL skills for children focus on teaching them how to calm themselves when angry, making friends, resolving conflicts respectfully, and making ethical and safe choices (Zin, Weissberg, Wang, & Walberg, 2004). SEL is also a framework for school improvement and the promotion of a positive school climate.

Subsequently, these two policies provide an arena for the expansion of school social work services from the traditional role of providing individual, group counseling, crisis intervention services, and school/ agency partnership to becoming a visionary practitioner with a focus on systems, strengths, and resilience. Both of these approaches incorporate evidence-based practices and use data to support students and program outcomes.

The following are strategies that school social workers should consider incorporating into their clinical practice. With response to intervention, the school social worker can try the following:

• Actively participate as a member of the school leadership team and help to design the RTI process at your local school.
• Assist in the development of the universal (Tier 1) implementation plan for both the academic and behavioral areas
• Assess services/programs currently provided by the school social worker and identify opportunities for expansion of school-wide or group-based supports for students
• Provide targeted (Tier 2) services for at-risk students utilizing evidence-based individual, small group–modalities, and classroom-based push-in services.
• Provide intensive (Tier 3) services for students who have not benefited at the universal (Tier 1) or targeted (Tier 2) level and may require more individualized, intensive support including agency partners or a special education referral.

School social work practices align equally as well with SEL and provide an ideal opportunity to address the prevention needs of students. Strategies to address SEL for the school social worker include the following:

• Actively participate in the school-wide SEL planning and implementation at the universal level
• Integrate SEL skill development with clinical work with students in individual and group counseling
• Infuse SEL in the classroom in a number of ways including classroom meetings, classroom-based topical discussion where SEL is integrated in the curriculum, and classroom activities that align with concepts that are being taught in the curriculum content areas
• Employ your expertise in SEL by providing consultation to administrators and to the classroom teacher to encourage the infusion of SEL throughout the curriculum.

School social workers have excellent leadership skills in facilitation and coordination. Utilizing these skills, you may also volunteer to lead the RTI or SEL change process. In so doing, it is important to engage all aspects of the school community and develop a team of people who can help to lead the charge: school administrators, grade level teachers, parents, pupil personnel staff, and other support staff (lunchroom staff, custodian, etc.).

Finally, it is important to look at ways to work with students from a strengths perspective. One such model is critical service-learning. Critical service learning engages students in meaningful service activities in their schools and communities which helps them to develop a sense of civic responsibility, caring and concern for others, and their own feeling of self-worth. Critical service-learning is integrated into the academic curriculum where students are empowered to brainstorm, plan, and implement activities that will have a direct impact on their school, community, and their own personal development (McKay & Johnson, 2010). Critical service-learning is different from community service and service projects in that it goes beyond mere altruism shown to the unfortunate. The mission of critical service-learning is to support critical thinking, reflection, and action in order to bolster societal change within the life world of the adolescent (McKay, 2010).

Although service-learning research is ongoing, it is felt that service-learning, partly through its effects on students’ sense of community and positive school climate, may help to increase the engagement and motivation of all students, particularly at-risk or disadvantaged students. Service-learning emphasizes youth empowerment so that they begin to see themselves as partners to others in order to bring about change in their environments (McKay 2010). Service-learning builds upon student’s developmental assets and serves as protective factors for youth.

In today’s education system, it is critically important that all school social work services clearly demonstrate their relationship in supporting the academic achievement of students. Based on their training in systems theory, leadership skills in facilitation, advocacy, coordination, and strong clinical skills, school social workers have the unique opportunity to align existing services and clinical practices with emerging expectations to support RTI and SEL mandates in schools. These expectations and challenges should be met, developed, and expanded by the school social worker. They should be viewed as an opportunity to becoming a visionary practitioner and segue to the future of the profession.

REFERENCES

• Durlak, J. A., Weissberg, R. P., Dymnicki, A. B., Taylor, R. D. & Schellinger, K. B. (2011). The impact of enhancing students’ social and emotional learning: A meta-analysis of school-based universal interventions. Child Development, 82, 405–432. doi: 10.1111/j.1467-8624.2010.01564
• Illinois State Board of Education (n.d.). Illinois learning standards: Social/emotional learning. Retrieved from http://www.isbe.net/ils/social_emotional/word/SEL_goal1.doc
• McKay, C., & Johnson, A. (2010). Service learning: An example of multilevel school social work practice. School Social Work Journal, 35(1), 21–36.
• McKay, C. (2010). Critical service learning: A school social work intervention. Children and Schools, 32(1), 5–13.
• Morrison, V., (2006). History of school social work: The Illinois perspective, one hundred years of school social work: past, present, and future 1906-2006. School Social Work Journal, 30(3), 1–23.
• The National Center for Response to Intervention. What is RTI?. Retrieved from http://www.rti4success.org/whatisrti
• Zins, J., Weissberg, R., Wang, M., & Walberg, H. J. (2004). Building academic success on social and emotional learning: What does the research say? New York, NY. Teachers College Press.

Annette Johnson, ACSW, LCSW, is clinical assistant professor at the University of Illinois at Chicago Jane Addams College of Social Work where she teaches in the school social work concentration. She has a keen interest in developing school-based clinical practices that focus on strengths and assets.
 

As the United States emerges from the Great Recession, family financial stability is rocky, confidence in a brighter economic future is anemic, American competitiveness has been challenged, and faith that government has the competency to fix things is at an all-time low. Contrary to the rhetoric of election-minded politicians, these realities and sentiments are not simply the result of a challenging last few years, but rather have been fermenting over the course of the last three decades. In The Price of Civilization, economist Jeffrey Sachs sets out to diagnose how it is that America got to this disheartening point by providing historical and economic context, then devotes equal time to outlining a framework for the nation to emerge from this economic crisis to once again live up to its values of prosperity, equality, and opportunity.

America's economic woes, according to Sachs, are the result of failing to recognize and adequately plan for the implications of the global economy. Instead, beginning with Ronald Reagan, who insisted that government was the problem and not the solution, and continuing full-force with every presidential administration since, Washington has dismantled government programs that could improve America's international standing, decimated programs that help ameliorate the impacts of globalization for Americans, and handed over key functions and decisions to the private sector, thus severely handicapping the government's ability to effectively steer the economy and ultimately resulting in the 2008 meltdown.

Sachs argues that the result is not just an economic crisis, but a moral crisis: "America has developed the world's most competitive market society but has squandered its civic virtue along the way. Without restoring an ethos of social responsibility, there can be no meaningful and sustained economic recovery."

The perpetrators of this moral crisis are many: The economic elite who accumulate vast sums of wealth and spend enormous amounts of energy to ensure that as little of it as possible is taxed for use to support the collective well-being. The political elite who through campaign contributions and the revolving door between Washington, Wall Street, and Big Oil are all but beholden to those economic elite, passing policy after policy that ultimately favor special interests over the common good. The media—owned by massive corporations—that happily plays along. And an American public that has retreated behind televisions and computer screens, foregoing meaningful engagement with their communities and thoughtful consideration of social, political, economic, and environmental issues.

While there is certainly no shortage of doomsday writings on the dangers of unbridled capitalism, The Price of Civilization brings a solutions-oriented perspective to the milieu, one ultimately grounded in faith and optimism in America and more specifically, in Americans. While readers may not fully agree with Sachs' assessment of the country's ills or concur on all his suggested solutions, the thoughtful reader will certainly be challenged by Sachs's call to a mindful society where citizens, communities, and government alike look beyond themselves and the here and now to help ensure American prosperity for generations to come.

Social workers in particular will further gain an appreciation for how larger social and economic forces influence the realities—such as poverty, injustice, isolation, fear—that many of us face in our work on a day-to-day basis. Sachs' book is an important reminder to social workers that not only must we be present on the ground helping to ameliorate the symptoms of society's most pressing issues, but we must also be fully engaged citizens who personally exhibit compassion and generosity, who commit to principles of sustainability and responsibility, and who demand the same of their government and their business sectors.

Amy Terpstra, MSW, is associate director of the Social IMPACT Research Center at Heartland Alliance. Amy’s work focuses on researching and disseminating knowledge on poverty, income, and housing-related issues. As an agency spokesperson, Amy educates decision-makers at all levels as well as media about economic hardship and solutions. She is lead contributor to many of IMPACT’s ongoing projects including the annual Report on Illinois Poverty and the Illinois Self-Sufficiency Project.  Amy is currently leading a multi-year, multi-method evaluation of Illinois’ subsidized employment program, Put Illinois to Work.
 

As we head into 2012, preparation begins for the new spring legislative session in Illinois. There are no scheduled session days until January 31, 2012. During January and early February there will be thousands of bills introduced in both the Illinois House and Senate. Committtee hearings on bills will begin in February.

Key issues this year will be, as usual, the Illinois state budget and the closely related issues of how to address the state's growing pension payment obligation and unpaid bills that disproportionately affects human services and health care providers.

Here is a timetable of important dates on the 2012 Spring legislative schedule:

• January 26: House Deadline for New Bill Requests at the Legislative Reference Bureau
• January 31: Senate Deadline for New Bill Requests at LRB
• February 1: Governor's State of the State Address
• February 10: Deadline for introducing new bills (Senate)
• February 13–17: No Session
• February 16: Deadline for introducing new bills (House)
• February 22: Governor's Budget Address
• March 9: Deadline for Substantive Senate Bills to Advance out of Senate Committees; Deadlne for Substantive House Committees to Advance out of House Committees
• March 20: Primary Election
• Late March: Social Work Advocacy Day
• March 30: House Third Reading Deadline for House Bills; Senate Third Reading Deadline for Senate Bills
• April 1–16: Easter and Passover Break
• May 4: Deadline for Substantive Senate Bills to Advance out of House Committees; Deadline for Substantive House Bills to Advance out of Senate Committees
• May 25: Senate Third Reading Deadline for House Bills; House Third Reading Deadline for Senate Bills
• May 31: Scheduled Adjournment

BUDGETING FOR RESULTS COMMISSION
The Budgeting for Results (BFR) Commission issued its first report on November 2, 2011. To read the report go to www. Budget.Illinois.gov and click on the link for the BFR Commission. A link to the report will be available on the commission's home page. The commission has scheduled meetings each month from January through August. The schedule and minutes from previous meetings are available on the commission's website. The next meeting will be held on January 27, 2012, by video conference in Chicago (16-100 Thompson Center) and Springfield (Room 205 State Capitol Building) from 1:00 to 3:00pm.

The governor is set to issue a report on budget priorities and revenue projections for the next three years in the next couple of days. This is required under the same law that created the BFR Commission.

I have just returned from the NASW Ohio state conference. Their theme this year was Effective Leadership: Built on the Code of Ethics. Effective leadership based on the NASW Code of Ethics translates to ethical leadership. The code purpose states: “[E]thical responsibilities flow from all human relationships, from the personal and familial to the social and professional.” The implication is that, as social workers, the goal is to integrate the fundamental values of the profession into every aspect of our lives.

The title of the Ohio conference was “Leadership with Vision.” Leadership is not specific to a position, role, or skill set. "The very essence of leadership is that you have to have a vision. It's got to be a vision you articulate clearly and forcefully on every occasion (Theodore Hesburgh, President of the University of Notre Dame).” It involves, “knowing yourself, having a vision that is communicated well, taking effective action to realize your own leadership potential” (Warren Bennis).

In Everyone Leads: Building Leadership from the Community Up, Paul Schmitz states that leadership is not simply about being in charge. Leadership is earned “by the values, practice, and responsibilities you take on.” He offers the example of The U.S. Army Field Leadership Manual that utilizes the following model:

Be: Know who you are, be aware of your own values, vision, and what guides you.
Know: Have the knowledge base and skills to realize your vision and goals.
Do: Living into and exemplifying your values on a daily basis and putting into practice the tangible steps to achieve the goals.

Leadership is also the process of social influence in which one person can enlist the aid and support of others in the accomplishment of a common task. We choose to assume a role based on our values and vision, independent of our assigned role or position. Ethical leadership is about how we approach and manage each situation in our personal and professional lives. Whether we are the director of an agency, are working in the community, or are involved in clinical practice, we are attempting “to persuade others to see something from a new perspective and to motivate them to take action on behalf of that perspective” (Jaime Chahin, PhD Ethical Leadership and Values).

A clear vision results from awareness of our own values. Values are distinguishable elements denoting preference based on belief or obligation, our attitudes about the worth of people, concepts, or things. Values underlie our highest priorities as well as our deeply held driving forces and beliefs. Our personal values define where we spend our time if we are truly living them. Will we be the same person at home as at work? How do we interact in various community settings?

As social workers, ethical leadership is fundamentally about having the insight and courage to live out our values when there is pressure to compromise or rationalize them away. It is in situations where we are faced with ethical dilemmas—competing duties that require rank ordering of value—that ethical leadership is most needed.

Professional ethics are at the core of social work. “The NASW Code of Ethics offers a set of values, principles, and standards to guide decision-making and conduct when ethical issues arise. It does not provide a set of rules that prescribe how social workers should act in all situations. Ethical behavior should result from personal commitment to engage in ethical practice. Principles and standards must be applied by individuals of good character who discern moral questions and, in good faith, seek to make reliable ethical judgments (NASW Code of Ethics).”

The purpose section of the Code of Ethics states:

“[S]ocial workers also should be aware of the impact on ethical decision making of their clients' and their own personal values and cultural and religious beliefs and practices. Ethical decision making in a given situation must apply the informed judgment of the individual social worker and should also consider how the issues would be judged in a peer review process where the ethical standards of the profession would be applied. Actions should be consistent with the spirit as well as the letter of this Code.”

The core values embodied in the Code of Ethics are:

Service: Elevate service to others over self-interest.
Social Justice: Pursue social change, nondiscrimination, cultural awareness, equal access.
Dignity and Worth of the Person: Respect, cultural sensitivity, self-determination, dual responsibility to clients and society.
Human Relationships: Vehicle for change; way to strengthen and restore individuals and communities.
Integrity: Being trustworthy and honest, self-assessment, promoting ethical practices.
Competence: Practice within areas of expertise, increase knowledge, contribute to the profession.

The Code of Ethics does not specify which values, principles, and standards are most important and ought to outweigh others in instances when they conflict. It acknowledges the possibility of conflicts within sections of the code and the need to consider the context of in any situation.

A central conflict or challenge that most social workers face frequently is in the area of service. We are asked to draw on our “knowledge, values, and skills to help people in need and to address social problems.” This value can only be truly and consistently lived into when it is in balance with using “knowledge, values, and skills to help” ourselves. Ethical leadership and practice requires social workers to do critical thinking, make difficult and crucial decisions, manage our own human reactions, interact respectfully with clients, colleagues and organizations and contribute to the mission of “enhancing human well-being”. It is impossible to achieve this vision if we are burned out, exhausted, ill, stressed out, or chronically overextended. Ethical competence is closely associated with the concept of emotional competence or intelligence which determines our awareness level and how well we handle ourselves and each other. It means knowing both what our clients need and what we need to be successful.

Leadership qualities embraced by the Code of Ethics include the following:

• Leading in a manner that respects the rights and dignity of others
• Assisting followers in gaining a sense of personal competence that allows them to be self-sufficient
• Encouraging and empowering others
• Leadership with, from behind, or shoulder-to-shoulder
• Awareness of how decisions impact others
• Using personal and social power to serve the greater good instead of self-serving interests (avoiding conflicts of interest)
• Combines ethical behavior and ethical decision-making

Bill Grace offers a model for values-based leaders. It is very compatible with the NASW Code of Ethics. He describes some of the following traits of values-based leaders:

• Remain grounded in a sense of self-understanding that lends stability to their purpose and keeps them pursuing their vision over the long haul.
• Actively notice where their practice is not in alignment with their primary values and continually make adjustments to increase conformity to their ideals.
• Know when they face moral choices and exercise courage to wrestle with competing values, make the choice, and defend their decisions.
• Earn the respect of their peers because they are reliable, trustworthy, and consistent.

The Code of Ethics is aspirational. It offers guidance in the daily process of personal and professional decision-making. Ethical leadership is about who we are and how we live our lives. Ask yourself what is truly important in your life. If you listed five values and had to rank them in order, which would rise to the top? Where am I living into my values and where are they compromised? In the final analysis, it comes back to our own willingness to ask difficult questions and act on the answers.

Ruth Lipschutz, LCSW, ACSW, is a licensed clinical social worker with postgraduate certification in ethics, mediation, Transformational Imagery, hypnotherapy, and Eye Movement Desensitization and Reprocessing (EMDR). She received her MSW from the University of Illinois in 1978 and went on to complete the two-year postgraduate training program of the Institute for Family Studies at Northwestern University. She has extensive experience in the areas of ethics, mental health, addictions, traumatology, program development and implementation, supervision, consultation and Alternative Dispute Resolution. She is the chairperson of NASW’s National Ethics Committee and has served as a panelist, consultant, mediator, and trainer for the NASW Illinois Chapter Ethics Committee. She is currently in private practice.
 

OFFICE FOR RENT - Orland Park
Hourly/monthly office rentals-new furniture/carpet, computer/internet, shared waiting area, restrooms & kitchenette, parking-utilities included. 630-890-1907 & office pictures @ jamessimmerer.com.

OFFICE FOR RENT - Oak Park
Oak Park Lake Street Location. Atrtractively furnished office and wait room.
Large windows with eastern exposure. Seeking full or part-time renter.
Joel Sherr 708-214-8768. jsherr611@comcast.net

NASW ILLINIOS CHAPTER JOB BOARD
For a complete and up-to-date list of job board postings, visit the NASW Illinois Chapter Job Board: http://www.naswil.org/education-career-development/association-job-board/.

• Social Service Director
• Mental Health Specialists III (Cook County Health & Hospitals System)
• PT/FT Outpatient Therapist (Lake County Counseling for Seniors)

It was Thursday, November 7, 1991. I had just begun my career in the field of social work at a small private child welfare agency on the south side of Chicago and was enjoying every minute of it.

I was with co-workers and we were preparing to go out to lunch together. As we settled into the car, we turned on the radio to listen to music as we scouted out a place to eat. There was a program interruption and Earvin “Magic” Johnson of the Los Angeles Lakers began announcing that he would be retiring from the NBA because he had tested positive for HIV, the virus that causes AIDS. We were silenced by this announcement. As young men and women just starting our careers in the field of social work, it meant a lot of things to many of us. Most of all, it put a familiar face to the disease. A 32-year old African American heterosexual man who was known all across the country had been diagnosed with HIV. Although many Americans had fallen ill and died from complications related to AIDS from 1981 to 1991, it was widely believed that this disease was more prevalent in the white homosexual community. As we would learn over the next twenty years, this was not the case.

Here we are twenty years later, and the statistics have changed drastically. According to the Center for Disease Control, there is an estimated 1,142,714 people that have been diagnosed with AIDS in America since the beginning of the epidemic. HIV and AIDS disproportionally affect racial and ethnic minorities in impoverished communities. As a result, community health centers have become a major source of HIV prevention, care, and treatment. New infections are increasing in the African American heterosexual community as well with individuals between the ages of 24 and 40. Social workers across the country play vital roles in working with and advocating for people living with the disease in the areas of prevention education, advocating for low-cost testing, and working closely with medical providers to ensure that people receive the best medical care possible. Although gains have been made in the development of antiviral drugs and people are living longer with the disease, there is no cure and we still have a very long way to go.

December 1st is World AIDS Day. This is an opportunity for people worldwide to unite in the fight against HIV. The red ribbon has been an international symbol of AIDS awareness since 1991. It is worn as a sign of support for people living with HIV. On this day, we challenge everyone to do something to support this cause as we continue to raise awareness, eradicate the stigma and prejudice around the disease, and support individuals and families impacted by this disease.

Yolanda Jordan, MSW, LCSW, has an extensive background in abuse/neglect issues in the field of child welfare. As a placement manager with the Illinois Department of Children and Family Services, she is responsible for managing supervisors who are responsible for children who are placed in the foster care system. Yolanda is also a practicing psychotherapist and has been in private practice for the past ten years. Services are provided to children, couples, and families with a special emphasis on relationship issues that African American women face.

Yolanda is a graduate of Western Illinois University where she received her bachelor of arts in mass communications and master of arts in public communications human relations with a minor in African American studies. Due to her extreme love for people and having the heart of a servant, she continued her education and received a masters in social work with an emphasis on child and family practice from the University of Illinois at Chicago’s Jane Addams College of Social Work. Yolanda has been an active member of the NASW Illinois since 1996 and enjoys the work of advocating for the profession of social work and the community that social workers serve.

It was an honor being asked to write an article for the NASW Illinois Chapter newsletter. Then I realized I actually had to come up with something to say to my peers who know the practice arena in Illinois far better than I do. I decided to write about return on investment, something that has been an important part of my professional agenda lately. I am often challenged when asked, particularly by non-social workers, what the value is or added worth of having social workers involved in our processes.I hope that the thoughts are relevant to practice here, and I so look forward to meeting my new colleagues and joining with old friends as I make my return to Chicago and Illinois.

When we think about today’s social work practice environment, it is absolutely imperative that we consider the ways in which our practices are able to produce changes we intend, to minimize undesirable outcomes, and to do so in an economically efficient way. Additionally (and no less important) is the impact of our practices on multiple stakeholder groups (i.e., clients, funders, other professionals, etc.) who either receive or are affected by our practice. In sum, we consider the total return on investment of the work we deliver.

While return on investment (ROI) is not a new concept (Chorptia & Regan 2009), its’ application in social work educational, research, and practice arenas is not so evident. In fact, in preparing this essay, a literature review of social work journals found very few published articles on the topic. This is unfortunate because in today’s tight economic environments where greater emphasis is placed on cost containment, use of evidence-based or evidence-informed models of practice have become goal- and results-oriented. It has become necessary for social work practitioners to be able to: (1) Speak clearly to the ways in which their practices will produce not just desired results, but (2) a positive return on the investments of time, monies, and human resources, and (3) are seen as valued by client/patient groups. This is no small order and deserves considerable attention in educational and training environments as well as in our practice settings. In this essay I will provide a few ideas offered as points of departure (not solutions) for our profession to consider in setting and advancing a strategic social work agenda. The goal here is to contribute to the resources that stimulate our collective professional energies for optimal client outcomes and professional rigor.

In its crudest definition, a return on investment assesses the efficiency of an investment against the costs of that investment. In contemporary social work and human and health practices, this is often operationalized as the ways in which evidenced-based practices are diffused or translated by trained professional in “real world” settings and used consistently to produce desired outcomes. The additional consideration of financial impact is added to this logarithm in ultimately weighing societal value for utilizing a practice or set of practices.

Arguably there are more astute articulations of the science that goes into actually calculating an ROI; however, these far exceed the capacities of this paper or the skill sets of this author. In fact, for the purposes of this essay we might argue that ROI can be framed simply as a clear articulation of three things: What practice(s) we do; Why we do that practice; and What differences (outcomes and financial) the practice(s) makes. The point I am trying to make here is that increasingly in competitive professional environments, we as professional social workers have a responsibility to speak not just about the good we do; it is also our responsibility to speak about the ways in which the good we do is purposive and considers investments of time, finances, and other resources if we are going to continue to be viable competitors in mental health, health, and human and social services. This is not just about re-languaging ourselves, but rather it goes to the very fiber of our professional commitment to social justice. The discourse on and practice of ROI must include an understanding of the ways in which our clients see, understand, and experience the impact of our work, not just the impact we believe we have our clients. These commitments to social justice actually move us into a closer alliance with meaningful societal returns that can be articulated in service outcomes as well as economic returns.

There are at least three areas we must address across the spectrum of professional practice in order for us to be able to competently incorporate this focus on ROI. This would include the academic training of students entering the profession, the development of practice and supervision models that incorporate ROI content, and advancing the theory and research on specific benefits of social work contributions.

The academic preparation of students—and by extension, the ongoing learning of social work academicians—will need to incorporate practices that speak to ROIs for clients and social work professionals. In their work examining the financial returns on specialty training for physicians, Weeks & Wallace (2002) offer contextual lessons for social workers to consider in developing practice-oriented learning environments (i.e., specialties) that are anchored to market forces, student desires and interest, and societal needs. Recognizing that many forces are beyond the control of educational institutions is not a panacea for ignorning these factors in advising students about the profession or for developing curricula that do not take into consideration the social, political, and economic realities of the practice environment. Social work learning models and the professionals our institutions produce must consider these factors in framing our educational platforms. Rigidly articulated competencies that are based on evidence-based practice (EBP) have mixed results in terms of translating to innovative and applicable scaled-up “real world” practice and should be critically examined in an ongoing process that includes the voices of those who will receive the services we implement, including the clients/patients and providers (Jacobson, Jones & Bowers, 2011).

Secondly, practice environments—although often constrained by practical matters of finances and limited staff—have to incorporate supervision and ongoing staff development that address ways to assess and incorporate return on investment thinking and practices. It is not enough to say we want it without finding ways to bring it into the practice setting.

Lastly, social work scholars have to produce knowledge that is directly relevant to social practice and not just resulting in “more research needs to be done” or based solely on randomized clinical trial (RCT) models as we know these have very dubious payoff in terms of translating the findings into good social work practice (Jacobson, Jones & Bowers, 2011).

There are undoubtedly many other factors that will challenge and perplex social workers (and other professionals) in taking on the questions of how to incorporate return on investment in their practices. However, without this focus it is likely the relevance and viability of our professional practices, and ultimately our profession, may be left to others to measure and evaluate. The consequences of this would likely not bode well for us or for the clients we value and serve daily.

REFERENCES

Chorpita, B.F. & Regan, J. (2009). Dissemination of effective mental health treatment procedures: Maximizing the return on significant investment. Behaviour Research and Therapy, 47, 990-93.

Jacobson, J.M., Jones, A.L. & Bowers, N. (2011). Using Existing Employee Assistance Program Case Files to Demonstrate Outcomes. Journal of Workplace Behavioral Health. 26:1, 44–58.

Weeks, W.B. & Wallace, A.E. (2002). Financial returns on specialty training for surgeons. Surgery. 132, 795–802.

Darrell Wheeler, PhD, MSW, MPH, is dean and professor at Loyola University Chicago School of Social Work. Prior to taking this position, he was professor and associate dean for Research and Community Partnerships at the Hunter College School of Social Work. He is also on the doctoral faculty of the The City University of New York (CUNY) School of Public Health, The CUNY Graduate Center, and a member of the Center for Study of Gene Structure and Function at Hunter College. He currently serves on the editorial boards of Journal of Gay and Lesbian Social Services, International Journal of Men’s Health, and Journal of HIV/AIDS in Social Services. Dr. Wheeler is a fellow in the New York Academy of Medicine, and is a member of the American Public Health Association and the National Association of Social Workers (national Vice President 2009-2012).

Social workers are increasingly using electronic communications technologies to expand and refine their practices, including psychotherapy performed via videoconferencing, and this has raised many questions about professional social work standards.  Use of videoconferencing technology in mental health service delivery is variously referred to as “telepsychiatry,” “telemedicine,” “telemental health,” “e-therapy,” “distance counseling” and other terminology.  One of the most widely available videoconferencing technologies is an online service and software program known as Skype.  Its wide acceptance as a consumer technology has made telemental health services readily available for clients in their own homes and for solo and private practice clinicians without a burdensome investment in new technology.  This first of two articles will review some of the emerging legal and professional issues involved in the use or potential use of Skype or similar technology as a communications modality for clinical social work assessment and treatment of clients.  Part II will review legal cases and statutes, including state social work licensure. 

To read the rest of the article, click here. NOTE: NASW login required.

I continue to consider myself beyond fortunate to have been surrounded by positive, encouraging, and uplifting professionals in my career. Early on in my social work career, one of my mentors would frequently instruct me that until I recognized myself as an expert, others would have no choice but to doubt my credibility as well. At that time, I was a single, twenty-six-year-old woman with no children who was working in an addiction treatment center’s women and children’s program. A big part of my professional duties at that time included a combination of teaching parenting skills to people who had an addiction issue as well as testifying in court. Both of these duties required me to develop the mindset of being the best at what I did. This is an essential skill in building a private practice in that the majority of people who begin seeking a therapist are looking for the expert in what they are struggling with. The truth of the matter is that most of us want the expert in whatever area we are looking to assistance for, whether it’s plumbing repairs, mechanic issues, child care providers, or medical professionals.

The next step to being a successful private practitioner is understanding compensation. If you are providing a service, you need to be able to claim that service with attitude, conviction, pride, and in payment. Early on, I easily allowed myself to be manipulated by people not wanting to pay the full cost of my services. The reality was that I not only short-changed their self-esteem (If you are offered a discounted rate on something that is in many respects saving your life, how would that impact your view of yourself?), but I also diminished my ability to know, believe, and proclaim that I was the best at what I do. In other arenas, the best of the best do not generally offer random people discounted services. Social workers need to adapt that mindset.

At some point in my professional career I subconsciously developed the mindset that as a social worker, I needed to help the most impoverished people. While I will always hold a special place in my heart for those people, creating my own private practice has taught me that not only do people who can afford services deserve help, but they need it just as pervasively as people who are struggling financially. This was not only a paradigm shift for me, but it also forced me to adjust my business practices. In the beginning of my private practice whenever someone would call and inquire about the cost of my services, I would sheepishly tell them that. The obvious next step was for them to try and convince me to reduce the charge, and in the beginning I did this. My mindset at that time was that a few clients paying a reduced rate were better than no clients being charged the full price. What I was unaware of during that time was that when I offered discounted services to people, it not only diminished my professionalism but it short-changed their self-esteem. The people I work with today know and believe that they are worth paying full price for my services. Changing my rates sends them the message that they are not worth paying full price or that their issues are not sacred enough. My company motto is “You are worth the effort,” and as such, I need to remain cognizant of the factors involved in this. Currently, I do not offer a sliding fee scale in my private practice. This is primarily done to strengthen the gap between my full-time position in a nonprofit agency and the clients I serve in my own practice. As my referral base, client load, and demand continue to grow, it may be something I look into. However, at this time I must recognize that the best electrician, physician, and mechanic do not offer discounts simply because they hold some convoluted belief that they are not entitled or deserving of making a profit.

In my reading I ran across a statement, “Social workers, by their nature, do not believe that they deserve to make good money.” If you had the option between two physicians, one who did not offer discounted services and believed he/she was the best at what he/she did, or the other who offered the discounted service but also believed he/she was good at what he/she did, which one would you put your faith and trust in? The answer seems pretty simplistic, yet it can be a huge paradigm shift for most professional social workers.

Jenn Bovee, MSW, LCSW, CRADC, graduated from St. Ambrose University (Davenport, IA) with her MSW. Originally from Iowa, Jenn moved to central Illinois in 2008. Jenn has always been very active social worker striving to help as many people as possible. Most recently Jenn has been employed full-time in a residential treatment center and a group private practice. Earlier this year she opened her own practice—Finding Your Path to Freedom in Bloomington, Illinois. Jenn uses her rich professional experience, her education, as well as her intuition to specialize in mental health, addiction, and trauma.
 

For decades, the role of social work in schools has been fulfilled by skilled clinicians assigned to counsel a caseload of students with behavioral or mental health issues and to aid in compliance for students with special education needs. While this role for social work clinicians continues to be important, recent research and urban education reforms have redefined the connection between social work and education.

Institutions such as the Consortium on Chicago School Research (CCSR) have offered an exciting body of empirical evidence which makes clear that school-based socio-emotional supports are an essential element of academic success and school improvement. In 2006, a key CCSR report, “The Essential Supports for School Improvement,” found that with increased student-centered learning environments and adequate parent/community ties, Chicago schools saw the most compelling gains in student outcomes (Sebring, Allensworth, Bryk, Easton, and Luppescu, 2006). Further, schools with higher evidence of relational trust—the positive relationships among members of a school community, including staff members and families—saw a crucial improvement in student performance (Bryk, Sebring, Allensworth, Luppescu, & Easton, 2010).

Simultaneously, recent education reform efforts have brought forth the creation of many new schools—charter schools—independently operating outside of the traditional urban school models. While there is earnest debate about the propriety or effectiveness of charter schools in urban districts, they have nonetheless claimed a presence in the current landscape of urban education. Despite criticism, some of these new schools are turning towards social work as they invest more resources in promoting social-emotional well-being and sustained community partnerships. In many cases, this investment in social work support appropriately departs from the traditional model by commissioning workers to bring their unique training directly to school leadership teams.

The Traditional Model of Social Work in Urban Schools

Perhaps the largest single employer of school social workers in Illinois, the Chicago Public School’s Department of Special Education and Supports defines the responsibilities of the school social worker’s role almost entirely through their work with students with Individualized Educational Plans (IEPs). They define a school social worker’s role into four areas of responsibility: 1) Managing and documenting IEPs; 2) Delivering social work service minutes as determined by students’ IEPs; 3) Assisting in whole-school crisis intervention; and 4) Creating community partnerships and linkages (http://www.cpsspecialeducation.org). Missing from this model is a place for social workers on the leadership teams to help organize power structures in their assigned schools. Also missing from their job description is a clear directive towards community organizing and relationship-building within the local power structures in a given school’s greater community. Not only are social workers’ lack of organizational power immediately glaring, never before has it been so important that school leadership teams understand the effects of these policies from an ecological systems perspective.

It is common for many social workers in urban settings to work with student caseloads at multiple schools in vastly different community contexts. In addition, in urban contexts like Chicago, families are now given unprecedented access to schools across districts through “open enrollment” policies. No longer are families necessarily connected to the school buildings in their neighborhoods; instead, many students may commute one or two hours each way on buses and trains, at times traversing the entire city through unfamiliar neighborhoodsand facing potential roadblocks to their success. Due to the multifaceted training that social work education provides, social workers may be among the best leaders to help understand and meet these growing needs of urban students and families.

Joining Social Work and School Leadership: A Personal Perspective

I received my Type 73 ISBE certification after completing a second-year internship working primarily with students with IEPs within a large suburban Chicago high school. This experience was invaluable to me in my development as a clinician and provided me with an understanding of the social work supports provided for students with social-emotional and developmental disabilities. However, I knew that my personal interest in balancing clinical responsibilities with an administrative leadership role would not be supported in most “Type 73” school social work positions available.Through my affiliation with The University of Chicago’s Community Schools training program, I became familiar with researchers and school social workers in the field who are currently redefining the role of social work in urban schools. Beyond their clinical responsibilities, I was struck by how much influence these social workers had as leaders in their schools. These workers were free from the responsibility of solely carrying a special education caseload and providing minutes; rather they worked with teachers and administrators to bring social supports to the school as a whole.

I was fortunate to secure a position at Perspectives Leadership Academy, a charter high school in Chicago’s Auburn Gresham community. Utilizing a unique school social work position, the Perspectives Charter School Network has made an increasing investment in social support services by hiring social workers for each of its five schools to be school leaders free of the traditional duties of IEP service delivery. (At Perspectives schools, important special education responsibilities are fulfilled by a separate team of Type 73 workers tasked with ongoing clinical work.) Therefore, I am able to work within the context of the entire school with both general and special education students and teachers.

One of the most distinctive elements of my role has been my place on the school leadership team. Matters of school policy, programming, teacher support, and mitigating difficult issues are met by a team led by the school principal and involve instructional leaders, administrators, and support staff. In this role, I am able to bring a social work perspective to the table, especially when an understanding of adolescent development and ecological systems perspective is warranted to problem-solve or advocate for the needs of our students or staff.While I am working to hone the responsibilities and limits of this role, it has allowed me to have the ability to be more impactful in developing social supports on a school-wide level while retaining the ability to provide individual support services for students and families.

Part of my leadership role in the school has been to provide fellow school leaders with access to different forms of student voice. Through crisis intervention, clinical case management and group work, whole school surveys, and focus groups, I am able to help distill some of students’ pressing social and emotional needs in order to help design curriculum and policy that might begin to address them. I am able to bring social work–informed needs assessments on a variety of topics to school staff through collaborative consultation, professional development workshops, and providing connections to community organizers and outside agencies.

Redefining Social Work Roles in Your School or District

Alongside describing aspects of an emerging field of social work within the context of education reform, this is a call to action for social workers to explore and advocate for leadership positions. Indeed, many social workers will continue to provide the clinical services necessary for special education students, but new opportunities for social workers are emerging that combine clinical skills with administrative responsibilities. Research clearly indicates that urban education cannot continue to look at instructional practices and school programming independently of social and emotional well-being and the health of the surrounding community. Through a unique training in systems theory, in human development, and in class, culture, and power, we as social workers can bring a necessary perspective to school leadership teams as they design and operate schools.

Recent innovations in new school development have led to different ways of organizing leadership roles and school power structures, but principal-led models of school leadership will likely remain for well into the future. Perhaps social workers may not be the best candidates for the role of principal; indeed, strong leaders in instruction and curriculum are likely the best candidates to manage and support a workforce comprised primarily of teachers. In light of this, how can social workers—individually and as a field—begin to explore a redefinition of their roles within education’s organizational structure? With a renewed awakening surrounding the importance of social and emotional well-being in schools, school administrators and investors will be looking for individuals in leadership positions who possess a broad understanding of social problems and creative, person- and community-centered solutions. Therefore, the responsibility now firmly rests on education-minded social workers and graduate training programs to meet this need and advocate for the place of social work in this emerging landscape.

Closing questions:

• How can individual social workers strengthen relationships with school administrators and further advocate for a redefined leadership role in their schools?
• How can professional advocacy organizations like the Illinois Association of School Social Workers, the NASW, and graduate training programsin social work help to open this emerging field?
• What opportunities are available to help policy-makers and funders understand the unique lens that social work can bring to strengthen our young people, families, and communities through ever-important school contexts?

References

Sebring, P. B., Allensworth, E., Bryk, A. S., Easton, J. Q., & Luppescu, S. (2006). The essential supports for school improvement. Chicago, IL: Consortium of Chicago School Research.

Bryk, A. S., Sebring, P. B., Allensworth, E., Luppescu, S., & Easton, J. Q. (2010). Organizing schools for improvement: Lessons from Chicago. Chicago, IL: The University of Chicago Press.

Benjamin McKay, MA, serves as Dean of Student Support at Perspectives Leadership Academy, a charter high school in the Auburn Gresham neighborhood. A graduate of the Clinical School Social Work program at The University of Chicago’s School of Social Service Administration, he has worked in the fields of mental health, mentoring, and drug abuse research, and has served in public high schools in Baltimore, Chicago, and Evanston prior to his current role at Perspectives. His interests in school social work focus on clinical case management, developing community partnerships, and expanding the role of social work in school leadership and organization.
 

County: Life, Death, and Politics at Chicago's Public Hospital by David Ansell, MD, was truly revealing as to the medical care provided during the 70s through 80s at a leading public medical center. As a social worker having worked seventeen years at Cook County Hospital, I would certainly have to agree with Dr. Ansell’s concern for care, the way patients were processed, the lack of accountability by some staff, and the patronage of people coming on board that have no experience or who are in the process of disciplinary action and are simply moved to another department to save their jobs. I would agree that Dr. Ansell captured the culture, frustrations, and experiences faced when advocating to patient and community needs. The attention to the detail of conversations was remarkable, and I related to the same comments made when I started in 1992. I recall my first years at Cook County Hospital as feeling overwhelmed with dread after seeing patients pack the hallways trying just to see someone that day.

Dr. Ansell mentioned other medical residents that helped to advocate for improved patient care in an antiquated healthcare system. Some of the leaders mentioned in the book are still very much active, such as Doctors Terrance Conway, John Raba, and Linda Murray. I was fortunate to have the privilege of working side-by-side with these individuals, watching them inspire leadership and advocate to provide quality and dignity of care.

This book not only depicts the horrors of medical care provided at the time, but also shows champions standing up to a political machine that should not have been in the business of providing healthcare; that change came about only through the consistent hard work of strong leaders. After having worked at Cook County Hospital and then later for ten years under the Ambulatory Network, I feel extremely comfortable seeking care at the county system with its remarkable care teams and changes to leadership. The Cook County Hospital Trauma Center consistently ranks as one of the top two centers in the United States; its’ oncology program ranks well above the national average in survival; and the infectious disease, neurology, neonatal, and a host of other programs continue to rank highly as well.

Despite constant chaos, a lack of resources, a missing vision and sense of mission, and a culture of indifference to change, champions like Dr. Ansell and others remained to change the healthcare system. They didn’t know whether they would have a job, be arrested, or be fired. Instead, they worked to create a process to change the culture, make healthcare accessible, and strive for maintaining standards for a number of programs within the county healthcare system.

I find the book an inspiration not just to see the barriers that were in place at the time (and which, to a degree, might still exist), but empowering in its message for change. As a social worker, who better to understand and know how to work with systematic organizations as change agents?

In Chicago, Occupiers have been supported by the Chicago Coalition for the Homeless, The American Federation of State, County, and Municipal Employees (AFSCME), and other nongovernmental organizations. Because people experiencing homelessness are clearly the “99%”, and the Occupy Movement is promoting more equitable distribution of wealth, these are natural partners. Members of AFSCME are likely participating because of the Illinois state worker pension cuts, which seem ironic in an era where Wall Street criminals get bailouts and profit off of the public money keeping their business afloat. What is clear is that the Illinois and national debts have forced lots of cuts—but primarily to consumers of social work services and to the social workers who provide these services.

However, Occupy Wall Street has drawn heavy criticism for many reasons. The movement is highly organic, and there are not official spokespeople or leaders. Furthermore, there is not yet a consensus-approved list of demands or a political platform. In fact, you can plainly see the disorganized mess of ideas reflected in the varied signs and slogans promoted by participants. Chicago organizers have coordinated a week-long “teach-in” to accompany the protest, and about a dozen professors from local universities have given brief lectures on the sidewalk. The topics presented sound like a year’s worth of MSW classes: nonviolent protest; gendered capitalism; labor, value, and exploitation; and public housing and the plan for transformation. Certainly not least suspect is the fact that hundreds of Chicagoans have been arrested in connection with the protests, primarily for refusing to leave public property when directed to do so by police officers.

The preamble to the NASW Code of Ethics begins: “The primary mission of the social work profession is to enhance human well-being and help meet the basic needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty.” This message will help social workers assess the importance of the movement in the months ahead.

OFFICE FOR RENT - Oak Park 
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NASW ILLINIOS CHAPTER JOB BOARD
For a complete and up-to-date list of job board postings, visit the NASW Illinois Chapter Job Board: http://www.naswil.org/education-career-development/association-job-board/.

• Outpatient Therapist (Palos Community Hospital)
• Psychotherapist (Grand Oaks Behavioral Health, LLC)
• PT/FT Private Practice (Herington Counseling and ConnectEdPAIRS)
• Alzheimer’s Association-Greater Illinois Chapter

The late fall traditionally begins the leadership recruitment process in the chapter. The NASW Illinois Chapter thrives because of the involvement and leadership of our membership. Moreover, the social work profession is strengthened by strong chapter leadership. If you or a colleague is interested in joining the NASW Illinois Chapter leadership team, you can find out more by reviewing our 2012 Leadership Recruitment Packet on the chapter website: http://www.naswil.org/volunteer/join-the-board/. Please consider joining or nominating a colleague today!

This past week, the first week of the Illinois General Assembly veto session ended. We’d like to thank all of our members who responded to our alert regarding SB 1652 which passed the Illinois General Assembly during the spring 2011 session. It would allow ComEd and Ameren to impose nearly automatic yearly electric rate increases on consumers for the next decade, while diminishing regulatory oversight by the Illinois Commerce Commission. Unfortunately, both houses voted to override Governor Quinn’s veto. Regarding our advocacy in relation to the Chester Mental Health Center, the Illinois state’s Commission on Government Forecasting and Accoutability (COGFA) voted 11–0 to recommend against the closure of Chester Mental Health Center. The vote is only advisory, but it was a victory nonetheless. A complete update on the first half of the veto is summarized in Phil Milsk’s November update.

We look forward to seeing all of you at the conference.

Joel L. Rubin, MSW, CAE, has served as executive director of the 7,000 member Illinois Chapter of the National Association of Social Workers (NASW) since October 1999. He has over twenty-five years of nonprofit management and fundraising experience including extensive work with boards of directors, committees and volunteers, and advocacy around a wide variety of social work, human service, and international political issues. Joel is a graduate of the Wexner Heritage Fellowship Leadership Program and a current adjunct professor at the University of Illinois at Chicago Jane Addams College of Social Work as well as Loyola University Chicago School of Social Work.
 

• Kilbane, T., & Spira, M. (2010). Domestic violence or elder abuse? Why it matters for older women. Families in Society, April-June 2010, Vol. 91, No. 2.
• Otto, J. & Quinn, K. (2007). Barriers to promising practices for collaboration between adult protective services and domestic violence programs. Retrieved from http://www.ncea.aoa.gov/ncearoot/main_site/pdf/sBarrierstoPromisingPractices.pdf.
• Straka, S. M., & Montminy, L. (2006). Responding to the needs of older women experiencing domestic violence. Violence Against Women, 12(3), 251–267.

Teresa Kilbane, PhD, is associate professor at Loyola University Chicago where she’s been since 1997; she teaches research and policy to graduate and doctoral-level students. Teresa returned to her early roots where her initial research projects were in the field of aging. She is the recipient of summer research grants to study domestic violence of older women. Qualitative interviews were conducted with elder abuse investigators, domestic violence workers, law enforcement, and older abused women. Her research was presented at the NASW Illinois Chapter Statewide, the Fifth Annual Summer Institute on Aging, Governor’s Conference on Aging, and recent publications.
 

The Illinois General Assembly has completed its first week of the fall veto session. They will return to Springfield on November 8 through 10, 2011, to finish business before they return in January 2012 to start the spring session.

The following action was taken that will likely be of interest to our readers:

• Both houses voted to override the governor's veto of legislation to fund electric smart grid technology and other electric infrastructure improvements by increasing electric rates for consumers. Governor Quinn, Attorney General Madigan, AARP, NASW Illinois, and other groups strongly opposed the override, but it prevailed anyway. There were 36 Illinois Senate votes in favor and 74 Illinois House votes in support. Both houses also passed a "trailer" bill that made additional changes to "sweeten the pot" a little for low-income consumers. However, the bottom line is that instead of asking ComEd and Ameren to make improvements using their sizeable profits over the past several years, the Illinois General Assembly is making consumers pay for these improvements.
• A bill to restore funding for Regional Offices of Education (ROE) failed in the Illinois House. The governor had used his veto pen to strike funding for the ROE. The bill, HB 3828, would have drawn monies from the Personal Property Replacement Tax Fund to fund the ROEs. The bill could be called again during the second week of the veto session. There is also a slim chance there could be a vote to override the governor's line item veto.
• A bill passed the Illinois House that would grant immunity from prosecution to an individual who seeks or obtains emergency medical assistance for someone experiencing a drug overdose. The bill, SB 1701, passed the Illinois House with 61 votes. It had already passed the Illinois Senate, so it will now go to the governor. 
• The bill that would establish the governing board for Illinois' Health Insurance Exchange, SB 1313, has not been heard yet in the House Insurance Committee, but is posted for hearing on November 8, 2011. House Amendment #2, filed by Representative Mautino, has received positive comments from health care advocates, and NASW is supporting the amendment. The health insurance industry is opposing the amendment because it is seeking a representative on the board. The amendment is careful to avoid conflicts of interest. The exchange is an online marketplace for health insurance that will make it easier for consumers and small businesses to shop for insurance, compare costs and cost predictability, and determine coverage suitable for the individual or business.
• A bill to require comprehensive and medically appropriate sex education in high schools appears to be dying in the Illinois House. It has already passed the Illinois Senate. The bill is SB 3027.
• The Commission on Government Forecasting and Accountability (COGFA) has voted to recommend that the state facilities slated by the governor for closure remain open. The vote on the Chester Mental Health Center was unanimous. NASW had advocated to keep Chester open. COGFA's role is advisory only, but carries weight. There was no vote taken on the Jacksonville Developmental Center.
• HB 605, as amended, passed the Illinois House and is now in the Illinois Senate. The bill revises the school report card provisions in the school code to add factors such as early childhood programs, gifted programs, afterschool programs, parental and community participation, and elective courses.

On the federal level, the "supercommittee" of twelve continues to try to reach agreement on deficit reduction. The prospects of an agreement are dim as Republicans continue to reject revenue enhancements and Democrats are resisting deep cuts in entitlement programs. However, some fear that the Democrats might be going too far in offering cuts to social safety net and healthcare programs. If no agreement is reached, there will be cuts of 10% across the board with a few areas being exempt. This would be devastating to our clients and their communities. The deadline for agreement by the supercommittee is November 23, 2011.

For a complete up-to-date list of ALL classified ads, be sure to visit the NASW Illinios Chapter Classified Ads: http://www.naswil.org/news/networker/networker-classifieds/.

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NASW ILLINIOS CHAPTER JOB BOARD

For a complete and up-to-date list of job board postings, visit the NASW Illinois Chapter Job Board: http://www.naswil.org/education-career-development/association-job-board/.

• Mental Health/Substance Abuse Clinician (Salina & Associates)
• President & CEO (Pillars)
• Licensed Clinical Social Worker (EB Pediatric Resources Inc)
• Renal Social Worker (Nephron Dialysis Center, Ltd)

When I attended my very first NASW Illinois Chapter conference, I was overwhelmed by the different areas within social services. I hadn’t realized that the field of social work had such an extensive list of areas in which social workers practice. Undergraduate and graduate students, as well as new and veteran social workers, can all benefit from attending social work conferences because I have learned that there is something there for everyone no matter where you are in your career or what your career goals are. Attending conferences allow you to:

• See veteran social workers “in action” as they present on their areas of practice
• Explore all options as it relates to your preferred area of practice
• Obtain updated and groundbreaking social work practice information
• For students, it can provide information and ideas for your class projects
• Network, network, and network!

Based on the points listed above, you can see why I advocate for all social workers to get involved in the profession. Not just through your daily work, but as an advocate for social justice as well by being active in developing your skills and networking with other social workers by attending social work conferences.

November is fast approaching, and we are gearing up for our 2011 NASW Illinois Chapter Statewide Conference: A Meeting of the Profession. The conference will be held on November 9–11, 2011 at the DoubleTree Hotel in Oak Brook, Illinois. I am excited about the variety of topics covered by the intensive workshops. The roster of professionals that will be speaking are all very impressive and have extensive experience in their topics of choice as it relates to their expertise in social work. One of the major highlights will be the keynote speaker who will be sure to inspire everyone in the room! Did I say that I was excited? Well, I hope that you get excited too for what is sure to be an inspirational, educational, and networking social work event. I look forward to meeting you there!

Register for this year's conference at: https://www.eiseverywhere.com/ehome/index.php?eventid=16599&.

Yolanda Jordan, MSW, LCSW, has an extensive background in abuse/neglect issues in the field of child welfare. As a placement manager with the Illinois Department of Children and Family Services, she is responsible for managing supervisors who are responsible for children who are placed in the foster care system. Yolanda is also a practicing psychotherapist and has been in private practice for the past ten years. Services are provided to children, couples, and families with a special emphasis on relationship issues that African American women face.

Yolanda is a graduate of Western Illinois University where she received her bachelor of arts in mass communications and master of arts in public communications human relations with a minor in African American studies. Due to her extreme love for people and having the heart of a servant, she continued her education and received a masters in social work with an emphasis on child and family practice from the University of Illinois at Chicago’s Jane Addams College of Social Work. Yolanda has been an active member of the NASW Illinois since 1996 and enjoys the work of advocating for the profession of social work and the community that social workers serve.

Dr. Brieland, founding director of the Illinois Department of Children and Family Services, was a true giant in the social work profession in the state of Illinois and in the country. He served as social work dean at both the University of Illinois at Urbana-Champaign and at the University of Illinois at Chicago (Jane Addams College of Social Work). His obituary can found at: http://www.news-gazette.com/obituaries/2011-10-02/donald-brieland.html.

His obituary reads as follows:

Donald Brieland
Champaign—Donald Brieland, the founding director of the Illinois Department of Children and Family Services and author of one of the foremost texts on social work and the law, died at 7:05 pm Friday September 30, 2011 at Provena Covenant Hospital in Urbana, Ill. He was 87.  A beloved father and husband, world traveler, a leader and pioneer in the field of Social Work and the law, Don's memory is a blessing to all those whose lives he has touched.

Brieland is survived by his wife, Wynne Korr of Champaign and his children, Lisa Castor (son-in-law Randy) of  Mahomet, IL and Joan Brieland (son-in-law Greg Shoultz), of Chelsea, MI; and grandchildren Joe Castor and Anna and Kathryn Brieland- Shoultz..
Visitation will be held at Morgan Memorial Home on Tuesday October 4, 2011 at 3:30 pm, memorial service immediately following at 5 pm. Burial service will be private.

Brieland, of Champaign, was dean emeritus of the Jane Addams College of Social Work at the University of Illinois at Chicago, where he served from 1980 to 1990. Previously, Brieland had been the dean of the School of Social Work at the University of Illinois at Urbana-Champaign from 1975 to 1980. His wife, Wynne Korr, of Champaign, is the current dean of the School of Social Work at the Urbana campus.

Brieland was professor and director of the Social Service Center at the University of Chicago from 1965 to 1970 and an associate dean of the School of Social Service Administration at the University of Chicago from 1968 to 1970. He was the director of the Illinois Department of Children and Family Services from 1963 to 1965.

At Urbana, Brieland led the push for accreditation of the bachelor of social work program and the development of courses and texts in contemporary social work, and social work and the law.

Brieland's research and teaching focused on contemporary social work as well as child and family policy; social work and the law; human behavior and the social environment; and social work education.

He wrote "Social Work and the Law," with John Lemmon, and "Contemporary Social Work," with C. Atherton and L. Costin.

Brieland was a Fulbright Lecturer at the University of Peshawar, in Pakistan, and also a visiting professor at the University of Melbourne, in Australia. He served as a visiting professor during summer sessions at Virginia Commonwealth University, Iowa State University, Union College, the University of Omaha, and Macalester College.

He was a member of the National Association of Social Workers, the Council on Social Work Education, and a Fellow of the American Psychological Association. In addition, he was editor in chief of the journal Social Work from 1976 to 1979.

Born in 1924 in Pencer, MN, Brieland earned his bachelor's degree at Carleton College, in Minnesota; his master's at Northwestern University; and his doctorate at the University of Minnesota. He was an ordained Episcopal Minister and served in the clergy at Saint Michael's Church in Barrington, IL.

The family has requested memorial donations may be sent to the Brieland Visiting Scholar Fund, in care of the University of Illinois Foundation, Harker Hall, 1305 W. Green St., Urbana, IL 61801. Flowers can be sent to Morgan Memorial Home.

Social Worker of the Year
Mary Garrison, MSW, LSCW, ACSW, is currently assistant professor of social work at Millikin University and adjunct faculty at the University of Illinois at Urbana-Champaign. Mary has had extensive practice experience in the social work field, with over fifteen years of practice in mental health services. She is also a part-time private practitioner at Decatur Psychological Associates. Throughout her career, Mary has served as a therapist, clinical supervisor, manager, consultant, child development specialist, and victim/witness advocate. Mary has been active in providing continuing education opportunities for colleagues through professional workshops, presentations, and trainings domestically and internationally.

Lifetime Achievement Award
Richard L. Jones, PhD, currently serves as president emeritus for Metropolitan Family Services. Previously, Richard served as president of the Center for Families and Children in Cleveland, Ohio and executive director of Boston Children’s Services in Boston, Massachusetts. Richard completed his master’s and PhD in social work administration from the Mandel School of Applied Social Sciences of Case Western Reserve University. Previous leadership responsibilities have included serving on the board of directors of Leadership Cleveland and the Cleveland United Way; co-chairing the International Year of the Family; and serving as chair of the Commission on Chemical Dependency and Child Welfare for the Child Welfare League of America. Metropolitan Family Services was recipient of Bank of America’s Neighborhood Builders Award in 2006 and was presented the Alford-Axelson Nonprofit Managerial Excellence Award in 2007 by North Park University.

Public Citizen of the Year
Benjamin S. Wolf, JD, is an attorney who has served as director and chief legal counsel of the ACLU of Illinois' Institutionalized Persons Project since 1984. The Illinois Institutionalized Persons Project provides legal representation to Illinois residents of prisons, jails, mental health centers, and developmental centers and institutions for children such as group homes and foster homes. He supervises the project's legal and educational work and provides legal backup on such issues for the ACLU's lobbyist in Springfield. A native of Evanston, Wolf received his undergraduate degree from Washington University in St. Louis. Ben served as a law clerk for U.S. District Judge James B. Moran in the Northern District of Illinois from 1979 through 1980. Prior to joining the ACLU legal staff, Wolf was a litigation associate at the law firm of Jenner & Block in Chicago from 1980 to 1984.

Legislative Award
Illinois Senator Kwame Raoul (D-Chicago) and Illinois State Representative Karen Yarbrough (D-Maywood) are honored for their efforts in repealing Public Act 96-1543, a landmark legislation repealing the death penalty in Illinois. As key sponsors of the bill, Senator Raoul and State Representative Yarbrough championed (and ultimately saw passed) a bill that NASW Illinois supported yet seen fail numerous times previous.

These individuals, as well as the 2011 Emerging Leaders, will be honored at an awards reception at this year’s 2011 NASW Illinois Chapter Statewide Conference on Wednesday, November 9, 2011, at the DoubleTree Hotel in Oak Brook, IL, from 4:00 to 6:00pm.

To attend this year’s statewide conference for an opportunity to earn up to 18 continuing education units (CEUs), register online here.

For a look at the 2010 Statewide Awardees, click here.
 

Older adults are living longer than ever. Increased life expectancy brings an increase in the number of people living with chronic conditions, inadequate caregiver and community support, and poor medical care. The growing complexity of medical needs experienced by older adults necessitates more frequent visits to primary care physician offices and hospitalizations. Each interaction with the medical system, while aimed at improving the presenting issue, also comes with the risk of complications, whether from the treatment itself or because of a poor transition between care settings.

Every year older adults experience over 13 million transitions from hospital to home (1). All too often these transitions are unsuccessful and result in hospital readmissions—one in five Medicare beneficiaries returns to the hospital within thirty days of discharge (2). Readmissions have traditionally been viewed as largely a medical problem to be approached through better patient care, improved treatment options, better medications, and targeted coaching. These are no doubt critical to improved outcomes, but are only part of the client-centered picture. Social work—community social work in particular—shows that problems with care transitions are greatly complicated by the post-discharge psychosocial environment.

Years of on-the-ground social work in geographically varied settings in Illinois have demonstrated that a poor transition home is related to uncoordinated service providers, untimely community service implementation, confusion with the discharge plan of care and medication list, burdened caregivers and family members, and difficulty connecting with post-discharge physicians (3). To put it simply, the world beyond hospital doors is chaotic and disorganized. It can be confusing and scary out there for any patient, but for an older adult confronted with chronic conditions, multiple follow-up appointments, a burdened caregiver, and no strength to keep up with it all, it is an extremely daunting time.

Historically, the discharge team at a hospital included the hospital discharge planner, physician, nurse, therapists, home health, and (sometimes) the patient. The social work perspective was most often missing, yet it has been shown that 40 to 50% of hospital readmissions are connected to social problems and limited community resources (4). It is important to note that this does not imply that social work is only able to address 40 to 50% of readmissions. By connecting proper care providers, assisting with information transfer, and serving as the central care coordinator during a discharge, social workers are able to successfully intervene on most readmission cases.

In 2008, several experienced social workers in Illinois came together to formally address the gap in traditional transitional care approaches. Each came from different geographic and organizational settings and was able to bring varied perspective to the table. The result of years of collaboration was the Illinois Transitional Care Consortium (ITCC) and its Bridge Model (Bridge), now an evidence-based approach to transitional care recognized by the Administration on Aging. Bridge combined the evidence-based practices from Rush University Medical Center’s Enhanced Discharge Planning Program with best practices from the Aging Resource Center Program (developed by Aging Care Connections), thus yielding a comprehensive, social work–based approach that brought a true person-based, systems approach to transitional care and care coordination.
Bridge is the first and only social work–based approach to transitional care. Its’ research shows an impact on readmissions, physician follow-up, understanding of the discharge plan, understanding of prescribed medications, access to and time to start of community services, decreased caregiver and patient burden and stress, and, importantly, mortality. As would be expected from a social work approach, Bridge has significant flexibility allowing it to retain its essential elements in urban, suburban, and rural settings.
Bridge helps older adults to safely transition back to the community through intensive care coordination that starts in the hospital and continues after discharge to the community.
Bridge employs master’s prepared social workers, called Bridge Care Coordinators, to coordinate post-discharge older adult care and integrates Aging Resource Centers (ARC) inside hospitals. ARCs are a vital part of the model. They represent a tangible, real-world collaboration between the hospital and the community. The ARCs provide a dedicated space for older adults and their caregivers to explore community resources, health information, and caregiving materials, and to develop community care plans prior to discharge.
The essence of the Bridge Model is textbook social work practice: conduct a comprehensive, systems-based assessment and intervene on identified gaps. To garner meaningful results during a transition, an assessment is necessary both before and after discharge. The post-discharge assessment is absolutely crucial in its ability to tell the social worker what a client is actually going through when they get home. After all, it is only once a patient finds himself/herself home again after a hospital stay that the suspended systems typically interacting with them resume their machinations.

The Bridge Model consists of three intervention phases:

1. Pre-Discharge: Bridge Care Coordinators (BCCs) identify older adult patients who may be at risk for post-discharge complications. Referrals can originate with hospital discharge planners or be generated through an integrated risk screen in the electronic medical record. The BCCs meet with older adults and/or their caregivers in the hospital room or in the ARC to identify unmet needs and to set up services prior to discharge. BCCs may also prepare for discharge by reviewing medical records or meeting with an interdisciplinary team within the hospital.
2. Post-Discharge: New needs are frequently identified soon after an older adult returns home. The map is not the territory, as they say, and upon returning home, patients very frequently identify surprises. BCCs call consumers two days after discharge to conduct a thorough secondary assessment and intervene on identified needs. Areas of need include understanding discharge instructions, transportation issues, physician follow-up, burdened caregivers, problems with home health care, difficulty obtaining and/or understanding medications, and others. All post-discharge communication is telephonic. The typical intervention requires just over five calls over the period of five days. Calls are made to clients, caregivers, community physicians, the discharging hospital, home health, and any other community care provider.
3. Follow-Up: The BCC follows up with consumers at thirty days post-discharge to address emerging needs, connect or reconnect consumers to long-term supports in the community, and to conduct quality assurance and evaluation surveys.

Bridging the gap between the community and hospital is imperative in meeting the needs of older adults transitioning home. Thorough knowledge of the target community a patient transitions to is essential. For that reason, every BCC must be an expert in the community resources of their service area. For those older adults navigating the aging network for the first time, the BCCs are tasked with explaining and normalizing its use. Interestingly, the hospital setting greatly de-stigmatizes community resource use, particularly if referrals are made prior to discharge.

Many older adults lack the knowledge of the breadth of community resources freely available to them. It is the BCCs job to educate, advocate, and implement the resources on behalf of or with the client. For example, while the older adult may have been told upon discharge what medications to take by their doctor, the older adult may not have information on benefits assistance to be able to afford the medications. BCCs offer benefits assistance and guide patients through the often confusing process of securing financial assistance. Similarly, an older adult may have a follow-up appointment scheduled with his/her physician but may not have transportation to reach the office. A BCC knows the transportation services available to older adults in the community. Instead of charging the older adult with the job of securing community resources upon the return home, the BCC plans for services with the individual to reduce the risk and burden associated with transitions between healthcare settings.

Upon returning home, the difficulty of the post-discharge reality sets in. An older adult may have an accurate list of medications but may not understand how to take each medication because the directions were not provided in Spanish. A caregiver may know how to assist their loved one with dementia but may not know what to do when caregiving becomes overwhelming. An older adult returning home may be afraid of falling again. An older adult may not want to give up his/her independence and resists a discussion about homecare services. An especially frustrating layer is added when the community systems in place to care for the discharged patient do not communicate with one another and thereby represent significant hurdles of their own.

A BCC addresses these psychosocial and care coordination needs that impact the health and well-being of older adults transitioning home. By being both the patient advocate and the connecting link between numerous silos of care surrounding the patient, the BCC covers all the necessary bases to ensure a safe landing after a hospital stay.

BCCs, as social workers, are trained to provide person-centered care necessary for a successful transition home. As a profession, social workers are charged with the mission to preserve the worth and inherent dignity of their clients through the NASW Code of Ethics (5). Bridge requires its BCCs to be master’s level social workers because they have the expertise to work with older adults struggling between accepting the help required to successfully return home and preserving a feeling of independence. The clinical toolkit necessary for the role includes the ability to quickly build trust and rapport, work towards client goals while managing family dynamics, and utilizing therapeutic techniques such as motivational interviewing to assist with the ambivalence so frequently found in frail older adults. Social workers know how to work with resistant or reluctant clients. BCC social work training and expertise resulted in hospital discharge planners sometimes asking, “Can you please work your magic on this patient?”

Nearly every older adult voices a desire to remain independent in the community, living at home. In order to assist older adults with this goal, social workers must be at the table in the healthcare setting to create a seamless and holistic approach to transitional care.

The Bridge Program: An Innovative Social Work Approach to Transitional Care will be presented during the 3:15–4:45pm time slot on Friday, November 11, 2011. Sign up to attend the workshop here.

REFERENCES
1. Jencks, S. F., Williams, M. V., Coleman, E. A. (2009). Rehospitalizations among patients in the Medicare fee-for-service program. New England Journal of Medicine, 14(360) 1418–1428.
2. Perry, A., Golden, R., Rooney, M., and Shier, G. (2011). Best practice: Rush University Medical Center’s enhanced discharge planning program. In. P. Shelton and C. Schrader (Eds.), Comprehensive care coordination: Community care of chronically ill adults. Wiley-Blackwell.
3. Proctor, E. K., Morrow-Howell, N., Li, H., & Dore, P. (2000). Adequacy of home care and hospital readmission for elderly congestive heart failure patients. Health and Social Work, 25(2), 87–96.
4. Summary Proceedings: Transitional Care Leadership Summit. (2006) http://www.healthresearchforaction.org/sites/default/files/REPORT_PUBS_H2H%20SummitProc%20FNL_0.pdf. Accessed September 19, 2011.
5. National Association of Social Workers. (2008). Code of Ethics of the National Association of Social Workers. Washington, DC: Author.

Walter Rosenberg, LSW, is program coordinator of Older Adult Programs at Rush University Medical Center where he oversees the business and strategic planning of the department and its health promotion and disease prevention membership program, Rush Generations. In addition, he serves on numerous hospital committees, including the Medical Home and Adults with Intellectual and Developmental Disabilities committees and co-leads the departmental grant writing team. He provides transitional patient care as a social worker in Rush’s Bridge Program and Medical Home pilot. Walter serves on the management team of the Illinois Transitional Care Consortium (ITCC).

Ilana Shure, EdM, MSW, LSW, Ilana Shure is program manager at Aging Resource Center, a transitional care program created by Aging Care Connections based on-site at Adventist La Grange Memorial Hospital in La Grange, Illinois. Ilana supervises master’s–level social workers and provides in-service training to hospital staff on the aging network, aging issues, and community-based services for older adults. As a representative for Aging Care Connections to the Illinois Transitional Care Consortium, Ilana assists with the development and implementation of the Bridge Model at the Aging Resource Center in La Grange, as well as across the Bridge Model sites throughout Illinois.

Retired Social Worker SIG: Is Social Work Retirement Unique?
by Joseph Marlin and Betty Dayron

In this workshop we will examine some of the ways in which retiring as a social worker is similar to retirement from other kinds of jobs. We will also talk about what seems unique to planning for and experiencing retirement as a social worker.

Most people retire unless they have little or no work history or, sadly, die prematurely. Many young people may feel that retirement is so far distant as to defy active planning; many nearing retirement may have apprehensions about economic, residential, health, or other issues.

 At some point, we generally begin to actively plan for retirement, especially in regard to fiscal issues. Our current job choices, sex, and success in maintaining relationships all impinge on our retired life. When retirement looms, and hopefully we have control over when this is, we need to answer many questions, even if only tentatively at first. Will our health make our choices easier or more difficult? What legal issues may arise? What will the pattern of our retirement be? Will we rest on our laurels, or climb new mountain, or at least hills? How closely will reality match our fantasy about retired life? Will we wish to, or need to, retire more than once?

Most social work employers have guidelines for ending work and offer some kind of pension or retirement plan. Those in private practice have other issues to consider, both in regard to their own financial futures and protecting clients’ records.

There are broader issues involved when we as social workers are required to focus on what’s good for ourselves. We’re not always as good at that. We are professionals: competent, self-reliant, nonjudgmental, but full of opinions. Are we good at contemplating our own aging processes, or are we perhaps handicapped by our need to always be so helpful to others?

And then there are all the identity issues. When we retire, are we still social workers? If not, what are we? Who are we? Does the answer depend on whether we are getting paid for what we do or not? If we volunteer, does that count? Is being a social worker about how we think about things? We tend to think systemically and diagnostically without asking ourselves to do it, and without getting paid to do it. Sometimes that is useful thinking, and at other times, not so welcome.

There will be a lot of time in this session for questions and interaction. After all, we are the pros of planning and problem-solving. We are change agents and focused on improving the world. We are also sometimes the folks who don’t carve out enough time to consider what’s best for ourselves. This session will be an opportunity to learn from each other, to think and talk about our own lives, both present and future.

Is Social Work Retirement Unique? An Overview of General and Unique Retirement Issues will be presented during the 10:45am–12:15pm time slot on Friday, November 11, 2011. Sign up to attend the workshop here.

The Older Adults (RSW) SIG will be presenting the workshop Older Adults SIG: How Social Work Interventions Can Help People with Dementia and Their Families Live With Purpose and Meaning. 

Older Adults SIG: How Social Work Interventions Can Help People with Dementia and Their Families Live With Purpose and Meaning
Darby Morhardt, MSW, LCSW
    Older adults and their families, most specifically those living with some form of cognitive impairment in the community setting has been the focus of my work for over 25 years.    I have learned much and been enriched by what they have taught me about aging, about facing challenge and coping with loss, and most importantly about living life with purpose and meaning.   In spite of the progressive nature of dementia and although we currently lack medications to prevent, arrest or reverse its course, we can enhance the quality of life for the person with dementia and their family.
    While non-medical interventions cannot stop disease progression, there are effective ways to help individuals and families cope.  A 2010 systematic review suggests that non-pharmacological treatments initiated early in the disease, have the potential to improve outcomes related to cognitive ability, physical functioning and well-being for those with dementia and their families (Olazaran, 2010).  Multimodal therapies that incorporate emotional support, exercise and promotion of physical health, creative expression and cognitive stimulation have been shown to positively affect physical, cognitive and behavioral outcomes (Burgener et al., 2008).  With the anticipated increase in individuals diagnosed with dementia there will be a demand for programs focused on participants’ strengths, abilities, creative potential and valuable contributions, rather than for their disease.
    In this workshop, Improving Quality of Life for Persons with Dementia and Their Families, we will review the growing body of research that calls attention to the impact of dementia on the affected person and their struggle to maintain a sense of identity despite diminishing abilities.  We will then review ways to help both the person with dementia and their family live and cope with cognitive decline by exploring a number of innovative education and quality of life enrichment programs targeting their multiple and complex needs.
    For example, we will discuss one program in which persons with early stage dementia are paired with a first year medical student for an academic year, allowing for the person with dementia to experience an empowering relationship in which they are not the “patient”, but a mentor and guide to a medical student.  This interaction, in turn, has led medical students to reconsider their images and ideas of illness and aging and allowed them to witness first-hand how the person with dementia and their family cope with the changes they are experiencing.
    The arts have long been recognized as enhancing health and well-being across the lifespan and interventions tapping into creative abilities of persons with early stage dementia also show promise.   Published results from model programs will be discussed and a new program using an improvisational theatre intervention for persons with early stage dementia will be introduced.
    Finally, the need for more research on the efficacy of non-pharmacological interventions will be examined.  In essence, what are the most effective ways of helping people with dementia preserve their sense of self and live their lives as meaningfully as possible?   I hope you will please join me in exploring these issues.
References
Burgener, S., Yang, Y., Gilbert, R., Marsh-Yant, S. (2008).  The effects of a multimodal     intervention on outcomes of persons with early-stage dementia.  American     Journal of Alzheimer’s Disease & Other Dementias, 23(4), 382-394.
Olazaran, J., Reisberg, B., Clare, L., Cruz, I., Pena-Casanova, J., del Ser, T., Woods, B.,     Beck, C., Auer, S., Lai, C., Spector, A., Fazio, S., Bond, J., Kivipelto, M., Brodaty,     H., Rojo, J.M., Collins, H., Teri, L., Mittelman, M., Orrell, M., Feldman, H.H., &     Muniz, R. (2010).  Nonpharmacological therapies in Alzheimer’s disease:  A     systematic review of efficacy. Dementia and Geriatric Cognitive Disorders,     30,161-178.
 

IF GIVEN A BUCKET OF CUCUMBERS, MAKE PICKLES
A humorous look at a sad but true story by Patrick White

Should a person with schizophrenia or any other mental/nervous disorder have to worry about being politically correct, as far as the disease is concerned? My first thought is that I have to put up with the disease and don’t really want to waste time and energy with being correct. But is that really realistic?

Having been diagnosed with chronic paranoid schizophrenia over fourteen years ago, I have been put in some unusual situations because of the disease or disorder. I have found some people get upset if you call it a disease. This is a politically correct thing I just don’t connect with. There are some things you just don’t say, but the difference between calling schizophrenia a disease or a disorder just seems so minute that it borders on being ridiculous.

I wrote an article that was published in a newsletter recently. The editing did not amount to much, but I was surprised that you are not suppose to say someone is schizophrenic; instead, you say a person with schizophrenia. We who have the disease had better not be so thin-skinned or we may have a miserable life. I wonder whether it is the people with the disease/disorder who take offense or others that are so touchy about these things.

The worst situation I have gotten in since I've had the disorder was very strange, and you talk about not being politically correct. I had my semi-annual cold/sinus infection plus bronchitis and went to a walk-in clinic to see a doctor. I was taken back to a room, and the nurse did her usual check of blood pressure, temperature, and symptoms. We were doing just fine until we started on the medications I was on. I told her thiothixene. She asked what it was for. I said, It is an antipsychotic drug. Yes, but what is it for? I told her chronic paranoid schizophrenia. I was sitting on the end of the exam table. She was on a stool five feet away at a writing area. She immediately got up and walked to the door. She held the clipboard up to the wall and tried to finish the chart holding the chart with her palm and writing with the same hand. Her other hand was behind her on the door knob while she finished the paper work and got out as soon as she could. I was embarrassed, my feelings were hurt, and I was angry. I mean, this is a medical professional. My psychiatrist had warned me early on, "Give as little information about your disorder as possible.” And I certainly learned what he meant that morning. The doctor came in and gave me an examination and a prescription. He said, “Your blood pressure is pretty high today; you’d better keep an eye on that.” He had no way of knowing what had just happened.

After being diagnosed with schizophrenia and put on medication, I did a lot of thinking. This disease or disorder is my problem and should be no one else’s. I know it has had some effect on my family and friends, but it should not cause a total stranger problems. So I said nothing about what had happened to anyone. My father’s health was starting to fail, and we were in the clinic a lot. If that nurse happened to be in the lobby when we came in, she speed-walked to the nearest door. I have had similar situations in other medical facilities, but nothing this drastic. My question is why are some medical professionals so uncomfortable with the mentally ill? Are they shown the worst of the worst people with mental diseases while in school? Are they not taught that most people with mental problems are harmless and that many are downright timid? I have thought about this a lot and don’t know who, if anyone, would have the answer.

I am more experienced with how to conduct oneself if such situations arise now. There is Plan A (My personal favorite ). Yell, "Boo!" at the top of your lungs. And Plan B would be to say, "Boy! Am I hungry for some fresh liver." The problem with this is that the poor nurse might have had a heart attack or hurt herself running through the door. I have been meaning to ask my attorney if I would have any liability issues if any of this occurred.

I just read this to my mother, a former English teacher, to see what she thought. She replied, “When did this problem with the obnoxious nurse take place?” I said, "There have been a lot of cukes through the brine since then.” It happened around 1996 or 1997, a few years after I was diagnosed. "If I had been there,” my mother said, “I would have hit her.” “I know you would," I said. At that time, my mother was in her early 70s, 4'9" tall, and 110 pounds. She still could have got away with it.

That’s another downfall of this disease. You really don’t dare lose it, even if you should. If I had said something to her, she would have run out of the office screaming that the schizophrenic has lost it. “Get help, call the police!” That possibly could have led to being put in a mental unit against my wishes to evaluate me for several days.

My mother said, “ I still would have hit her.” I told her, "It's a good thing I am the person with schizophrenia rather than you.” You see, there are two sides to this politically correct thing. The people who aren’t mentally ill can get away with more than those of us who are mentally ill. I am the one with the disease, yet I still feel like I should not have to waste time and energy with being politically correct. But I have learned I need to. It’s rather annoying, just as my psychiatrist told me from the get-go: “Don’t give any more information than you have to.” But it does get better with time.

Some may think I am right-wing with my attitude towards being politically correct, but I am not. I have seen social programs such as Medicare, Illinois RX, and hospice work. No, they are not perfect, but they help a lot. I also know all too well the failure of health insurance in this country, and we do need social programs.

We put the cucumbers in the brine.
Sometimes you wonder why waste your time.
It takes more energy than yours and mine.
But the end result is fine.

A BOLD NEW APPROACH TO MENTAL ILLNESS
Marvin Lindsey, MSW, CADC

“We need a new type of health care facility; one which will return mental health care to mainstream of American medicine, and at the same time upgrade mental health services.” —President John F. Kennedy in an address to Congress, 1963

The state of Illinois is in the beginning stages of a bold approach in how people with mental illnesses will be treated in the community mental health system. It is very different from the bold new approach that was presented in 1963. Illinois’ bold approach appears to be an approach in which the state abdicates many of it responsibilities toward its citizens with mental illnesses, especially the working poor and the uninsured.

The statement by President Kennedy ushered in what we know today as community mental health centers (CMHCs). The new approach called for CMHCs to be a “safety net” for people with mental illnesses and to provide five essential services: inpatient services, outpatient services, day treatment, emergency services and consultation, and education services.

As we highlight National Depression Awareness and Education Month, the funding for Illinois CMHCs to provide essential services, such as community education, has declined substantially over the last three to four years due to disproportionate budget cuts. Two invaluable and important features of CMHC’s has been their ability to treat and educate individuals and the general public about depression and other mental illnesses.

In my work as a public policy social worker for the Community Behavioral Healthcare Association of Illinois (CBHA)—a trade association of mental health and substance use prevention and treatment providers—I have been very fortunate to witness the efficient time spent by CMHC staff in providing mental health education at community and neighborhood fairs, at rallies, in malls, at sporting events, in schools, and numerous other venues.

However, due to continuous disproportionate state budget cuts and other systemic changes over the last several years, CMHCs have been forced to dramatically reduce consultation/education and treatment services, especially for those who are uninsured. The state budgets for the mental health and substance use treatment system have seen deeper budget cuts than other state agencies. All of the cuts have targeted services for the uninsured or people without Medicaid or other insurances. The bold approach in Illinois has become a very frightening experience.

Over the last forty years, CMHCs have survived but service priorities and the locus of control have changed. Currently, in Illinois, this is especially true. The mental health system is undergoing dramatic changes, such as the proposed closing of state psychiatric hospitals, the contracting of mental health services to Managed Care Organizations (MCOs), the restriction of certain psychiatric medications, and the underfunding of services for the uninsured. Over the last two years, the state budget for community mental health has been cut by close to $65 million, which translates to tens of thousand of people with mental illnesses either losing services or being unable to access services. However, an admitted $30 million “mistake” in this year’s budgeting process has a chance of being corrected.

On the last day of this year’s legislative session, the chairperson of the Illinois House Appropriation Human Service Committee recognized that $30 million was mistakenly taken out of the budget that funds community mental health programs and put into another department’s budget. A bill, SB 2407, was drafted to correct the mistake and was passed by the Illinois House, 109 to 7. SB 2407 was then sent to the Illinois Senate and put on the legislative calendar for a vote of concurrence, but time ran out and SB 2407 was not called.

On October 25th, the Illinois General Assembly will reconvene for its fall veto session. It is essential that the Illinois Senate correct the mistake by passing SB 2407. The bill does not increase the budget and is merely a transfer of funds from one department to another.

The $30 million that was mistakenly cut from the mental health budget are funds that cover mental health services for those without Medicaid or any type of insurance. Without these funds, uninsured people with mental illnesses will be forced to cycle in and out of hospital emergency rooms and jails which will be even more costly to the state. For example, in one Illinois community, psychiatric hospital admissions have more than doubled over the last two years.

As the state of Illinois works towards a bold approach, we must our legislators that it must factor in all people, with or without insurance; the bold approach must include CMHCs and the state as true partners. It must be one that reduces or eliminates unnecessary bureaucratic paperwork and redundant procedures or processes; it must pay a fair rate to those it contracts with and cut down on the time it takes to pay them (currently six to nine months). Lastly, this bold approach can begin with the passing of SB 2407, which will help thousands of people with mental illnesses to access and/or maintain community mental health services.

Marvin Lindsey, MSW, CADC, is specialist on addictions and co-occurring substance use and mental health issues for the Community Behavioral Healthcare Association of Illinois (CBHA). Prior to coming to CBHA, he worked in several community-based social service and behavioral healthcare agencies. He also has ten years of experience in social science research with Harvard University, the University of Illinois at Chicago, and Treatment Alternatives for Safe Communities (TASC).

After completing my MSW and then passing the licensing exam, friends in the profession immediately began to ask things like, “So when are you going to hang your shingle?" It’s one of those automatic questions similar to when you get married and people start asking you when you are going to have a baby. Honestly, I had no interest. I liked the security of regular pay and regular hours. I also knew very little about the world of managed care, deductibles, and co-pays. But, as often happens, life took a turn and one professional door appeared to be closing at the exact moment that a friend was leaving her position in a group private practice and I was invited to explore the opportunity. Although my primary focus at that time was on pay and paperwork, in the last nine years I have come to learn that there are many other aspects that are critical to consider in a group practice. In this article, I’ll share a few of the things that I have learned.

Pay
Of course pay is important and probably one of the primary concerns on any new practitioner's mind. In a group private practice pay is often factored in one of two ways. Most often, pay is based on either a split of receipts or each practitioner pays a base rate for rent and expenses. Regardless of the way pay is determined, you should consider some additional factors.

First off, your pay is directly influenced by the actual reimbursement rate that has been negotiated with managed care companies. It is important to ask questions about the fee scale for services that are charged by the office, as well as the actual reimbursement rates that have been negotiated. Frequently, managed care companies have special negotiated rates for practitioners that participate in their networks. It is also important to know who negotiates these rates and how often the rates are reevaluated. In order to get the best reimbursements, you need someone competent in negotiations to work with the managed care companies on a regular basis.

Another factor to consider is collections. Once you have negotiated a fee and rendered a service, what does the organization do in order to make sure that the money due is actually collected? When I joined my practice, I hadn’t considered the number of hours that can be spent tracking money. The money received for each service rendered may have several payment sources. For me, I wanted to know that the money was collected, but I wasn’t interested in spending hours calling clients, parents, and insurance companies asking for my money. I was happy to discover that the practice I joined had an experienced staff well versed in collections with clear policies as to the expectations of when payment was expected and what procedures would transpire when that did not occur. I found it beneficial for me to not have to wear two hats.  While I do discuss client bills with them when there is an issue, I don’t have to spend extensive clinical time discussing reimbursement issues. Our office staff manages this well, and I find it helpful to have this division of responsibility.

Expenses
After discussing pay, the next major issue is to clarify exactly what expenses each clinician is individually responsible for. I once had a supervisor that talked about her first days as a clinician where her only supplies consisted of manila files, cardboard boxes, and a box of pens. We have come a long way since then. Today a typical office will require a computer, printer, possibly a fax machine, phone system, stationary, business cards, office furniture, educational materials, etc. It’s critical to know what expenses will be the responsibility of the organization and what expenses each individual will incur.

In conjunction with establishing a clear understanding of the division of office expenses, it is also important to understand how purchasing decisions are made. I have found that in an office with several practitioners, individuals will have different priorities in terms of office maintenance and resources. It helps to have a clear understanding how purchasing decisions are researched and determined. These expenses can quickly influence the pay check a practitioner takes home.

Policy and Procedure
There are many standardized practice procedures and imposed policies by affiliated agencies, but there is also great variability. Professionals often have specific needs and preferences in terms of the way they practice. It is important to know the office policies and to feel comfortable in your ability to work within the established policies. Some additional things to consider include: Do practitioners create their own forms of documentation? Is there a centralized charting system? How are policy decisions made? Who is included in these decisions?

Marketing
I have the advantage of working in an office with four psychiatrists and two other social workers. I am grateful to have inter-office referrals. That being said, I have always felt that it is important not to become a feeder fish relying on one referral source. I believe that it is important for individuals, as well as the organizations, to create a presence in the communities they work. This is hard work and takes money. It requires someone to spend time out of the office which in turns means he/she is not seeing clients. It is time-consuming work and difficult to find a balance between marketing and working. There is also some actual expense realized. In order to market yourself, you need resources to disburse and reference. There is no fixed formula to guide the right type of and amount of marketing to create a successful practice. It is important to understand the marketing practices of the organization. Are there practices or strategies in place? Will these practices support the type of clinical work that you wish to do? Are these practices consistent with your beliefs? Are these practices affordable and shared?

Referrals
Finally, it is important to know what happens when a potential client calls the office to make an appointment. You may work for a wonderful organization with effective policies, a good pay structure, and solid marketing practices, but none of that matters if you don’t get referrals. It isn’t always easy to think of things this way, but in a group practice you are as much a team as you are competitors. Unless there are clear, agreed-upon policies to determine how referrals are disbursed, you won’t survive professionally and work will be very unpleasant. Management of referrals needs to include how to handle both individuals that call and request a specific provider, as well as cold calls. The policy should be very clearly defined and agreed upon. You also want to have the ability to review this policy periodically, particularly when there is a change in providers. In the end, it is critical that everyone feel comfortable with how referrals into and within the organization are handled.

Conclusion
There are numerous advantages to a group private practice. The practical advantages are the shared resources, knowledge, reputation, and ideas. The secondary benefit is the camaraderie. It is a powerful thing to sit around a table and actively share ideas about practice, clinical cases, regulations, and life. The group practice allowed me to do what I love with a tolerable level of risk in a supportive environment. I have no regrets, but I am aware that not all practices are the same and it is vital to know what to expect.

Audrey LeMasters (PhD, Walden University; LCSW) has lived her whole life in the Peoria area. Though graduating from the high school in the early 1980s, she was unable to attend college immediately due to the economy. She returned to college as a nontraditional student in the mid 1980s, eventually graduating from Illinois State University in 1993 with a degree in psychology.

Audrey applied and obtained a job at a private agency working in child welfare. To this day, she is convinced that the reason she got the job was because of the fear she expressed during the interview at being able to adequately fulfill all of the responsibilities of the job. She continued her work at various private agencies for nearly eight years. During this time, she returned to school to complete her master’s degree in social work from the University of Illinois at Urbana-Champaign.

After completing her master’s, she obtained a job as a clinical coordinator for a Partial Hospitalization program in Peoria. She was then offered the opportunity to work at a local private practice. She has worked for the past nine years in private practice. She also works part-time at the Heart of Illinois HIV/AIDS program.

I.  FEDERAL CLASS ACTION SUIT FILED ON CHILDREN'S MENTAL HEALTH SERVICES

A class action lawsuit has been filed alleging that the state of Illinois has failed to meet its legal obligations to provide services to children with behavioral and emotional disorders under Medicaid's EPSDT mandate for children ages 0 through 21. The lawsuit, titled N.B. by Buchanan v. Hamos, was filed in the United States District Court for the Northern District of Illinois by attorneys Robert Farley, Michelle Schneiderheinze, Mary Denise Cahill, and Alysha Briggs-Miller. The complaint alleges that the state has failed to comply with federal laws which mandate that Medicaid-eligible children up to age 21 who have behavioral or emotional disorders be provided mental health and behavioral interventions to correct or ameliorate their conditions. The complaint further alleges that the state's failure has resulted in repeated unnecessary institutionalization and hospitalizations of some class members, and the "locking out" of some children by parents who cannot deal with the emotional or behavioral problems. The suit mentions, among other things, the state's very stingy use of Individual Care Grants (ICGs) to serve children with severe mental illness. Another issue raised by the lawsuit is the state's use of a waiting list of children waiting for services. Waiting lists are impermissible under federal law for services that are considered entitlements.

II. NASW ILLINOIS OPPOSES CHESTER MENTAL HEALTH CENTER CLOSURE

NASW Illinois Chapter Executive Director Joel L. Rubin has sent a letter to Governor Quinn in opposition of the proposed closure of the Chester Mental Health Center in Chester, Illinois. Joel and I have also contacted several members of the Commission on Government Forecasting and Accountability (COGFA) about the proposed closure. COGFA has the responsibility to hold a hearing on the proposed closure of any state-operated facility and to make recommendations. NASW Illinois' concerns include the fact that the services provided at Chester are unique in Illinois, that these services cannot be successfully assumed by other state mental health centers, and that closing Chester poses a serious threat to public safety and the health of current Chester residents. It should be noted that the establishment of Chester and its functions was created by statute; the statute would have to be repealed by act of the Illinois General Assembly before the facility can be closed.

The governor, citing a shortage of appropriations, has also proposed to close several other state facilities including the Tinley Park Mental Health Center, two centers for persons with developmental disabilities (Mabley and Jacksonville), and a youth correctional facility in Murphysboro. 

III.  VETO SESSION COMING UP

The fall Veto Session of the Illinois General Assembly is scheduled for October 25-27, 2011, and November 8-10, 2011 in Springfield, Illinois. The veto session is convened each year to consider bills for which the governor has issued either a total veto or an amendatory veto. The legislature can either override a total veto or an amendatory veto, meaning the bill will: be enacted over the governor's objection; accept an amendatory veto; or take no action on a vetoed bill, thus rendering the bill dead. Also under consideration will be budget line items that the governor has either reduced ("line item reduction") or zeroed out ("line item veto"). The Illinois General Assembly can also conduct other legislative business during the veto session.  

Some significant issues that could be taken up during the veto session include (1) SB 744, a major gambling expansion bill; (2) SB 1652, a bill that would allow utility companies to raise rates to pay for electrical grid improvements; (3) HB 1353, a bill dealing with the controversial legislative scholarship program that the governor wants to abolish; (4) the governor's veto action to eliminate state funding for Regional Offices of Education; (5) the proposed closures of seven state-operated facilties referenced above; and (6) legislation to put into effect the recommendations of a legislative study committee on a health benefits exchange in preparation for the implementation of the federal Affordable Care Act in 2014.

IV.  FEDERAL DEFICIT REDUCTION

I will be brief and to the point about this issue: We MUST be actively involved in advocating for the preservation of critical social service, health, and education programs funded in whole or in part by the federal government. Everything is on the table as the "supercommittee" of twelve legislators considers various ways to cut over $1 trillion in spending from the federal budget. Social workers have to understand that the social safety net and programs we have counted on for years could be slashed or eliminated if not enough voices are heard. Please call you United States Senators and your members of Congress and urge them NOT to cut vital programs for the poor, children, older adults,and persons with disabilities.

For a complete up-to-date list of ALL classified ads, be sure to visit the NASW Illinios Chapter Classified Ads: http://www.naswil.org/news/networker/networker-classifieds/.

CONSULT/SUPERVISION - Consumer Eyes
Looking to interview SWs who work with lower-income families to understand their attitudes, mindset, etc.
Pay = $150 for 1 hr interview in Chicago on 10/18
Contact: dave@consumereyes.com

OFFICE FOR RENT - Skokie
Sublet and/or lease in 3 office suite, waiting room, free parking in medical office bldg. Call Rosemary at 773-936-9955.

OFFICE FOR RENT - Buffalo Grove
BUFFALO GROVE/LONG GROVE:Small office available. Quiet & confidential waiting room. Large window. New paint & carpet. Ideal location with 13 other medical offices.Please call Susan (847) 913-140

NASW ILLINIOS CHAPTER JOB BOARD

For a complete and up-to-date list of job board postings, visit the NASW Illinois Chapter Job Board: http://www.naswil.org/education-career-development/association-job-board/.

• Clinician (Fraser Vaselakos & Associates)
• LSW Social Worker (Hospice of Kankakee Valley)
• Renal Social Worker (Nephron Dialysis Center, Ltd)

• Maneuvering Around Potential Landmines and Roadblocks in the Treatment of Eating Disorders
• The Hurting and the Hurt: Clinical Approaches to Help Those Who Are Bullied and Who Bully
• Planting Seeds and Hope: The Therapeutic Value of Gardening
• If I Don’t Look Like You, How Can I Be Like You? Skin Color and Attachment in Transracial Adoption
• Now What? Strategies for Eliminating Disproportionality in Child Welfare
• LGBTQ Transitions to Adulthood: Intersecting Development Trajectories
• The Alchemy, Art, and Craft of Teaching Storytelling for Social Workers
• Casa Hogar Los Angelitos: Lessons I Learned in a Mexican Orphanage
• Social Work with American Muslims
• Tell Them to Take Their Medicine: Adolescent Medication Adherence
• How Does Broken Find the bone? Developmental Trauma Disorder in Children and Adolescents
• Art of Mindfulness: The Intersection of Yoga and Child Therapy
• The Realities of Divorce: The Truth About the Legal Process and Its Impact on Emotions and the Family
• Empowering Youth Identified by Police Officers
• Surviving the Storm of Teen Depression: Opportunities for Hope and Healing
• Seeing Under the Surface: The Meaning of Out-of-Control Behavior in Adopted Children
• At-Risk or Model Minority Kids? Facts of Asian American Children

With over 80 courses and 100 speakers, the NASW Illinois Chapter Statewide Conference is THE place for school social workers to earn CPDUs! Click here to find out more about the statewide conference. Sign up today!

The NASW Illinois Chapter Statewide Conference meets the continuing education requirements for Illinois CADCs, CPDUs (TYPE 73), and licensed social workers in Indiana, Iowa, Missouri, and Wisconsin per the National CE Provider Program.

There remain many barriers to full legal recognition of gay and lesbian couples’ relationships although this is an area of family law that is developing at a rapid pace.  In recent years many cases have been litigated across the country addressing foster care and adoption, child custody rights, and same-sex marriage.  Past NASW Legal Defense Fund Legal Issue of the Month articles have outlined earlier cases addressing these issues (NASW, 2006, 2008).  NASW continues to be involved as a “friend of the court” to support the family relationships of same-sex couples and their children and this Legal Issue of the Month article provides an update on the status of state laws addressing these matters.

To read the rest of the article, click here. NOTE: NASW login required.

What Happens If I Renew My License After November 30, 2011?
If you renew your license after November 30, 2011, additional fees are required, CEUs must be submitted, and your license may be suspended temporarily.

What About CEUs?
Every licensed social worker in the state of Illinois is required to accumulate a total of 30 CEUs during the current licensure cycle. NOTE: No CEUs are required for the remainder of the first two-year licensure cycle in which you are licensed. This means, you are not required to submit CEUs the first time you renew your license.

Three Ethics CEUs Required
 Section 1470.95 of the Illinois Clinical and Social Work Practice Act now states that “[A]t least three of the 30 hours must include content related to ethical practice of social work.” This means three of your 30 CEUS must be related to ethics. Need your three ethics? No problem! NASW Illinois offers three-hour ethics classes throughout the licensure period. For upcoming classes, go to the ‘Education and Career Development’ tab on our website and click on CEU Opportunities.

Do I Send My CEUs to IDFPR Along with My Licensure Renewal?
IDFPR does NOT require copies of your CEU certificates unless they request them at a later date. Social workers are on the honor system except for a small percentage that is audited after they complete their licensure renewal. Be sure to keep records of your CEUs on file for at least five years.

How Do You Earn CEUs?
That’s easy! NASW Illinois is a licensed provider of continuing education units (CEUs). It is our goal to make it as easy as possible for you to obtain your CEUs by providing workshops and webinars throughout the state at your convenience. And did we mention NASW Illinois members receive FREE CEUs for attending in-house* events? All of our current workshops are listed on our website, along with pre-recorded workshops available for purchase.

*Excludes ethics, supervision, and statewide conferences

Have More Questions?
Be sure to check out the Licensure page on the NASW Illinois Chapter website, or contact IDFPR directly at 217.785.0800.

• Social Worker of the Year: Mary Garrison, Assistant Professor, Millkin University
• Public Citizen of the Year: Ben Wolf , Director and Chief Counsel, Children’s Initative and Institutionalized Persons Project, American Civil Liberties Union (ACLU) of Illinois
• Lifetime Achievement: Richard Jones, President Emeritus, Metropolitan Family Services, Chicago, IL

Earlier in the summer, State Senator Kwame Raoul and State Representative Karen A. Yarbrough were selected for the chapter’s 2011 Legislator of the Year award for their efforts in repealing the death penalty in the state of Illinois.

The awards ceremony will take place at the 2011 NASW Illinois Statewide Conference on Wednesday, November 9, 2011. 

Joining Amicus Brief
On July 27, 2011, the Executive Committee of the NASW Illinois Board of Directors, which is responsible for chapter affairs between board of directors meeting, approved a request from the National NASW to join in on an amicus brief that Lambda Legal submitting in regards to a case brought by four dioceses of Catholic Charities against the state of Illinois. These dioceses seek to force the state to fund their foster care services even though they refuse to follow state law by licensing couples in civil unions as foster parents, claiming they are exempt from state nondiscrimination requirements on religious grounds. http://www.lambdalegal.org/news/pr/il_20110816_lambda-legal-represents-child.html#.Tkv6glPPY8E.twitter

A Sangamon County judge ruled earlier in the month that the state can stop working with Catholic Charities on adoptions and foster care placements. In that ruling, Sangamon County Circuit Judge John Schmidt said no one has a legal right to a contract with the state, but he did not address the church's conflict between the civil-unions law and religious freedom. http://www.news-gazette.com/news/politics-and-government/2011-08-24/more-250-area-affected-battle-between-catholic-charities-ill

NASW Illinois and NABSW – CC Reception for Dr. Darrell P. Wheeler
On August 25, 2011, over 40 people welcomed Darrell P. Wheeler, PhD, MPH, the new social work dean at Loyola University Chicago School of Social Work at a reception in his honor. Taking place at the NASW Illinois Chapter offices, the chapter co-hosted the event with the Chicago Chapter of the National Association of Black Social Workers (NABSW). Photos of the event can be found here: http://www.naswil.org/volunteer/gallery/2011-reception-for-darrell-wheeler/.
 
NASW Illinois Chapter Board of Directors Meeting – August 26, 2011
The NASW Illinois Chapter Board of Directors held its quarterly meeting on August 26, 2011, at the NASW Illinois Chapter office in Chicago. The board acted on the following:

• Approved a recommended slate for the new NASW Illinois Political Action Committee (PAC), as well as well resources to support a PAC fundraising effort;
• Approved a proposal to research and analyze untapped social work markets in the state of Illinois which will support membership recruitment initiatives as part of the 2012 NASW Illinois
• The chapter board was also briefed by Congresswoman Jan Schakowsky (via teleconference) who provided an update on the current situation in Washington, DC, regarding the debt reduction discussions, the debt super committee, and what organizations like NASW Illinois do to influence their work.

Additional events that occurred during the month are posted on the chapter’s website at http://www.naswil.org.

To honor National Hispanic Heritage Month, the September 2011 Networker features several Hispanic social workers writing on issues vital to the profession. They include Judith Susan Rocha writing on “Culture and Social: The Building Blocks to Something More than a Career,” Aida Giachello writing on The Midwest Latino Health Research Training & Policy Center, and Adam Alonso reviewing the book, Growing Up Hispanic: Health and Development and Immigrants. NASW’s Help Starts Here website has also interviewed Latino social workers asking them about their careers and proudest achievements: http://www.helpstartshere.org/about-social-workers/2011-hispanic-heritage-month/2011-e-morales-kuchler.html.

Also included in this month’s issues are two ethics related articles by Ruth Lipschultz and Yvonne Chase, who will be presenting an Assurance Services Inc. (ASI)–sponsored intensive ethics workshop at the conference.

Joel L. Rubin, MSW, CAE, has served as executive director of the 7,000 member Illinois Chapter of the National Association of Social Workers (NASW) since October 1999. He has over twenty-five years of nonprofit management and fundraising experience including extensive work with boards of directors, committees and volunteers, and advocacy around a wide variety of social work, human service, and international political issues. Joel is a graduate of the Wexner Heritage Fellowship Leadership Program and a current adjunct professor at the University of Illinois at Chicago Jane Addams College of Social Work as well as Loyola University Chicago School of Social Work.

• Conducting health and social disparities research.
• Providing mechanisms for communication, coordination, networking, and information dissemination, including translational research to consumers, services providers, researchers, and community-based organizations.
• Engaging in community capacity-building through the provision of technical assistance and training to diverse audiences such as health professionals, community-based organizations, community lay health workers (health promoters), hospitals, and neighborhood health facilities.
• Increasing the pool of culturally and methodologically competent Latino and non-Latino faculty, students, and community practitioners in research and in the provision of culturally, linguistically, and health literacy appropriate services.

The Latino Center’s work has been primarily in the area of chronic diseases (i.e., diabetes, hypertension, asthma), but has conducted research in the areas of maternal and child health (e.g., pregnancy outcomes, adolescent pregnancy), occupational health/social discrimination in the workplace, injury prevention, child welfare, and genetics education, among others.

Latino Research Center Philosophy

The center’s philosophy is one of re-framing the research agenda on Hispanics/Latinos and other racial and ethnic minority populations. The research process on these populations has traditionally included methods of observation and criteria for validating facts and theories that intentionally or unintentionally have been designed to justify pre-conceived ideas and stereotypes of these populations. Research on Latinos and other minorities have not always been “scientific,” “ethical,” “objective,” or “useful.” Therefore the center agenda has also focused on unlearning “old knowledge” (which is as important as learning new knowledge), and on moving the research process from research on Latinos, to research with Latinos. This is particularly important due to shortage of researchers that understand the language, the culture, the history of immigrant, and social determinants (e.g., housing, employment, occupation income, education) affecting Latino health.

The center has pursued an agenda of social justice based on social work values that are embedded in humanitarian and democratic values of respect and dignity, and individual and community self-determination. The center’s position has been that Hispanics/Latinos and other minorities and vulnerable populations have the right to affordable, accessible, linguistic, culturally, gendered, and health literacy–appropriate health and mental health services. The United States health and human services system tends to be middle-class oriented, with a series of organizational policies and practices, and biases toward the poor, racial and ethnic minorities, and women as a group. It has limited flexibility to meet the needs of populations who may have different illnesses, cultural practices, or languages. These factors affect the quality of services delivered to these populations, their adherence to treatment, and ultimately their health outcomes and social well-being.

Community-Based Participatory Action Research (CPAR)

Due to Giachello’s social work training as a community organizer at The University of Chicago School of Social Services (SSA), she used her organizing skills to mobilize communities for action and to form diverse coalitions in Chicago—and throughout the United States—using health and social issues as topics for mobilization. Regarding this approach, Margaret S. Sherraden (2010) stated that Giachello and her collaborators have developed innovative and effective models based on popular education ideas of Paulo Freire and that CPAR combines “reflective thinking about circumstances and root causes of health problems with principles of adult education and community organizing.” The CPAR model developed by Giachello includes six steps summarized by Sherraden (2010:90) as follows:

1. Community engagement through partnership and coalition-building using health and social issues as tools for community mobilization.
2. Community capacity-building, in which community leaders learn about key health issues in the community, as well as the socio-political and economic context.
3. Participatory data collection and analyses, in which community members engage in needs and asset assessments, such as community mapping, focus groups, community surveys, and Photovoice (technique of using photos to document a grassroots issue).
4. Information dissemination during which community researchers provide evidence and offer directions for community action through town hall meetings and community forums.
5. Action planning, in which a broader group of community members develop strategic community action plans for changing health and social conditions.
6. Community social action, in which community members implement the action.

Key Accomplishments

In the last eighteen years since the Latino Research Center was formed, the center has:

• Mentored a new generation of researchers and community organizers (Sherraden, 2010). It has trained numerous high schools, undergraduate, and graduate students, pre- and post-doctorate and fellows, faculty and community health and human services practitioners, including community physicians and community lay health workers. Most of the students and center staff have continued their education and are currently working in leadership roles. In her teaching, Giachello also engages social work students in the same way as she does the community. She stresses community work and the commitment toward social justice.
• Has been instrumental in the formation of health and human services organizations in Chicago, the Midwest Region, and across the United States.
• Engaged in capacity-building through the development of curricula and toolkits that have been used to educate the community on issues such as genetics, management and control of diabetes, advocacy and policy work, among other areas. The center has organized local and regional training seminars and conferences on health disparities, health needs of the elderly, clinical trials, diabetes, and on many other topics of community interest.
• Obtained funding to engage in numerous research projects from the local and federal government, and private foundations and corporations (e.g., pharmaceuticals).

Before her retirement from UIC and the Latino Research Center, Giachello obtained funding from the Centers for Disease Control and Prevention (CDC) to establish a Center of Excellence in the Elimination of Disparities (CEED) through Community and System Change in partnership with the Chicago Department of Public Health and the UIC Chicago Neighborhood Initiatives. This new center was aimed at contributing to the elimination of diabetes and cardiovascular conditions affecting African Americans and Hispanics/Latinos. CEED is addressing the social determinants of health. It is improving the distribution of healthy food, promoting the local production of food by removing policy barriers to community-based agriculture, and increasing access to data to help policy makers make informed decision in this area. CEED has developed a much larger metropolitan coalition that includes businesses (particularly in the food industry), government, academic institutions, health professionals, and community-based and health and human services professional organizations and policy-makers (http://www.ceedchicago.org).

Also in partnership with Westat, Inc., Research Corporation located in the Washington, DC, area and with funding from the USDHHS Office of Minority Health, and the Latino Center is working in a Patient-Center Care Collaborative (PCCC) aimed at developing, implementing, and evaluating and disseminating interventions to reduce obesity, hypertension, and Type 2 diabetes in selected minority communities. Most recently, the project implemented a one-day seminar on the role of health information technology in improving minority health.

Reference
Sherraden, Margaret S. (2010). Aida L. Maisonet Giachello: Improving health in the Latino community. In Alice Lieberman (ed.), Women in social work who have changed the world. Alice Lieberman (editor). Chicago, IL: Lyceum Books, Inc.

Aida L. Maisonet Giachello, PhD, is currently professor at Northwestern University Department of Preventive Medicine, Feinberg School of Medicine where she serves as Co-Principal Investigator of the Chicago Field Center of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). This is the largest Hispanic cardiovascular study funded by the National Institutes of Health (NIH), National Heart, Lung and Blood Institutes (NHLBI), and other centers and institutes.

CEU Opportunity for Reading This Article!
NASW Illinois members can earn one CEU by completing an online quiz regarding this article! The free CEU opportunity is only valid until November 1, 2011, after which the CEU fee will change to $15.00. Nonmembers must pay the regular $10.00 rate for the CEU, which will increase to $15.00 after November 1, 2011.

As my formative years began while in high school, I had the pleasure of working closely with the school social worker for several years. She was the coordinator for the Latin American Student Organization (LASO), which I was very involved in and eventually became the president of in my senior year. That experience provided a sense of empowerment and having a social worker as a mentor and guide through it all made it one of the most influential moments in my life. To this day, I still keep close ties with her and continue to seek her out when I am dealing with very important career decisions. I am humbled and honored to know that I can now consider myself as her colleague in this great field of social work. I will continue to make attempts to pay that guidance forward with other youth that I cross paths with because I know how big of an impact that was on my life. She helped me in ways I never imagined, and I look to help others with all that I am capable to provide in order to empower them to excel to their fullest capacity possible.

As I embarked in higher learning, I was not sure what exactly I would do in life professionally. My ties to my cultural and personal experience led me straight to the social work field because I felt it only natural to help others as it had been done for me. By this point, we had moved further south in the city to the Gage Park and Chicago Lawn communities. It was there that I faced a culture shock more than once, having left a neighborhood that was predominantly Latino of Mexican origin to a neighborhood that included Caucasian, African-American, and Middle-Eastern families. The second time I experienced an even bigger transition was when I attended college at Southern Illinois University at Carbondale (SIUC), where not only would I be exposed to American students of various ethnic backgrounds, but also international students that enriched my university experience. It was also there that I saw firsthand existence of such organizations as the Ku Klux Klan, actively carrying on in meetings and rallies in southern Illinois. It was through all of these experiences that I continued to define my identity and my place in society. There I found an even greater motivation and passion to go back and work with the very families that I may have lived next door to during my childhood.

Upon my return to Chicago, I did just that—I obtained employment with organizations that provided services to low income families in neighborhoods that included Little Village, Lower West Side (Pilsen), New City (Back of the Yards), and South Chicago, to name a few. My ability to build a rapport with the families came about based not only on the skill set learned while in social work classes, but also some of my cultural skills. These included fluent native Spanish-speaking, similar family experiences of immigration, and the first-hand experience of living in communities that served as ports of entry for first generation Latinos migrating from Mexico and other Latin American countries. Just as I had experienced culture shock when relocating to another area of the city, many of these families had never really left their neighborhood for things other than official business at government offices in downtown Chicago, and that experience oftentimes was not a smooth one. Coming from countries where government services are extremely bureaucratic and oftentimes not trusted creates a huge barrier for these families in the United States. This does not even include things such as the different language spoken at these offices and the feelings of intimidation they may experience when they do not see staff that reflect their own heritage, especially if they are undocumented. In the programs where I provided services, the model was that of empowerment, and with this ideology, many of the parents we provided services to would eventually become a part of the staff within the program. They also served as liaisons between the community and the program to aid in the development of policies and the review/evaluation of program outcomes to determine better programming based on the needs of the community. Parents/families were seen as partners in the well-functioning of the program; that was essential in seeing the great outcomes and lasting ties I created with the families I served during that time. I come across some of these families in other community activities even now since I continue to frequent and see these neighborhoods as my home even though I have not lived there in the last several years; it is that kind of loyalty one feels in our community.

When working with Latino families, at times I would serve in the role of interpreter/translator and as a liaison between the consumers and the government agencies where they would seek benefits/services. Now in my current employment at the Social Security Administration (SSA), I am able to fulfill the role on the opposite side and have a commitment to serve the public well. I am always consciously providing the best customer service possible when I have direct contact with the public. Even when my contact is limited to a telephone call or a written notice requesting information, my social work skills of starting where the client/customer is and rapport-building—as well as providing clear expectations in understandable language—are applied regularly. Although the setting of my current employment is not commonly identified as a social work–related job, I find that having more staff with professional backgrounds in human service fields would greatly benefit the agency in providing quality service to members of the public that usually are the most vulnerable populations. Some of these include older adults, people with special needs, children, and families dealing with grief/loss based on the death of the head of the household. With this in mind, there is definitely room for additional social workers in federal agencies such as SSA.

Social work more than a career has become a way of life for me from a very young age. Having the opportunity to see social services as both a consumer and provider has enhanced my ability to provide the empathic support that others may need as well as identify where the client may be in order to create better, longer-lasting outcomes when possible. My heritage has been essential in the services I provide, and they continue to provide not only to Latinos/as, but to vulnerable populations in general because there is a shared experience of being disenfranchised that can be understood universally. In addition, as I continue in my career path, I look forward to contributing to the field for years to come, and I strive to uphold the legacy of Jane Addams and her strength among such adversity; even though she won many battles in her time, we continue to live out the war of poverty and injustices every day. Her teachings lay for us the groundwork, and it is now up to us to continue to carry on the construction.

Judith Susan Rocha, MSW, LCSW, is a second-generation United States Latina and the first in her immediate family to attend college in this country. Issues of significant interest include immigration, Latinos’ well-being in the United States and abroad, as well as access to quality education and higher learning for all. Currently working as a federal employee for the Social Security Administration, her service in the past has included support to children and families in the near south and south side of Chicago.
 

By its very definition, risk assessment refers to making a judgment when there is a certain amount of uncertainty, leaving an unavoidable opportunity for error. However, risk assessment instruments are not able to eliminate the impact of individual values and ethics. As Munro pointed out in her study on the protection of children, values are an essential component in risk management (Munro, 1999). With that in mind, how should systems like child protection attempt to manage risk? Weinberg proposes that the ethics lens should be widened to understand the contradictory nature of practice. She further defines the concept of what she identifies as ethical trespass, recognizing the inevitability of some level of harm in the application of human service work, despite intention or skill. Weinberg argues that human service workers can move closer to ethical relationships with clients if the nature of ethical trespass is recognized. By accepting that recognition, the ethical lens is effectively broadened to include a focus on structural and institutional inequities (Weinberg, 2005). Ethics is an integral part of the framework of social work, and ethical adherence has been a central feature of the profession. Yet ethics and malpractice complaints against social workers, while relatively low in comparison to other disciplines, continue despite the focus on ethics in schools of social work and the ongoing requirements for continuing education credits in ethics for licensure renewal. Perhaps reflecting on the evolution of social work ethics provides us the opportunity to look back, consider the present, and plan forward.

Frederick Reamer classified the time in which social work ethics has been a concern into four distinct periods: the morality period, the values period, the ethics theory and decision-making period, and the current ethical standards and risk management period (Reamer, 1998). The first period refers to the late 1900s when the focus was on the client’s morality more than on that of the social worker. Jane Adams, Hull House, and the period of settlement house arrived and the focus shifted from the client’s moral state to identifying the cause for the client’s situation.

The values period had a very concentrated focus on social work values, and the period was marked by a number of publications on that topic. The Context of Social Work Ethics by Levy (1972) is just one example of numerous publications during that time. Levy is credited with developing a typology of social work’s values (Levy, 1973). In 1977, Charles Levy chaired a task force to make recommendations to NASW on the Code of Ethics. As a result of the work completed by his task force, NASW adopted a new code in 1979 which was far more extensive than the earlier code and contained more than seventy ethical principles, clearly a move toward less abstraction and an increased focus on social workers’ conduct. (Reamer, 1998)

Reamer’s third period, the ethics theory and decision-making period, brought renewed focus and attention to the role of ethics within the profession and led into the fourth and current period, the ethics standards and risk management period. Reamer contends that if one believes in the existence of ethical standards, then it makes sense to identify the content of the standards and use the standards to judge the rightness and wrongness of actions (Reamer, 1990).

Arthur Berliner reviewed all individual ethics complaints filed with NASW from 1978 to 1985. One in every twelve complaints involved a social worker’s inappropriate sexual behavior toward a client. At the time of Berliner’s data collection, 14% of the sexual misconduct cases involved private practitioners. Of the fifty-five NASW chapters in the states and territories, 34 (62%) filed at least one complaint during the seven year period covered by the study. There was an assumption that a positive relationship existed between the chapter size and the volume of complaints. However, the data did not support this assumption (Berliner, 1989).

In 2003, Kimberley Strom-Gottfried reviewed and reported on ethical complaints filed with NASW from 1986 to 1997. This study described the adjudication process that was in place with NASW at the time, the source and location of the complaints, how the cases were resolved, and what corrective actions or sanctions resulted. The total number of case files reviewed was 894. Her data revealed the most commonly occurring violations to be sexual activity, dual relationships, and other boundary violations (Strom-Gottfried, 2003). When compared to Berliner’s data, Strom-Gottfried documented an increase in boundary violations in the same period. This increase occurred when mandatory continuing education credits were becoming standard requirements for licensure renewals in almost every state (Gottfried, 2000).

A workshop on Ethical Practice: A Social Worker’s Best Defense Against Malpractice will be presented by Yvonne M. Chase, PhD, ACSW, LCSW, and will further explore the categories in which ethics and malpractice complaints currently fall, identify factors that contribute to risk prevention and explore through the use of case situations, how we process ethical dilemmas and reduce the possibility of ethical violations. A question to ponder in advance of the workshop: As a social worker, what are your responsibilities as a result of the Tarasoff Decision in the state in which you practice?

To sign up for the conference, please visit the NASW Illinois Chapter Conference website: https://www.eiseverywhere.com/ehome/naswil/28961/?&

REFERENCES

• Banks, Sarah (October 2005). The Ethical Practitioner in Formation: Issues of Courage, Competence and Commitment. Social Work Education, 24(7), 737–753.
• Levy, C.S. (1972). The context of social work ethics. Social Work, 17(2), 95–101.
• Levy, C.S. (1973). The value base of social work. Journal of Education for Social Work, 9, 34–42.
• Munro, E. (1999). Protecting children in an anxious society. Health, Risk & Society, 1(1), 117–127.
• Reamer, F. (1990). Ethical Dilemmas in Social Service, A Guide for Social Workers. New York, NY: Columbia University Press.
• Strom-Gottfried, K. (2003). Understanding Adjudication: Origins, Targets and Outcomes of Ethics Complaints. Social Work: 48(1), 85–94.
• Strom-Gottfried, K. (2000). Ethical Vulnerability in Social Work Education: An Analysis of NASW Complaints. Journal of Social Work Education, 36(2), 241–252.
• Weinberg, M. (2005). A Case for an Expanded Framework of Ethics in Practice. Ethics and Behavior, 15(4), 327–338.

Yvonne M. Chase PhD, ACSW, LCSW, is the president/CEO for Denali Family Services, a mental health center in Anchorage, Alaska. She is also adjunct faculty in the School of Social Work and in Human Services at the University of Alaska/Anchorage. Yvonne’s prior experience includes serving as deputy commissioner for two state departments in Alaska and one in Washington State. She also has significant experience in the non-profit sector.

Yvonne’s social work experience includes a wide range of areas including: teaching on a university level, field instruction, policy, and administration. She has been very active in the social service community, in her home state, nationally, and internationally. Yvonne has served as president of the Alaska Chapter of NASW, a delegate to the Delegate Assembly, member of the National Board of Directors, Chair of the National Committee on Inquiry, and Chair of the Task Force on changes to NASW’s procedures for handling ethics complaints. Yvonne currently serves as a director on the board of NASW Assurance Services.
 

Growing Up Hispanic: Health and Development of Children of Immigrants is a unique and ambitious look at the health and development of children of immigrants. As a human service professional, this is a tool that helps to contextualize the richness of the immigrant experience in community, health, education, and development. This book takes on interesting research about Latinos and challenges the reader to rethink or consider new and/or alternative ways of working with families. In one such article by Rosalie Corona, “Moving Beyond the Mother-Child Dyad in Prevention Planning for Latino families,” Corona highlights the importance of reconsidering the roles of fathers and siblings and their influence on the family unit and suggests the importance of moving towards a family-focused approach. A family unit approach has been proven to demonstrate a higher level of familial functioning in all domains of life.

With the shifting demographics of many suburban and rural communities, the research can be used as a planning tool for community work with Latinos. Many communities that have begun to see a large influx of Latinos into their communities are faced with the challenges of understanding their new residents—culture, habits, decision-making, and the influence of the existing community structure.  Important to the fabric of any community, immigrants bring with them “cultural scripts and repertoires” that influence their behavior. Growing Up Hispanic provides an in-depth look at the impact of cultural scripts on decision-making, whether it’s the decision on where to live, how to engage in the education system, or where to get health care for the family. Human service providers will find the research relevant, informative, and poignant to their work with Latinos. 

Confidentiality and Minors

A social worker in a high school setting has been meeting with a fifteen-year-old student. The student is not special ed. She reveals to the social worker that she has tried some of her friend’s attention deficit disorder (ADD) medication, smokes marijuana, and “drinks a lot at parties.” She is open to exploring concerns around these issues, but does not want to tell her parents. Her grades are starting to drop. She has attended school regularly, but is starting to miss classes. She is not suicidal. What would you do?

The social worker is presented with an ethical dilemma. There are conflicting sections of the NASW Code of Ethics and laws. There may also be conflicts between the social worker’s personal values and school policy.

In addressing an ethical dilemma, social workers need to implement a procedural standard of care; an accepted decision-making process or procedure for critically analyzing the dilemma; and determining the best actions to implement.

The first step is to identify the competing ethical duties.

There are potential conflicts between several sections of the NASW Code of Ethics, including:

• Self-Determination (1.02) and Commitment to Clients (1.01)
• Section (a) and section (c) of Privacy and Confidentiality (1.07)
• Commitment to Clients (1.01) and Clients Who Lack Decision-Making Ability (1.14)

The student does not want the social worker to share information with her parents, but the social worker may feel that to fulfill her “primary responsibility” to “promote the well-being of clients,” the parents need to be involved. The social worker may assess that the client’s ability for decision-making is impaired and that the obligation to “take reasonable steps to safeguard the interests” of the student require informing her parents. Section (a) of Privacy and Confidentiality requires social workers to “respect client’s right to privacy,” yet section (c) states that information may need to be shared for “compelling professional reasons.”

Additionally, Illinois and federal law outline distinct confidentiality guidelines related to drugs and alcohol. Social workers in all settings, not only formal drug and alcohol treatment programs, need to be aware of the provisions in the following two laws:

• Consent by Minors to Medical Procedures Act (410 ILCS 210/)
• Alcohol and Drug Abuse Patient Records Confidentiality Regulations (42 C.F.R. Part 2 of federal Public Health Service Act)

These acts provide expanded rights to confidentiality for minors.

The Consent by Minors to Medical Procedures Act section on “substance abuse treatment” applies broadly. It is not limited to formal treatment programs. It states:

“Minors 12 years of age or older who may be determined to be an addict, an alcoholic or an intoxicated person or who may have a family member who abuses drugs or alcohol, may give consent to medical care or counseling related to diagnosis or treatment. The consent of the parent, parents or legal guardian shall not be necessary to authorize medical care or counseling.”

“With the minor's consent anyone involved in providing medical care to the minor or counseling related to the drug or alcohol use by the minor or a member of minor’s family shall make reasonable efforts to involve the minor’s family in his or her treatment, if the person furnishing the treatment believes that the involvement of the family will not be detrimental to the progress and care of the minor. Reasonable effort shall be extended to assist the minor in accepting his or her family’s involvement in the care and treatment being given.”410 ILCS 210/4

“Any provider who provides counseling to a minor who abuses drugs or alcohol or has a family member who abuses drugs or alcohol shall not inform a minor’s parent, parents, or legal guardian or other responsible adult of a minor’s condition or treatment without the minor’s consent unless that action is, in the person’s judgment, necessary to protect the safety of the minor, a family member, or another individual.” 410 ILCS 210/5

The Alcohol and Drug Abuse Patient Records Confidentiality Regulations give minors expanded rights related to release of confidential information. They state that: “If a minor obtained treatment without parental consent, then minor needs to consent to release of information. If parental consent is needed to obtain treatment, then both parental and minor's consent need to occur before release of information.”

This act also “requires separate and explicit consent for disclosure of drug or alcohol treatment records.”

The Illinois Mental Health and Developmental Disabilities Act states that a minor can have “five outpatient counseling sessions” without parental consent. Sessions are defined as forty-five minutes long. The Consent by Minors to Medical Procedures Act expands the rights of minors over twelve “who may be determined to be an addict, an alcoholic or an intoxicated person or who may have a family member who abuses drugs or alcohol.”

These situations often require social workers to rank order ethical obligations. A procedural standard of care step for rank ordering involves thoroughly examining the reasons in favour of and opposed to each course of action, considering relevant:

1. ethical theories, principals and guidelines
2. codes of ethics and legal principles
3. applicable laws
4. personal values

An overriding ethical obligation is social workers’ awareness of their own knowledge and skill level related to drug or alcohol–related issues. The expectation is not that social workers be all-knowing or expert in every area. This is impossible. The ethical duty is to be self-aware and honest about our knowledge base, intervention skills, comfort level, and personal values. Personal values are part of every ethical decision we make. They are even more likely to arise in working with minors. Addiction-related issues with this population can be complex and difficult. Seeking appropriate supervision or consultation is an integral part of a procedural standard of care.

FOOTNOTES

• http://www.netaddiction.com
• Children’s Mental Health Fact Sheet – Illinois Consent & Confidentiality Laws: http://www.cico-il.org/legislation/childrens_health.html
• Confidentiality of Drug and Alcohol Patient information-Illinois Drug and Alcohol Treatment Confidentiality Act: http://www.dhs.state.il.us/page.aspx?item=38493
• Confidentiality of Alcohol and Drug Abuse Patient Records: http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&tpl=/ecfrbrowse/Title42/42cfr2_main_02.tpl
• Illinois Department of Financial and Professional Regulation: http://www.idfpr.com
• Illinois Mental Health & Disabilities Code: http://www.dhs.state.il.us/mhdd!ddlpdf”imhddcO2.pdf
• Alcoholism and Other Drug Abuse and Dependency Act: http://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=232&ChapterID=5
• Illinois Alcohol and Other Drug Abuse Professional Certification Association, Inc: http://www.iaodapca.org/
• Illinois Alcoholism and Drug Dependence Association: http://www.iadda.org/
• Center for Substance Abuse Treatment (SAMHSA): http://www.samhsa.gov/index.aspx

Ruth Lipschutz, LCSW, ACSW, is a licensed clinical social worker with postgraduate certification in ethics, mediation, Transformational Imagery, hypnotherapy, and Eye Movement Desensitization and Reprocessing (EMDR). She received her MSW from the University of Illinois in 1978 and went on to complete the two-year postgraduate training program of the Institute for Family Studies at Northwestern University. She has extensive experience in the areas of ethics, mental health, addictions, traumatology, program development and implementation, supervision, consultation and Alternative Dispute Resolution. She is the chairperson of NASW’s National Ethics Committee and has served as a panelist, consultant, mediator, and trainer for the NASW Illinois Chapter Ethics Committee. She is currently in private practice.

FEDERAL

The political battle over the federal budget, debt ceiling, deficit reduction, and taxation threatens to leave many victims in its wake, including social services professionals, provider agencies, and individuals and families that are reliant on their assistance. Our Board met with Representative Jan Schakowsky via telephone at its meeting on Friday, August 26, 2011. Rep. Schakowsky is a leading progressive voice in Congress. She inspired us to vigorously advocate for our profession and our customers, especially over the next 60 days when the "gang of 12", a new special Congressional Committee on deficit reduction, will be trying to reach agreement on ways to reduce the federal deficit. However, as Rep. Schakowsky correctly pointed out, the deficit is not the problem in the short term. The real issue that needs to be addressed now is putting people back to work.

We need to all take action by contacting our U.S. Senators and members of Congress, Democrat and Republican, to tell them how important it is to preserve entitlement programs like Social Security, Medicare and Medicaid, and to also preserve a strong social safety net for the poor, persons with disabilities, older adults, and children.

STATE

The governor recently signed into law several bills of interest to NASW members:

House Bill 1152, now Public Act 97-166 (Essential Community Behavioral Health Care Providers). I reported on this in my last article. We are attempting to find out more about the practical impact of this new act, which requires the Department of Human Services (DHS) to establish a new category of behavioral health care provider that (1) promotes co-location of primary and behavioral health care, (2) promotes behavioral health care as part of the insurance exchange established by the state in accordance with the federal Affordable Care Act; (3) promotes continuity of care for persons moving between various health care coverage; (4) promotes continuity of care for persons not yet eligible for Medicaid or who are without coverage; (5) improves access in underserved areas of the state. We are asking DHS to provide information on how this model differs from what we already have in the state and what, if any, financial incentives there will be to create "essential" care providers.

HB 1530, now Public Act 97-437 (Mental Health Parity), essentially aligns our state's parity law with the federal Wellstone-Domenici Act. NASW was represented by executive director Joel Rubin at the bill signing.

HB 1193, now Public Act 97-556, effective January 1, 2012, limits the ability of health insurance carriers to recoup payments made to health care providers that are subsequently determined to have been made in error. Many of our private practice clinicians have indicated that this is a problem, so we supported this legislation. The new law provides that no recoupment or withholding from future payments may occur 18 months or more after the original payment is made except (1) when a court, governmental agency, other tribunal or independent arbitrator makes a formal finding of fraud or material misrepresentation, (2) the insurer is acting as a plan administrator for the state's CHIP program; or (3) the provider has already been paid in full by another source.

SB 1622, now Public Act 97-528, effective immediately, requires, as part of the state's commitment to long term care re-balancing, that the Department of Human Services conduct a geographic analysis by July 1, 2012, of supports and services for individuals with developmental disabilities and mental illness. The analysis must identify gaps in services by geographic region. A final report is due by January 1, 2013.

SB 2015, now Public Act 97-614, effective January 1, 2012, amends the Probate Act of 1975, with respect to temporary guardianships by (1) allowing a court to appoint a temporary guardian for a ward upon the death, incapacity, or resignation of a guardian, and (2) allowing for the granting of an extension of a temporary guardianship under certain specified conditions.

HB 2870, now Public Act 97-505, effective immediately, requires that when school districts register students, the caretaker who registers the student shall be permitted to voluntarily report that the student has a parent or guardian in one of the branches of the United States armed forces. While some districts already collect this information, many do not. This data may enable a school district to apply for federal impact aid if a certain number or percentage of its students are connected with the military. It also helps the districts identify students who may need support services such as social work intervention due to the absence of a parent who is on active duty or other circumstances related to a parent's military status.

OTHER STATE NEWS

Budgeting for Results Commission

Pursuant to Public Act 96-1529, the governor has appointed members of the Budgeting for Results Commission. The purpose of the commission is to advise the governor as he defines budgeting goals and priorities. There are no human services provider representatives on the commission, unfortunately.  The chair of the commission is State Senator Dan Kotowski (D-Park Ridge), who sponsored the enabling legislation. The governor's liaison to the commission is Crystal Thomas. We need to watch this commission very closely and participate actively in its public hearings. For more information, you can do an online search for "Illinois Budgeting for Results Commission."

Illinois Human Services Commission

This body was created in 2009 by Executive Order. It has issued a report and has scheduled four public hearings next month in Chicago, Springfield, Aurora, and Mount Vernon. For a copy of the report and a schedule of the hearings, go to http://www2.illinois.gov/hsc/Pages/default.aspx.

1. Time Management. In academics, what gets measured becomes important. Similarly, where one spends one’s time ultimately reflects one’s priorities. Coursework, internships, family, friends, jobs, and other potential commitments must be juggled. I start by asking questions such as: What is most important to me? What do I enjoy doing? What must I get done? Approached differently, time management can be determined by taking a mental step into the future and asking, “How do I want to be remembered?” or “What type of impact do I want to leave on this world?”
2. Self-Care. Setting aside time for self-care can prove to be a challenge given one’s personal and professional demands. However, there are benefits to eating healthy, getting enough sleep, and finding healthy physical and emotional outlets to counterbalance stressful workloads. Running, biking, and time with family and friends are examples of outlets in my life. I also find value in establishing weekly traditions, such as Friday lunch with friends. Not only do traditions give me something to look forward to, they also break up the monotony of daily life.
3. Know Yourself. Of course, we are all a work in progress. At the same time, knowing how we function can add tremendous value to our lives and to the lives of those around us. What are your fundamental study techniques? How do you best manage stressful situations? What strengths can you bring to group projects? What are your values and biases, and how might they impact your contributions to the social work profession?
4. Networking. Establishing connections with others offers many benefits inside and outside the classroom. Clarifying assignment requirements, forming quality teams for group work, self-care, and potential links to future employment are a few advantages to networking. Naturally, it is best when both sides add equal value to the partnership.
5. Create Opportunities. In some form, every day is an interview for your next job. Are you able to build positive rapport with others? Are you an effective contributor to group projects and in-class discussions? Opportunities also exist outside the classroom. If your schedule permits, activities such as volunteering at a nonprofit agency may turn out to be a win-win for you both personally and professionally.
6. Celebrate Successes. Successes and their subsequent celebrations can be large or small. As with self-care, celebrating success seems to break up the monotony of daily life and counterbalance stressful workloads. Celebrations may also serve as motivation during difficult tasks. Furthermore, failing to recognize accomplishments may leave a person feeling as though they haven’t achieved anything when indeed they have.

The above is by no means meant to be an all-encompassing list of topics to consider heading into an academic year. There are certainly many different ways to successfully approach and excel in academia. If nothing else, perhaps the above information can serve as a primer to move you toward that “back-to-school” state of mind. Best to you in the coming academic year!

The Student Network SIG provides support and networking opportunities to Illinois social work students. To find out more about the SIG and upcoming events, please visit the Student Network SIG website.

For a complete up-to-date list of ALL classified ads, be sure to visit the NASW Illinios Chapter Classified Ads: http://www.naswil.org/news/networker/networker-classifieds/.

OFFICE FOR RENT - Downers Grove
Downtown Downers Grove Office space for rent. Beautifully remodeled building, waiting room, bathroom, off street parking & more. First month free, $700 month utilities included. 630-968-9817.

OFFICE FOR RENT - Orland Park
Beautiful $7.50-$10 hr. office rentals. Everything new-Includes Computer/Internet, Shared Waiting Area, Restrooms & Kitchenette-Util. Included. 630-890-1907 & PICS @ jamessimmerer.com.

OFFICE FOR RENT - Chicago
Psychotherapy office for sublet. Has spectacular southeast views of city; lake, park & museums. windows Open for fresh air

Personal bathrm
Available Fri - Mon
Great locale/transportation
$600/month

OFFICE FOR RENT - Oak Park
I'm seeking part-time/hourly office space for rent in Oak Park.
Please call Laura at 708.288.5054 or email ljguentherlcsw@sbcglobal.net.
 
OFFICE FOR RENT - Buffalo Grove
BUFFALO GROVE/LONG GROVE:Small office available. Quiet & confidential waiting room. Large window. New paint & carpet. Ideal location with 13 other medical offices.Please call Susan (847) 913-1400

OFFICE FOR RENT - Hyde Park
Office for rent in Hyde Park Bank Building. Spacious, light-filled room with waiting room, available all day Wed and weekends; Mon or Fri; and mornings. Contact 773-536-5353 or cbrickma@sbcglobal.net

NASW ILLINIOS CHAPTER JOB BOARD

For a complete and up-to-date list of job board postings, visit the NASW Illinois Chapter Job Board: http://www.naswil.org/education-career-development/association-job-board/.

    Child & Family Specialist (Saint Anthony Hospital)

    Renal Social Worker (Nephron Dialysis Center, Ltd)

    Care Advocate - LCPC, LCSW, RN, & PhD (UnitedHealth Group)

    Worker-Bridges Early Childhood Adolescents Program

    Full-Time Therapist (Samaritan Counseling Center of the Northwest Suburbs)

    Field Support Specialists (Illinois State University School of Social Work)

    Social Worker or Transition Specialist (The Menta Group)

    EAP Sr. Specialist, Benefits (Abbott)

    Site Based Program Coordinator (Big Brothers Big Sisters of Metropolitan Chicago)

    Drug Court Evaluator/Counselor (Family Service and CMHC for McHenry County)

    Mental Health Therapist/Social Worker (Human Resources Center of Edgar and Clark Counties)

One of the reasons that I chose to become a social worker was because of the joy that I felt when I was able to help someone. I looked forward to being a support and finding resources for those who did not have access or the wherewithal to do it for themselves. As I entered the field of social work, I began to interact and learn how to work with families. I was excited about my work with children and families as I learned how to celebrate their successes and encourage them when they needed uplifting. I often went out of my way to ensure that the needs of others were met, even if it meant that I had to sacrifice some of my own personal time to support a child or a family. I understood my role and valued the relationships that I developed in this wonderful profession that I had longed to be a part of.

As the years have gone by and I have worked tirelessly in this field, I now understand the need and the importance of self-care as a social worker. What I have learned over the years is that although we are social workers and we give of ourselves daily, this doesn’t exempt us from being impacted by this life that we live. We are all human and vulnerable to all of the challenges that life sends our way. I often tell my patients, “We don’t happen to life, life happens to us.” Although many of life’s events are out of our control, we do have some control over how we internalize these events and how they impact our lives.

When we are in the role of a social worker, many times we are constantly listening to stories of trauma, grief, sadness, and despair, and as a natural consequence, we vicariously participate in the trauma of others. This leaves us vulnerable to becoming overwhelmed with compassion, sometimes to the point that we are either under a great deal of stress that begins to impact the work that we do, or we develop compassion fatigue which causes us to develop emotional and physical symptoms that interfere with our ability to be effective as we work with children, individuals, and families.

Our lives are all very different, and we all face our own personal struggles at various points in our lives. How much help are we as social workers to the people that we serve if we are stressed, sick, or tired, and don’t take the time to take care of ourselves? It is easy for social workers to neglect their own well-being while focusing on others, but it is critical to recognize the warning signs that tell us when we need to take care of ourselves. When we finally get the lesson about taking care of ourselves, it’s usually because we have gotten to a point in our career where we have experienced what it is like to become burned out or to develop compassion fatigue. When we know better, we do better. We learn how to take better care of ourselves and learn how to balance our work and personal lives in order to ensure our well-being.

We all have different ways in which we cope with personal and work-related stress. It is important to recognize the signs and find ways that are helpful for us to take care of ourselves so that we are physically and emotionally healthy enough to do the work that we enjoy.

NASW Code of Ethics

2.09: Impairment of Colleagues
(a) Social workers who have direct knowledge of a social work colleague's impairment that is due to personal problems, psychosocial distress, substance abuse, or mental health difficulties and that interferes with practice effectiveness should consult with that colleague when feasible and assist the colleague in taking remedial action.
(b) Social workers who believe that a social work colleague's impairment interferes with practice effectiveness and that the colleague has not taken adequate steps to address the impairment should take action through appropriate channels established by employers, agencies, NASW, licensing and regulatory bodies, and other professional organizations.

2.10: Incompetence of Colleagues
(a) Social workers who have direct knowledge of a social work colleague's incompetence should consult with that colleague when feasible and assist the colleague in taking remedial action.
(b) Social workers who believe that a social work colleague is incompetent and has not taken adequate steps to address the incompetence should take action through appropriate channels established by employers, agencies, NASW, licensing and regulatory bodies, and other professional organizations.

Yolanda Jordan, MSW, LCSW, has an extensive background in abuse/neglect issues in the field of child welfare. As a placement manager with the Illinois Department of Children and Family Services, she is responsible for managing supervisors who are responsible for children who are placed in the foster care system. Yolanda is also a practicing psychotherapist and has been in private practice for the past ten years. Services are provided to children, couples, and families with a special emphasis on relationship issues that African American women face.

A National Public Radio (NPR) story broadcast in April 2010 revealed that the story of the Russian boy being returned to his native country is not as unusual as many might think. NPR reported that many foreign adoptions have failed over the years because families are not prepared to deal with children that are damaged by institutionalization (NPR, April 13, 2010). In the same broadcast, Chuck Johnson, the then acting CEO of the National Council for Adoption pointed out, “[T]he vast majority of families who adopt children from Russia have a very positive experience.” He expressed concern that such incidents as the one involving the child from Russia would have an adverse impact on future adoptions of children who are desperately in need of families. On another front, however, Dr. Ronald Federici, a neuropsychologist in Virginia who specializes in adoptions and attachment disorders, pointed to the more than 4,000 children adopted from overseas that have ended up in United States foster care and the hundreds of cases that have concluded with parents taking their adopted children back to their country of origin. He further added that many other internationally-adopted children have also been victims of abuse and neglect. It is important to note that data focused on international adoptees related to these issues is difficult to locate, although some data related to disruptions is collected by the U.S. State Department.

The U.S. ratification of the Hague Convention in 2008 is contributing to improving the chances of international adoption success by setting up a process for adoptions that is designed to prevent exploitation of children and child trafficking. The convention includes a requirement that agencies participating in international adoptions be accredited when they operate in participating nations, and they must have counseling and other services in place to help families cope with problems (U.S. Department of State, Office of Children’s Issues). Although improvements in the process are being made, helping current adoptive parents and their children requires that families know how to access help. One important step is to educate social workers and other helping professionals who come into contact with adoptive families about resources that are available. It is also important to help social work professionals expand their understanding of particular issues related to international adoption. By being aware of the difficulties that international adoptees and their families may have to cope with, the more effective social workers can be in linking them to practitioners and programs that are prepared to help with post-adoption issues.

Social workers in child welfare and school settings may come in contact with parents of internationally adopted children. These social workers need to understand the detrimental impact that living in an orphanage can have on these children, along with the special challenges that families face in terms of finding practitioners who can effectively intervene to provide support in their post-adoption issues. This is especially important in Illinois since it has ranked in the top five states for international adoptions (2006 to 2010). From 1999 to 2010, 10,747 children have been adopted internationally by families in Illinois (U.S. Department of State, Intercountry Adoption). As the numbers of international adoptions increased over the years, more adoptive families in Illinois are finding themselves in need of post-adoption services. The problem is they may have trouble accessing these services, or the resources that they find are not prepared to help them. For those who have adopted internationally, locating providers who are familiar with the effects of institutionalization as well as other circumstances specific to the international experience are critical. Social workers who are knowledgeable about post-adoptive issues and resources are better able to link parents with supportive resources that increase the probability of the family staying together.

In an effort to respond to the need to develop greater awareness and sensitivity within the social work community of Illinois about the challenges faced by families who adopt internationally, the upcoming NASW Illinois Statewide Conference will feature an intensive workshop entitled, International Adoption: A Forum for Post-Adoption Issues and Resources for Social Workers. The major objectives of the workshop include identification of specific post-adoption issues confronting families who adopt internationally, a description of the effects of institutionalization on children, a description of the types of situations that are coming to the attention of child welfare agencies around the state, and identification of critical resources within the state and throughout the country. The presenters plan to include participants at the workshop in a discussion of their own experiences in working with adoptive families, and to assess interest in establishing a special interest group (SIG) to extend the effort to develop a network of services and expertise.

To find out more about this workshop intensive as well as sign up for the conference, visit the NASW Illinois Chapter Conference website at: https://www.eiseverywhere.com/ehome/index.php?eventid=16599&.

REFERENCES

• Clarridge, C. (2010, April 15). Russia's adoption suspension leaves would-be parents in limbo. Seattle Times. Retrieved from http://seattletimes.nwsource.com/html/localnews/2011619501_adoption16m.html.
• Tedford, D. (2010, April, 13). Russian case spotlights potential adoption risks. National Public Radio. Retrieved from http://www.npr.org/templates/story/story.php?storyId=125903954.
• U.S. Department of State Intercountry Adoption. (2011) [Statistics provided on international adoption by year, by state, and countries adopted from 1999–2010] Retrieved from http://adoption.state.gov/about_us/statistics.php.

Kathryn Conley Wehrmann, PhD, LSW, is associate professor at the Illinois State University School of Social Work. Her professional experience includes a background in public child welfare. She worked extensively with Romanian officials on child welfare reform efforts and has also been awarded Fulbright Senior Scholarships for research and teaching in Romania. International post-adoption issues are a recent interest and one that she is teaming with colleagues to create a forum for initial and ongoing discussion and dissemination of critical information that social workers need in order to support families who have adopted internationally.

I realized from the beginning of my graduate school career that I wanted to be in private practice. Some of the professors were in private practice and during their lecture they would share their clinical experiences. I truly enjoyed when they intertwined theory with a case example from their private practice. To me, it was exciting; I hung on their words, expert opinion, and down-to-earth approach when they described their clients making progress. I was in awe as they spoke about the autonomy of being in a private practice, the independence to specialize in client populations, and the freedom to create their own schedule. Ten years later, as a clinician in private practice, I can definitively state that the clinical experience in my program was invaluable. The program, professors, and school resources shaped me to become an ethical, competent, and confident therapist. At this time in my career, I can also say that there is much more to running a private practice than the experiences I heard about in those case examples during class. In other words, it takes more than just “hanging a private practice shingle” to start a private practice. The following are some highlights of my lessons learned over my time as a clinician in private practice.

Create a Vision For Your Private Practice. This step is very easy to do and very easy to overlook. Begin by determining the population that you are most interested in helping. Do you want to work with adults, children, couples, individuals? Do you want to be a generalist that works with many different client diagnoses or specialize in a certain area like anger management or substance use? Determine the number of clients you would like to work within a given week. What will your availability be like for clients? Your vision can certainly change over time. Just be aware of this change and what you are basing it on.

Develop Standard Protocols. Procedures for your practice can help guide administrative and clinical decisions. For instance, what are the instructions you will give to clients who are experiencing a mental health emergency? When you are on vacation? When a client does not show for an appointment

Establish Goals For Your Practice. This includes both short-term and long-term measurable goals. Goals will vary from clinician to clinician, depending on personal needs and the amount of time that can be devoted to building a private practice. Goals may include a targeted number of clients seen each week, submitting claims to insurance companies in a specified timeframe, finding a certain number of opportunities to market your practice, or carving out time to meet other clinicians that are in private practice. Regularly revisit your goals to see if they are being met or need to be revised.

Understand Your Strengths and Limitations. We possess both strengths and limitations which can help and hinder our success in private practice. Determine which of your strengths will help you build and sustain your private practice; how can you build upon these strengths? For example, if you are good with computer design, you can create your own website or online marketing advertisements via affordable online software rather than hire a computer designer. Alternatively, determine which of your limitations might hinder the growth of your practice; how will you best control these limitations? For example, if you have a challenge with time management and you see that this might impact your day-to-day operations (e.g., keeping to appointment-designated times), then can you find a way (read books, articles, work with a professional) to address this challenge?

Explore Marketing Opportunities. Marketing yourself and your practice is a considerable investment and should be treated accordingly. Marketing requires a significant amount of time, energy, and at times, money. You must “spread the word” that you are in private practice to potential clients. This can be done by advertising on the internet, print ads, professional directories, and so on. Even your business cards can be a source of marketing as you can readily hand them to colleagues. Creating a website can give clients who are looking for a therapist a clearer picture of who you are as a clinician, your therapeutic approach, your experience, location, hours of operation, and so forth. Many web hosting sites have an option where you can create your own website. Or you can hire a design company to create a website for you. A mentor once told me that you can be the best clinician in the world, but if no one can find you then you will not be of help to anyone.

Build a Supportive Professional Network. A good network is valuable to a private practice. A network can consist of colleagues, local mental health practitioners, community medical professionals, and others. Your network can provide guidance when you need help with administrative questions, finding resources in the community for your clients, providing referrals to your clients that need additional assistance, and at times be a referral source for your practice. For example, if you are working with a couple and the male client presents with depression, a referral to a therapist that you are confident is a competent clinician is imperative for this client. If you are working with a client and they are in need of psychotropic medication, a referral to a psychiatrist that you know and trust will provide excellent care is essential.

Develop Referral Strategies. There are many internet and print marketing tools which help in obtaining referrals. For a fee, you can advertise on one of the many therapy directories on the internet. Print marketing includes brochures, flyers, and business cards. Additionally, current and past clients that have had success with treatment may refer their friends, family, or co-workers. Finally, you may be a good referral source for local physicians and other community health professionals who are looking for mental health professionals to help their patients.

Determine If You Will Work With Insurance Companies. You will want to determine whether or not you will be an in-network or out-of-network provider. If you decide to be in-network, you must apply when the insurance network is open. This process can take anywhere from thirty days to six months. When you are in-network with an insurance company, it does not mean you have to be in-network with every insurance company. As with most decisions in private practice, joining an insurance panel has its tradeoffs. For instance, an advantage to joining an insurance panel is that you are opening up your potential client base, while a disadvantage is that the reimbursement process takes fourteen to ninety days or more.

As with any career decision, establishing a private practice takes a lot of careful thought and consideration. There are benefits and limitations to being in private practice, all of which need to be explored. Graduate school does a wonderful job of preparing you to be the best clinician and to practice with the most skill and confidence. The aspects of running a thriving practice require business savvy as well as clinical skills. The business side of private practice takes time to learn, but it is not impossible.

Justin Tobin is owner and therapist at Justin Tobin and Associates, a group psychotherapy practice that works with individuals and couples in downtown Chicago. He has helped many individual clients manage depression, anxiety, and stress, as well as work through trauma. He has helped couples improve their communication and build trust and honesty in their relationship. Prior to working in private practice, he provided therapy for clients in residential care facilities, drug treatment centers, and community mental health agencies. His therapeutic style is blended with empathy, sincerity, and genuineness. He truly enjoys working with clients and helping them find the answers they seek.

The NASW Illinois Chapter is looking to start a shared interest group (SIG) devoted to the issues of school social workers around the state. To be become involved in forming this group, please contact NASW Illinois Chapter Executive Director Joel L. Rubin at jlrubin@naswil.org.

FOR SCHOOL SOCIAL WORKERS: BEGINNING AT THE BEGINNING—SUPPORTING CHILDREN WITH ADHD THROUGH MEDITATION

Here’s something of an understatement: children today have a lot going on. The traditional childhood milestones of progressing through grade levels, making friends, getting into trouble, experiencing puberty, etc., are compounded by the increasing need to navigate evolving technologies. Today, children use computers, cell phones, and various other means of social communication heavily. The average child must embody some hyperactive, inattentive, or impulsive behavior patterns to operate well within the current environment. Children with natural tendencies towards the symptoms of attention deficit hyperactivity disorder (ADHD) may be understood as having some slight advantage over the rest of the crowd.

However, ADHD tendencies and symptoms put these children in a position to create stress, amplify stress, become distracted, and commit decision-making missteps. My experience working in therapeutic day schools has shown me that adding any number of at-risk factors to the mix can quickly create a pattern of failure and traumatic experiences for a kid. Repeated loss of self-confidence fosters a child who believes that they are incompetent, unlucky, or disliked. Happily, my experience has also shown me that every child wants to be valued and successful.

Defining the Issue

Parents, teachers, and school social workers may counsel a child with ADHD by offering an abstract solution or rationalization. There are many aphorisms and adages we can use: “Stop, think, then act,” “Slow down,” or “Put your listening hat on.” Using this advice will feel genuine and convincing, speaking from a place of experience. Most adults have mastered the skills they need to use these strategies and may assume that the child in question will go through the same learning process. While the previously mentioned advice or instruction may seem immediately useful, some children may not be able to access its usefulness due to a deficiency in an earlier skill set.

The difference between a generally successful student and one who fails to thrive in the school environment will often be the mastery of an important coping skill. I learned working in special education that while we should understand each individual’s learning process, it is always important to review the basic skills a child needs to cope or function well in the social environment. Often, intervening at the root can solve the various contingencies of the main issue. Clearing up any ineffectually gained skills at the fundamental level also gives a child confidence to continue through the learning process independently.

Using a strengths-based approach, we can help these kids hone their symptoms into effective skills. Reframing the symptoms of ADHD helps a counselor identify the area of need. These children have hyperactive movements that satisfy their heightened sensory needs. Their impulsive pattern of action can be a confident reliance on decision-making. Seemingly inattentive, they often adeptly engage in multiple and shifting lines of thought. A counselor can identify areas that are not strengths for the child by noticing the marked presence of stress and insecurity. For example, a child who poorly makes impulsive decisions will appear anxious due to his/her flimsy and apprehensive consideration of the possible choices.

Considering Meditation as a Solution

My own strategy for helping children with ADHD (as well as other emotional issues) has been to engage them in mindfulness meditation and support them in the real-time use of its components. Mindfulness may be defined as being attentive to a momentary experience without judgment or engagement. Mindfulness meditation practices calming the mind and body, controlling movement and breathing, acknowledging but not engaging in occurring thoughts. You are not attempting to focus on any narrative or guidance, but simply doing as little as possible.

The purpose of mindfulness meditation is to know and understand your body and mind, and realize that they are often doing much more than is needed. How often do you find yourself doing one thing, yet thinking about one or many other things? For children with ADHD, this creates undue anxiety and stress which leads to mistakes. Our mind naturally experiences a state of empty calmness, and in reaching this state by choice, we build up experiences of confidence in action and thinking. The root skills needed to control hyperactivity, impulsivity, and inattentiveness are also the skills needed to practice meditation.

The advantages of practicing meditation for short periods on a daily basis are immediately relevant to those with emotional difficulties. A recent study published in Psychiatry Research: Neuroimaging showed that participants who practiced meditation daily experienced some growth in the gray matter density of their brain. The areas of the brain that grew are linked to learning, memory, and self-referential processing as well as emotion regulation and perspective-taking. The skills commonly found deficient in children with ADHD specifically involve the areas of the brain benefited by mindfulness meditation.

Practicing Meditation: A Quick How-To Guide

Children can practice mindfulness meditation both in school and at home. All it requires is a small amount of time and a quiet space. While most meditation guides would recommend meditating for anywhere between 15 minutes and 2.5 hours, I have found that the child novice should begin with 5 to 10 minute sessions. The school day is a mess of forced concentration and stifled half thoughts. Mornings are a good time to practice meditation, allowing the effects to sink in over the course of the day. If possible, meditation should be done after school as well to counteract any residual stress or anxiety.

As a teacher, social worker, or parent, you can practice meditation with your kids. Giving them a few simple prompts for instruction is necessary, but modeling the practice of meditation will be much more powerful for the student. Start by finding a relaxed, seated posture either on a chair, floor cushion, or carpet. Good posture should give you a feeling of stability and strength. Fix your eye gaze immediately in front of you and slightly downward to lessen distractions. Breathe normally and let your breath be the fixture or focus of your meditation.

Once settled in, the meditation can actually begin. I like to start and end the session with a long and calming sound, usually by ringing a gong. While meditating, simply maintain focus on the breath. Breathing will be both relaxing and a reminder for singular concentration. Your mind will naturally move and begin thinking about stress, problems, interests, people, or things you’ve forgotten to do. Acknowledge the thoughts, but allow them to travel past you like leaves on a breeze. Bring your focus back to the breath anytime you become distracted.

When you end the meditation, remind the children that the purpose of the exercise is to reduce stress and increase focus and emotional stability. Every time they practice, they are immediately receiving these benefits. Using the techniques of controlled breathing and calmed, singular focus when presented with a choice or problem will help them think clearly and act confidently. Whenever a good opportunity presents itself, prompt your children to momentarily focus on their breathing, and then consider the task at hand. They should be present within the moment, and fully experience whatever it is they are doing. This will be relaxing to them, and give them insight beyond what is typical. The technique can be applied to anything: from eating lunch to a math quiz, a kickball game or a panic attack.

Once they become practiced in this purposeful means of thinking, children with ADHD may find that their hyperactive and impulsive tendencies are better balanced. All children bounce in and out of flittering experiences in school and play. Being fast-moving and quick minded are ever more desirable attributes for kids and working adults. Children that keep a regular meditation practice naturally become better at taking correct action and having sound judgment.

Justin P. Gunderson is a new member to NASW. He has worked in special education and therapeutic day schools since receiving his MSW from Loyola University Chicago in 2008. Justin currently works at Camelot Therapeutic Day School – Kankakee. He is a resident instructor for Therapeutic Crisis Intervention, training school staff in crisis prevention and de-escalation. He also practices private therapy in the Kankakee County area.
 

Irene McGoldrick’s Two Chai Day: One Widow’s Story About Living Beyond Grief is a journey into the heart of a young mother who loses her beloved husband. Her self-aware and remarkably honest writing allows you to experience the painful journey with her and her family.

Each chapter begins with a quote that summarizes the insight Irene has gained from each stage of the mourning process. The eclectic blend of wisdom from which these quotes are drawn characterizes Irene's openness to drawing support and insight from many sources. I found this to be one her most striking resiliencies. She remained open to help from those who offered it and even found wisdom and humor in insensitive comments from those who didn’t know what to say. The sources of the quotes vary from pop music singers to mystic poets. The beginning of Chapter One cites a quote from the poet Rumi:

Lovers don’t finally meet somewhere.
They’re in each other all along.

This quote aptly describes the love Irene and Bob have for each other, and how she found the strength to share her story with others. The depth of their love for each other and the strength it provided them slowly unfold as the book progresses. Having found the strength to write down her raw and honest emotions during this vulnerable time, she has offered a gift to those who feel as if no one can understand their pain or that they are suffering alone.

One of the most unique aspects of this book is that Irene shares excerpts of her late husband’s journal entries. These journal entries give us a glimpse into the emotional and spiritual world of a man facing the end of life and the insight and strength he drew upon during this time. It also allows us to feel the bond between the two and understand the depth of their relationship.

Irene is incredibly candid with her emotions, and her level of self-awareness that social workers are known for is woven throughout the book. This is one the greatest strengths in the book. At one point, about a month after the loss of her husband, Irene feels incompetent at raising two boys alone and decides to come up with a success journal so she can feel as if she has accomplished something. In the beginning, she can only write that the kids are alive and safe in their beds. As she continues, she is increasingly aware of how far she has come and how she has found the ability within herself to do what she thought only her husband could do for the family. Her struggles with finding a way to parent on her own are chronicled in such raw and touching ways that anyone who has experienced this will be relieved someone had the courage to put this on paper.

The openness with which Irene describes how it feels to be enveloped by grief and the loss of control over emotions helps demystify the grieving process. Many have read about stages or what to expect while grieving, but Irene lets you experience it with her and gives the reader the possibility of learning life lessons by reading her story. The depth of pain in losing a loved one is so vividly described that it is difficult to imagine how the family moves on. Her honest portrayal of her meltdown at a food co-op where they could not figure out how to get her husband’s name off their membership card had me laughing and crying at the same time.

The quote that encourages us to continue on the joyous task of living comes at the end of the book. Irene finds the courage to move beyond her grief and continue living, or as she puts it, “Plan B.” The complicated task of dating after a loss is also addressed.

The book ends on a hopeful note that things don’t always turn out as we plan but by allowing ourselves to grieve fully, we can move through the grief to a new place.

Tracie Pape, MA, LCSW, is currently a therapist at the Center for Grief Recovery in Chicago, Illinois. The Center For Grief Recovery offers services to those suffering from loss. She strongly believes in the possibility of healing from pain and loss and the resiliency of the human spirit. She has worked in the mental health field for over fifteen years.

Many social work clients depend on health insurance companies to cover the costs of their mental health treatment and, in return, many clinical social workers depend on reimbursement from health insurance companies for their income.  In order to facilitate the claims and payment processes, health insurers generally require access to some information about the clients’ emotional or mental conditions and the progress of treatment. As insurers’ requests for confidential information have increased, social workers sometimes have experienced conflicts with the ethical and legal obligations to respect the privacy of their clients and to maintain confidentiality. This Legal Issue of the Month article will evaluate the effects on client privacy when social workers interact with health insurance companies and will focus on provisions of the Health Insurance Portability and Accessibility Act of 1996 (“HIPAA”) that provide mechanisms for protecting clients’ privacy.

To read the rest of the article, click here. NOTE: NASW login required.

To answer this question, I conducted a very unscientific and decidedly lackadaisical survey of the databases of the following social work and non-social work publications. 

Neither of the two social work publications have published any articles about networking or job networking in the past decade. Psychology and psychiatry publications posted similar results. However, publications for business people, human resource professionals, and attorneys have provided much more information about networking to its members than those of us in the human services field. I think that the social work profession should play a leading role in providing information to its members about networking. 

What Is Networking?

I have been using the term “networking,” but what does it mean?

• Networking involves building relationships with other professionals who share your areas of interest. (USCO PowerPoint presentation)
• Networking is all about visibility, creating your own community, and building alliances. (Ibid)
• Networking is about searching for opportunities to work together with others toward the achievement of mutual goals. (Ibid)
• Networking is not just about asking someone for a job. Networking is about developing contacts and building long-term relationships. And, most jobs come from people who know you and your skills. (Source unknown)
• Networking is not a one-way street. What you put into it is exactly what you will get out of it. Be proactive in assisting others in their job search and in their other areas of interest. (Katie Chiariello PowerPoint presentation )

Why Is Networking Important?

We live in tough economic times. Finding and keeping employment is a challenging proposition for us all. We need to utilize every means available to cope with these difficult conditions. Adding networking to your arsenal of job-seeking strategies can be beneficial to you because:

• The vast majority of job openings are never advertised. Half of all jobs are obtained through the hidden job market. Job seekers need to have a network of contacts that can provide support, information, and job leads. (Ohio University Career Services PowerPoint presentation)
• A referred job candidate has a 35 to 1 chance of getting hired versus a 500 to 1 chance for a non-referred candidate. (Katie Chiariello PowerPoint presentation)
• Networking is critical to your professional growth and development. Being connected with others who share your interests will keep you from becoming outdated and behind the times. (Julia Jamieson/Blog)
• Networking can help you improve your social skills and ability to relate to others in a variety of settings. (Susan RoAne, How to Work a Room)
• By developing long-term relationships for mutual gain, you make a lasting impression with people so that they think of you positively when an opportunity arises. (Ohio University Career Services PowerPoint presentation)
• Keep networking even after you’ve found a job. You never know when you might need your network contacts again regarding a job or some other venture. (Ibid)

The NASW Illinois Social Workers in Transition Shared Interest Group

Recognizing the importance of networking, the NASW Illinois Chapter launched a job networking group for social workers in April 2010 called the Social Workers in Transition Shared Interest Group (SIG). The purpose of the group is to assist social workers and other human service professionals find jobs through the use of networking.

The group meets on the second Wednesday of the month at the NASW Illinois Chapter office (404 S Wells Street, 4th Floor, Chicago, Illinois). The only cost of membership is participation. You do not have to be a member of NASW to become involved, nor do you need to be a social worker.

You may bring information to the group meeting to help the group remember you. Be prepared to tell the group who you are, what you are looking for, who you would like to work for, and what you have done in the past. Everyone is welcome to join regardless of their job status. You may join in-person, electronically, or both.

For more information on how you can become involved with the Social Workers in Transition SIG, contact group facilitator Carl E. Johnson at transition@naswil.org.

Carl Johnson is a social worker with over twenty-five years of professional experience. He has worked in social service agencies in clinical and administrative capacities. He had a clinical private practice for over eight years. Carl is also an organization development consultant and trainer with experience assisting organizations with issues such as diversity, conflict resolution, and staff development. Carl currently works as case manager at Hines VA Hospital.
 

Our main advocacy concern right now is about potential cuts in federal entitlements and domestic discretionary spending that would disproportionately harm the poor, elderly, disabled, and children, as well as the threat to the national and global economy brought about by the debate over raising the debt ceiling. Hopefully everyone has contacted Senators Kirk and Durbin as well as his/her member of Congress regarding these issues.

However, we should not disregard what is occurring in our own state. Governor Quinn has signed several pieces of legislation into law that may interest our members:

SB 1555 Creates the Illinois Health Benefits Exchange Law

Effective October 1, 2013, this bill provides that in accordance with the federal Patient Protection and Affordable Care Act, the state shall establish a Health Benefits Exchange to help individuals and small employers with no more than fifty employees shop for, select, and enroll in qualified private health plans. The bill creates a twelve-member Legislative Study Committee consisting of three members from each of the four legislative caucuses appointed by the legislative leaders. The Legislative Study Committee is responsible for making findings and recommendations and reporting back to the Illinois General Assembly and to the governor. The bill also contains controversial provisions that create a voluntary Health Care Savings Account program for state employees. The bill was signed on July 14, 2011, and went into effect immediately. Sponsors: Sen. Bill Haine (D-Alton); Rep. Frank Mautino (D-Spring Valley). Public Act 97-142.

HB 785 Adults Under Guardianship—Mental Health Treatment

Provides that an adult under a guardianship may request and receive counseling services or psychotherapy without the consent of the guardian. Further provides that the guardian shall not be liable for the cost of such services if the guardian did not give consent. Finally, the bill provides that the guardian shall not be informed of such counseling or psychotherapy services without the consent of the adult receiving the services. Signed into law on July 22, 2011, and effective January 1, 2012. Sponsors: Rep. Ann Williams (D-Chicago); Sen. John Mulroe (D-Chicago). Public Act 97-165.

HB 1706 Home and Hospital Instruction

Amends the Illinois School Code to clarify school districts' responsibilities with respect to the provision of home or hospital instruction to students who are unable to attend school due to illness, injury, or disability per a physician's statement. For example, the bill provides that services must be commenced no later than five school days after receipt of the physician's statement. In addition, in regard to a student with an IEP or section 504 plan, the bill provides that "related services" must be provided as part of home or hospital instruction unless the IEP team or 504 plan team determine that the services cannot be provided due to the student's condition. Signed into law on July 14, 2011, and effective immediately. Sponsors: Rep. Robyn Gabel (D-Evanston); Sen. Mike Noland (D-Elgin). Public Act 97-123.

HB 1152 Community-Based Behavioral Healthcare

Provides that the Department of Human Services (DHS) shall strive to guarantee that adults and children suffering from mental illness, substance abuse, and other behavioral disorders have access to locally accessible behavioral health care providers who have the ability to treat such conditions in a cost-effective, outcome-based manner. Contains a series of provider requirements such as a commitment to serve low-income and underserved populations. Signed into law on July 22, 2011, and effective immediately. Sponsors: Rep. John Bradley (D-Marion); Sen. Maggie Crotty (D-Oak Forest). Public Act 97-166.

HB 1825 Oral Cancer Medication Parity

Provides that insurance plans cannot impose treatment limitations on orally-administered cancer medications that are more restrictive than those applied to intravenously administered or injected cancer medications. Signed into law on July 27, 2011, effective January 1, 2012. Sponsors: Rep. Ann Williams (D-Chicago); Sen. Heather Steans(D-Chicago). Public Act 97-198.

For a complete up-to-date list of ALL classified ads, be sure to visit the NASW Illinios Chapter Classified Ads: http://naswil.org/news/networker/networker-classifieds/

OFFICE FOR RENT - Orland Park
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OFFICE FOR RENT - Oak Park
I'm seeking part-time/hourly office space for rent in Oak Park.
Please call Laura at 708.288.5054 or email ljguentherlcsw@sbcglobal.net.

OFFICE FOR RENT - Berwyn
Office space for rent or sublet in prime Berwyn, IL location. Close to train line, in a medical office building, recently painted, fully furnished with private waiting room and bathroom!

CONSULT/SUPERVISION
Monthly Consultation Group: Case exploration in a safe atmosphere, using attachment and relational theories to deepen the therapy. My Glenview home, Sundays, 5-7 pm. Call Ruth Sterlin, 847 480 9159

OFFICE FOR RENT - Buffalo Grove
BUFFALO GROVE/LONG GROVE:Small office available. Quiet & confidential waiting room. Large window. New paint & carpet. Ideal location with 13 other medical offices.Please call Susan (847) 913-1400

OFFICE FOR RENT - Hyde Park
Office for rent in Hyde Park Bank Building. Spacious, light-filled room with waiting room, available all day Wed and weekends; Mon or Fri; and mornings. Contact 773-536-5353 or cbrickma@sbcglobal.net

NASW ILLINIOS CHAPTER JOB BOARD

For a complete and up-to-date list of job board postings, visit the NASW Illinois Chapter Job Board: http://naswil.org/education-career-development/association-job-board/.

• Child Welfare Field Support Specialist (Jane Addams College of Social Work)
• Executive Director (Family Service of Glencoe)
• Executive Director (Family Service Center of Wilmette, Glenview, Northbrook & Kenilworth)
• Mental Health Therapist/Social Worker (Human Resources Center of Edgar and Clark Counties)
• Clinical Assistant Professor for Field Education (University of Illinois at Urbana-Champaign)
• Director of Counseling Services (Columbia College)

• The Chicago District brown lunch program on June 16, 2011, titled Chicago Girls and Women Who Are Trafficked for the Sex Trade Industry, presented by Jody Raphael, JD, a senior research fellow at the DePaul Schiller DuCanto & Fleck Family Law Center. She is a nationally known expert on violence against women and undertakes research and advocacy in the areas of family violence, sexual assault and prostitution.
• The Northeastern District brown bag lunch program on, Topical Issues on Aging: Family Conversations About Aging and the Coming Tsunami of Alzheimers, presented by NASW Illinois Chapter Member At-Large, Joan Ente, LCSW, ACSW, C-ASWCM, who is a geriatric care manager at CJE SeniorLife.
• On Monday evening, June 20, 2011, the chapter, together with the Retired Social Workers SIG, presented a screening and discussion of the film of Irena Sendler: In the Name of Their Mothers, the story of a 29-year old Warsaw social worker, Irena Sendler who for five years during World War II outfoxed the Nazis to save thousands of Jewish children from certain death. Audrey Cantor, LCSW, director of Holocaust Community Services (a collaborative effort of Jewish Child and Family Services, CJE SeniorLife, and HIAS Chicago, and in partnership with Jewish Federation of Metropolitan Chicago) facilitated the discussion following the film.
• On Friday, June 24, 2011, Ruth Lipschutz, presented an ethics workshop entitled, Ethical Considerations for School Social Workers, which was offered live at the chapter office and live-virtually.

More CEU opportunities are available during July including the Fundamentals of Being a Clinical Supervisor on July 15, 2011 (4 CEUs); another ethics workshop entitled Ethical Practice: A Social Worker’s Best Defense Against Malpratice (3 CEUs) sponsored by the NASW Assurance Services Inc. on July 21, 2011; and on July 22, 2011, the chapter’s International Activities Network (IAN) SIG will be presenting The Impact of Globalization on Community Resources and Social Services (6 CEUs) at Dominican University. Attending this event will help support the efforts of the IAN SIG.

This month’s issue of the Networker includes several articles covering a range of social work practice–related issues:

• This month’s feature article and free CEU opportunity comes from Alan Goldstein, JD, a senior attorney at Equip for Equality, which provides an array of services to advance the human and civil rights of children and adults with physical and mental disabilities in Illinois. Alan has written for the Networker on several occasions in recent years. Those articles can be found here and here.
• Longtime NASW member, Carlean Gilbert, PhD, an associate professor at Loyola University Chicago School of Social Work, has co-written an article on Clinical Supervision in Healthcare in the Internet Era that originally appeared in Social Work Today magazine this past spring.
• Additionally, school social workers Dan L. Williams II, LCSW, CADC, and Cathy Bertrand, MSW, LCSW, and Sandra Montes, MSW, LCSW, have written separate articles of interest—Sex Therapy in Private Practice: Challenges and Rewards and For School Social Workers: How Do You Recharge Your Battery?

You can find this month's Networker magazine under the 'News' tab on the NASW Illinois Chapter website.

Also, congratulations to NASW Illinois Chapter member Sue Razbadouski who was elected Regional Representative to the NASW National Committee on Nominations and Leadership (NCNLI). You can read more about this important nomination here.

Once again, welcome to the new leadership of the NASW Illinois Chapter Board of Directors that officially takes office July 1, 2011.

Enjoy the summer!

Joel L. Rubin, MSW, CAE, has served as executive director of the 7,000 member Illinois Chapter of the National Association of Social Workers (NASW) since October 1999. He has over twenty-five years of nonprofit management and fundraising experience including extensive work with boards of directors, committees and volunteers, and advocacy around a wide variety of social work, human service, and international political issues. Joel is a graduate of the Wexner Heritage Fellowship Leadership Program and a current adjunct professor at the University of Illinois at Chicago Jane Addams College of Social Work as well as Loyola University Chicago School of Social Work.

Social workers are ethically required to safeguard their client’s best interest and enhance a client’s well-being while also attending to a larger "moral community" and social justice concerns. These goals are shared by the Americans with Disabilities Act (ADA), a civil rights law passed in 1990 to “assure equality of opportunity, full participation, independent living, and economic self-sufficiency” for individuals with physical and mental disabilities. Clearly, the ADA greatly impacts a variety of social worker services. The ADA is much more than parking and bathrooms and ramps. The ADA’s application in a myriad of situations facing social workers is demonstrated by the following examples.

1. A college student seeks treatment at the school’s health care facility for depression, including suicidal ideations and consults with a social worker. Another member of the medical staff wants to contact the dean and inform her about the situation.
ADA Implications: A similar situation was alleged to have occurred at George Washington University leading to the expulsion of the student for Code of Conduct and other violations. A lawsuit alleging discrimination under the ADA, Rehabilitation Act, Fair Housing Act, and other anti-discrimination laws was settled under confidential terms.
Social Worker Implications: A social worker could have advised the school regarding possible breach of confidentiality and discrimination concerns as well as helping the student obtain treat for her mental health.

2. A social work student with a learning disability needs reasonable accommodations such as: double testing time, materials on CD-ROM or in electronic format, receiving copies of teacher’s notes and materials in advance, and extra tutoring. The professor, a social worker who also teaches, fears that the accommodations would give the student an unfair advantage.
ADA Implications: These accommodations are often provided to students with disabilities.
Social Worker Implications (Student and Professor): Knowledge of the ADA would benefit both the social work student and professor.

3. An applicant for the Illinois Social Work Licensing Examination is asked the following question: “Have you had or do you now have any disease or condition that interferes with your ability to perform the essential functions of your profession… If yes, attach a detailed statement, including an explanation whether or not you are currently under treatment.” The applicant has bipolar disorder, but the condition is under control with medication and therapy and has not negatively impacted her school, training, or work activities. However, in the interest of full disclosure, she answers the question “Yes.”
ADA Implications: The author of this article represented an individual who was placed on probation for disclosing her bipolar disorder in the above situation. Her diagnosis of bipolar disorder and her probationary status were posted on the Illinois Department of Financial and Professional Responsibility website, but were removed after Equip for Equality became involved and raised ADA and confidentiality violations. The application question is problematic as essential functions are not defined and essential functions may vary significantly from social worker to social worker. In addition, there is no reliable evidence to support the proposition that applicants with a history of medical conditions, including mental illness, are more likely to violate professional standards than a person without such a history. The question remains on the state’s licensing application.
Social Worker Implications: Social work licensing applicants should be aware that if they have a medical condition that does not interfere with their ability to practice social work, they can ethically and honestly answer the above question “No.”

4. A client with an intellectual disability in state-funded facility for the past fifteen years seeks to live in the community, but is unsure of his rights, what is available, or what types of supports are needed.
ADA Implications: The U.S. Supreme Court ruled in 1999 that unjustified institutional isolation of a person with a disability constitutes segregation and is a form of discrimination under Title II of the ADA. In Illinois, Equip for Equality, together with the ACLU of Illinois, Access Living, and private law firms, has filed three community integration class actions against the state of Illinois alleging ADA/Olmstead violations. A Consent Decree in the class action on behalf of people with developmental/intellectual disabilities who live in, or are at risk in living in, private state-funded institutions was recently entered in the case of Ligas v. Maram, and will allow thousands of people with developmental disabilities to be served in the community. A Consent Decree in a second class action on behalf people with mental illness living in large private facilities was approved last year, and a class action on behalf of people with physical disabilities and mental illness living in traditional nursing homes in Cook County is currently pending.
Social Worker Implications: Social workers will likely be serving as consultants in assessing the needs of the individuals who need to live in the community and arranging for proper supports. NASW Illinois submitted letters in support of the proposed consent decrees in one of the class actions.

5. A social worker rents an office on the top floor of a two-story building without an elevator and is contacted by a potential client who uses a wheelchair.
ADA Implications: Titles II and III of the ADA require accessibility or alternative arrangements for providing services.
Social Worker Implications: The social worker may be required to investigate finding another office that is accessible or by providing alternative arrangements to meet the client, making sure find a private, accessible location for the meeting.

6. A high school graduate who receives social security disability benefits wants to work but is not sure how that will affect his social security or housing benefits.
Legal Implications: While unrelated to the ADA, the Ticket to Work and Work Incentives Improvement Act was passed in 1999 to make it easier for social security beneficiaries to return to work. The Ticket to Work Act allows individuals to obtain employment-related services from private and public organizations. It also allows beneficiaries to maximize financial benefits and maintain health care coverage while working.
Social Worker Implications: Knowledge of the Ticket to Work will enable the social worker to properly advise the client regarding their rights while working. This knowledge may lead to the client taking steps toward employment, maximizing the client’s well-being economically, socially, and in other ways.

7. A person with a personality disorder is not hired for a job at a rental house due to her low score on a personality test that she was required to take as part of the job application process.
ADA Implications: Use of the Minnesota Multiphasic Personality Inventory (MMPI) for job applicants was found to be unlawful under Title I of the ADA in the case of Karraker v. Rent-A-Center. Title I of the ADA prohibits medical examinations of job applicants prior to a conditional offer of employment and also prohibits using selection criteria that exclude or tend to exclude people with disabilities. Pre-employment tests may be discriminatory to other individuals as well, for example, a person with an intellectual disability who is not hired for a job due to a pre-employment test that they found confusing or a person who is deaf who has difficulties in understanding the test as their primary language is American Sign Language.
Social Worker Implications: Social workers are generally aware of the MMPI and can advise clients to seek legal information if a personality test may be preventing them from finding employment.

8. A teacher with post-traumatic stress disorder has trouble sleeping due to medication and needs an adjusted work schedule and/or time off from work. She also wants to bring her service animal to work and everywhere else she goes and wants to understand her legal rights. She has not previously disclosed her disability and is unsure how to approach the situation.
ADA Implications: Modification of work schedules or allowing psychiatric or other service animals that perform specific tasks may be reasonable accommodations under Title I of the ADA. A person is not required to disclose a disability unless it is in connection to reasonable accommodation request and the disability is not known by the employer or apparent or where the employer requests medical information for reasons that are job-related and consistent with business necessity. In addition to reasonable accommodation requests, appropriate disability disclosure situations arise when there is a reasonable basis for the employer to think the employee is unable to perform the essential functions of the job or poses a direct threat to the health or safety of the individual or others.
Social Worker Implications: Basic ADA knowledge would enable the social worker to advise a client needing reasonable accommodations to seek legal information about their rights. This knowledge may enable the client to maintain employment, maximizing the client’s well-being economically, socially, and in other ways.

In all of these situations, a social worker with ADA awareness would be in the best position to offer appropriate counseling, advice, and information. In addition, the ADA may also be important to social workers in their own professional and educational endeavors.

While ADA knowledge is imperative for social workers, social workers should make sure they do not give legal advice or otherwise practice law without a law license. Social workers should advise clients with disabilities who have potential discrimination claims to seek the assistance of an attorney who has ADA expertise so that clients can better understand their rights and responsibilities under the ADA, including statutes of limitation. However, by understanding the ADA, social workers will be in the best position to fulfill their ethical obligations, advise clients about their basic rights, and know when to advise a client to consult with attorneys or other professionals in order to safeguard their client’s best interest and enhance their well-being, while working to achieving social justice on a broader scale. The ADA is an important social work tool that cannot be overlooked.

More a more detailed analysis of the ADA’s impact on social workers, a three-hour workshop intensive will be prestented by Alan M. Goldstein on Disability Hot Topics for Social Workers: Best Practices for Effectively Serving Clients with Disabilities at the upcoming 2011 NASW Illinois Statewide Conference.

Alan M. Goldstein is a senior attorney at Equip for Equality (www.equipforequality.org) (EFE), the protection and advocacy agency for people with disabilities in Illinois. There he handles employment discrimination cases, reasonable accommodation issues, and denial of access cases at the federal, state, and administrative levels on behalf of individuals with disabilities. In addition, Alan provides employment-related training to individuals with disabilities, service providers, businesses, government agencies, and other organizations. Alan would like to thank EFE Legal Advocacy Director, Barry C. Taylor, for his assistance with this article.

Alan has spoken at local and national conferences for organizations including: National Disability Rights Network (NDRN), National Association of Social Workers (NASW), Society of Human Resource Managers (SHRM), and the Social Security Administration (SSA). As part of his volunteer efforts, Alan served as a U.S. Coach for the 1996 Powerlifting team in the Atlanta Paralympics for athletes with disabilities.

REFERENCES AND RESOURCES
Introductory Paragraph: Code Of Ethics Of The National Association of Social Workers, found at: http://www.socialworkers.org/pubs/code/code.asp. 42 U.S.C. § 12101(a)(7),(8).
Example 1: Nott v. George Washington University, Civil Case No. 05-8503, Superior Court of D.C. (2005). See Bazelon Center for Mental Health press release at: http://www.bazelon.org/In-Court/Closed-Cases/Nott-v.-George-Washington-University.aspx.
Example 2: 42 U.S.C. § 12101, et seq.
Example 3: See the Illinois Department of Financial and Professional Responsibility (IDFPR) Website for the Licensing Application, Page 14, Question 4. IDFPR is the Illinois licensing agency for social workers and other professionals. The author previously wrote about this issue in an article titled, “Does the Social Worker Licensing Application and Process Violate the Americans with Disabilities Act” that appeared in the July/August 2008 issue of the Networker, the NASW Illinois quarterly publication for social workers. The article can be found at: http://naswil.org/news/networker/featured/does-the-social-worker-licensing-application-and-process-violate-the-americans-with-disabilities-act/.
Example 4: Olmstead v. L.C., 527 U.S. 581 (1999); Ligas v. Maram, 05C 4331. See www.equipforequality.org for more information.
Example 5: 42 U.S.C. § 12131, et seq.; 42 U.S.C. § 12181, et seq.
Example 6: See http://ssa.gov/work/aboutticket.html and www.equipforequality.org/programs/tickettowork/ for more information about the Ticket to Work.
Example 7: Karraker v. Rent-A-Center, 411 F.3d 831 at 833 (7th Cir. 2005). 42 U.S.C. 12112(d)(2)(B); 29 C.F.R. §§ 1630.13(b), 1630.14(a), 1630.14(b)(3). The author co-wrote an article on this subject titled, “Personality Testing In Employment: Useful Business Tool Or Civil Rights Violation?” for the American Bar Association Labor And Employment Law Journal, The Labor Lawyer: A Journal Of Ideas And Developments In Labor And Employment Law; Volume 2, Number 2, Fall 2008; by Alan M. Goldstein and Shoshana D. Epstein.
Example 8: 42 U.S.C. § 12111(6); 29 C.F.R. § 1630.2(o). See also, EEOC Enforcement Guidance on Reasonable Accommodation and Undue Hardship Under the Americans with Disabilities Act (2002), found at: http://www.eeoc.gov/policy/docs/accommodation.html; EEOC Enforcement Guidance on Disability-Related Inquiries and Medical Examinations of Employees Under the Americans with Disabilities Act (2000), found at: http://www.eeoc.gov/policy/docs/guidance-inquiries.html. There also may be an argument that the use of an animal in the workplace as a reasonable accommodation need not meet the definition of “service animal” under Titles II and III of the ADA. See e.g., McDonald v. Dept. of Environmental Quality, 2009 WL 1680784 (Mont. Sup. Ct. June 17, 2009) (The court referenced the ADA in applying Montana law when noting that the "employment (Title I) regulations do not address service animals in substantial detail" and suggesting that the use of an animal in the workplace would be analyzed as an assistive device similar to “a wheelchair, scooter, or walker.”) The Job Accommodation Network from the U.S. Department of Labor is an excellent resource for possible reasonable accommodations, http://askjan.org/.

CEU Opportunity for Reading This Article!
NASW Illinois members can earn one CEU by completing an online quiz regarding this article! The free CEU opportunity is only valid until September 1, 2011, after which the CEU fee will change to $15.00. Nonmembers must pay the regular $10.00 rate for the CEU, which will increase to $15.00 after September 1, 2011.

During the summer months, school social workers have the luxury of some time away from work. It is during summer that we recharge our batteries and get ready for the next school year. These months are often when we are able to focus on self-care. Professional self-care is important for school social workers in particular because of their unique roles in education. They listen to a plethora of individual client stories of economic uncertainty, limited programming, overwhelmed community resources, and issues such as bullying, domestic violence, autism, ADHD, grief, substance abuse, child abuse, suicidal ideations, and homelessness, all of which have no easy solutions. School social workers, like all therapists, need to take time for self-reflection, be aware of signs and symptoms of stress, and know what to do in order to practice good self-care.

NASW’s Social Work Speaks, Eighth Edition (Lowman, 2009) states: “[P]rofessional self-care is an essential underpinning to best practice in the profession of social work” (p. 268). In addition, the profession recognizes several conditions that may affect those who provide direct service to clients. “Frameworks have been developed for understanding specific experiences such as compassion fatigue (Figley, 1995, 2002), secondary traumatic stress (Figley, 2002; Stamm, 1999), and vicarious traumatization (McCann & Pearlman, 1990; Pearlman, 1995; Pearlman & Saakvitne, 1995). Compassion fatigue, or secondary traumatic stress, is defined “as the natural, predictable, treatable, and preventable unwanted consequence of working with suffering people, that is, the cost of caring” (Figley, 1995; Stamm, 1999). Vicarious traumatization refers to a cumulative transformative effect or condition experienced by trauma therapists as they work with specific populations of survivors of traumatic life events (McCann & Pearlman, 1990; Pearlman & Saakvitne, 1995). The common characteristic is that they represent the negative, unwanted, psychological effects of the experience of helping and therefore, uniquely affect the helping professional” (p. 268).

Good self-care habits are crucial in warding off the everyday stressors that are precursors to these conditions. Social Work Speaks states that the critical key to prevention and management of adverse conditions such as stress, burnout, compassion fatigue, and secondary traumatic stress or vicarious traumas is the practice of self-care (Lowman, 2009). Françoise Mathieu with Compassion Fatigue and Professional Development (2007) lists the following common warning signs that may indicate a helping professional who is experiencing the negative psychological effects of helping others:

• Exhaustion
• Reduced ability to feel sympathy and empathy
• Anger and irritability
• Increased use of alcohol and drugs
• Dread of working with certain clients/patients
• Diminished sense of enjoyment of career
• Disruption to world view, heightened anxiety or irrational fears
• Intrusive imagery or dissociation
• Hypersensitivity or Insensitivity to emotional material
• Difficulty separating work life from personal life
• Absenteeism – missing work, taking many sick days
• Impaired ability to make decisions and care for clients/patients
• Problems with intimacy and in personal relationships

These symptoms are an occupational hazard for school social workers in virtue of the unique role we play. As a “support service” we are often the only social worker in the building, while there may be a school psychologist or school counselor to work with, when faced with ethical dilemmas social work perspectives and codes of ethics may differ from these other professions. While individuals must create their own self-care routine designed to meet individual life circumstances, every school social worker needs to find other social workers to consult with professionally. Attending NASW– or Illinois Association of School Social Workers (IASSW)–sponsored events is an excellent way to build a supportive network.

While having a support network is a good place to start for self–care, there are other things we can do to take better care of ourselves. Eating three meals a day with two snacks will make a difference in how we feel, especially during the mid-afternoon. Staying hydrated; the rule of thumb is to drink eight glasses a day. Keeping a well balanced diet is a small change that can help in times of stress. Getting enough sleep is also something that can be added to the self-care plan. The summer is a good time to start adjusting your sleep schedule. Exercise is also a good way to manage stress. Some schools have facilities that can be used before or after school.

Meditation and mindfulness practices are relaxation methods that are easily used during the school day. For example, one can always focus on the present moment by remaining aware of one’s breathing; the practice of taking deep breaths while counting to 10 (or 20), or the practice of abdominal breathing can be used during passing periods or throughout the day. In addition, creating a mantra or reciting a prayer during the moment of silence that most schools have can help focus your personal self-care goals.

Self-reflection is important in developing a prevention tool kit. Françoise Mathieu, MEd, CCC, is a compassion fatigue specialist that developed a rating scale for avoidant behaviors (see it here). Some self-refection questions include: What things do I have control over and what things do I not have control over? What stress reduction strategies work for me? What stress resiliency strategies can I use? These questions can be used as guides to journal entries or as a starting place for self -care.

The high demand for services and the variety of presenting conditions require school social workers to remain competent in many areas, one of which is in the area of good self-care. Self-care wards off stress-related illnesses and similar conditions such as compassion fatigue and vicarious traumatization. The competent school social worker needs to create a self-care plan and continually monitor his or her emotional battery. Good self-care plans are personal in nature but must include consultation with other social workers. The summer months offers school social workers an opportunity to charge their batteries by creating and implementing a personal self-care plan.

REFERENCES

• Lowman, S. (Ed.). (2009). Professional Self-Care and Social Work. Social work speaks national association of social workers policy statements 2009 - 2012. (pp. 268). Baltimore, MD: VictorGraphics, Inc.
• Mathieu, F. (2007). Running on empty: compassion fatigue in health professionals. Retrieved from http://www.compassionfatigue.org/pages/RunningOnEmpty.pdf

Cathy Bertrand, MSW, LCSW, is a 2006 graduate of Loyola University. She has previously served on both the NASW and IASSW Board of Directors. She is employed as a middle school social worker for the Plainfield Consolidated School District 202.

Sandra Montes, MSW, LCSW, is a 2006 graduate of Loyola University. She is employed as the Title 1 social worker for Township High School District 211, while also working registry at Hartgrove Hospital. She previously served on the board of directors for Youth Crossroads, Inc., a youth service organization in Berwyn, Illinois.

The National Association of Social Workers (NASW) has received numerous inquiries from social workers and relatives of social workers seeking assistance with the closing of a private social work practice. Whether a social worker is retiring, becomes incapacitated or dies, there are many things to consider when closing a practice, including client referrals, billing, and the disposition of client records.  These issues can be further complicated if a social worker leaves a practice unexpectedly and family members with no social work expertise are left without guidance on how to manage and close a practice.  NASW has created several publications to assist in this process.  This Legal Issue of the Month highlights actions social workers may consider when planning for their retirement, as well as the actions others may have to consider when closing a deceased or incapacitated social worker’s practice.

To read the rest of the article, click here. NOTE: NASW login required.

This article was originally printed in Social Work Today, Vol. 11 No. 2 P. 24. Reprinted with the permission of Social Work Today ©. Great Valley Publishing, Co.

The adage once was “Money changes everything.” It’s time to add “technology” to that adage, and clinical supervision in healthcare is now a different ballgame because of it.

The number of people in the United States who use the Internet at home, work, or school has continued to increase, according to surveys conducted for the Pew Research Center Internet & American Life Project (Madden, 2006). Findings from the 2006 Pew Research Center survey indicated that 73% of participants used the Internet to shop, pursue personal interests, or enhance their work.

Few would disagree that technology has contributed to significant changes in personal lives and professional cultures, and clinical supervision in healthcare is no exception. Patients and providers increasingly use the Internet to obtain information about a variety of healthcare needs. Twenty-two percent of the female respondents and 17% of the male participants in the 2006 Pew Research Center survey noted that the Internet improved their ability to obtain healthcare information (Madden, 2006).

Healthcare providers, including social workers, have participated in telehealth, which Nickelson (1998) defined as “the use of telecommunications and information technology to provide access to health assessment, diagnosis, intervention, consultation, supervision, education, and information across distance” (p. 527). Examples of populations that have benefited from clinical services via telephone, videophone, or telemonitoring include frail elders (Duke, 2005), people with diabetes (Hopp & Hogan, 2009), individuals with schizophrenia (Rontondi et al., 2005), and behavioral health clients (Surface, 2007).

Many current social work supervisees have been surrounded by technology since birth in the forms of computerized baby toys, video games, computers, cell phones, e-mail, the Internet, instant messages, and social networks. Prensky (2001) purports that these recent generations “think and process information fundamentally differently from their predecessors” (p. 1). He refers to people born into the digital language world of technology as digital natives. They are accustomed to accessing information quickly and continuously, receiving instant gratification, multitasking, and simultaneously using multiple programs such as instant messaging, word processing, and e-mail. Digital immigrants, in contrast, is Prensky’s moniker for those who did not grow up in a digital language environment and who may have acculturated to it in varying degrees.

What does this growth in the use of technology have to do with social work supervision in healthcare? As the relative percentage of digital natives in the United States dramatically escalates, supervisors are increasingly challenged to understand the ethical, legal, and treatment implications of the use of technology for clients, supervisees, and themselves. Failure to manage the appropriate use of technology could give rise to supervisors misusing it and, through the doctrine of vicarious liability (Reamer, 1993), being found accountable for actions or inactions performed by their supervisees.

Dual or Multiple Relationships

Standard 1.06 of the NASW Code of Ethics states that social workers are responsible for setting clear and appropriate boundaries. Identifying the edges of appropriate professional behavior can be difficult due to changing therapeutic techniques; cultural, economic, sociopolitical, and legal contexts (Gutheil & Gabbard, 1993; Kroll, 2001); and technology. Gutheil and Gabbard distinguish between boundary violations, which are transgressions such as sexual misconduct that harm clients, colleagues, and clinicians (Reamer, 2003), and boundary crossings. Boundary crossings occur when practitioners deviate from traditional therapeutic activities in ways that are not intentionally exploitive, manipulative, deceptive, or coercive, such as attending a funeral. The consequences of benign boundary crossings, however, may be salutary, neutral, or harmful “depending entirely on the context” (Gutheil & Gabbard, 1998, p. 411). The following case illustrates the enhanced potential for extreme harm when boundaries are crossed through the use of technology:

• Michael was a young, good-looking social worker in a small, rural hospital that did not have on-call services for patients who needed care outside of business hours. Michael had provided supportive treatment and case management services to Gabriella, a 19-year-old woman, and her parents since she was diagnosed with type 1 diabetes at age 14.

During her last hospitalization, Gabriella confided to Michael that she was having a difficult time with her parents. When she was ready to be discharged, Michael gave Gabriella his home phone number and encouraged her to call him if she wanted to continue to talk. Over the course of a few weeks, they had lengthy and frequent telephone conversations, and it became increasingly evident to Michael that Gabriella had developed a crush on him. He explained to her that he cared for her and wanted to help her but did not share the same amorous feelings. Gabriella became extremely distraught, arrived at Michael’s home after a three-hour drive, and threatened to shoot both of them if he rejected her. Fortunately, Michael was able to persuade Gabriella to admit herself to the hospital, where she received successful psychiatric and medical care.

Supervisors might avoid similar problematic situations involving the use of technology if they preemptively examine the steps taken by supervisees to protect clients by setting clear, appropriate, and culturally sensitive boundaries as stated in standard 1.06. An examination of Gabriella’s ego functions, developmental stage, and family issues in addition to Michael’s motivations could have indicated this boundary crossing. The supervisor might also attempt to heighten Michael’s awareness of the power differential in his relationship with the patient. Finally, the supervisor might have asked Michael, “If you give her your telephone number, what might be the consequences?” While there are other ways Gabriella could have found Michael’s address with his telephone number, in this case, she was able to find it through reverse look-up on the Internet.

Practitioners commonly offer anecdotal reports that current and former clients have asked to be connected with them on social networking sites. In the following vignette, a supervisee was faced with the dilemma of “friending” a patient’s relative on Facebook:

• Despite the fact that his supervisor discouraged him from friending clients, Dan accepted an invitation to friend a patient’s father. Dan was confident that he and the father would have become personal friends if they had met under different circumstances, and he was genuinely interested in keeping up with the patient’s and the family’s progress. Dan later saw a posting on the father’s Facebook page that concerned him and shared his unease with his supervisor.

Although many practitioners would likely decline offers to friend patients, little evidence-based research exists to inform practice. Dan’s supervisor could use this case to explore Dan’s boundary issues. The supervisor could then initiate a discussion of whether Dan should address the posting with his client and/or the family member. The supervisor also could follow Lehavot’s (2009) suggestion that an invitation from a client to friend a clinician could be an opportunity to explore a client’s request within the context of treatment. What would it mean to the client for the clinician to be a friend on Facebook? Could the client be testing boundaries?

Self-Disclosure

Self-disclosure, or the revelation of clinicians’ personal information to clients, has been viewed as a potentially harmful technique for two reasons. Although some self-disclosure has long been considered either unavoidable (e.g., race, gender, pregnancy) or accidental (e.g., media coverage, chance encounters), “the Internet has irreversibly changed the nature of self-disclosure and psychotherapists’ transparency” (Zur, 2009, p. 22).

The Internet has enabled responsible clients to access relevant professional information about social workers’ education, licensure, certifications, specializations, and malpractice complaints. Clients can use Internet search engines to locate personal information about clinicians such as home addresses, photographs, family members, religious affiliations, political contributions, and even crime reports. Many individuals also use social networking sites such as MySpace, Facebook, and Twitter for personal and professional purposes such as advertising.

Those who have been acculturated to using the Internet to probe for information and connecting with others through social networking sites often have matured alongside the burgeoning reality television industry. Competition-based programs such as Survivor and The Apprentice, social experiment programs such as Supernanny, and talk shows based on dramatic portrayals of real-life problems such as Dr. Phil are a few examples of shows with high viewership. Does reality show consumption combined with Internet usage effect a culture in which boundaries between public and private, personal and professional lives are blurred, especially for digital natives? The following illustration demonstrates the kinds of personal transparencies that remain perpetually online in some mode, can breach privacy settings, and may affect not only client but also supervisory relationships:

• Maria befriended her supervisor, Nancy, on Facebook and checked out recent postings of the bridal shower that Nancy hosted for another staff member. The supervisee was astonished to see pictures of Nancy noticeably intoxicated and wearing a coconut bra. Although the coconut bra was worn over other clothes, Maria was unable to get the visual out of her mind when she met with Nancy for supervision.

Should supervisors be allowed to have a life outside of work? Can supervisors be friends with supervisees as long as they keep personal issues outside of the workplace? How would knowing about the personal actions of the supervisor affect the dynamics of supervision?

Privacy

Technology has enabled the sharing of information, including photographs, to become commonplace, and distinctions between personal and professional activities have become increasingly unclear. The acquisition of private information from clients and the protection of their confidentiality are regulated by standard 1.07(a) of the Code of Ethics, which states that “social workers should respect clients’ right to privacy. …Once private information is shared, standards of confidentiality apply.”

Privacy breaches are also addressed in federal regulations and accreditation standards. Even when names are omitted, writing about patients or their private health information on the Internet violates patient privacy according to HIPAA, enforcement of which is strengthened by the HITECH Act. The Joint Commission also comments on information management and has requirements regarding patients’ right to privacy. Standard IM.02.01.01 states that “the hospital protects the privacy of health information” (p. IM-5), and standard IM.02.01.03 mandates that “the hospital maintains the security and integrity of health information” (p. IM-6). As the following situation indicates, violations of privacy can have serious consequences:

• Work was stressful and Susan routinely used Facebook to gain emotional support from her friends about her job-related frustrations. Thinking that she had deidentified the patients, Susan blogged about the problems of patients and families and her responses to them. Unfortunately, a friend of a friend realized that Susan had talked about one of her relatives and reported Susan to The Joint Commission for a HIPAA violation, which was reported to the Office for Civil Rights. Susan, her supervisor, and the hospital faced a large fine for breach of confidentiality, not to mention an unannounced survey by The Joint Commission and possible terminations of employment.

Did Susan’s organization provide adequate education regarding patient privacy that included warnings against the use of social networking sites to debrief professional activities? Did the supervisor discuss these potential pitfalls with Susan?

Workplace Boundary Issues

The development and use of technology is both a blessing and a curse when it comes to supervisors’ work-life balance. Technology has enabled supervisors to answer e-mails, access payroll systems, respond to disasters, obtain information necessary for quick decisions, and meet deadlines from off-campus sites. Supervisors can gain flexibility in choosing when to work, save commuting time, and demonstrate maximum commitment to the organization during times of employment insecurity. Conversely, supervisors complain of “workplace creep” due to increasing expectations of being available 24/7. Items such as “the organization takes efforts to balance my work and home life” on employee surveys generally yield unfavorable responses. Some describe feeling infringements on personal and family time, perpetual states of urgency, and increased stress. Consider the following:

• Janice was manager and clinical supervisor to members of a midsized social work department. Since she was assigned a smartphone three years ago, Janice has been “always on” to her administrators and staff with the exception of a two-week vacation to a remote location. Increasing numbers of supervisees learned to correspond about routine matters outside of normal work hours. Janice prided herself on replying immediately to their work e-mails, and she smugly wondered, “How come I am the only one working so hard?” She also began to view the supervisees who didn’t answer her frequent after-hours solicitations as uncommitted.

Does “off-the-clock” work allow employers to take advantage of supervisors and, by extension, supervisees? Could adherence to the covert norms of 24/7 availability contribute to favoritism of certain supervisees? How much time do supervisors spend in unpaid work? What responsibilities do supervisors have to guide and model work-life balance for their supervisees?

Off-Site Supervision

As departments and organizations have merged to contain costs, managers and supervisors have assumed oversight of supervisees who are spread over a large campus or distant ancillary or global locations. When face-to-face supervision becomes a rarity, cybersupervision in the forms of teleconferencing, text messaging, e-mailing, instant messaging, chatting, and videoconferencing can substitute for in-person sessions. Some critical issues to be considered are the fact that confidentiality can be breached, legal and malpractice issues can blur when state or national boundaries are crossed, and state regulations regarding the use of technology for supervision vary (NASW, Association of Social Work Boards, 2005).

Supervisors face numerous challenges in supervising off-site supervisees, including establishing mutual trust and confidence in the absence of daily contacts, monitoring supervisees’ accountability to clients and organizations (e.g., tardiness, attendance), evaluating supervisees who have site-specific variations in standards for clinical competency, providing high levels of structure and creativity, and using technology such as text messaging or even poor-quality videoconferencing that obscures the nonverbal communications necessary for giving and receiving feedback.

Multisite supervision requires more structure and creativity than traditional supervision. In an age when one manager or supervisor oversees supervisees in multiple sites or systems, it may be impossible for them to have the usual, frequent on-site supervision of the past. The appropriate use of technology could help the supervisor and supervisee assure competency, build a stronger relationship, and help the supervisee feel connected to the broader organization. Such efforts might increase retention while using the supervisor’s time efficiently.

The availability of the Internet and technology has strongly impacted attitudes and practices regarding issues such as boundary crossings, self-disclosure, privacy, and delivery of clinical supervision. In some areas, technological advances have preceded the development of associated ethical, legal, and practice standards for the use of technology. Supervisors have a responsibility to educate and oversee the appropriate use of technology by their supervisees and also ensure that employing organizations provide adequate training and safeguards.

Carlean Gilbert, DSW, LCSW, ACM, CGP, is an associate professor in the School of Social Work at Loyola University in Chicago and editor of The Clinical Supervisor.

Carol Frazier Maxwell, LCSW, ACSW is director of social work, family services, and interpreter services at Arkansas Children’s Hospital in Little Rock.

REFERENCES

Duke, C. (2005). The frail elderly community-based case management project. Geriatric Nursing, 26(2), 122–127.

Gutheil, T. G., & Gabbard, G. O. (1993). The concept of boundaries in clinical practice: Theoretical and risk-management dimensions. American Journal of Psychiatry, 150(2), 188–196.

Gutheil, T. G., & Gabbard, G. O. (1998). Misuses and misunderstandings of boundary theory in clinical and regulatory settings. American Journal of Psychiatry, 155(3), 409–414.

Hopp, F. P., & Hogan, M. (2009). Community-based tele-health systems for persons with diabetes: Development of an outcomes model. Social Work in Health Care, 48(2), 134–153.

Kroll, J. (2001). Boundary violations: A culture-bound syndrome. Journal of the American Academy of Psychiatry and the Law, 29(3), 274–283.

Madden, M. (2006). Internet penetration and impact. Retrieved from Pew Research Center, Pew Internet & American Life Project site: http://www.pewinternet.org/Reports/2006/Internet-Penetration-and-Impact.aspx

McCarty, D., & Clancy, C. (2002). Telehealth: Implications for social work practice. Social Work, 47(2), 153–161.

National Association of Social Workers and Association of Social Work Boards standards for technology and social work practice. (2005). Retrieved from http://www.aswb.org/pdfs/TechnologySWPractice.pdf

Nickelson, D. W. (1998). Telehealth and the evolving health care system: Strategic opportunities for professional psychology. Professional Psychology: Research and Practice, 29(6), 527–535.

Prensky, M. (2001). Digital natives, digital immigrants. On the Horizon, 9(5), 1–6.

Reamer, F. G. (1993). Liability issues in social work supervision. Administration in Social Work, 17(4), 11–25.

Reamer, F. G. (2003). Boundary issues in social work: Managing dual relationships. Social Work, 48(1), 121–133.

Rotondi, A. J., Haas, G. L., Andersoln, C. M., et al. (2005). A clinical trial to test the feasibility of a telehealth psychoeducational intervention for persons with schizophrenia and their families: Intervention and 3-month findings. Rehabilitation Psychology, 50(4), 325–336.

Surface, D. (2007). Country comfort — Mental health telemedicine in rural America. Social Work Today, 7(1), 28–31.

Zur, O. (2009). Psychotherapist self-disclosure and transparency in the Internet age. Professional Psychology Research and Practice, 40(1), 22–30.

It is rare to find a social worker taking center stage in a work of pop fiction. An internet search of recent publications reveals just a few such characters: a fledgling MSW named Emily Shaw, central to a novel called Graced Land; a male caseworker featured in a novel called Zachary’s Wings; and a book called Madchild Running by Keith Egawby which tells the story of a social worker at a fictional agency—Urban Native Support Services—in Seattle.

Harlan Coben’s mystery-thriller, Caught, features Dan Mercer, a wounded but caring clinical practitioner, decent, selfless, devoted to his work with troubled teenagers—or is he?

The plot of Coben’s fast-paced story begins with Dan, resident of a suburban New Jersey town, entrapped and publicly shamed for depraved acts which he may (or may not) have committed. A loyal ex-wife and flamboyant attorney stand behind him in the community’s rush to judgment. Dan is relentlessly pursued by a tabloid television journalist with secret sorrows of her own. She is determined to unmask him and to explain the strange disappearance of a local teen, all while managing her own challenging life as a single parent.

The book is filled with colorful characters who come and go, each with sinister secrets to protect. Indeed, there are more secrets in Coben’s fictional setting than one would expect to find in the backrooms of the Chicago City Council!

Harlan Coben’s story line has many twists and turns, with subplots related to larger themes of loneliness, grief, forgiveness, and loyalty. It raises issues about (seemingly) model families, teenage drinking, and the internet. The narrative moves quickly and makes for easy summer reading, if plotline alone can sustain your interest as a reader. As The Washington Post critic Dennis Drabelle wryly commented, “[F]or all its strands of mystery, the book offers little suspense and few characters who escape being caricatures.”

I read Caught quickly on a recent airplane trip. It is the kind of book that lends itself to fast warm weather reading, a page-turning beach book that invites you to pass the time on a sultry day. It is action- and dialogue-driven, written in easy conversational language, and does not ask much of the reader. The characters are superficially drawn and written as though ready for instant transport to a made-for-television weeknight movie. Admittedly, my personal reading taste runs to books that are more layered, with nuance, subtlety and deeper character development. I like to think about the books that I read. That said, it was still delightful to find a paperback bestseller that describes a social worker’s darker side and allows him to do a star turn.

July 26 is the 26th anniversary of the Americans with Disabilities Act (ADA). In honor of the anniversary, this article will focus on ethical consideration in the area of disability.

The World Health Organization offers the following definition:

“A disability may be physical, cognitive, mental, sensory, emotional, developmental or some combination of these.

Disabilities is an umbrella term, covering impairments, activity limitations, and participation restrictions. An impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations. Thus disability is a complex phenomenon, reflecting an interaction between features of a person’s body and features of the society in which he or she lives.”(1)

More recently, chronic diseases such as Chronic Fatigue and Fibromyalgia, have been considered as disabilities. A disability may occur during a person's lifetime or may be present from birth.

Social workers address disability related issues through providing services to clients, social advocacy, addressing their own disabilities, and dealing with the impact of ableism and discrimination in society. This article will focus on ethical considerations addressed by the NASW Cultural Competency Standards and sections 1.01, 1.02, 1.04, 1.05 and 4.02 of the NASW Code of Ethics.

Standard 1. Ethics and Values

Social workers shall function in accordance with the values, ethics, and standards of the profession, recognizing how personal and professional values may conflict with or accommodate the needs of diverse clients.

Language plays a central role in defining personal and social identities. It is crucial to explore what language each individual client, group or community feel comfortable using. The wide spread history of discrimination and continuing impact of stigma and ableism effect client’s beliefs and preferences in their use of language.

This article will use the term “disability” in the wide context defined by the WHO. The National Association of Social Workers and American Psychological Association endorse person first language. When identifying a person, their name or pronoun should come first, rather than referencing the disability. An example would be, “a woman who is deaf” rather than "a deaf woman”. Adaptive equipment should be described functionally as something that assists a person, not as something that limits a person, e.g., "a woman who uses a wheelchair" rather than "a woman in/confined to a wheelchair."

The NASW Code of Ethics articulates general ethical parameters for working with any population. The following sections address issues that often lead to ethical dilemmas in daily practice.

1.01 Commitment to Clients

Social workers' primary responsibility is to promote the well-being of clients. In general, clients' interests are primary.

1.02 Self-Determination

Social workers respect and promote the right of clients to self-determination and assist clients in their efforts to identify and clarify their goals. Social workers may limit clients' right to self-determination when, in the social workers' professional judgment, clients' actions or potential actions pose a serious, foreseeable, and imminent risk to themselves or others.

Ethical consideration come in when these sections are in conflict or when the values/beliefs of the social worker and client are conflicting. One example comes up with decisions around psychiatric hospitalization. What the client wants, what their family members or partners want and what the social worker believes will optimally “promote the well-being” of the client may all differ. Social workers ethical obligation is to utilize a critical decision making process that includes seeking appropriate consultation or supervision, assessing for safety issues, weighing various options and determining the best course of action.

Another example comes up when working with a family where the father is visually impaired and the family has been very involved in helping him with daily personal and professional tasks. When the children  became adults, they wanted to be less involved with their father’s activities. The wife was now dealing with fibromyalgia and increased pain management concerns. All the family members are feeling both guilty and resentful. Additional services are suggested to increase the father’s capacity to accomplish tasks independently. The family want the father to accept the services. The father wants to continue with the same family arrangement. This example presents both clinical and ethical challenges. Self-determination issues are in conflict. The social workers own values and beliefs will play a role in how they intervene with this family: what they emphasize, suggest and offer.

1.05 Cultural Competence and Social Diversity

a. Social workers should understand culture and its function in human behavior and society, recognizing the strengths that exist in all cultures.
b. Social workers should have a knowledge base of their clients' cultures and be able to demonstrate competence in the provision of services that are sensitive to clients' cultures and to differences among people and cultural groups.
c. Social workers should obtain education about and seek to understand the nature of social diversity and oppression with respect to race, ethnicity, national origin, color, sex, sexual orientation, age, marital status, political belief, religion, and mental or physical disability.

4.02 Discrimination

Social workers should not practice, condone, facilitate, or collaborate with any form of discrimination on the basis of race, ethnicity, national origin, color, sex, sexual orientation, age, marital status, political belief, religion, or mental or physical disability.

There is a well documented, long standing history of violence, oppression and discrimination toward PWD’s in the United States. There still exist wide spread negative attitudes and behaviors which are driven by distorted assumptions and beliefs about disability and PWD’s. The "ableist" societal world-view is that the able-bodied are the norm in society, and that people who have disabilities must either strive to become that norm or are somehow less worthy. A disability is thus, inherently, a "bad" thing that must be overcome. Disability is seen as an error, a mistake, or a failing, rather than a simple consequence of human diversity, akin to race, ethnicity, sexual orientation or gender. (2)

On December 13, 2006, the United Nations formally agreed on the Convention on the Rights of Persons with Disabilities, the first human rights treaty of the 21st century, to protect and enhance the rights and opportunities of disabled people. It addresses equal rights to education, employment, and cultural life; to the right to own and inherit property; to not be discriminated against in marriage, and to not be unwilling subjects in medical experiments. Article twenty five of the Convention requires “health professionals to provide care of the same quality to persons with disabilities as to others”.

Standard 2. Self-Awareness

Social workers shall seek to develop an understanding of their own personal cultural values and beliefs as one way of appreciating the importance of multicultural identities in the lives of people.

Cultural competency standards state that social workers need to first be aware of our own beliefs, values and potential biases. In dealing with disability, it is important to be clear through what model or perspective we are understanding disability. The medical model is presented as viewing disability as a problem of the person, directly caused by disease, trauma, or other health condition, which requires sustained medical care and is generally aimed at a "cure," or the individual’s adjustment and behavioral change. In the medical model, medical care is viewed as the main issue, and modifying or reforming healthcare policy is the central political response.

The social model sees the issue of "disability" as a socially created problem and a matter of the full integration of individuals into society. Rather than individual changes, the focus is on social action and the collective responsibility of society at large to make the environmental modifications necessary for the full participation of people with disabilities in all areas of social life. Equal access for someone with a disability is seen as a human rights issue.

These are not the only two lenses through which to view disability. The goal is awareness of how beliefs and values impact decision making with clients. The social work value of dignity and worth of the person states that “social workers respect the inherent dignity and worth of the person.” The ethical obligation is to develop a strength based approach. What is important to this client? What are their goals and priorities? How do they identify themselves? What language are they comfortable with? Are their ways they have been impacted by discrimination and stigmatization? Are internalized judgments affecting their functioning or access to services? How do they see the role of medical interventions and social accommodation?

A dilemma often faced by social workers, particularly those working with youth population, is the combined impact of insufficient availability of services, different criteria for accessing available services and clients who do not want to self-identify as having the disability that may qualify them for a needed service. Commitment to clients states that “social workers' primary responsibility is to promote the well-being of clients.” When the client’s self-determination presents potential risk to their ‘well-being”, how a social worker resolves the dilemma will be informed by their own beliefs and values.

Standard 3. Cross-Cultural Knowledge

Social workers shall have and continue to develop specialized knowledge and understanding about the history, traditions, values, family systems, and artistic expressions of major client groups that they serve.

An important aspect of social workers knowledge base relates to microaggressions. Microaggressions are “subtle, stunning, often automatic, and non-verbal exchanges which are ‘put downs’” (Pierce, Carew, Pierce-Gonzales, & Willis, 1978, p. 66). They are not demonstrations of overt hostility or discrimination. They are subtle, daily expressions of covert discrimination that devalue, depersonalize and violate the personal boundaries of others.

Richard M. Keller and Corinne E. Galgay describe eight domains of microaggressions.

Domain One: Denial of Identity

When some salient aspect of the person’s identity, other than their disability, is disregarded. This disregarded aspect of their personal identity remains invisible, leading to an overemphasis on their disability. An example of this might be a reaction of surprise about the person’s career or some other affiliation. Another example the authors give is being asked ‘what do you like to be called, disabled, handicapped, challenged?’ The author’s response is to simply be called by their name. The underlying message is that the only aspect of their identity is their disability. Other areas of skill or talent feel discounted.

Denial of Experience

1. Denial or minimization of a negative or discriminatory experience.
2. Indicating understanding or identification with an experience, or know the solution to a situation, in a manner that invalidates the individuals experience.

Domain Two: Denial of Privacy

Inappropriate demands for explicitly or subtly, personal information. An example would be a stranger asking “what happened to you?” in a crowded elevator. These demands seem to transcend appropriate social norms and ignore the impact that levels of intimacy play in the self disclosure process (Braithwaite, 1991; Chaikin & Derlega, 1974) as well as a lack of attention to the impact of differences in communication in public/private settings.

Another form of denial of privacy is the experience of having someone “lay hands on” and pray over the person without their consent.

Domain Three: Helplessness

The negative stereotypes that PWD’s need help most of the time, that PWD always want help from others and the underlying belief that living with a disability is a torturous experience hardly worth enduring.

Domain Four: Secondary Gain

Behaviors and choices motivated by an expectation of being recognized or praised in some way for the interaction with a PWD. This example could be on the part of an individual or an institution (i.e. having a token individual for political or financial gain).

A second variation is when others hope to feel better about themselves through their experience with a PWD. This often involves comparing themselves in a way that communicates pity and feels demeaning to the PWD.

Domain Five: Spread Effect

The assumption or misconception that limitation in one functional area leads to limitations in other functional areas. An example would be speaking more loudly to someone with visual impairment.
Another example is ascribed either high or low intelligence to someone due to the presence of their disability.

Domain Six: Patronization

Infantilizing people by speaking to or acting toward them as if they were children.

Domain Seven: Second Class Citizenship

This occurs when the rights of PWD’s for equal access are construed as unreasonable unjustified and bothersome. Expression of this happens through avoidance of a PWD or the lack of recognition of their existence, suggesting that the person with the disability represents a burden and requires too much time, effort or resources and environmental discrimination due to decisions by the dominant culture to allow structures which prevent equal access for PWD’s or provides for separate access.

Domain Eight: Desexualization or Exoticization

All aspects of the sexuality and sexual identity of the person are ignored or denied or assigning hyper sexualized status to a person based solely on his/her disability.

Standard 4. Cross-Cultural Skills

Social workers shall use appropriate methodological approaches, skills, and techniques that reflect the workers’ understanding of the role of culture in the helping process.

1.04 Competence

(a) Social workers should provide services and represent themselves as competent only within the boundaries of their education, training, license, certification, consultation received, supervised experience, or other relevant professional experience.

(b) Social workers should provide services in substantive areas or use intervention techniques or approaches that are new to them only after engaging in appropriate study, training, consultation, and supervision from people who are competent in those interventions or techniques.

The crucial ethical consideration is self-awareness related to competency. How open am I to learning from my clients? When do I need to seek out additional consultation or training? Do I have sufficient expertise to serve this client? Am I truly competent to utilize this intervention? What values or biases of my own are effecting my interactions and decision making?

Standard 5. Service Delivery

Social workers shall be knowledgeable about and skillful in the use of services available in the community and broader society and be able to make appropriate referrals for their diverse clients.

One additional area of ethical considerations relates to the debate over whether there needs to be a specialized category of disability ethics, as exists for medical or business ethics. Below are some of the arguments on both sides. Social workers and the social work profession will continue to play an important role in this conversation.

• Health ethics, medical ethics, feminist ethics, etc., already constitute focus areas
• Traditional Ethics not informed by Human Rights
• Disability is largely socially determined
• Quality of life is subjective
• Perspectives of people with disabilities have been largely ignored by traditional health ethics
• Focus on accommodation.

NO SEPARATE FIELD

• Ethics is the same for everyone–Should not be fragmented
• Disability can be well understood by people who have not experienced it
• Disability=impairment
• Quality of life can be objectively quantified
• Disability is already considered in current health ethics
• Focus on prevention and elimination of disability.

FOOTNOTES

1. World Health Organization
2. Snopes.com
3. Marshak, et al., 2009, p. 50
4. The Experience of People with Disabilities and Microaggressions
5. Richard M. Keller and Corinne E. Galgay, Teachers College, Columbia University
    

Ruth Lipschutz, LCSW, ACSW, is a licensed clinical social worker with postgraduate certification in ethics, mediation, Transformational Imagery, hypnotherapy, and Eye Movement Desensitization and Reprocessing (EMDR). She received her MSW from the University of Illinois in 1978 and went on to complete the two-year postgraduate training program of the Institute for Family Studies at Northwestern University. She has extensive experience in the areas of ethics, mental health, addictions, traumatology, program development and implementation, supervision, consultation and Alternative Dispute Resolution. She is the chairperson of NASW’s National Ethics Committee and has served as a panelist, consultant, mediator, and trainer for the NASW Illinois Chapter Ethics Committee. She is currently in private practice.

The Illinois General Assembly returned to Springfield on Wednesday, June 22, 2011, for one day to complete some pending business. No action was taken on the Illinois Senate's attempt to restore over $430 million in funding for social services and other areas of the budget. Instead, both houses moved a 1,600-page bill full of capital improvement projects which the governor is expected to sign. In addition, the legislature approved a bill that reduces the pay of legislators and requires them to take 12 unpaid furlough days each year.

Since no action was taken on the Illinois Senate's proposal to add money to the budget, including over $25 million in community mental health funding, that issue appears to be dead.

Another bill with significance for mental health service providers and consumers, SB 2407, Illinois House Amendment #2 moved a bit closer to passage when the Senate sponsor filed a motion to concur with the Illinois House Amendment. This amendment, offered by Representative Feigenholtz and passed by the Illinois House at the end of May, would correct a $30 million error in community mental health funding in the budget bill that passed this spring. SB 2407 now is pending in the Illinois Senate Committee on Assignments and could be acted upon by the Illinois Senate the next time the senate convenes.

The governor is expected to act on various budget bills next week. The new fiscal year begins on Friday, July 1, 2011. There is no plan in place to pay the accumulation of unpaid bills from the current fiscal year, estimated at approximately $6 billion. The "lapse period" (time within which the state has to legally pay bills from the previous fiscal year) was moved back to December 31st from August 31st. If FY2011 bills are paid with FY2012 funds, then FY2012 bills will be pushed back well into the new fiscal year.

Meanwhile, DHS has announced that its budget was cut by over 35% for FY2012. We will have more budget detail from DHS next month.

Since 2008, I have been working to establish my private counseling and consulting practice in sex therapy. By “sex therapy,” I am referring to the specific treatment of sexual dysfunctions such as: premature ejaculation (PE), loss of desire, painful intercourse, and erectile dysfunction (ED), to name a few. Like other forms of therapy, sex therapy can be provided individually or as a couple. I do not treat sexual predators or the paraphilias, which is inclusive of sexual addiction. With this said, there are four specific challenges I would like to address: (1) referrals; (2) the tabooed nature of sex; (3) differentiating between a sex therapist and a sexual surrogate; and (4) treatment goals.

The first challenge I have encountered is establishing a steady stream of appropriate referrals, which is the lifeblood of any private practice. One obstacle I have had to surmount is scheduling. I find it very challenging to actually meet with medical professionals (OBGYNs, urologists, and primary care doctors) due to their demanding schedules. The same scheduling challenge has also proven to be true meeting with other mental health professionals, such as solo therapists in private practice.

A second challenge revolves around the tabooed nature of sex. Even in the post-Viagra years, many patients still find it difficult to speak about sexual matters. Arguably, it is much easier to address issues such as depression and anxiety due to their social acceptability rather than to discuss one’s inability to obtain an erection or have an orgasm. Likewise, as a clinician or medical professional, it takes a certain degree of personal comfort to inquire about sexually-related matters. Clients mistakenly believe that doctors, as well as marriage therapists, are specifically trained in sexual dysfunctions and therefore can easily discuss the topic. Unfortunately, this could not be further from the truth. Most doctors and therapists receive little (if any) training in sexual dysfunctions. In essence, if clients and professionals don’t feel comfortable discussing sexual matters, or lack the appropriate training, they are most likely not going to open “Pandora’s box” to situations they cannot address. While I have been working to fill this void, I believe these systemic issues have proven to be a challenge in securing referrals.

The third challenge is managing the client’s expectations. Many clients who seek treatment may have preconceived notions of sex therapy based upon what they have seen or heard in the media. For example, it is not uncommon for clients to confuse a sex therapist with a sexual surrogate. A sex therapist is a licensed mental health professional who has undergone additional post-graduate training and supervision specifically in sex therapy. Most sex therapists provide services under their state mental health licenses and are bound by their respective professions’ code of ethics. Conversely, sexual surrogates are individuals who are paid to work intimately with clients that have specific sexual dysfunctions. Sexual surrogates can work closely with a sex therapist to implement a treatment program or work alone. Historically, the use of surrogates has always been a controversial topic. Critics cite the potential for the abuse of power and the risk of contracting a sexually transmitted infection(s) (STIs). Yet there is research establishing the effectiveness of sexual surrogates.

The reason for this critical distinction between sex therapists and sexual surrogates is simple: clients who enter treatment need to be educated from the outset about what is going to be expected of them in subsequent sessions as a way of reducing their anxiety and managing their expectations. Clients need to be advised that the weekly tasks assigned to them will be completed in the privacy of their own home. I do not use surrogates or recommend their services in my private practice.

The fourth challenge concerns establishing treatment goals. I work collaboratively with the client to establish attainable treatment goals. As a therapist, this allows me to foster the therapeutic relationship while simultaneously assessing the client’s sexual knowledge. Both of these areas are paramount to successful treatment. For example, say a male client is seeking treatment for his premature ejaculation (PE). During the assessment, he shares with me that he ejaculates before he can penetrate his wife. While in the process of establishing treatment goals, the client indicates by the end of treatment that he would like to last 30 minutes before having an orgasm. In this scenario, I would gently share with the client that his goals are a little too ambitious. At this juncture, it would be appropriate for me to provide some basic sex education to the client showing him that most men ejaculate in a shorter amount of time. When the client’s goals are set at an achievable level, their confidence grows as he/she witnesses his/her progress in the treatment program.

Despite these challenges, I have found the practice of sex therapy to be an incredibly rewarding experience. One benefit of sex therapy is the opportunity to work closely with medical professionals. Over the last three years, through hard work and persistence, I have managed to establish a relationship with a few doctors. When a doctor gives me a referral, I regularly consult with him/her about his/her client’s progress as a professional courtesy. It is important to note that sex therapy must be approached holistically, not just solely as a medical problem or a psychological problem. For instance, loss of desire can be hormonal as well as psychological due to relationship factors. Additionally, as a sex therapist, I can also be an invaluable resource to doctors. With so many medical problems linked to sexual health, I can suggest other areas of intervention to explore that they may have not considered. I can also act as a hub for mental health referrals through my network of colleagues.

On the direct practice level, I believe that sex therapy has some distinct advantages over other forms of psychotherapy in regard to the length of treatment and outcomes. Sex therapy is based on a brief treatment model. Typically, most sexual problems can be resolved in about twenty sessions or less. During the assessment stage, I rule out any issues that may be detrimental to treatment such as extramarital affairs, substance abuse, domestic violence, and serious untreated psychological problems. By screening for these problems at the beginning of treatment, I increase the likelihood of a successful outcome in a shorter amount of time. If a client reports any of these problems, I will explain to them that it might be best to work on their relationship for a while before proceeding in sex therapy.

Finally, the outcomes for sex therapy are very promising. The vast majority of sexual dysfunctions have a high rate of symptom reversal. This fact is important for clients to hear because it helps instill hope and motivates the client towards change. One of the reasons I enjoy working with individuals and couples who are experiencing sexual difficulties is that I can see the treatment is working based on self-reports. Building on the example given earlier with the man who has PE, I can establish a clear baseline for treatment. If the client states at the beginning of treatment that he cannot penetrate his wife before ejaculating, and now after working his treatment program can last approximately three minutes, this is clearly a successful outcome.

In this article I have strived to provide a brief overview of some of the challenges and rewards I have encountered as a sex therapist. While the article is not meant to be comprehensive, it does offer a snapshot of the scope of my practice. If you have any further questions or would like to make a referral, please feel free to contact me through the information provided below.

Dan L. Williams, II, LCSW, CADC, is founder of Innovative Social Work Solutions (ISWS), PC. Dan has nearly a decade’s worth of combined clinical experience working with adolescent and children, adults and couples. Dan holds an MSW from The University of Chicago’s School of Social Service Administration and an MSc in evidence-based social intervention with an HIV-AIDS concentration from Oxford University. Presently Dan is employed by Chicago Public Schools as a school social worker. He can be contacted by e-mail at dan@innovativesws.com.

For a complete up-to-date list of ALL classified ads, be sure to visit the NASW Illinios Chapter Classified Ads: http://naswil.org/news/networker/networker-classifieds/

OFFICE FOR RENT - Chicago
I am looking for hourly office rental space in the Loop; or locate 2-4 others interested in sharing a space at 25 E. Washington. Custom built suites w/easy "L" access, parking. Call Dan, 312.658.0887.

OFFICE FOR RENT - Berwyn
Office space for rent or sublet in prime Berwyn, IL location. Close to train line, in a medical office building, recently painted, fully furnished with private waiting room and bathroom!

CONSULT/SUPERVISION
Monthly Consultation Group: Case exploration in a safe atmosphere, using attachment and relational theories to deepen the therapy. My Glenview home, Sundays, 5-7 pm. Call Ruth Sterlin, 847 480 9159

OFFICE FOR RENT - Buffalo Grove
BUFFALO GROVE/LONG GROVE:Small office available. Quiet & confidential waiting room. Large window. New paint & carpet. Ideal location with 13 other medical offices.Please call Susan (847) 913-1400

OFFICE FOR RENT - Hyde Park
Share office space in Hyde Park Bank Building. Spacious, light-filled room with separate waiting room.Celia Brickman at cbrickma@sbcglobal.net or 773-536-5353.

NASW ILLINIOS CHAPTER JOB BOARD

For a complete and up-to-date list of job board postings, visit the NASW Illinois Chapter Job Board: http://naswil.org/education-career-development/association-job-board/.

• Part-Time Contractual LCSW for Private Practice (Terry Hefter Associates, LLC)
• Field Support Specialist (Southern Illinois University Edwardsville)
• LCSW or LCPC - Bilingual: English/Spanish (VNA of Fox Valley)
• Director of Education (Elyssa’s Mission)
• Contingent Therapist (National Youth Advocate Program)
• Social Worker: Assistant Professor in Transplantation (Northwestern Memorial Hospital)
• Executive Director (St. Mary’s Services)
• LCSW Psychotherapist (Novo: Renewing Joy in Life, LLC)
• Coordinator of Social Services (Hospice of Kankakee Valley)
• Licensed Clinical Social Workers (Northwestern Medical Faculty)
• Charge Therapist (Palos Community Hospital)
• Therapist/Clinician (Provident Inc.)
• Therapist (Herington Counseling and Learning Alternatives)
• LCSW Psychotherapist (Partners for Change, LLC)

Sue served as NASW Illinois Chapter President from 2003 through 2005 and was an Illinois delegate to the 2011 NASW Delegate Assembly. Currently, Sue serves on the NASW Illinois Chapter’s Committee on Nominations and Leadership Identity (CCNLI). She is also a member of the Social Work Examining and Disciplinary Board of the Illinois Department of Financial and Professional Regulation, and serves on the NASW Illinois Chapter’s Licensure Task Force. Sue is executive director of Family Counseling Services in Rockford, Illinois.
 

OVERVIEW

When the Illinois General Assembly left Springfield close to midnight on May 31, 2011, they had accomplished much of what they set out to do last winter. (1) A new legislative map was passed and almost immediately signed into law. (2) A bill that would significantly expand legalized gambling in Illinois was passed. Revenue would be used for a variety of things, including gaming addiction treatment, education, and reducing state debt. The governor has expressed strong concerns about the bill. (3) A bill touted by proponents as a strong school reform bill, SB 7, was passed and is pending on the governor's desk. The bill actually does more to reform labor-management relations in K–12 education than it does to ensure better outcomes for children. (4) Workers' compensation reform was passed by slim margins in each house. No one seemed particularly happy with the bill.

About the only major issue not addressed this spring was governmental pension reform (see SB 512). This effort stalled despite strong efforts by House Speaker Madigan and Republican Leader Cross to move the bill. Strong union lobbying killed the proposal temporarily. The issue is not dead, and there are plans to hold summer hearings and to move a proposal during the fall Veto Session.

BUDGET

One fulfilled promise was to make significant cuts to the state budget. To satisfy voters that big cuts would be made, the Illinois General Assembly (1) enacted strict spending limits in the tax increase legislation it passed last January, and (2) the Illinois House used $2.3 billion less in revenue in crafting its budget than the governor used in the proposed budget he unveiled in January, and $1.1 billion less than the Illinois Senate used in developing its budget. About $600 million of the difference between the governor and the legislature is due to the failure of the Illinois General Assembly to "decouple" Illinois from a new federal depreciation bonus for businesses. Unless there are more changes to the budget, the House's lower budget levels have prevailed and have been passed along without amendment by the Senate to the governor. The House human services budget bill is HB 3717. House cuts to human services were moderated somewhat by millions of dollars of cuts to state operations, which allowed some funding to be restored to community-based human services.

Although it passed the House's budget to the Governor unchanged, the Senate used another tactic to add money back into the budget. An end-of-session amendment to a huge capital projects funding bill, HB 2189, would have added another $430 million back into the operating budget for FY2012. However, the House rejected this amendment by "non-concurring" and appointing a conference committee. The Senate rejected the conference committee. Consequently, billions of dollars in capital projects may be held up until the two houses reconcile their differences. The governor may call the legislature back into special session in June to resolve this conflict or temporarily halt major projects such as road repair.

BILLS OF INTEREST

The following bills of interest passed both houses and will go to the governor. A more comprehensive list of bills will be provided in future articles over the summer.

HB 1530 (Mental Health Parity): This was a Department of Insurance initiative to align our law with the new federal parity law. However, it would apply to any employer who offers group health insurance.

SB 145 (Long Term Care Reform): This bill has two parts: First, it removes five IMDs from the Nursing Home Care Act and puts them under a new act as facilities that focus only on rehabilitation and recovery for persons with serious mental illness. The intent of this part is to allow the state to gain approval for a proposed nursing home bed tax. Second, it addresses long-term care health and safety issues for persons with development and intellectual disabilities following deaths at a pediatric facility in Chicago last year.

HB 1193 (Recoupment of Insurance Payments): This bill would set time limits for insurance companies to recoup payments made to medical providers that are subsequently determined to have been made in error. The bill provides for an 18 month time limit, with some specific exceptions.

HB 3027 (Sex Education in Schools): The bill would require schools to provide age-appropriate, medically-appropriate, and scientifically validated sex education. It is intended to align Illinois with federal law and to enable Illinois school districts to access federal funding for such educational activities. The bill passed the Senate and currently remains in the House, where a vote is expected in the veto session.

Anyone having questions about any legislation or budget issues should contact the NASW Illinois Chapter office.

I am the daughter of a mother who is a breast cancer survivor and a father who is a prostate cancer survivor. Although the journey was a difficult and sometimes painful one, I am inspired by the courage and the faith that they showed in the face of diseases that can sometimes be fatal.

On Sunday, June 5, 2011, America’s 12 million cancer survivors will join survivors around the world in observing the twenty-fourth annual National Cancer Survivors Day. There will be events hosted in communities all over the country throughout the month of June to celebrate life and to show those who are currently fighting the disease as well as others that there is life after a cancer diagnosis; a life that can be full and meaningful.

As a social worker in the community, I have had the opportunity to work with individuals over the years that have been faced with a diagnosis of cancer. For many, the initial diagnosis is usually shocking, and quickly moves into feelings of fear and uncertainty of the disease and the medical procedures ahead. Faith, family, and a positive attitude are three common areas that have been consistent in my work with survivors as ways in which they were able to remain encouraged. Going through the process of treatment for cancer presents a range of emotions as survivors have to find ways to balance positivity with acknowledging the difficult road ahead of them. One-on-one peer counseling through various organizations have proven to be very helpful because of the common experiences that are shared by survivors.

I am grateful for my parents as I continue the journey of survivorship with them. They both acknowledge a deeper appreciation of life. My father has become an advocate in his community as he speaks to various organizations regarding the need to get prostate exams and the importance of early detection and treatment. My mother approaches life differently, and often encourages me to appreciate life as it comes and not worry about tomorrow because each day comes with its own challenge. So today and each day I honor the life of those who are survivors of cancer, and I am inspired by their strength and courage.

Yolanda Jordan, MSW, LCSW, has an extensive background in abuse/neglect issues in the field of child welfare. As a placement manager with the Illinois Department of Children and Family Services, she is responsible for managing supervisors who are responsible for children who are placed in the foster care system. Yolanda is also a practicing psychotherapist and has been in private practice for the past ten years. Services are provided to children, couples, and families with a special emphasis on relationship issues that African American women face.

Yolanda is a graduate of Western Illinois University where she received her bachelor of arts in mass communications and master of arts in public communications human relations with a minor in African American studies. Due to her extreme love for people and having the heart of a servant, she continued her education and received a masters in social work with an emphasis on child and family practice from the University of Illinois at Chicago’s Jane Addams College of Social Work. Yolanda has been an active member of the NASW Illinois since 1996 and enjoys the work of advocating for the profession of social work and the community that social workers serve.