“Utilizing Implementation Science I will endeavor to translate the work of the Center for Financial Social Work for implementation and use at our Behavioral Health Clinic. This work will be utilized to mitigate the transgenerational impact of financial trauma on the communities and individuals that we serve. Specifically, through the development of group interventions, and the implementation of Financial Social Work individual interventions as insurance reimbursable fee-for-service sessions, I will seek to demonstrate Financial Social Work as an Evidence-Based Practice appropriate to be delivered in the treatment of Mental Health to mitigate symptoms of trauma, anxiety, depression, and stress to meet Office of Mental Health Guidelines in achieving and exceeding the treatment plan Objectives and Goals for the Financial Needs PGOI. Utilizing Data from this Capstone Project, I will also demonstrate the Macro Level impact that Financial Social Work and Implementation Science and Technology can have on the 14215 Zip Code.”
As I state on my about me page, “We ask our patients to reveal to us, often on their very first meeting, the inner most feelings and fears of their souls; and yet, even in our own spaces, we act as if it’s almost indecent to be human…to reveal of ourselves to others, to share of our own humanity. I choose to share, to live without secrets. I choose this path not due to a lack of boundaries, but instead as a well thought out, radical act of freedom, liberation, and resistance.”
Part of the DSW program is not only working to become an authority and a thought leader, but becoming a visual story teller, a communicator, a teacher, and an educator of Social Work Knowledge and Practice through the use of Implementation Science. While we work to do our own research, our biggest work is in educating practitioners, stakeholders, shareholders, community leaders, and activists, to help translate research done at the universities into practice in the field.
That work can’t happen in a vacuum. Part of how we’re doing that in 2020 is through the use of digital spaces, and we have to do that ethically. Right now the guiding documents that help us do that are the NASW Technical Guidelines and the NASW Code of Ethics.
A conundrum often occurs: Social Workers have been mistakenly led to believe, for years, that we don’t need to be at the forefront of technology, or that technology doesn’t impact us (we do, it does). So, we have been made to believe that instead of learning how to work and live in in digital spaces (hat tip to Dr. Patton for his work in this area) that we have to lock down, and hide because our patients may “find us.”
So rather than addressing the issue head on, we’ve been hiding from it in the guise of professionalism (which is word that is more a dog whistle for comfort, status quo, ableism, and white supremacy than it ever has been or will be for how we practice — that’s a blog post for a later time).
DSW students, researchers, and practitioners cannot operate in a vacuum: our work requires the feedback of outsiders, and not just academics or those in the field…but individual DSWs also have to setup boundaries for those who have been their clients, or are their clients to avoid a dual role/dual relationship.
This is not impossible. First, I created a Social Media Policy (and I am very sorry I can’t find the reference for it, because I used a lot of boiler plate that came with a sampler embedded in an article or a blog post around…two-three years ago…if anyone has the source, please share it with me so I can provide credit where credit is do).
Second, I added a module that reminds all commentators on my site of the rules associated with interacting with my site (including the Social Media Policy, but also the Terms of Service, and the Privacy Policy) before they can comment. It also reminds all commentators who are current clients that they are not allowed to comment, and that boundary violations may impact their treatment (e.g. transfer to another counselor, discharge from the clinic) and that all boundary violations are immediately brought to the attention of my supervisors:
Finally, I don’t allow anonymous comments on my website (which means that those who want to comment have to go through a registration process); and all comments have to be approved, in order for me to vet them, to ensure that they are relevant, appropriate, and not posted by a former or current client. If they are, I can securely print them out (at work), and bring the boundary violation to immediate supervision with either my supervisor or a manager on duty.
In this way, while we can’t assume that a boundary violation will never happen (in that a patient may one day theoretically try and contact me), I can know that I have taken every step to ensure that their comments will not appear on this website/blog (ensuring their confidentiality), while at the same time, the comments of my colleagues, shareholders, stakeholders, thinkers, etc. can become incorporated into my work and research, ensuring that I can work outside of a thought vacuum, and take into account the diversity of thought necessary to have DSW practice.
So for the first time in…many years…comments are once again open, and I open myself up, I make myself vulnerable, to the ideas, comments, and thoughts of others in a space that while mine, can also be a collaborative space, as I navigate the digital world.
Holy, Holy, Holy!! Holy is the Great Mystery that surrounds us and calls us to atone…Kadosh Kadosh Kadosh!! Holy are the Hosts of Heaven that set and maintain the Planets and Stars, their course and movement at His holy command…balance and order, night and day.
Aveinu Malkeinu – our Father, our King – we have sinned against you: your children are hurting and screaming and we reach out to the void, the Psalmist David called to you “from the depths of my soul” but what soul have we left for you? We have provided but wickedness. What redemption can possibly come for us? Each day a new plague, a new horror, at the hands of man.
We have sinned… We have transgressed… We have sinned… We have transgressed…
A thousand beats upon my chest, my rib cage bruised, and yet it would never be enough to admit my sins for myself alone…what hope is there then for the world? We have taken your gifts and the beauty that you bestowed upon us at Eden and the knowledge to us at Mt. Sinai and like dust in the wind we have allowed them to blow through our fingers.
It is written that you keep faith with those who sleep in the dust, we have left so much of it across the world that would any sack cloth be enough? Have we done anything, at all pleasing to You, in this year that could garner us favor or attention? No…I can’t see how…not this year.
Repentance, Prayer, and Charity – these are what is said to temper your severe decree! Yet year after year after year we stand before you, and here we are again, wicked in front of your presence, and even if your decree is tempered, still would I fear to feel it.
What have we done to deserve any temperence in your judgement? Does your patience with us wear thin? It must. You have made so many covenants with us, and what have we done to be worthy of them, or to keep them. After Noah you made a new one, so each of us to be judged by our individual actions…but we have failed to stop so much…and whom among us can say that we tried enough, or even tried at all this year?
On Rosh HaShanah it is written, on Yom Kippur it is sealed…and I fear the wax being placed next to my name.
What of this year, as we move ever closer to midnight? Will we even have a next year to be in Jersualem or will we end with mutually assured destruction?
There are a thousand fears that keep me awake now, in the middle of the night…and yet, in the stillness and quietness of the evening hour, as I stand before you naked yet fully clothed, you who can hear and see the innermost workings of my mind:soul:heart, I hear a voice echo back to me, a disappointed Parent…not one filled with rage, or anger…but with sadness…which is worse in a way…because here we are, You and I, here again this year, as you assure me that we’ll be together again next year, and the year after that, as you remind and correct me that plagues are never an end, but merely a beginning into Exodus.
Tear gas can be breathed in the air across the country tonight.
The first week of the first semester of the first year of the Doctor of Social Work program is in the books. To say that I’m excited is an understatement.
A good cup of coffee (espresso, which is the basis for all good coffee) starts with a single coffee bean…whichever one makes it into the hopper first. Then it’s joined by its fellow beans, and then rapidly ground and packed before water is propelled through it, to bring us its beautiful and incredible essence.
This is graduate school. Right now we’re in the phase where we’re adding the beans. Thinking, ideating, and processing adds more beans…next year we’ll get to grinding those beans up…and finally, when we’re all DSW candidates, we’ll be ready to move forward and blast the hot water through those beautiful grounds…and come up with a perfect cup.
Each coffee bean I come up with I’m adding to my Capstone research page; this week I was able to speak in larger terms about what I want to work on, how I want to work on it, and why it, and the DSW program is meaningful to me:
As someone who works in Micro Practice daily, but also loves Macro level practice (policy and history) and has an MBA, and loves entrepreneurship, and finance, and banking, and accounting, I want to work on a capstone that functions at the Macro, Mezzo, and Micro levels to benefit my agency, my patients, and the community I work in.
This week was very much about figuring out the flow of doctoral level work, while working full time, with chronic illness. I found that flow (in its entirety) over the course of the week, leveling out this morning. This means I’m ready and prepared for next week, which is an awesome feeling.
I have to say, I am also eternally thankful for my cohort, with whom I have built (and feel) a strong bond and connection to. We did a lot of work well before orientation in order to get to know one another, and I am sure that our feeling of mutual support, mutualism, and camraderie will not only grow as we go through this program, but will be integral to our success in it. I haven’t felt this kind of togetherness since my Non-Commissioned Officer Course days, so it’s refreshing!
In other news, on September 16th I begin my Certified Financial Social Worker exam for the CFSW credential through the Center for Financial Social Work, and my new couch comes on Tuesday, so that’s exciting.
I have off tomorrow (Labor Day) and I’m taking Tuesday off for the new holiday I’m celebrating in life: “Couch Day!”
So when I completed my MBA at University of Phoenix (side note: awesome school, accredited, and ahead of their time being fully online…who’s laughing now, in the age of COVID-19). I needed a system to organize myself and my work so I could stay on top of things. That system also got me through my MSW and I’m now using it in my DSW (albeit now I only use an iPhone and an iPad)
The “New Course” Template Folder
So I have a mostly empty template folder because this way I can just copy and paste it and that way every course is already setup for each semester. I’ll upload a zip file of it here later as a resource. The main components are the course materials and the weekly folders. The “completed” folder is where I slide each week when we’re done with it so I can see the semester progress and get a sense of accomplishment.
The “Course Materials Folder”
The course materials folder contains a few important items. First; some blank word docs where I paste critical information like instructor contact info so I don’t have to scour the syllabus. It’s also where I save the syllabus. It’s also where I put in the most common citations (e.g. the textbook…) and where I save any reserve readings that will be used for the duration of the course. I also always get my books as PDFs (at UOPX all of our books were secure PDFs) and so they were saved here for easy access.
A sample “Weekly” folder
So each week has the same layout, though I updated the DQ folder to include DQ & Flipgrid. That folder is where I compose my message board responses. If you’ve ever written a message board response with five academic citations to have your browser crash on you, or the schools learning system due…you’ll understand why you want to compose and save in word first, and then copy and paste. Additional bonus, you get to have a record of what you wrote if you want to look back on it.
The read, read-read again, and to read folders are important. Weekly readings (PDF articles, journal articles, YouTube video URLs) are stored in the read folder at the start of the week. As I read and go through them they’re moved to the read folder, unless I didn’t get something or REALLY need to dissect an article, and then it goes into the read – read again (after all the other readings are done).
I can’t recall which of my MBA professors chastised us for attempting to read articles word by word (my recollection is that it was my business law professor) but I no longer do that. At all. Unless it’s one I’m really interested in tearing apart. We had a special class session because of it where he was like “you will not make it through grad school if you do this.” So I literally read abstract, findings, discussion and move on. When I’m doing my own research I’m way more thorough, but I don’t have time in my day/week. I do make it a habit to read the textbook chapters in their entirety (but I use a reading app at near warp speed for that, and you can train yourself to listen faster).
Also (literally citation needed, I am desperately trying to find the bookmark for the blog I saw this on, so if you know it, send it to me please!) one of the things I’ve seen mentioned is to make an annotation at the top of each pdf with a brief summary in your own words. I’m going to start that this year. I never highlight because I’ve never found it helpful, but I think this has promise. The way I read anything is to be able to explain it to the person next to me (UB Department of Linguistics methodology, which hasn’t failed me yet).
Okay typed out rapidly in between patients. Grammar on greater detail/content to be added later.
Today is the first day of my DSW program! The program begins with some wonderful cohort building, a thorough explanation of what is to come ahead through our formal onboarding (virtually) via our two day orientation, hope, and excitement.
The program also begins within the context of the United States closest to Civil War than it ever has been in anyone’s living memory; taking place in the greater context of a pandemic that is taking both a physical, economic, and mental health toll on the entire nation, and – on a Macro Level – the globe.
Context is important. Context helps us understand the whats and the whys of what’s happening now, and helps us put those questions into a framework that we can understand for patients when we ask “what happened?” when begining to explore trauma [zotpressInText item=”H4V6HWT7″ etal=”yes”]. Context is the difference between seeing the larger picture (as scary as it sometimes is), and staying stuck at the micro level. Context is what allows us to function at the three levels of our practice (Micro, Mezzo, and Macro). Context is what also allows us to address policy, and shut down bullshit when we see it (e.g. those bills that magically take away context when discussing funding important programs, or providing relief, etc.).
Context is key.
And in this context I begin some new habits; daily writing among them. Years ago, I used to blog profilically (back before LiveJournal was bought, and sold, and bought, and sold, and eventually bought by a Russian company and then had its data illegal transferred out of California (more on that in another post, because I think it has a lot of relevance to what we’re experiencing today).
In any event, my new routine is to write daily, whether academic, or personal…I am going to write…hopefully this will also put my studies, my thoughts on class (both economic and what I’m learning in my program), my life, and what we are experiencing in the United States right now, into context.
Today was the first day of DSW orientation for what is going to be the second cohort of students (Class of 2023!) for the UB School of Social Work’s Doctor of Social Work Program in Social Welfare & Implementation Science. A forward thinking program working to bridge the gap between agencies and universities in order to reduce the time between when research is conducted and when research is implemented in the field.
It was wonderful to meet my colleagues virtually (while I would have loved to have met them IRL, social distancing and safety remain paramount as we continue to battle COVID-19). I live in University Heights and work one minute from my house in the same zip-code on the East Side. University Heights and my workplace share a zip-code of 14215. Presently, and throughout the pandemic, the 14215 has had some of the highest infection rates in the City of Buffalo.
I don’t think it’s hyperbole to say that a few capstone projects are likely going to be on implementing interventions during pandemics. I couldn’t help but reflect on what it means to be starting now, in this context, in this background, in this zip-code, in this 2020 reality of the United States.
So what is my DSW, what exactly am I studying, and why?
Currently it’s estimated that it takes around ten years for completed research to be implemented in the field. This means that once initial research has hit the ground running (…ten years later…) that a feedback loop has to be created between the universities and researchers who can study it further and the agencies who are implementing it.
The researchers need to find out if their interventions are effective, if they’re applicable to other groups (have they only been studied on one kind of group, or one kind of condition?), and what (if any) changes can, or need to be made for them to be transferable…and then we wait even longer for more research to be done, that research to be disseminated back to the field and implemented again, and feedback sent back to the universities (and round and round and round we go).
My cohort, and the cohort before us…and those that are going to come after us, are about to change all of that. We’re working to reduce that feedback loop, to make it more efficient, and to work to understand systemic barriers that agencies, and workers face, along with the populations that they serve. We also want to reduce the barriers that researchers have, in order to shorten bridges and close gaps. While we do this, we conduct our own research into the best ways of implementing new evidence based practices, science, and technologies into the field so that they can be deployed as safely and as rapidly as possible.
What can we do to make sure agencies and workers remain on top of cutting edge information and technology while understanding the realities they face in their day-to-day lives? How do we help researchers design methods that take into account better the realities of the field, so that they can receive more accurate data? How do we make that feedback loop into weeks or months instead of a decade? A lofty goal, but a necessary one as we move past 2020 and into the future.
I am beyond excited. I took a lot of notes in my BuJo today; I would say that most of them were some inspirational, in the moment quotes, from our professors (and others were resources, and just good information to have). I need to now process that, and this moment.
I have always loved living in University Heights. From my first forays as a visitor making my way to Amy’s Place, to my first apartments it held a special place for me. The real magic, though, was when I finally started staying summers as an undergrad, instead of returning home. Taking summer courses, allowing my mind to expand and wander, while at the same time listening to music, walking, drinking iced tea and soaking in the neighborhood is still, to this day, one of my favorite memories. Equally, perhaps, as enjoyable as the memories I hold of sitting at restaurant tables outside watching students return and move back in. There was always excitement in the air, and I was happy having been firmly established in my apartment at the time that I didn’t need to do anything, or any heavy lifting: I could just people watch and soak up the energy.
I have always loved how much a part The Heights is with UB (though, sometimes to the consternation of the neighbors, the university, or both). I love the idealism, the activism, the antics of the frats (usually. Not the hazing, to be sure, but certainly the goofiness that goes on at all hours). I love the music, and the casual football, and the study sessions. I love the countless eateries. I love the constant-noise-but-not-too-big-a-noise-because-we’re-studying hum that exists.
I love the sound of UB’s clock tower. I love knowing my way around Buffalo by the position of South Campus. When looking to buy what is my first (and last!) house, I was happy to purchase it in University Heights.
Many years ago, when I was still in Israel, and still in Uniform, a friend of a friend who I had helped get into my unit (an elite nerd unit) remarked, as we were talking about whether or not we were going to stay in Israel, that he was going to place money on the fact that I wouldn’t. He shared ‘you can’t, you need to be in a small town, as a college professor to be happy…” and while not a college professor (yet?), and while I vehemently disagreed with him then (Zionist that I am)…he was right, I have to live in a University Town, with a University Vibe, and a University Library, and University Life to be happy…and so here I am, happy…but also quite sad.
I am sad that this year is, likely, to be more quiet than in the past. Much, much more quiet. I purchased my house in January looking forward to watching students move in, and University Heights come alive this autumn. Small, and certainly insignificant on the global and universal scale of the pandemic we’re facing, but still, a loss that I’m grieving this year, will be the cacophony of moving trucks and cars, worried parents and embarrassed students, long lines at the coffee shop and book stores…and other signs that my alma mater is the beating heart of the place I love to call home.
This is an updated entry from my previous discussion on the topic, which can be found here.
The genesis of this is that I was discussing recently with a friend and colleague, former professor, mentor, and one of the people who got me started on my path to be a Solution Focused Counselor/Therapist (that’s a lot of titles) what my notes look like as a Solution Focused Brief Therapist in public practice in the United States where, especially when billing insurance, we must justify our work through documentation, to say nothing of our ethical requirements to document appropriately…so I figured I’d share the template and format I use.
I have come up with the following format for therapeutic interactions which, with the exception of the MSE, I write collaboratively with my patients. This takes no more than five minutes at the end of our session, and ensures I don’t ever get behind on paperwork/case noting.
I do not take any notes during a session in order to foster open and direct communication. There is nothing between myself and the patient (no pad, no pen). This requires a great amount of practice in active listening. I recommend a lot of role play to become comfortable with the technique.
Below is an example of a contrived session I made up about John Doe, it should bear no resemblance to anyone living or dead since I just came up with it on the fly, sans-coffee, while waiting for my flight:
MSE:
Patient presented on time, dressed appropriately, appeared alert and well-oriented. There was no evidence of disruption in speech flow or content, memory, or perception. Current mood observed as euthymic with affect congruent to mood. Thoughts were organized and goal-directed. Judgment appeared good, and insight appeared moderate.
Patient presented with: – Desire to reduce symptoms is depression; – Desire to reduce symptoms is anxiety; – Desire to improve capability for regulating moods/emotions; – Desire to reduce stressors regarding family; – Desire to reduce stressors related to work.
Clinical Note: WBTW (What’s Better This Week): John Doe shared that this week he was able to get out of bed and go to classes twice. John shared that he was also able to wash half of the dishes in his sink.
BHFTS (Best Hopes For Today’s Session): John shared that if he could work on finding a way to attend his classes, and finish doing his dishes, then today’s session would be helpful, useful, and productive.
Scaling (1-10/Zombies-to-Unicorns): 4.5; Goal (1-10): 5/John shared that he will be at a 5 when he is able to do all of the dishes and is able to go to all of his classes.
Discernment: John and this writer discussed barriers to doing his dishes and to attending classes, and how these barriers are negatively impacting his mental health symptoms**.
Exceptions: John shared that the problem of doing dishes and cleaning in general is not a problem when he comes right home after work. John shared that attending classes weren’t an issue when he got more sleep.
Experiment: John was able to brainstorm ways in which he can address his barriers to move to a 5 on the scale. John will try to do dishes twice this week right after work. John decided he will set a reminder on his phone to go off part way through his commute to remind him. John will set his bedtime back by an hour to get an extra hour of sleep.
Clinical/Psychoeducation: This writer provided psychoeducation on the importance of sleep hygiene and behavioral activation for reducing the sxs of depression.
Risk Assessment: John denied thoughts, plans, or intents or harming himself or others.
Follow Up: Follow up in two weeks. John to complete experiment as outlined above. John will call/come in if he requires additional support between now and his next appointment.
**While problem talk is discouraged, linking the patients concerns, and treatment to their mental health symptoms in discussion is necessary for ethical treatment under insurance. This is possible even in SFBT when we look at the “preferred future” (i.e. “I won’t be so anxious,” or “I won’t be as depressed,” etc.). We have to show how they are negatively impacting mental health symptoms because that is the structure of the medical/insurance setup in the United States.
In any event, I hope this is helpful to the wider SFBT community who is forced to balance SFBT work and insurance (without which, only the wealthy could afford our services), and I look forward to turning this into some kind of presentation at some point (SFBT & Insurance: An Uneasy Truce?).
moocowinthecity 
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