Thursday, December 31, 2009

Inspiration

When you learn, teach. When you get, give.
--Maya Angelou

Building a Bridge in Social Work

Most, but not all, Social Work Professors have two years or less of clinical experience.

Most, but not all, Social Work Clinicians haven't read a research or journal article since their two-year Masters program.

How do we begin to bridge this divide?

Scaling

fear -----------------------hope
doubt ---------------------believe
second-guessing self ------ trusting inner voice

where are you on the continuum today?

Transitions

I can't believe the first quarter is over. It felt slow - fast - slow, like a Pixie's song.

I survived, I didn't get thrown out of the program, my fellowship has not been revoked, I passed all my classes.

I remember the pain in my chest because of the pressure I felt the night my epistemology paper was due.

I remember the feeling of panic and praying a lot the morning I drove into school to take my Statistics final exam.

I remember sleeping a lot the week after everything was submitted and the quarter was officially over.

Winter quarter begins next week and I just finished the reading that is due for my Monday afternoon Intervention Research class. I am looking forward to this class.

I am looking forward to the new schedule - driving in to school only two days a week.

I feel very lucky to be in this situation - tired and stretched thin with a big smile of fulfillment.

It has been my new years resolution since forever to spend more time writing. Cheers to making good on dreams. Happy New Year and everything that means...

Tuesday, December 29, 2009

Comprehensive Soldier Fitness

"...a new Army-wide holistic initiative focused on building resilience" and here is the link:

http://www.army.mil/csf/

Including 5 Dimensions of Strength:
Physical
Emotional
Social
Family
Spiritual

Can you believe this? wow. How can we get this into the schools for teachers, administrators, learning support staff and students? I think that Martin Seligman would be game - are we ready?

Sunday, December 27, 2009

Martin Seligman on Flourishing

Here are my cryptic notes from Martin Seligman’s one-hour talk at the recent Evolution of Psychotherapy Conference in Anaheim. It was one of the best hours – we gave him a standing ovation. The inspiration may not translate in my notes, but if it does, it will be worth the read…

Martin Seligman's book The Search for Well Being, comes out in 2010!

Well-being is concerned with, but is not about, happiness. It is what people do when choosing freely (not oppressed or forced):
1. Happiness/positive emotion
2. Meaning – using what is best inside you in the service of something bigger
3. Positive relationships
4. Accomplishment - achievement/mastery/competence

Happiness (positive emotion, engagement, meaning) vs. Well-being (not a real construct but hypothetical, like freedom)

Human flourishing = building positive emotions, meaning, relationships & accomplishment

What makes people lastingly happier?
In the book, he describes 8-12 exercises that work (based on measures of depression over six months and a comparison of placebo and happiness exercises), for example:

(Placebo) write about a memory
(Happiness exercise) journaling about a blessing

(Placebo) write a story
(Happiness exercise) gratitude visit (highest trait correlated with life satisfaction)

(Placebo) taking the VIA (an assessment of strengths on Seligman's website)
(Happiness exercise) Using VIA, that is, using identified signature strengths in work setting more often

We have tricks to relieve depression and anxiety but there are many days that you will wake up depressed/anxious and that doesn’t mean that you can’t function beautifully despite depression.

“Teaching people to shoot when they’re dead tired” – how snipers are trained because it takes 24 hours to get in position and 12 hours to stay on a target. Sniper training is an analogy for teaching people to do things despite their weaknesses.

Removing depression & anxiety leads to an empty person instead of a happy person.

Teach people to overcome the negative symptoms AND teach skills for building positive emotions, meaning, relationships, achievement.

Psychiatric drugs mask symptoms (temporary symptom relief). The goal is permanent change vs. palliation.

Positive Education
What things do you want for your children? (in 2 words or less) – love & happiness
What do schools teach? – rules, conformity

Positive Psychology Experiment
1. Trained teachers to use it in their own lives first
2. Then, how to embed this into what they are already teaching

We need a highly psychologically resilient workforce (especially in education and LAUSD!)

Comprehensive soldier fitness (google this to find out more)
Army testing all soldiers, beginning October:
Part 1: emotional, social, family, spiritual fitness testing
Part 2: online courses in emotional, social, family, spiritual (family fitness course by Gottman’s) based on fitness test results

Positive Psychology training for 40,000 drill sergeants in the army (train the trainer model). Capacity to love or be loved – is the highest correlate with successful leadership in the Army.

If this can be done in the Army, then we can build flourishing & resilient school communities!

Mental health is the presence of positive emotions, meaning, relationships, achievement – not just absence of mental illness.

Formerly, studies only analyzed risk factors. Now they are taking the same data and analyzing for protective factors like optimism. In a reanalysis of longitudinal studies of cardiovascular death, where optimism was measured, it was discovered that optimism is a major health asset, controlling for risk factors.

Politics of well-being – investing our surplus in beauty lead to the Renaissance period. Let's build a monument of well-being. Wealth should be used for well-being, not more wealth. More positive emotion, engagement, meaning, better relationships, achievement!

Flourishing adults – variations of flourishing rates among Europeans. Seligman goal/benchmark: By the year 2051, 51% of the world population is flourishing. Worthwhile goal even if we are not there to see it. Increased productivity at work, better health, peace & calm.

We have long been the custodians of pathology, now we have tools to build positive emotion.

We can be agents of human flourishing.


Wednesday, December 23, 2009

Protective Factors


"When stressful life events outweigh the protective factors, even the most resilient . . . can develop problems (Werner, 1990, p. 111)."

"Protective buffers...seem to be helpful to us [as] members of the human race....[They] appear to make a more profound impact on the life course of individuals who grow up and overcome adversity than do specific risk factors. "
--Dr. Emmy Werner (1996)

So what are the much needed research-based protective factors?

1. Caring relationships
2. High expectations (I believe you can do it!)
3. Opportunities for meaningful participation
4. Social competence: cooperation & communication skills, empathy and problem-solving skills
5. Autonomy & sense of self: personal conviction, self-efficacy, self-awareness
6. Sense of meaning and purpose: optimism, goals & aspirations


From:

Gu, Q. & Day, C. (2007). Teachers resilience: A necessary condition for effectiveness. Teaching and Teacher Education 23, 1302–1316.

Constantine, N.A., Benard, B., & Diaz, M. (1999). Measuring Protective Factors and Resilience Traits in Youth: The Healthy Kids Resilience Assessment. Paper presented at the Seventh Annual Meeting of the Society for Prevention Research, New Orleans, LA

Tuesday, December 22, 2009

Self-Efficacy

"When faced with obstacles, setbacks, and failures, those who doubt their capabilities slacken their efforts, give up, or settle for mediocre solutions. Those who have a strong belief in their capabilities redouble their effort to master the challenges. (Bandura, 2000, p. 120)."

Have you ever heard anyone say, "cut 'em some slack" or "give 'em a break" and thought that person was just being nice? Turns out they were doubting someone's capabilities - essentially saying, "I don't believe you can do it." Wow. Not very nice.

I don't feel sorry for you - I believe you can do it. If you don't believe you can do it - I wonder what or who shook your confidence to believe?

"...Ordinary social realities are strewn with difficulties. They are full of impediments, failures, adversities, setbacks, frustrations, and inequities. People must have a robust sense of personal efficacy to sustain the perseverant effort needed to succeed. Self-doubts can set in quickly after some failures or reverses. The important matter is not that difficulties arouse self-doubt, which is a natural immediate reaction, but the speed of recovery of perceived self-efficacy from difficulties.. . . Because the acquisition of knowledge and competencies usually requires sustained effort in the face of difficulties and setbacks, it is resiliency of self-belief that counts. (Bandura, 1989, p. 1176)."


From:
Gu, Q. & Day, C. (2007). Teachers resilience: A necessary condition for effectiveness. Teaching and Teacher Education 23, 1302–1316.

Positivity

Barbara Fredrickson proposed a ‘broaden-and-build’ theory of positive emotions and observes that positive emotions—joy, interest, contentment and love— build personal resources.

These personal resources, ranging from physical and intellectual resources to social and psychological resources, ‘‘function as reserves that can be drawn on later to improve the odds of successful coping and survival.’’ In other words, positive emotions fuel psychological resilience.

Evidence suggests, then, that positive emotions may fuel individual differences in resilience. Noting that psychological resilience is an enduring personal resource, the broaden-and-build theory makes the bolder prediction that experiences of positive emotions might also, over time, build psychological resilience, not just reflect it.

That is, to the extent that positive emotions broaden the scopes of attention and cognition, enabling flexible and creative thinking, they should also augment people’s enduring coping resources.

‘‘The personal resources accrued during states of positive emotions are durable, (outlasting) the transient emotional states that led to their acquisition,’’ and that ‘‘through experiences of positive emotions . . .people transform themselves, becoming more creative, knowledgeable, resilient, socially integrated and healthy individuals.’’

From:
Gu, Q. & Day, C. (2007). Teachers resilience: A necessary condition for effectiveness.
Teaching and Teacher Education 23, 1302–1316.

Friday, December 11, 2009

Measuring What We Do

If it exists, we can measure it.


Rubin, A. & Babbbie, E. Research Methods for Social Work. 1993. Brooks/Cole Publishing Company: Pacific Grove.

Sunday, December 6, 2009

The Body & Trauma

They will fail to cope psychologically with their problems until they have a sense of security in their bodies. In loosing control over their bodily functions they are not the competent people they were before. (Kolb & Multipassi, 1982 p. 985).

Saturday, December 5, 2009

Courage in Learning and Theory-Building

From Bretherton, I. (1992). The origins of attachment theory: John Bowlby and Mary Ainsworth. Developmental Psychology, 28, 759:

"In his last work, a biography of Charles Darwin, Bowlby may have been talking about himself when he said of Darwin:

Since causes are never manifest, the only way of proceeding is to propose a plausible theory and then test its explanatory powers against further evidence, and in comparison with the power of rival theories..,. Since most theories prove to be untenable, advancing them is a hazardous business and requires courage, a courage Darwin never lacked. (Bowlby, 1991, p. 412)"

It takes courage to be curious, question, imagine, challenge, offer up an alternative explanation, and test it, knowing all the while that you may be wrong, publicly, or that you may be on target and still viewed as wrong, publicly.

Attachment

“If a community values its children it must cherish their parents” (Bowlby, 1951, p. 84).

Finals Week

It is all fun and games until MidTerm or Finals week. Then it all becomes due. And studying becomes an act of discipline and meditation. Sitting for hours to read and attend and focus despite where your thoughts lead you and distract you. Like now I am distracted because I really have to finish a 20-page paper that analyzes the epistemology and ontology of my chosen topic - attachment theory and it's mediating effects on post-trauma symptomatology. And as much as there is an urge to quit and shuck it all for more leisure time, I realize I am too far in, too invested to turn back now.

Pearls from Dr. Crimmins

May you have light moments of play with observer as you move through the "red"!

Graduate School Math

Time spent per week*…

30+ hours of course reading

10+ hours of commuting time from Eastside to Westside

12+ hours of in-class time (lectures and labs)

16+ hours of School Mental Health part-time work on projects like:
Response to Intervention and social-emotional interventions website content
Reflective Learning Groups (RLGs) for Psychiatric Social Workers and Social Work Interns
Organizing RLG Facilitator meetings
Organizing Professional Development committee meetings and developing training powerpoints
Training, consultation and product development for the Trauma Services Adaptation Center
Disseminating the South Los Angeles Resiliency (SOLAR) Project model and findings
Other duties as assigned

56+ hours of sleep (8 hours of sleep per night is mandatory for my functioning)

*Not including math and Spanish tutoring time with my daughter and all the stuff that makes life fun and worthwhile – family and friend time!

This is a fraction of the cost of investment.

Wednesday, November 25, 2009

Final Stretch

Two final papers (40 to 45 pages in total), two final exams (Statistics and Research Methods), article presentation in class and reading summaries/questions for three evidence-based practice articles (Epistemology), and a research proposal powerpoint presentation - then Fall quarter is in the can.

whew.

Saturday, November 21, 2009

Resilience

I came across this definition of resilience in an email from UCLA's Urban Planning Journal...

Derived from ecology, the concept of resilience is defined as the "measure of the persistence of systems and of their ability to absorb change and disturbance and still maintain the same relationships between populations or state variables" (Holling 1973). A resilient system is formed by the dynamic interplay between deterministic forces and random events, structural factors and human agency, linear paths and contingency. Such heterogeneity and variability allow resilient systems to absorb unforeseen shocks, continually adapting and evolving so as to resist collapse.

Any thoughts or reactions to this dynamic and interactive definition?
How will any institution that children and families depend on (including LAUSD), adapt and evolve "so as to resist collapse" in the face of so many shocks, changes and disturbances? With so much at stake, what are our best ideas?

Evidence-Based Practice (EBP)

One development in the human services that shows great promise for linking practice and research is evidence-based practice: the conscientious, explicit, and judicious use of the best evidence in making decisions about human service assessment and intervention. According to this approach, the best evidence is knowledge that has been gained via the research process (from Applied Social Research: A Tool for the Human Services, 2008).

What is the point of conducting research and finding approaches or interventions that relieve suffering and make people's lives better, if no one knows about them, reads about them or uses them?

How can we all bring about the "great promise for linking practice and research" - what will this take? What can this look like? How can we capitalize on the advantages of current technology to help?

Thursday, November 19, 2009

One of the Perks

One of my classmates is recovering from a flu that knocked her out for four valuable school work days. A friend of hers (an advanced doctoral student) told her to enjoy the flexibility of being in school and to do at least one thing every week that she might not otherwise be able to do if she was working.

It is Lila's (my UCLA carpool partner) birthday on Monday.

Yesterday, after statistics support with Todd (2 hours) and before Research Methods with Aillee (5 hours last night), we decided to celebrate Lila's birthday at Palomino's in Westwood. We had berry martinis and appetizers at 1:00 in the afternoon! woohoo!

What will I try next week? Any suggestions?

Sunday, November 15, 2009

Week 8

SW 245A, Epistemology (the philosophy of knowledge)
Everyone agrees this is thee most difficult course in the program. It is offered first up, welcome to the doctoral program! A bit of hazing, if you ask me. Every week there are about four articles and a textbook chapter of reading on a different epistemology (positivism, post-positivism, hermeneutics, social constructivism, interpretivism, critical realism, critical theory, feminist/standpoint theory, etc.). Every Friday a summary and three questions from the readings are due. Sometimes, this means posting assignments online just before midnight. Reading is often slow because the material is dense. Philosophers don't seem to speak or write plainly. It is beyond jargon, it is another language completely. I am learning abstract and difficult concepts in an entirely new language.

Our midterm assignment was a paper describing a well-researched theory which we will later analyze epistemologically and ontologically. Ontology refers to the nature of things that we know - are they real or ideal, independent and objective or socially constructed? I chose to examine Attachment Theory and how it explains our vulnerability to PTSD. Why don't all who are exposed to traumatic events later develop symptoms?

Despite the incredible challenges, this is my favorite class this quarter. The reading has become more and more fascinating and thought-provoking. The professor, Zeke, is knowledgeable and brings many real world examples of research using the different epistemologies, including his own. Zeke doesn't seem to mind all my questions. Even when I persist in challenging an assumption of our beloved Critical Theory.

SOC210A Statistics
This is a three-quarter series on Statistics taught by sociology professors. First up is Gabriel Rossman. He is a 32 (!) year-old UCLA and Princeton alum. He writes about pop culture, like music and the movie industry. His examples are fun in that they help explain the how and why of t-tests or bootstrapping or sampling, but also become interesting stories in themselves. He writes about the halo effect of teamwork on movie sets and its impact on the success of movies. He also uses mythology and quotes from rabbis to make his points. I like all this. I forget now which stats point he was trying to make but he told us about the ancient Hoplites and how they lined up for battle with the youngest in the front and the oldest in the back. This was not so much because the youngest were strongest in battle but because it prevented the youngest from turning around and running away in fear. This reminds me of field instructors and interns. Would any intern actually follow through with a biopsychosocial assessement and parent interview without the veteran field instructor holding the line?

I know that Gabriel is a Princeton alum because I actually wore a Princeton t-shirt to class one day (isn't wearing a t-shirt and yoga pants and a pony tail one of the perks of being back at school?). Anyway, when I reached over to get something out of my backpack, he noticed my t-shirt and asked me something about it, only I didn't hear him on account of I wasn't really paying attention yet because I was reaching for my legal pad for notetaking. Anyway, there he was smiling at me and waiting for a response and I didn't know what to say. Also, there is no back and forth conversation in that class. There are about 20 students and no dialogue, even when he asks us direct questions. It's a quiet group. My classmate thinks it is a sign of the fact that everyone is lost. Anyway it finally dawned on me, after a very pregnant pause, that he was asking about Princeton, I told him I had not attended but bought it on campus when I was back east for a conference. What conference he wanted to know. I was feeling uncomfortable in the spotlight, as usual. I am a horrible extemporaneous speaker. When I told him it was at the Robert Wood Johnson Foundation nearby, he said his wife did health policy work for them, then went back to his lecture. My carpool partner said I will get an A in that class for wearing that t-shirt (thanks, Pia!). Then I wanted to know where he attended undergrad.

Every week we have one chapter of reading. Homework problems from the chapter and a lab assignment (using STATA not SPSS, Gabriel hates SPSS) are due every Tuesday. There are two 2-hour lectures every week (Tuesday and Thursday) and two 1-hour labs with our TA, Yool, every week (Tuesday and Friday). In addition, Todd Franke, a SW professor, offers a required Stats support session every other Wednesday from 11 am to 1pm. There will be a cumulative final in 3 weeks. I'm wearing the t-shirt again for good luck.

SW286A Survey of Research Methods
This is an optional course in the program, but I figured a review would help. The last time I took a Stats course was Summer 1994. I highly recommend that class. It was a math course taught by Michael Allen at Glendale Community College. I took it as a prerequisite for my admission to the MSW program at Berkeley. Even with all the Stats instructors I have this quarter, I am leaning on what I learned in that summer to get through Stats this quarter. The last time I took Research Methods was three semesters at Berkeley (Spring 1995 to Spring 1996). This is the course that gets my short-shrift. The reading is good but I rarely have time for it. The mid-term paper was the first half of a research proposal and I chose to use the South Los Angeles Resiliency Project to develop reasearch questions, hypotheses and a lit review. I figured it may serve me when I have to submit a publishable paper in my second year. This course is great in that it is walking us through every aspect of research - questions, hypotheses, units of analysis, reliability, validity (face, criterion, etc.) sampling, survey methods, etc.

I have to admit I took a break last week. I felt the exhaustion in every cell of my body. Not even the salmon oil was working. We got a new bed and that helps with having a refreshing good nights sleep (no body aches and pains upon waking). I had a massage, an accupuncture session (and left with Chinese herbs for energy), a color appointment (I was overdue by 2 weeks!), a nice walk at Descanso Gardens and another around the Rose Bowl. I read, A Round-Heeled Woman, in one day (I could not put it down) and now I am feeling restored again.

Monday begins week 8 of the fall quarter and that means we are close to the end of this round of boxing. Finals week is three weeks away and a three week break will follow after that. If the first year is all about survival, then I suppose I can say, with confidence, that I am indeed surviving. But it feels like so much more than that. When you pursue your goals, dreams or set about on your intentions, it feels like so much more than survival, it feels like living, real living, no matter how hard, it feels like being alive, like the pit in your stomach wants to burst out and scream, this is real, this is really happening, I am doing this now!

Thank you, Yesus, again and again and again...

Wednesday, November 11, 2009

Critical Theory

Epistemology is the philosophy of knowledge or the ways of knowing. How do we know what we know?

One of the epistemologies used in the social sciences is Critical Theory. Critical theory makes the assumption that all of us inherently want to be free. Critical theory further argues that oppression can’t continue without the acquiescence of the oppressed, however, proponents of this theory assert that the oppressed don’t know that they have a choice.

If you knew you had a choice, would you pursue freedom? No matter the cost?

After Moses led the Israelites out of Egypt, they grew tired of eating manna from heaven and wanted to return to Egypt - where they had been previously enslaved!

There are rules that we learn because we are good students of our family, culture and society. But what if those rules were learned in coercive conditions? What if those rules serve an oppressive other but don't serve us - that is, serve to frustrate our freedom? Do we perpetuate them or do we challenge them?

Is it impolite to disagree? Who does this rule serve? And why is being polite more important than voicing your perspective? You may walk away with the self-satisfaction of being agreeable. But maybe the oppressive force who created this rule and sold it to generations, is the real winner, or at least ends up with the last word.

Tuesday, November 10, 2009

Cultural Rules?

I am the only brown person in my Statistics course (19 students) - the rest are White, Asian, and European nationals. No affirmative action rules apply at UCLA.

Sometimes I feel like I am missing Thee Rule Book. That is, when and when not to ask questions. What kinds of questions are okay and which are definitely not okay. What is appropriate and what is just not done. I know I have overstepped the bounds of propriety when I get the squinty-eyed look of contempt and half-smile in response. I anguish over having said too much, been too much for my environment.

Then I think, if someone did give me Thee Rule Books for how to be successful in middle-class white society or even how to be a good Latina in Latina society or how to be a nice Social Worker in Social Worker society or a properly coiffed woman in woman society, it wouldn't change a thing. I might still break the rules. I would still be me. One of my older sisters used to say to me, has de hacer lo que tu quieres - you're going to do what you want. Nimodo que haga lo que tu quierras - what else am I going to do, what you want? That leads me to my favorite question, "What do you want?" Feel free to reply and post your answer.

Either way, there is a price to pay. Follow the rules and belong to the group (but what part of you do you lose?). Break the rules and risk being an outsider (and lose the group). What is the middle path? Is it really okay for me to be me and for you to be you?

The Rule Book would still help. Then I could break rules with intention and not out of ignorance. Heard any good rules lately?

Wednesday, November 4, 2009

Status Update

Reevah (my longtime clinical supervisor and mentor) always said, "we feel ambivalent about everything" and "we have a right to our thoughts and feelings." With those sage assumptions in mind, I am feeling all my feelings right now. I am feeling confident and overwhelmed. Tired and stimulated. In control and out of control. I am so grateful to be having this experience and cranky that it is kicking my butt. Dr. Susan Crimmins might call this noticing, without judgment, tracking, orienting and pendulating. Asking for help and leaning on my support system is helping. Now I am planning the rounds with all my healers - chiropractor, accupuncturist, massage therapist, pedicurist, colorist, etc. I am tackling self-care in a way that is tested and true - through the body (especially, when going to the gym for a sauna & steam bath after a work out sounds like too much work).

Thank goodness for my primary resiliency factor, spirituality. Thank goodness for the humanistic-existentialist approach that I learned by reading and listening to Irvin Yalom and Carl Rogers. Also, thank goodness for buddhism and mindfulness. They have saved my life more than once. The self-awareness and self-acceptance espoused by these approaches allows me to face my challenging new experiences full-on in order to integrate them and come out whole. Stoicism is over-rated and inauthentic. Who needs it? There's nothing weak about being real - in fact, it takes a whole lot of courage and confidence to be vulnerable and lift the veil on the horribly beautiful truth that there is a lot we don't know, we are imperfect. And isn't that grand? Where does striving to reach "perfection," internally or in polite company, lead to anyway? What a relief to be human and just as we are. The sign that the revolution took hold is being able to say (quoting Wanda Sykes) "I'ma be Me."

Sunday, October 25, 2009

Attachment and Vulnerability to PTSD

Attachment, as explained by Bowlby, is a biological and behavioral system. The infant or child seeks comfort and to be physically close to the caregiver. If the caregiver is available, willing and able to respond as needed, then the loop closes nicely. If this happens over and over again, then the child develops an internal working model about what she or he should expect in a relationship - any relationship - in the future, well into adulthood. This is a secure attachment.

If the caregiver is rejecting or unreliable, for any reason (for example, mental illness, crisis, trauma, substance abuse, fear, etc.), in providing care and protection, their children are left in an ongoing state of distress. Without an internal working model that facilitates confident expectations, these children are inclined to experience a generalized sense of anger and anxiety.

What Bowlby once referred to as an internal working model, today neuroscientists might refer to as - how our brain is wired.

On the whole, internal working models shape our expectations about the helpfulness of others, our worthiness to receive help and perceptions of support. Children showing a more secure attachment are less likely to react with anxiety and more likely to confidently seek support from others. Thus, under stressful conditions, the perception of support and its usefulness are reflections of working models grounded in the attachment relationship.

Our early system of need and response becomes how we see ourselves in relationships beyond our caregivers. It becomes how we expect, interpret and predict others to behave toward us in future relationships. As a result, attachment is seen as a stable process that endures into adulthood.

Research in the last 20 years focusing on adult attachment style has provided support for the stability of attachment, within individuals, across generations and across cultures. Research on adult attachment tells us that how we remember and tell the stories about our past attachment relationships can predict the quality of our current attachment relationships, specifically with intimate partners. A mother’s attachment style has been found to predict quality of interaction with her child, as well as the security of the child’s attachment. If the stories about our childhood are coherent, organized, full of detail and include both good and bad aspects of our attachment relationship, then we are more likely to have a secure attachment style in our relationships.

Ainsworth identified and categorized different types of attachment behavior as secure, insecure–avoidant and insecure–ambivalent/preoccupied. A fourth classification of disorganized–disoriented attachment was added to describe those children whose careseeking behavior lacked a coherent strategy and could not easily be categorized.

An insecure attachment style is often seen as a risk factor for the development of childhood psychopathology and is commonly found in children who have experienced abuse or neglect. The quality of attachment affects the degree to which an individual can adapt to disruptions in normal development without leading to psychopathology. It has been proposed that insecure attachment does not in itself lead to psychopathology, but leaves one vulnerable to disorder if combined with other risk factors, such as family dysfunction or trauma.

Given that attachment-seeking behaviors are activated by a perceived sense of danger, the presence of a secure attachment has the ability to mitigate trauma-induced psychopathology. Bessel van der Kolk says, “trauma occurs when one loses the sense of having a safe place to retreat within or outside of oneself to deal with frightening emotions or experiences.”

Furthermore, the frightening circumstances of maltreatment activate the attachment system. While maltreatment activates the attachment system, the need for proximity is likely to contradict with the circumstances of maltreatment, contributing to the root of disorganized attachment. If the person that a child turns to for comfort and protection is actually the same person inflicting harm, it obviously becomes very confusing and lonely for a child.

Thus, child abuse coupled with an insecure attachment may impede inner resources necessary for seeking support, coping, and adapting following trauma. An attachment framework suggests that secure working models may make a substantial difference in one’s ability to adapt and benefit from treatment. Research tells us that that the single best predictor of a positive psychological outcome for children who are surviving trauma is the support of a significant caregiver. We cannot say, for sure, why caretaker involvement improves treatment outcome. At a minimum, caretaker inclusion is presumed to assist in monitoring, understanding, and managing children’s symptoms. In this manner, caretakers are likely to be more perceptive and emotionally supportive of their children.

Researchers ask, "why do some adolescents and adults develop PTSD when exposed to a traumatic event (physical or sexual abuse, war or terrorist attack) while others don’t?" Some studies attempt to evaluate the efficacy of the quality of one’s attachments, well into adulthood, to examine the relationship between childhood abuse and vulnerability to the development of PTSD later.

Stubenbort’s findings suggest that those youngsters who had the benefit of a strong and secure attachment have more positive outcomes after treatment when functioning is measured at follow-up. This presents evidence for the hypothesis that secure attachment relationships may serve to buffer the impact of trauma and trauma-related symptoms.

A traumatic situation dramatically increases one’s psychological need for comfort and protection. A secure attachment bond provides a place from which a victim may perceive him/herself to be in touch with a powerful protector. Securely attached children are able to draw strength from a secure base and use learned adaptive strategies to contain the experience of danger. In contrast, those having an insecure attachment bond are likely to exercise maladaptive stress reducing strategies and will remain in a high state of distress and arousal.

Shapiro’s findings indicate that attachment style and coping strategies influence psychological and interpersonal functioning, mediating the direct effects of childhood sexual abuse and other types of child abuse and neglect.

Results of the Twaite study provide further support for the relationship posited to exist between childhood abuse and the emergence of PTSD in adulthood by much of the previous research, as well as the suggested association between childhood abuse and adult attachment quality and dissociative tendencies. For example, the positive relationships obtained between a history of childhood sexual and physical abuse and scores on the Impact of Event Scale–Revised are consistent with several previous studies suggesting that individuals who were abused as a child are more likely to develop symptoms of PTSD following the experience of a traumatic event as an adult.

These studies seem to warrant the hypothesized relationship between security of attachment as explaining the variability among those individuals that develop PTSD and those who do not. The implications for practice abound. Clearly, anything we can do to facilitate the effective call and response system between parent and child would be profound in its effects. The next question then focuses on us as professionals - what can we do to help parents notice, respond and soothe our students in times of stress?

References:
Bacon, H. & Richardson, S. (2001). Attachment Theory and Child Abuse: An overview of the literature for practitioners. Child Abuse Review, 10, 377-397
Shapiro, D.L. & Levendosky, A.A. (1999). Adolescent survivors of childhood sexual abuse: The mediating role of attachment style and coping in psychological and interpersonal functioning. Child Abuse & Neglect, 23 (11), 1175-1191.
Stubenbort, K., Greeno, C., Mannarino, A.P. & Cohen, J.A. (2002). Attachment quality and post-
treatment functioning following sexual trauma in young adolescents: A case series presentation. Clinical Social Work Journal, 30 (1), 23-39.
Twaite, J.A. & Rodriguez-Srednicki, O. (2004). Childhood sexual abuse and physical abuse and
adult vulnerability to PTSD: The mediating effects of attachment and dissociation. Journal of Child Sexual Abuse, 13 (1), 17-38.

Saturday, October 17, 2009

Pendulating on the Roller Coaster

Oh no! What have I gotten myself into?

(after turning in an assignment) I did it. I can do this.

(staring down another 20 hours plus of reading) OMG, this is a lot of work, how will I keep up and manage it all?

(after completing 3 weeks of schoolwork) I did it. I am doing this.

(laying down on the couch or bed because my body is too tired to move) Why did I choose this particular form of punishment and is it too late to cut out?

(after a great discussion in class or reading) Wow, this is really cool - I get to do this.

Tuesday, October 6, 2009

Evidence-Based Practice Articles

I just read two great articles about Evidence Based Practice (EBP) in Social Work. Let me know if you are interested in reading either one. They argue that some of the limitations of the EBP approach are:

1. SWs report not having enough time to read.

2. SWs report not having access to journal articles.

3. SWs have not had adequate training to interpret the evidence from research studies.

4. Based on past scientific movements in the profession, SWs may not see a need for or the appeal of the EBP framework in everyday practice.

5. A survey of agency-based field instructors found lack of time was the top barrier to implementation of EBP.

6. Social workers rarely use research evidence to strengthen decision making about client interventions.

7. Different stakeholders apply different standards to evidence that they are using to determine whether an intervention is effective or even needed in the first place.

8. SWs may see new knowledge as credible only if it fits with the existing professional theories that they agree with or with their political, religious, or other personal beliefs. So, training, professional knowledge, or personal beliefs can prevent a practitioner from being open to reviewing any evidence that is available on alternate therapies.

9. It is not known what type of evidence SWs value (and from where – psychology, social work, sociology, political science, etc.)?

10. Within social work, surveys that collect information on demographics, service counts, or reasons for referral may be an appropriate evidence of demand, but they are not necessarily an appropriate way to determine the effectiveness of interventions.

Do you agree with any of these? Could you tell me which of these (identified by their number on the list) that resonate for you? What about your colleagues?

Bonus tip:

Reviews of various types of SW practice have documented that the treatments with demonstrated effectiveness tend to be brief, group, skills-focused, intervention approaches.
(from Limitations of Evidence-Based Practice for Social Work Education: Unpacking the Complexity by Kathryn B. Adams et al.)

Saturday, October 3, 2009

My Advisor - Stuart Kirk

I was googling to find a Bertha Capen Reynolds quote for a PowerPoint presentation I am working on when I stumbled on this book excerpt online and I could not stop reading it because the ideas and writing were about the things that I care about - strengths perspective, the placebo effect, Paolo Freire's thoughts on hope, etc. I was thinking, "I really need to buy this book!" When I went to write down the book title and author I realized it was edited by Stuart Kirk - my advisor! Confirmations that I am in the right place keep coming. Thank you, Yesus because this is a lot of work!

Sunday, September 27, 2009

Imagination in Science

I believe that scientists tap into the transcendental force for inspiration much like artists, musicians, writers and mystics.

In Approaches to Social Enquiry, Blaikie quotes, "The transition from data to theory requires creative imagination. Scientific hypotheses and theories are not derived from observed facts, but invented in order to account for them."

And, "...there can be no set of rules given for the procedure of scientific discovery - a hypothesis is not produced by a deductive machine by feeding experimental observations into it: It is a product of creative imagination, of a mind which absorbs the experimental data until it sees them fall into a pattern, giving the scientific theorist the sense that he [sic] is penetrating beneath the flux of phenomena to the real structure of nature."

And, "...every discovery contains an 'irrational element' or a 'creative intuition' "

And, "Hesse...stressed the role of creative imagination, as well as logic, in the process of scientific discovery."

And, "In all these cases, because causal structures and/or mechanisms had never been observed, it was necessary first to imagine what they might be like, and then to formulate these ideas into some image or model."

Also, in describing the deductive process used by a clinician, Blaikie quotes: "Here there is a rapid reciprocation between an imaginative and critical process."

Daniel Gilbert in Stumbling Upon Happiness notes that imagination is what separates humans from the rest of the animal kingdom.

Albert Einstein said, "Imagination is more important than knowledge. Knowledge is limited. Imagination encircles the world."

I see a lovely pattern here.

Friday, September 25, 2009

Dr. Aurora Jackson's Research Interest

“In 2006, nearly 80% of births to black women under the age of 30 were out of wedlock. For black children, more than half (51%) are in families headed by single-parent mothers. Children in these families have extraordinarily high rates of poverty.”

I heard this during faculty introductions at the orientation - bowled over and thinking about the ramifications for our students. So what do we do?

OMG!

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
What sounds good and doable during summer vacation, becomes a what-were-you-thinking? in the fall. I don't know how I will keep up with this blog, except that posts will become more brief and concise (except for this one).

I am officially and completely overwhelmed. As a way to cope, I had been avoiding thinking about what being in school would be like (except for the fantasies about the off-shore breezes and marble libraries). I guess I figured that worrying about it wouldn't help. Now I am in it and it has hit me like a really tall wave (I am trying not to be catastrophic - initially, I wanted to call it a tsunami).

I have been affect regulating in full force and the pendulum is swinging far and wide. I feel scared, hopeful, anxious, excited, worried, relieved, stimulated and overwhelmed. I am feverishly (literally, I am fighting a flu bug - please, don't be H1N1) trying to digest all the information and it is making my head hurt.

How could I have prepared better for this experience? I always jump in with both feet and deal with the emotional consequences later. Big emotional consequences. I fear that attending to the emotional factors beforehand will psyche me out of even showing up. Anyway, paddling in the deluge that comes after is pretty scary and I am wondering - there has got to be a better way.

The really good news is that my fantasy about carving out time and space to read, think and write was totally right on. At the orientation, all the professors concured about this. And being asked questions like, what do you want to be expert at? was exhilirating. What will I immerse myself in reading over the next few years? What are my research questions? I am in the right place, doing the right thing.

So far, what has helped me through:
self-talk (it's going to be all right, one reading/assignment at a time, you can do it)
support and reassurance from 2nd year doc students, professors, family, friends, colleagues, and administrators
prayer
airborne
salmon oil
meditation cd's
sleep (sometimes nyquil-induced)
and writing

It's time to get ready for work. Thank God for work and that I have a job.

Sunday, August 23, 2009

Curiosity and Managing the Anxiety of a Learner

During individual supervision at my 2nd year field placement, the Healthy Start Program at Bahia Vista Elementary, when my field instructor said she was surprised that I didn’t conduct developmental assessments with my clients, why didn’t I ask, “what’s a developmental assessment?”

When I asked interns on their first day of field, “what are your fears, concerns, questions?” T----, brave and poetic, responded, “I am afraid that I will ask you a question and you will say, ‘you should know that already.' ”

How did our natural curiosity get squashed along the way? The revolutionary in me (re-awakened after watching Che, the movie, Part 1 and 2 - really good by the way) wants to fight to reclaim our birthright to curiosity. That is, asking questions, challenging the status quo and not knowing without shame or embarrassment.

I am afraid that all of those years of talking to interns about the learning curve, about how normal it is to be scared and uncomfortable when learning something new, about how Reevah always said it takes a lot of ego strength to be a learner and to acknowledge our dependency, and about how we all feel more in control and confident when we reach mastery, but that it takes hundreds of trial and error experiences to get there. I am afraid that all those words will come back to bite me. That they will not be sufficient reassurance. That I will need to find other ways to self-soothe - to manage my beginner's anxiety. And that being stoic or ignoring these feelings when they come up will not be acceptable to my body. So as I prepare for this big (overwhelming) new experience, I am open to learning how to attend to all the feelings that come up - and like a good parent to a wailing baby - find ways to respond, accept, comfort and soothe.

Saturday, August 22, 2009

How to Post a Comment

I am still learning how to use this technology, so for those of you who asked me and I couldn't answer at the time, here are the steps: Click on the title of the post that you want to comment on - it is a link to a window where you will be able to type in your own comments. Thank you for participating!

Questions as Motivation

One of the carrot sticks that kept me moving forward in the application process over the last year, despite all doubts and apprehension, was the picture in my head of sitting at a café on campus and feeling the off-shore breeze or sitting in Powell’s marble Library (this visual is thanks to a recommendation by Dr. Agbayani) with a tall stack of journal articles to read.

Reading calms me and helps me to feel like I am standing on the shoulders of giants. When I am feeling lost, confused or overwhelmed about a client or my work it helps to call forth what our predecessors have done. What have others tried and failed or succeeded doing? What works? How do we do that? How can we address the epidemic of depression on our campuses?

It’s a changing climate and a changing world. There are new expectations, demands and opportunities to learn and adapt in order to survive and grow. Accountability and outcome measures – how do we know that what we are doing is working? Always an important question, but in lean years when decision-makers have to prioritize and make difficult choices, the question goes from a whisper to a scream.

How do you build an airplane while in flight? Coming home after work to google “evidence-based practice” and “outcome evaluation” felt inadequate and taxing at the same time. My hope is to create the time and space to learn what this truly means and how to translate it to our work. Don’t our students and families deserve having interventions that work? Don’t we deserve knowing and doing interventions that work? And won’t we all be inspired by the “proof” that it’s working?

Monday, August 17, 2009

Encouraged by Friends and Feedback

My goal is to use this blog as a way to integrate what I am learning and share it. I am getting feeback from family & friends about how my stories and experiences resonate with them too. I am grateful for the support and feel encouraged to keep writing. It's nice to know we have the same questions, fears, hopes. It's nice to know we are not alone on this journey. We are going to UCLA!

Friday, August 14, 2009

Enrolling!

It’s time to register! Why do the simplest things like enrolling online feel so complicated to me right now? I guess the fear has to try to show itself somewhere.

I just registered online (in my pajamas on a Friday morning just before noon). There was some panic after realizing that the third class I needed, and had rearranged my work schedule for, was canceled! Fortunately, after re-reading the Doctoral Handbook, I signed up for a different advanced research class that had been previously closed. This feels like a little game sometimes. How many barriers do I face before I crack? And how many times do I have to overcome barriers before I realize that there are no barriers that can truly keep me down? Barriers, shmarriers – they are all just part of the game of endurance, persistence and faith. How much do I trust in my dream, goals, beliefs? If God is for us then who can be against us? (Romans 8:28-31)

The Story Behind the Story

I have always hoped that I would get a PhD eventually. My sister, Carol, would ask, “Ale, when are you getting your doctorate?” and I would say, “eventually.” I just didn’t know when it would really happen. I am married, raising a beautiful 8-year old daughter, making mortgage payments, working full-time, etc. How could I afford to pay for all my responsibilities? But the universe kept sending me messages in the form of live people, other than my sister, who kept asking me, “when are you getting your PhD?” When Dr. Brown asked me this question and then subsequently wrote me a reference letter, I knew this was going to happen and was meant to be.

I finally decided to apply last summer. I reassured myself, if I don’t get in, I’ll re-apply next year. If I do get in and can’t afford to attend, then I’ll try to defer enrollment and save up some money. I started by requesting a program brochure from one of my professional contacts at UCLA who also offered to introduce me to the director of the doctoral program (who became an ally and supporter in this process). I set about requesting my transcripts from every college/university I had every attended. I started on the application essay and compiling required documents. Things went smoothly and I was grateful for the the summer off to work on it. It felt a lot easier than the application I submitted to Berkeley for the MSW – then again, perceptions may be everything. I am a lot older (40!) and hopefully wiser now than I was then (25!).

Every step felt exciting at first – deciding to apply, working on the application, telling everyone my plans (Oh, no! What if I’m not accepted? Oh well, I’ll just re-apply until I am accepted. It took Arthur Miller three tries to get into grad school). Every step became a confirmation and encouragement to take the next. (Faith is taking the first step, even when you don't see the whole staircase. --Rev. Dr. M.L. King, Jr.).

Then my first real test of faith came. My part-time work leave request was denied and the UCLA deadline to submit my intent to register was April 15. So at 9 am on Monday, April 13, I completed the UCLA form online and before I pressed the "send" button, I paused and asked myself, even though my part-time leave request was denied and I don’t know how I will pay for school or replace my salary, I am still going, right? I did my part and God will figure out the next part, the how, right? The answer rang through my whole body and I pressed "send." This time I couldn’t see the next step but took it anyway and hoped it would be there when I set my foot down. At 11 am that same morning, my administrator called to tell me that my part-time leave request was being granted after all. My foot firmly landed on the next step, just in time. I almost cried right on the phone while sitting at my desk. It was a Thank You, Yesus moment – this is what my mom taught us to say whenever standing in the middle of a blessing.

I know people who consult readers and once a mentor kindly gave me a gift certificate to consult a reader. Only when I tried to fashion some questions for my reading, I kept getting stuck because it seemed that all my questions sounded like fear talking. Will I go back to school? What will happen? How will I pay for it all? I realized those questions are answered by faith. I don’t worry about the how, I choose to let God show me how.

Classes start September 24th. I am looking forward to the whole experience. It reminds me of the feeling I had when I began dating Chris, my husband, 18 years ago. Natural. Just right. No fear, no worries, no need for strategizing. This is going to happen. It’s only natural (like the Crowded House song that was popular then). Wow, this is really happening.

I received a fellowship that will pay for tuition and a quarterly stipend. I am working part-time – two days a week in the first quarter. After anxiously crunching numbers, comparing income and expenses (thank goodness for the expenses of a low-maintenance lifestyle) it looks like we are going to be ok. That is what I call a miracle, Thank you, Yesus and good night.

Why a Blog?

I begin a PhD program in Social Welfare at UCLA in the fall of 2009 and want to blog about what I am studying as a way to share this experience with others who may be interested in the information I am learning about, but not interested in quitting their day job or writing a dissertation or paying the tuition. My hope is that through this forum for reflection, we stumble upon insights that are useful for personal or professional purposes.