Monday, February 27, 2012

Lecture Notes about Social Media in Social Marketing

Social media is not really about technology.  It is powered by people talking to each other - timeless.

Social media takes out the middle person.  It is DIY.  You don't need an intermediary (publisher) to get your ideas out.  What you do need is a compelling idea to spread.  Power to the people, right on.

Figure out what people want to pay attention to and give it to them.  Find out what people are interested in and they will pass it on to each other.

Social media is about building a movement.  You need subscribers and followers.  It is about finding like-minded people who will bring their friends and family.  It is building a base of followers who trust you and want to hear what you have to say.

Mainstream media has a far (but shallow) reach.  Whereas, social media has the power to engage in depth.

Find the TALKERS (vocal folks with influence) and give them TOPICS (a reason to talk; funny, interesting, and important ideas worth spreading).  Use TOOLS (social media, telephone, text messaging, informal conversations at public events or meetings) that foster TAKING PART by listeners, responders, and organizations.  Remember TRACKING (tools to track reach, depth and behavior change) for evaluation.

Social Media Tips & Guidelines for Social Marketing:
  • Be authentic
  • Share - interesting information & insights that are relevant and useful to the lives of target audience.
  • Social Currency - what kind of value are you providing followers?
  • Be relevant - who is your audience?  what are they hoping to get?
  • Engage in 2-way conversation - ask and respond to questions
  • Community - connect people with niche interests
  • Find your Fans - other people passionate about your topic
  • Create Evangelists - for your cause and provide them with a toolkit of information.

Wow

When a super smart, funny, confident, honest, spiritual and attractive man
looks you straight in the eyes
(with a twinkle in his eyes that matches the twinkle in your own eyes)
and says, "I want to take you to dinner,"
wow.

Friday, February 24, 2012

Brave Faith

A close friend and confidante told me recently that I was the bravest person she knew.  I smiled at the profound compliment.

As I thought about it more, I realized it's faith that makes me brave.

I often say, "if God tells me to stand over there, then I don't want to be found standing anywhere but there, no matter how scary."

As I'd walk to "over there," I'd say, "Ok, God, I'm going, I'll trust you, even though I'm scared, you promised you'd take care of me, I'm counting on you..."  I figured if I talked my way to "over there," I'd arrive somehow.

Now, I wake up in the morning wondering, "what mountain top or cliff are we jumping off today, God?"  with a big anticipatory smile on my face relishing the rush of the impossible feat.

I get to do this.

I get to live this life fully.

Wow.  This is happening.

Cool.

Wednesday, February 22, 2012

BIG Values in Social Marketing

In social marketing, address what people really care about and the BIG values that people hold.

BIG benefits are derived from appealing to BIG values:
  1. Love
  2. Recognition
  3. Pleasure
  4. Health
  5. Success
  6. Security
  7. Power
  8. Positive self image
  9. Social Acceptance
  10. Comfort
  11. Freedom
  12. Peace of mind
  13. Status
  14. Adventure
Whatever you are selling, think about how to frame the message to address one of these values.

In my social marketing class, the instructor asked us each to fashion a message concept encouraging straight young men to use condoms.  

I was assigned #3 - Pleasure:  "Squeezing some lube inside the tip of a condom before putting it on feels even better (juicier) than not using one at all."

The classmate assigned to #1 - Love, came up with the message concept:  "If you love her, then you'll use one."  (Yikes, what if he doesn't love her?  What would motivate him to use one?)

Another classmate came up with:  "If you carry them, then you'll get some." (#5 - Success?)

#13 - Status:  "How many condoms did you go through this year?"

#4 - Health:  "Stay healthy for your future partners (picture of an older man with a hot, young wife)"

#10 - Comfort:  "If you're always stocked, then you'll never have to go out in the cold in the middle of the night to get one."

Fear-Based Appeals in Social Marketing

Is fear effective in motivating positive health behavior?

If it is, then what's the most effective use of fear-based appeals?

1.  We have to believe there is a real, credible threat
2.  We have to believe that we (or our family) are affected by it
3.  We have to believe that the solution presented is real and credible - it has to make sense to us

Question:  Is this a real threat?  Am I susceptible?

     No  -- then we attempt to control the fear through denial/avoidance (don't think about it)

     Yes -- Is the recommended response effective?

                No -- then we attempt to control the fear through denial/avoidance

                Yes -- then we attempt to control the danger through taking action 

Fear appeals may be used effectively, however, positive appeals can be more effective - "if you take action, these are the great benefits..."

Friday, February 17, 2012

Empowerment & Voice

I teach an Empowerment & Recovery in Mental Health course.  I lectured for an entire class period about the nuanced meaning of empowerment.  Then I challenged students to examine their own level of empowerment in all of their life roles.

Too often we buy into the idea of empowerment, but less so it's application.

Too often we complain about constraints and expectations put upon us, but spend less time speaking up, using our voice to offer alternative solutions, to demand better conditions, or to ask for basic wants and needs.

This is not just abstraction for me.  It is how I've chosen to live my life wholeheartedly.  So I gave students an example of my voice.

Below is a correspondence between an employer and colleagues about the role of assessment and diagnosis in social work practice.  Let me be clear - I really needed a salary to support myself and my daughter, so challenging the status quo was risky.  It seems that everything I do is risky.  I would not live it any other way but My Way (by Frank Sinatra).

I started the e-mail chain by sending various resources as attachments.  One of these was the Department of Mental Health biopsychosocial child/adolescent intake assessment form. I informed the team that I would be training interns to use this form with all their clients/families for supervision purposes.  Then I got this response from one of the team members:
Hi Alejandra,
Thank you so much for sending the screener. I think that is something that we can implement agency wide and will help us document 
I do want to have a discussion, however, about using the DMH psychosocial assessment instead of our in-house tool. 
First of all, I feel that all programs under the same funding should have the same paperwork for ease of quality control. 
Second, I think that the DMH assessment, although very thorough, is not necessarily the right tool for short-term, time-limited, family based services particularly by inexperience 1st time interns. Having done the DMH assessment I found it that although it is very thorough, it is very time consuming. It used to take me about 2 hours to complete the interview plus about 2 hours to write up. Our tool covers similar ground in a brief manner. Because we want to keep their caseloads at 50% clinical time plus some macro outreach activities, we have to truly assess whether that is a good use of their time.  
Third, I'm not sure I would feel comfortable formally diagnosing clients, particularly by interns, as required by this psychosocial. Because of our solution-focused strength based orientation we have decided not to formally diagnose any client in the agency. [Your site] would be the exception. 
Executive Director, what are your thoughts about this? Maybe we can setup some time for all of us to talk. Please note I removed the interns from this discussion thread so we can sort out this issue.
At this point, I had some choices, I suppose.  The following was my response:
Thanks, --------, for voicing your concerns. I support a group discussion around the issue and I believe we can come to an agreement about this.

1. I support your efforts to standardize the forms used by programs for quality control purposes. 
2. I am training interns to use the DMH form because I believe it is a reflection of good SW practice and these learned skills will be transferable to any setting in the future. I agree that a good assessment can take 2-3 hours. I believe that being comprehensive at the beginning saves a lot of time and misdirected/ineffective interventions later. I am training them to collect data for the assessment and then with my assistance during individual supervision, we can together come up with a short list of possible diagnoses.

For instance, if we are dealing with a student that I believe has moderate to severe ADHD and moderate to severe depression then I will move toward recommending that interns link them to services like a psych eval for treatment purposes because in my experience these students are at great risk for suicide. In this case, I think referral, family psychoeducation and advocacy make more sense as interventions conducted by grad interns than say, generic individual counseling.

I will train and supervise interns every step of the way - engagement, assessment, diagnosis, treatment planning, evidence based interventions, evaluation and termination. 
Another example is if we determine a student is depressed and one of his primary symptoms is irritability (most common symptom of depression among children and adolescents) then I would rather use a gold standard intervention like CBT and exercise than say, anger management counseling. 
Another example is if we determine the primary presenting problem is behavior problems and disruptive behavior (90% of children's mental health referrals) then the gold standard treatment is parenting and systemic or family therapy. The effect size of individual therapy is only .24 compared to .46 for parenting/family therapy. Also, some studies have shown that individual or group counseling may even make matters worse. 
I also support brief treatment and find that engaging families expedites child behavior change. Parents have a lot of power over child behavior. Also, happy parents-happy children, angry parents-angry children, depressed parents-depressed children. 
3. Finally, I believe that diagnoses give us an idea about how to intervene and choose evidence based interventions, whenever possible/available. I work in the paradigm of the recovery model where everything is done in the service of meeting the client treatment goals. I don't see diagnosis as a life sentence. I also do not see diagnosis as a stigmatizing label. I see diagnosis as a guide for choosing the most effective and efficient interventions.

I am also strength-based and practice (and teach interns) Solution-Focused Brief Therapy. I conduct (and train interns to conduct) a thorough assessment - both risks and protective factors. Last week, I gave them a personal resiliency checklist to use with their students to identify their own protective factors. I have both an informal and formal resilience scale that I use as part of my comprehensive biopsychosocial assessment. It is another potential for agency wide client data collection and reporting. 
I feel like I can work with students and their families to accomplish behavior change in 10 sessions or less, that includes 2-3 sessions for assessment. 
4. I want to share the framework I am using and training the interns to use: 
    The Levels of Intervention - Individual/Family, Organization/School, and Community. My goal is that their assessment, treatment plan and interventions reflect all relevant levels. 
    The Social Work Process - Engagement, Assessment, Diagnosis, Treatment Planning, Interventions, Progress Monitoring/Evaluation and Termination. This is our scientific process but not linear, rather I teach it as a circular process with Engagement (the relationship between clinician and client) as an important aspect throughout. 
    Mind-Body-Spirit-Soul - When we get to interventions, I will encourage them to use evidence based practices but also to privilege what our families say works and is important to them. I believe focusing on talk therapy alone may help kids to get a little better, engaging the body (exercise, sports, yoga, dance, etc) will make them feel even better, and engaging spirit and soul (if this is something that families value) will truly transform. 
Thanks for the communication, collaboration and opportunity to do this very important work. I am so impressed by your staff and team and the families with whom I get to work. I am having a great time and look forward to a further discussion in the near future. 
Alex
Fortunately, my voice (big mouth) did not get me fired.  Rather, the Executive Director offered me more hours.  And I would like to think that it is our voice, singular and collective, that leads to progress.  I don't know of any other way.

Wednesday, February 15, 2012

Juggling

I took a delicious 6-month sabbatical (no coursework and no paid work) from June to December.  I managed to submit my first publishable paper in November.  Now I find myself juggling again.

I'm hoping this time it will be different but as I write at 4am (first night of relapse insomnia), I have to be really reflective about what I can truly manage and what has to wait.

At 4:02 am, I took the mess of papers and notebooks scattered across my typically neat Virgo desk and organized them into piles labeled:
  • Publishable paper (need to revise and resubmit by March)
  • Social Marketing (course I am taking)
  • SW 589 (course I am teaching - 4 hours/week)
  • El NIDO Family Center (part-time consultant job - 11 hours/week)
  • Dissertation Proposal (70-80 page manuscript in progress that I hope to defend by Spring)
  • Bills (for which I am now solely responsible)
  • Correspondence (if it's not a bill, then it can wait - till when, I'm not sure)
  • Planner (where every event and thing to do is logged)
 I'm tired just thinking about it now.  Unfortunately, still not sleepy.

Daunted but not deterred.

In the "plus" column, I have a score of warrior women who care about and support me.  I sent them all a text last week asking for prayer.  It got so bad I needed back-up to pray.  I've gotten similar texts before and after I sent out mine last week - we all need help sometime.

Exercise (elliptical, strength training, dancing, tennis, hiking, walking, sex, Zumba class, Yoga, etc.), eating well and supplements (B vitamins and good quality salmon oil) are all very helpful and support my mood and energy level while I attempt to juggle.

Prozac is pretty good too.

Then there is a string of healers - both Western and Traditional - I have weaved together to catch me before I fall.

The good news is I have never been happier - seriously, happy.

My life makes so much sense now.  I am managing to find a balance.  Things are falling into place.  One reader I consulted said to me, "Things are supposed to get easier.  If they are not easy, then stop and do something different."  I have stopped pushing and things are falling into place. Nice.

Another reader I consulted said to me, "You are triumphant.  You cannot be squashed.  You fall and get up again and again."  She also said, "You prefer to be up front about things.  You don't like hypocrisy." She said, "Success is on its way.  A rebirth is coming.  You are visionary.  You will do interesting things in your life.  You are lucky in love.  You will experience a rebirth in health, stability, work and love."

I'll take it.

Now I gotta pay some bills.  Good night.

Tuesday, February 7, 2012

Irene's Theme Song

Irene Acuña (1937-2003)

My mom's favorite song ever was, "My Way" by Frank Sinatra.

I assume she was aware of Vicente Fernandez's version.  I doubt she ever heard Nina Simone's version, but you never knew with Irene.

The rendition that she tearfully belted was decidedly Frank's.

I didn't get it so much then - at about age 9.  Now I surely do.

When our ancestors die, we swallow them up and stand on their shoulders.  She lives forever in me now.  I am never alone.  I would not expect anything less from such a powerful force of nature. What a pair the two of us.

My Way lyrics
Songwriters: Revaux, Jacques; Anka, Paul (Eng Lyr); Thibaut, Gilles; Francois, Claude;

And now the end is near
And so I face the final curtain
My friend I'll say it clear
I'll state my case of which I'm certain
I've lived a life that's full
I traveled each and every highway
And more, much more than this
I did it my way
Regrets I've had a few
But then again too few to mention
I did what I had to do
And saw it through without exemption
I planned each charted course
Each careful step along the byway
And more, much more than this
I did it my way
Yes there were times I'm sure you knew
When I bit off more than I could chew
But through it all when there was doubt
I ate it up and spit it out, I faced it all
And I stood tall and did it my way
I've loved, I've laughed and cried
I've had my fill, my share of losing
And now as tears subside
I find it all so amusing
To think I did all that

And may I say not in a shy way
Oh no, oh no, not me
I did it my way
For what is a (wo)man what has (s)he got
If not (her)himself then (s)he has not
To say the things (s)he truly feels
And not the words of one who kneels

The record shows I took the blows
And did it my way
Yes it was my way

[ From: http://www.elyrics.net/read/f/frank-sinatra-lyrics/my-way-lyrics.html ]

Monday, February 6, 2012

Diversity Diner by Paolina

PTA Reflections Art Contest Winner.  Theme:  Diversity. 

My girl writes, "Diversity means following your own trends, doing what you love most and being free of other people's expectations."

Reaction Formation

En route to UCLA from the Eastside (on Santa Monica Blvd.)
Defense mechanism of the week:  Reaction Formation 

'The tendency of a repressed wish or feeling to be expressed at a conscious level in a contrasting form.'

Or, "The blocking of desire by its opposite." 

In other words, to say or do the opposite of what you really feel or want (because what you really feel or want is way too threatening to accept).

Like when you pulled that girl's hair in Kindergarten to show that you really liked her.

Or like when you said, "Whatever, don't come by, do whatever you want."

Or like when the Cure sings, "I won't say it if you won't.  I don't want it if you don't . . ."

Or like when Morrisey sings, "I don't mind, I don't mind if you forget me.  Having learned my lesson, I never left an impression on anyone, bye-bye . . ."

Psychological maturity is standing up for what you believe or feel, despite the costs.

My girl says, "Diversity means following your own trends, doing what you love most and being free of other people's expectations."

Wow, so proud I get to be her mama.

Saturday, February 4, 2012

Family Involvement in School-Based Mental Health Services

The research clearly shows family involvement in school-based mental health services is effective in improving student academic performance.

Researchers have found family involvement is a key component to both service utilization and effectiveness.

A review of family systems approach research shows it has been equally or more effective than other therapy, produces positive change quickly (20 sessions or less) and shows a 71% improvement in children’s behavioral problems.


Engaging Families in School-Based Mental Health Treatment
Linda M. Vanderbleek, 2004

Therapist Factor

Research shows that the effectiveness of therapy does not depend on the level of training or experience of the therapist or on the type of mental health professional providing therapy.

However, the effectiveness of therapy does depend on the skill of the therapist. The most effective therapists tend to be empathic, genuine, and warm.

Therapeutic Alliance and Treatment Outcomes

A study examined the relationship of the therapeutic alliance to the treatment course and outcome of 143 patients with non-chronic schizophrenia.

Results showed that patients who formed good alliances with their therapists within the first 6 months of treatment were significantly more likely to:
  • remain in psychotherapy
  • comply with their prescribed medication regimens, and
  • achieve better outcomes after 2 years, with less medication, than patients who did not.

Therapist-Client Relationship

"Among clients who reported a positive relationship with their therapists, 'feeling connected' was a recurring theme.

These clients used adjectives such as understanding, compassionate, warm, friendly, open, honest, and nonjudgmental to describe their therapists.

When describing how they felt in the presence of their therapists, clients made frequent references to feeling safe, relaxed, comfortable, and trusting, which facilitated vulnerability and self-disclosure and, hence, the basis for a therapist-client connection."

Laszloffy, T.A. (2000) The implications of client satisfaction feedback for beginning family therapists: Back to the basics. Journal of Marital and Family Therapy

Therapeutic Factors

40% of client improvement is due to their own strengths, talents, skills and resources.

30% is due to the client-therapist relationship (empathy, warmth, caring, genuineness, acceptance)

15% is due to positive expectations about the possibility of change (hope)

15% is due to using the right technique

(Murphy, 1999)

If we leave 40% of the questions on an exam blank, then we are likely to fail.

The difference between a C+ and an A- is 15%.

What kind of social worker do you want to be?

(from workshop by Jim Raines at SSWAA Conference in Denver)

Engagement and the Social Work Process

There is a process in social work - it is not linear, it is cyclical or spiral:

Engagement - Assessment & Mental Status Exam - Diagnostic Formulation - Goal Setting & Treatment Planning - Intervention(s) that are evidence-based (whenever possible) and culturally responsive - Evaluation & Progress Monitoring - Termination.

Every step is connected to the rest and some occur in tandem throughout the social worker-client relationship.

The social work licensing exam in California is based on this framework and yet many MSW students have never heard of it.  I didn't know about the social work process until I was five years post-masters.  It is my professional mission to change that. 

The first element in the framework is engagement.  It is critical to having a relationship.  It is often called "building rapport" but it is much deeper than that, it is "building trust and connection" and that process never ends in a relationship.  Indeed, it is not a relationship unless there is sufficient trust.

How does trust develop between two people?  Most of our cues are non-verbal - eye contact, smile, proximity, mirrored movements, and matched tones.

There is also the warmth that radiates from our heart when we open ourselves up to connect.  In an empathy workshop lead by my good friend, Karen Sorensen, she asked us to think about a person we love dearly (I imagined my daughter) and to hold their image in our mind and allow our heart to open.  I felt my heart open wide and radiate warmth.  Then she asked us to talk to the person sitting next to us with our heart open like this. We had to describe the loved one that we chose to conjure.  I was in tears talking about my girl.  Love is like that sometimes.

Since then, I have tried to open my heart whether my audience is an auditorium of teachers, a classroom of master's level students or a fourth grade boy that is shut down.

Inherently shy and analytical, I still have so much to learn about empathy, trust, feelings (my own and those of others), relationships and engagement.  Now I trust the process. It's getting better all the time.