Monday, October 26, 2015

Steve, I believe!

Mental Health Treatment

I'm re-reading his biography and I can't put it down. It feels like Steve Jobs is my new and annoying boyfriend. I am by turns enthralled and irritated, repulsed and charmed, inspired and disappointed. It's a rocky romance.

He was clearly a brilliant visionary (duh) but it makes me wonder what could be if brilliant people with mental illness, like him, received treatment.  Mental illness goes way, way back but even in 2015 treatment carries stigma.  People with mental illness, and the people who work with and love them, suffer needlessly when treatment is refused.

Personally, I'm a fan of traditional and Western medicine - in combo - for everything. When Steve got cancer - he didn't feel ashamed to get treatment. Part of our problem is that we artificially separate the mind and body. They are inextricably linked. Why is the body privileged for treatment but the mind is not? Especially considering that trauma is stored in the body! No artificial separation. It's all the same. Heart disease is a predictor of depression and depression is a predictor of heart disease. It's all connected.

"I was very lucky, because when I was a kid both my dad and the Heathkits [assemble-it-yourself kits for making ham radios] made me believe I could build anything (p. 16)."
Establish self-efficacy while they're young. Self-efficacy is defined as one's belief in one's ability to succeed in specific situations or accomplish a task.
"'It's kind of fun to do the impossible,' Walt Disney once said (p. 284)."
If we're not having fun, then what's the point?
"Jobs said he would provide the money. 'I believed in what John [Lasseter of Pixar] was doing,' he later said. 'It was art. He cared, and I cared. I always said yes'...By this point Jobs had poured close to $50 million of his own money into Pixar - more than half of what he had pocketed when he cashed out of Apple - and he was still losing at NeXT (p. 248)."
Jobs put his money into the people and projects that he valued. Who and what do you value?
"The quote he chose was from Lewis Carroll's Through the Looking Glass.  After Alice laments that no matter how hard she tries she can't believe impossible things, the White Queen retorts, 'Why, sometimes I've believed as many as six impossible things before breakfast.' Especially from the front rows [NeXT employees and former members of the Macintosh team], there was a roar of knowing laughter (p. 235)."
That's a good morning indeed.

Thursday, October 22, 2015

Lessons from Steve Jobs

I just saw the movie, Steve Jobs.  Before that, I saw the documentary about Steve Jobs.  Before that, I read the biography about Steve Jobs.  I'm reading it again now.

There are sooo many lessons.  My brain wants to explode.  I'm writing them down as a way of protecting my brain from total destruction.

Walking & Talking
"Taking a long walk was his preferred way to have a serious conversation" (Isaacson, 2011, p. xvii)
When friends want to talk about work or relationship problems, I invite them for a 3 mile walk around the Rose Bowl. I no longer agree to talk over lunch. At the end of the walk, we both feel better. It's like the trees and wind and earth have absorbed the energy they were dying to release. We both feel cleaner.

I provide clinical supervision to counselors and therapists at mental health and family agencies. This means we talk about the problems they are having in their work with clients, families and agency staff.  It can mean a lot of sitting and listening and absorbing problem energy.  So I take it outside and we walk around the neighborhood to talk.  Again, I find that we both feel better.  So much better that I encourage them to do the same on home visits with clients.  The literature supports the benefits of outdoor exercise for mood problems.  It makes sense but I can get you the references if needed.

Acceptance & Integrity

Job's official biographer, Walter Isaacson, points out that he agreed to write the book because Jobs ceded control over it saying:
"I've done a lot of things I'm not proud of...but I don't have any skeletons in my closet that can't be allowed out" (p. xix-xx). 
Isaacson confirms that Jobs "didn't seek any control over what I wrote, or even ask to read it in advance" (p. xx). Isaacson writes,
"[Jobs'] wife also did not request any restrictions or control, nor did she ask to see in advance what I would publish.  In fact she strongly encouraged me to be honest about his failings as well as his strengths. She is one of the smartest and most grounded people I have ever met.  'There are parts of his personality that are extremely messy, and that's the truth,' she told me early on.  'You shouldn't whitewash it.  He's good at spin, but he also has a remarkable story, and I'd like to see that it's all told truthfully'" (p. xx).
I am old enough not to do anything I'd be ashamed of other people knowing about. Also, I'm old enough to accept whatever I've done (no matter what it is) and not be ashamed. This is self-acceptance and protection from being manipulated.  No one can blackmail or shame you (emotionally, financially or otherwise) if you're not ashamed of the pictures, videos, text messages or other forms of evidence of your past behavior. :)

We are made up of shadow and light.  That's what makes us human.  Our ability to integrate the shadow and light is what makes us whole.  Amen.

I'm just getting started. I haven't even posted about the whole number pages from the book yet...

Monday, October 19, 2015

Cultural Humility vs. Cultural Competence

I'm prepping for a macro social work lecture and came across a movement away from "cultural competence" in cross-cultural practice to a practice of "cultural humility."

In short, cultural competence can be described as...
  • Interrelated actions, thoughts, and even policies that are joined within a system or organization to facilitate effective cross cultural work.
  • NASW recognizes it as both a process and product that includes self-awareness and respect for diversity and effective practice behaviors.
  • A process of growth that includes practitioner and agency awareness, knowledge and skills.
In turn, cultural humility is presented as...
  • Increasing knowledge and skills accompanied by ongoing self-evaluative processes and relationship building
  • Does not suggest one can master everything about culture
  • Suggests an on-going process that includes:
    • continual commitment to learning and self-reflection, to altering the power imbalances in the interactions between helping professionals and service consumers, and to developing collaborative and equitable relationships with community members.
The change from cultural competence to cultural humility is being sparked by questions like...
  1. Is the goal in cross-cultural practice learning from clients or knowing about clients?
  2. Aren't descriptions of difference by definition stereotypical and potentially overlook the uniqueness of each individual?
  3. Doesn't the ethical value of self-determination risk being undermined by a focus on the group?
  4. Can competence ever be achieved? (due to the lack of clarity of definition and the numerous unique combinations that comprise individual identities)
From Social Work Macro Practice by Netting, Kettner, McMurtry & Thomas

Wednesday, October 14, 2015

The Black Panthers: Vanguard of the Revolution

I was lucky enough to see this documentary but it was gone from the theater before I could take my daughter to see it.

Among many wonderful stories in the film, there was this one that choked me up with recognition and resonance.  A former member of the Black Panthers describes a 1970s shoot out with LAPD at the Black Panther Headquarters on Central and 41st.  He looks right into the camera with intensity and emotion and said that experience felt like being "free." He said he felt like a "free Negro" in that moment.  

I can totally dig it, brother. The feeling of taking the risk, standing up, not backing down, pushing back, making your own choices. Fuck yes. Freedom.

From the Black Panther 10-point plan:
"...3. We Want Decent Housing Fit For The Shelter Of Human Beings. 
4. We Want Education For Our People...We Want Education That Teaches Us Our True History and Our Role In The Present-Day Society...
7. We Want An Immediate End To Police Brutality And Murder Of Black People...
10. We Want Land, Bread, Housing, Education, Clothing, Justice And Peace." 

Doesn't it seem tragic that these demands sound like basic, simple human rights? And doesn't it seem even more tragic that we still aren't there yet?

Little Pearls I Found While Grading Papers

Grading Papers last week, I stumbled upon these pearls...

Vulnerability of Low-Income Women
  • "Dolores Huerta recalls, 'Harassment was part of the job, so to speak. Women are looked at as sex objects when they’re out there in the field. Sexual harassment is an epidemic in the fields, and it again goes back to the vulnerability that women have, that farmworker women have' (Public Broadcasting Service, 2013)."
Mass Incarceration
  • "Mass incarceration is a form of segregated social control that is all too similar to the Jim Crow laws (Alexander, 2012, p.24)...Limited benefits, limited rights, but full-access to the likelihood of re-arrest. Mass incarceration is a web of policies, laws, social views, and establishments that work together to keep people, who are largely defined by race, in a permanent state of social exclusion (Alexander, 2012, p. 49, p. 52)."
  • "The United States now leads the world with the highest incarceration rates per capita, with 2.2 million of its population currently incarcerated (Racial Disparity, 2015)."
  • "Chronic mental health disorders are one of the leading causes of homelessness and people who are living with untreated mental health disorders make up one third of the estimated 744,000 homeless population in the United States. (Martin, 2015)."
  • "According to the Los Angeles Homeless Services Authority, data collected in 2015 reports the homeless count in Los Angeles County is a shocking 44,359. Of that data, 31,018 are unsheltered versus 13,341 who are sheltered. Among this population of homeless are people 12,25 are living with a mental illness."
Commercially Sexually Exploited Children (CSEC)
  • "...United States has the highest number of servers hosting child abuse material and young people are frequent users of video chat platforms like Instagram, Facetime, Skype, Snapchat, Kik, and Twitter. This action is being exploited by people using “sextortion” methods. “Sextortion” is the term for the process by which young people are coerced into continuing to produce lewd material by the threat of exposure."
  • "In 2013, the National Center for Missing & Exploited Children (2015) determined that '68% of all sex trafficking victims were in the care of social services or foster care when they ran' ."
  • "The Coalition Against Sexual Exploitation states that one in three girls are tricked into prostitution by pimps within 48 to 72 hours of running away from home...demand creates supply and commercially sexually exploited children would not exist if the demand for them wasn't so high. The children who are most susceptible to this type of exploitation are minority children residing in large urban areas (Estes & Weiner, 2001)."
  • "Children who have experienced some sort of maltreatment in their home environment and have been involved with Child Protective Services are also flowing into the juvenile justice system (Sickmund, 2014)."
  • "It is estimated that 200,000 to 300,000 occurrences of sexual exploitation or child prostitution take place in the U.S. every year (Hardy et al., 2013)...Children are more likely to be arrested for prostitution than those who solicit or exploit them (FBI Uniform Crime Reports, 2014)...California Against Slavery is a non-profit, non-partisan human rights organization that is devoted to making human trafficking the riskiest criminal business in the state of California."
Deaf Community
  • "The systematic oppression of D/deaf people is called audism...the notion that one is superior based on one's ability to hear or to behave in the manner of one who hears (Harrington & Jacobi, 2009)...While the Deaf have and prefer to use American Sign Language, they are often forbidden and forced to learn the oral method, or oralism."
  • "One study of 500 transwomen found elevated rates of stigma against transwomen. This stigma lead to reduced social support, barriers to educational attainment, and employment discrimination...The unemployment rate of the trans-population is twice that of the state average here in California (Fletcher et al., 2014)."
  • "In 2011, Drury and Baer findings showed that teachers list supportive and knowledgeable colleagues/mentors as on of the most significant factors that help them teach." 

Grading Papers

I'm teaching macro social work this semester and just read a stack of papers about social problems.  I learned so much that I just have to share...

Commercially Sexually Exploited Children (CSEC)
  • In the U.S., human trafficking is a 32 billion dollar industry and is estimated to involve over 100,000 children (CA Child Welfare Council, 2012)
  • Trafficking involves the recruitment, harboring, provision, or transportation of a person for forced labor or services through force, fraud or coercion (Ijadi-Maghsoodi et al., 2014)
  • Commercially Sexually Exploited Children (CSEC) is closely related to sex trafficking and it involves crimes of a sexual nature committed against juvenile victims for financial or other economic reason.  These crimes include trafficking for sexual purposes, prostitution, sex tourism, mail-ordered-bride trade, early marriage, pornography, stripping and performing in sexual venues such as peep shows or clubs (Greenbaum et al., 2015)
  • There are 13 high intensity CSEC areas in the US identified by the FBI, three of the areas are in CA including, San Francisco, San Diego, and Los Angeles. In all of the CA cities, more than 75% of the CSEC had prior or current involvement with the Child Welfare System (CA Child Welfare Council, 2012).
Domestic/Interpersonal Violence
  • According to the National Coalition Against Domestic Violence, domestic violence is defined as willful intimidation, physical assault, battery, sexual assault, and/or other abusive behavior as part of a systematic pattern of power and control perpetrated against one intimate partner on another.
  • Abuse may include threats, harm, injury, harassment, control, terrorism, or damage to living being or property (McCue, 2007)
  • Domestic violence is defined as any incident of threatening behavior, violence or abuse (psychological, physical, sexual, financial or emotional) between adults who are or have been intimate partners, regardless of gender or sexuality (Baird, 2011)
  • A variety of tactics are used to maintain power and control, including verbal abuse, minimizing, denial and blame, intimidation, coercion, threats, isolation and using children (Gaines, 2008)
  • In most cases, perpetrators initiate violence through emotional and psychological abuse; they will also isolate their victims from friends and family and in some cases they appear charismatic, responsible and educated.  They become in control of the victim and the family unity.  Perpetrators become increasingly violent when they feel they are losing control over the victim or if the victim begins to reach out to family and friends for support (Ingram, 2007)
  • On 10/2/15, the LA Times posted an article that read, "Sheriff's deputies in the high desert have been known for a harsh brand of policing that singles out blacks and Latinos..."
  • The definition of Teen Dating Violence used by Centers for Disease Control and Prevention is the following:  the physical, sexual, psychological, or emotional violence within a dating relationship, including stalking. It can occur in person or electronically and might occur between a current or former dating partner.
  • Domestic violence is a public health emergency that affects 1 to 4 million women in the US each year and is responsible for approximately 30% of female murders (Dioloreto, 2001)
Childhood Obesity
  • Latinos have represented the largest at-risk group in the community of children with obesity and consequent chronic illness (Ogden & Carroll, 2010)
  • In Los Angeles, 40% of the Latino children are overweight or obese (DMH, 2010)
  • According to the American Heart Association, nearly 20% of Latino preschoolers are overweight.
Arts Education in Public Schools
  • "We have decimated arts education in this district, and access to arts education has really become not a right, but a privilege for the affluent or the lucky." --Steve Zimmer, LAUSD school board member (Plummer, 2015)
  • Political, societal values, and economic factors have manifested an 'educational apartheid' in which low-socioeconomic and minority students 'are systematically denied exposure to subjects' which has created less capable and competent urban students when compared to more affluent students (Heilig et al., 2010)
  • If the youth of the community have not experienced arts education they are unlikely to have the capacity to create art that is representative of the community's culture.  A population that does not have the knowledge or ability to express itself through its own lens may fall victim to the dominant cultures representation of their community. Therefore, without portraying their community accurately, those within the community may come to identify with the negative dominant portrayal of their community, creating a lack of pride and ownership within community members.
  • Art has the potential to connect students to their inherent human ability to create.  This connection fosters an interest in education and numerous studies have shown art has the capacity to increase the development of the imagination, create greater motivation to learn, lower dropout rates and increase social skills (Melnick, Witmer & Strickland, 2011)
HIV among Latinas in Los Angeles County
  • According to the Los Angeles County of Public Health, the annual HIV surveillance report in 2011 shows that Latinos represented 47% of those newly diagnosed with HIV
  • Among the newly diagnosed HIV cases in Los Angeles County in 2011, 186 were female and 47% of these newly diagnosed cases were females who identify as Latina.
  • The annual HIV surveillance report shows that 80% of Latinas living with HIV reported contracting the virus through heterosexual contact.
  • Despite the fact that Latinas are the females most impacted by HIV in Los Angeles County, research has shown that Latinas are reporting low-risk sexual and drug using behavior compared to their non-Latina counterparts and that other factors, such as their sexual partners may be contributing to their high rate of positive diagnosis (Wohl et al., 2010).

Monday, October 12, 2015

What's the Point of the Assessment Phase in Macro SW?

When I was in grad school at Berkeley, I was given a one paragraph case study and I wanted to jump to interventions that alleviated the client's problems and pain. Now I understand the value of engagement, assessment, diagnostic formulation and treatment planning before jumping in to intervene.
It's no different in macro-level social work practice (that is, bringing about change in communities and organizations).
Helpful points to consider when dealing with problems at the community or organizational level:
  • When anxious to make change, it is tempting to begin at the point of proposing solutions. This risks coming up with simplistic solutions.
  • Professionally guided change efforts make certain that a range of alternative/multiple perspectives and possible causes are adequately explored before proposing a solution
  • Quick solutions without adequate study is the opposite of professional practice
  • Quick and easy solutions are based on the assumption that the problem has one primary cause
  • Changing social conditions always means addressing more than one contributing factor
From Social Work Macro Practice, 5th edition
Netting, Kettner, McMurtry & Thomas
Pearson Education, Inc.

Truth Opened

Freud presented a paper in April, 1896 to the Society for Psychiatry and Neurology in Vienna on the sexual abuse of his female patients by t...