While there is widespread agreement that research should inform policy and practice, there is no clear roadmap for how to bring research to bear on solving important problems.Tseng, V. (2010). Learning About the Use of Research to Inform Evidence-Based Policy and Practice: Early Lessons and Future Directions. William T. Grant Foundation 2009 Annual Report. William T. Grant Foundation, New York, NY.
Welcome to my annotated bibliography and collage of musings, article excerpts, abstracts, questions, essays, stories, lecture notes, reflections, seed thoughts and topics that capture my imagination. Social Work is an applied social science and aims to improve the opportunities & living conditions of vulnerable people. Alejandra Acuña, PhD, MSW, LCSW, PPSC
Sunday, July 24, 2011
The Gap
Monday, July 18, 2011
Sheer Determination Part 2
Speaking of sheer determination, I just heard a story that exemplified it. An old friend (I'll call her Laura) told me this story over dinner recently.
Laura has a a friend (I'll call her Cathy) who knew since high school that she wanted to be a medical doctor. Cathy's grades were not very good so her friends weren't sure how that was going to happen. In college, Cathy hired a bunch of tutors to get through school and even so managed to graduate with a C grade point average, hardly suitable to most medical schools. But Cathy was determined, so she attended a medical school in a foreign country. After she finished school there, she took the board exams in this country but failed. When my friend, Laura, went to visit Cathy around this time, she found Cathy's room wallpapered in study notes (ceiling included). Cathy eventually passed the exam but had missed the residency placement opportunities so she crafted her own rotation at various hospitals and community clinics. Cathy is now a doctor and has successfully collaborated with my friend Laura on various national research grants.
I love this story of sheer determination. Not pretty or perfect but got the job done.
It also reminds me of the struggles of people with learning disabilities. I don't know if Cathy has a learning disability but what I have learned over the years as a school social worker is that people with learning disabilities have average to above average cognitive ability or intelligence but their academic performance is hindered by learning or processing deficits. They do have learning or processing strengths and once identified, these can be maximized for success.
I imagine there are many people with learning disabilities out there (15-17% of the general population) who have a sense that they can do something and don't understand why their performance doesn't seem to match up to their perceived ability. I have known people who spend years in community college, taking up to 10 or 12 years to earn an AA degree. They know they are in the right place because of their cognitive ability, but don't know why they struggle, especially if they have never been tested for a learning disability. Some become frustrated and depressed. Before we understood much about learning disabilities, the general notion was that people were lazy, crazy or stupid. Now we should know better.
Unfortunately, if you stop an educator on any campus and ask them, "What is a learning disability?" - many would not be able to answer accurately. There are professionals, in public schools from K to post-secondary, who are trained to assess students with potential learning disabilities. We, as parents or students, have a right to request these evaluations. If eligible, due to a learning disability, federal laws can protect students and workers. Getting accommodations for school or work becomes a civil rights issue. We know this applies to people with physical disabilities, as we notice wheelchair access ramps installed in most public buildings. It also applies to people with learning disabilities.
Teaching undergraduate students at a public university, I often met intelligent and dedicated students who disclosed they had learning disabilities. This is a tough call because you never know how people, including professors, will respond. Their knowledge about their learning strengths and limitations helped them to ask for and receive accommodations in college. Some took their mid-term or final exam in a quiet room and had extended time to complete it. Others had readers or their books paid for.
Sometimes, students and parents reject recommendations for testing to determine eligibility for accommodations due to learning disabilities. It is still something that is potentially stigmatizing or hard to accept.
Know this:
Laura has a a friend (I'll call her Cathy) who knew since high school that she wanted to be a medical doctor. Cathy's grades were not very good so her friends weren't sure how that was going to happen. In college, Cathy hired a bunch of tutors to get through school and even so managed to graduate with a C grade point average, hardly suitable to most medical schools. But Cathy was determined, so she attended a medical school in a foreign country. After she finished school there, she took the board exams in this country but failed. When my friend, Laura, went to visit Cathy around this time, she found Cathy's room wallpapered in study notes (ceiling included). Cathy eventually passed the exam but had missed the residency placement opportunities so she crafted her own rotation at various hospitals and community clinics. Cathy is now a doctor and has successfully collaborated with my friend Laura on various national research grants.
I love this story of sheer determination. Not pretty or perfect but got the job done.
It also reminds me of the struggles of people with learning disabilities. I don't know if Cathy has a learning disability but what I have learned over the years as a school social worker is that people with learning disabilities have average to above average cognitive ability or intelligence but their academic performance is hindered by learning or processing deficits. They do have learning or processing strengths and once identified, these can be maximized for success.
I imagine there are many people with learning disabilities out there (15-17% of the general population) who have a sense that they can do something and don't understand why their performance doesn't seem to match up to their perceived ability. I have known people who spend years in community college, taking up to 10 or 12 years to earn an AA degree. They know they are in the right place because of their cognitive ability, but don't know why they struggle, especially if they have never been tested for a learning disability. Some become frustrated and depressed. Before we understood much about learning disabilities, the general notion was that people were lazy, crazy or stupid. Now we should know better.
Unfortunately, if you stop an educator on any campus and ask them, "What is a learning disability?" - many would not be able to answer accurately. There are professionals, in public schools from K to post-secondary, who are trained to assess students with potential learning disabilities. We, as parents or students, have a right to request these evaluations. If eligible, due to a learning disability, federal laws can protect students and workers. Getting accommodations for school or work becomes a civil rights issue. We know this applies to people with physical disabilities, as we notice wheelchair access ramps installed in most public buildings. It also applies to people with learning disabilities.
Teaching undergraduate students at a public university, I often met intelligent and dedicated students who disclosed they had learning disabilities. This is a tough call because you never know how people, including professors, will respond. Their knowledge about their learning strengths and limitations helped them to ask for and receive accommodations in college. Some took their mid-term or final exam in a quiet room and had extended time to complete it. Others had readers or their books paid for.
Sometimes, students and parents reject recommendations for testing to determine eligibility for accommodations due to learning disabilities. It is still something that is potentially stigmatizing or hard to accept.
Know this:
- People with learning disabilities are as smart or smarter than the rest of us.
- People with learning disabilities can succeed, especially with additional resources, accommodations and support, which are entitlements thanks to the Americans with Disabilities Act (ADA) and the Individuals with Disabilities Education Act (IDEA).
- There is no shame in being diagnosed with a learning disability, a physical disability or any health condition.
- All people matter.
- All people have a right to the pursuit of happiness. Indeed, the U.S. may have the only Constitution that guarantees this right.
Wednesday, July 13, 2011
PTSD Blog
I stumbled upon this great blog about PTSD (Post-Traumatic Stress Disorder). It is written by someone who works with and manages his own PTSD.
He provides clear descriptions about what is happening in the body - dysregulation vacillating from depression to anxiety. Sometimes PTSD is mistaken for bipolar disorder because of the ups and downs in emotions. A trauma-specific assessment makes good sense, especially considering how incredibly prevalent trauma exposure is in our country.
He also provides self-help ideas for coping. As he mentions, there is not always a therapist around when PTSD symptoms spike.
Check it out and share with someone you know. There is no need to struggle alone or in shame. Clicking on the link below will take you to the PTSD blog...
Ramblings on Trauma
He provides clear descriptions about what is happening in the body - dysregulation vacillating from depression to anxiety. Sometimes PTSD is mistaken for bipolar disorder because of the ups and downs in emotions. A trauma-specific assessment makes good sense, especially considering how incredibly prevalent trauma exposure is in our country.
He also provides self-help ideas for coping. As he mentions, there is not always a therapist around when PTSD symptoms spike.
Check it out and share with someone you know. There is no need to struggle alone or in shame. Clicking on the link below will take you to the PTSD blog...
Ramblings on Trauma
Tuesday, July 12, 2011
Envy, Jealousy & Love
My clinical supervisor taught me that 90% of who we are is made up of the baby part (the rest are the adult and the parent parts). The baby acutely feels the pain of envy, jealousy and fear of abandonment - it is unbearable.
Envy is wanting what someone has - a thing or a virtue.
Jealousy is wanting someone all for yourself.
The baby is also greedy - all for me and none for you.
Fear of abandonment is especially painful - without you I will die.
There are ways to cope and soothe the painful feelings.
We can work to attain the thing or virtue that we admire. Or we can destroy it with our words or actions.
We can nurture the relationship with the person that we care about. Or we can try to control it through various manipulations.
We can live feeling like a victim and forever dependent on another for our life. Or we can foster independence and interdependence in our relationships.
I received a book, Sastun, as a gift from a colleague/friend recently about a traditional healer. It tells the story of Don Elijio's healing work in Belize. A common presenting problem is illness due to mal de ojo and envidia. Neighbors will pay a sorcerer to cast a spell on someone that they envy. Men will ask for love spells to enchant a woman they want. These are illnesses that may require spiritual healing. Unfortunately, traditional healers are often misunderstood, feared or ridiculed. I have met and read about loving and generous healers. I recently reconnected to a schoolmate that is a chaman. She said that the only difference between a chaman and a sorcerer is intention. They both are skilled at using energy.
In the book, The Good Earth, by Pearl S. Buck, the Chinese tradition of putting down one's good fortune is depicted - this meal my wife cooked is terrible, my son is ugly and no good - as a way to prevent misfortune brought on by invidious gods or neighbors.
When we feel the pain of envy or jealousy, we may have a hard time being responsible for our own feelings. Is someone doing it to us through their arrogance or condescension? Is someone lording it over us? Or is our baby part being triggered?
Thich Nhat Hanh talks about how we all have seeds - love, greed, envy, joy. It is up to us to choose which to focus on and grow. We are encouraged to notice, without judgment, all our feelings. No need to reject or run away from them. In psychodynamic terms, there is no need to deny or repress these intolerable emotions. As we notice them, we may also notice how they pass through, like a visitor, not staying or getting stuck.
The tenth law that Moses brought to his people when he came down from the mountain and his encounter with God was: You shall not covet your neighbor’s house. You shall not covet your neighbor’s wife, or his male or female servant, his ox or donkey, or anything that belongs to your neighbor. Exodus 20:17 (NIV).
The grass is not greener on the other side. It is a total lie. The gifts we have are unique. The dreams and desires within are one-of-a-kind. This desire can inspire you to work hard.
Jesus said simply: Love your neighbor as yourself (NAS, Mark 12:28-31) and Love one another (NIV, John 13:34-35).
We can delight in the good fortune of others as if it were our very own - evidence of the abundance of the Universe. There is enough for all of us. God loves you and everyone else.
Freedom & Friends
I took a course on Stress and Disease last quarter and it scared the s$!# out of me.
I have always known that stress is toxic but it is literally killing many of us through heart disease, high blood pressure, depression and metabolic disease (such as diabetes). Accumulated stress is especially fatal.
For the last two years I have dangerously juggled family (wife and mother), school, and part-time work. So I recently decided to take a full-leave from work. It didn't really occur to me that I could financially pull it off. But anything is possible and the risk on my health was no longer an option.
Juggling so much and stretching thin, I often cut out exercise and socializing with friends to meet all my responsibilities. Bad call.
Demands - Resources = Stress
When demands exceed our ability to cope, then we become stressed out. Friends are a resource, a source of support, so cutting out time with friends severely imbalances the stress-demand equation. When demands accumulate, don't voluntarily cut time with your sources of support in order to get things done. (Duh)
Now I am balancing self-care, family, friends and the last major projects of my doctoral program.
There is space to breathe and smile.
There is time to exercise and counteract the more than 20 years of overwork that have taken their toll on my body.
There is time for bedtime reading which my 10-year old daughter still loves (me too).
There is time for friends, old and new.
I don't want more stuff - just more freedom. A friend of mine said that the people who seem to "have it all" are paying for it with debt. My many years of reading financial articles, books and Oprah episodes taught me that if you bought it all on debt then you are living a lie. One financial set-back and it can all be gone. In the meantime, the debt can weigh on you (like low-grade anxiety) and the quality of your sleep.
So I have decided to re-organize and split the pie up in such a way that reflects my priorities better. Freedom and friends have made the cut.
Smiling more.
Sunday, July 10, 2011
Writing
I have been writing fairly regularly for the last two years. It is good practice for the next stage of my doctoral program.
It has helped me identify and organize my ideas about concepts, constructs, and research interests.
I realize that this blog has become my annotated bibliography - soon to be very helpful as I develop a potentially unwieldy 70-page dissertation proposal.
Thoughts and reflections that could linger on the brain, sometimes well into the night, now have a place to live.
I write in the first person because I believe that the deeper we go, the more likely we are to find the universal.
I started writing a public journal to document the information that I was drawn to and my reactions - to note my growth and development. This was good advice, from a mentor, that I didn't follow through on when I earned my master's degree.
It's cool to hear from teachers, colleagues, friends/family, writers and students about what they get out of this blog. Like when a colleague called after a post on resilience-building in the military because they had an enlisted relative. Or when I hear from people pursuing their own paths - in writing and academic projects. Or when someone told me they read the blog on their iPad during sleepless nights - going back to favorite posts. One colleague suggested I offer CEUs. I will look into that idea.
I try to focus on the positive and challenge notions of the impossible. It's a drop in the bucket but a counterpoint to the sea of doom, gloom and negativity that sells in the press.
My intention is to be painfully, brutally, lovingly honest. In this way, I am having an intimate relationship - with myself and with you.
Paolo Coelho, one of my favorite writers (friend him on facebook for regular nuggets of inspiration on your newsfeed), wrote a post recently:
It has helped me identify and organize my ideas about concepts, constructs, and research interests.
I realize that this blog has become my annotated bibliography - soon to be very helpful as I develop a potentially unwieldy 70-page dissertation proposal.
Thoughts and reflections that could linger on the brain, sometimes well into the night, now have a place to live.
I write in the first person because I believe that the deeper we go, the more likely we are to find the universal.
I started writing a public journal to document the information that I was drawn to and my reactions - to note my growth and development. This was good advice, from a mentor, that I didn't follow through on when I earned my master's degree.
It's cool to hear from teachers, colleagues, friends/family, writers and students about what they get out of this blog. Like when a colleague called after a post on resilience-building in the military because they had an enlisted relative. Or when I hear from people pursuing their own paths - in writing and academic projects. Or when someone told me they read the blog on their iPad during sleepless nights - going back to favorite posts. One colleague suggested I offer CEUs. I will look into that idea.
I try to focus on the positive and challenge notions of the impossible. It's a drop in the bucket but a counterpoint to the sea of doom, gloom and negativity that sells in the press.
My intention is to be painfully, brutally, lovingly honest. In this way, I am having an intimate relationship - with myself and with you.
Paolo Coelho, one of my favorite writers (friend him on facebook for regular nuggets of inspiration on your newsfeed), wrote a post recently:
Writing is a socially acceptable form of getting naked in public.What gets me about the quote is the freedom that comes from the vulnerability. Stripped down to my essence. Ahh, just in time for summer and for middle-age.
Yes and No
The story goes like this: John Lennon was at an art gallery and had to walk up a ladder and use a magnifying glass in order to read what was written on the small installation: Yes. He began to fall in love with the artist, Yoko Ono, at that moment. So did I when my husband told me that story.
Yes is a powerful word. It gets us from where we are to where we want to be. The Yes begins within. Yet, we are often woefully getting in our own way.
In a preemptive strike, we say no to ourselves before the sting of the rejecting no from others.
The unknown can be exciting and/or it can be very scary - a darkened room full of danger. What will happen to us? Will we be able to respond?
Our subversive core beliefs (I am loveable vs. I am unloveable, I am competent vs. I am incompetent) influence our positive or negative prediction of the outcome. If negative, then we may give up before we try.
Good stuff starts with a yes. I have had to say yes many times to get to this point - and not always with confidence and enthusiasm, sometimes, full of trepidation. But standing still was not an option I would consider.
Yes is an important word. So is No.
No is a hard word for most of us (remember the 70s book: When I say no, I feel guilty ?). No brings up a lot of emotions. It has hard edges. Especially when it seems to separate us from people or things we care about. Yet, no sets an important boundary.
As much as we would like to, we can't say yes to everything. Prioritizing can feel like Sophie's Choice - how can I possibly pick only one?
My mom would often tell me, let your yes be yes and your no be no - be clear with self and others. And yet, my clinical supervisor would say that we feel ambivalent about everything - yes and no. Therein lies the tension.
What are you saying yes to right now? Is that what you really, really, really want? What would you like to say no to in order to get closer to what you really, really, really want?
Yes is a powerful word. It gets us from where we are to where we want to be. The Yes begins within. Yet, we are often woefully getting in our own way.
In a preemptive strike, we say no to ourselves before the sting of the rejecting no from others.
The unknown can be exciting and/or it can be very scary - a darkened room full of danger. What will happen to us? Will we be able to respond?
Our subversive core beliefs (I am loveable vs. I am unloveable, I am competent vs. I am incompetent) influence our positive or negative prediction of the outcome. If negative, then we may give up before we try.
Good stuff starts with a yes. I have had to say yes many times to get to this point - and not always with confidence and enthusiasm, sometimes, full of trepidation. But standing still was not an option I would consider.
Yes is an important word. So is No.
No is a hard word for most of us (remember the 70s book: When I say no, I feel guilty ?). No brings up a lot of emotions. It has hard edges. Especially when it seems to separate us from people or things we care about. Yet, no sets an important boundary.
As much as we would like to, we can't say yes to everything. Prioritizing can feel like Sophie's Choice - how can I possibly pick only one?
My mom would often tell me, let your yes be yes and your no be no - be clear with self and others. And yet, my clinical supervisor would say that we feel ambivalent about everything - yes and no. Therein lies the tension.
What are you saying yes to right now? Is that what you really, really, really want? What would you like to say no to in order to get closer to what you really, really, really want?
Tuesday, July 5, 2011
Integrating Practice & Research
"The prize that my eye is always on, however, is the integration of practice and research, not for its own sake or to enhance the status of social work, but in the interest of those we serve and should be serving. To me, that is the essence of professionalism."
"...the integration of practice and research in social work is essential to social work's effectiveness and survival as a profession."
"...seeking ways to successfully engage practitioners in research studies, research consumption, research ways of thinking, and ultimately, research utilization."
"...practice and research are inextricably linked."
"...the Council on Social Work Education require that schools of social work prepare their students to 'engage in research-informed practice and practice-informed research.' "
--Irwin Epstein in Clinical Data-Mining
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