PROFESSORS_BOYKIN_BUDLONG_DE_ZEEUW_WRIGHTFLAHERTY_GOWDY_KILGO

PROFESSORS BOYKIN, BUDLONG, DE ZEEUW WRIGHT, FLAHERTY, GOWDY, KILGO, LEITH, MORGAN, PARLIER, SIMONS, WOLFER

SOWK 718 Systems Analysis of Social Work Practice

UNIVERSITY OF SOUTH CAROLINA SOWK 718: SYSTEMS ANALYSIS OF SOCIAL WORK PRACTICE

COURSE CALENDAR AND REQUIRED READINGS

All required readings are included in a course reader available for sale from University Readers, if not readily available via the Internet. Required readings not included in the course reader are available on Blackboard (and hyperlinked below). January 17-20 Introduction to course, objectives, assignments, and decision case method Golembiewski, R. T., & White, M. (1983). Conflict on the Human Services Coordination Team.

In Cases in public management (4th ed.; pp. 273-279). Boston: Houghton Mifflin. (Case #0)

January 24-27 Wolfer, T. A. (2006). An introduction to decision cases and case method learning. In T. A.

Wolfer & T. L. Scales (Eds.), Decision cases for advanced social work practice: Thinking like a social worker (pp. 3-16). Pacific Grove, CA: Brooks/Cole Thomson Learning.

Wolfer, T. A., & Scales, T. L. (2006). Tips for discussing decision cases. In T. A. Wolfer & T. L. Scales (Eds.), Decision cases for advanced social work practice: Thinking like a social worker (pp. 17-25). Pacific Grove, CA: Brooks/Cole Thomson Learning.

Rhodes, D., & Wolfer, T. A. (2017). Inside or out [Unpublished decision case]. Austin, TX: University of Texas—Austin, Steve Hicks School of Social Work. (Case #1)

January 31-February 3 Conklin, J. (2005). Wicked problems and social complexity. In Dialogue mapping: Building

shared understanding of wicked problems. CogNexus Institute. Available at: http://www.ideapartnership.org/documents/wickedproblems.pdf

Parker, R. C., & Wolfer, T. A. (2008). Unusual appeal. In T. A. Wolfer & V. M. Runnion, Death, dying and bereavement in social work practice: Decision cases for advanced practice (pp. 88-97). New York: Columbia University Press. (Case #2)

Recommended: Gambrill, E. (1997). A problem-focused model based on critical inquiry. In Social work practice:

A critical thinker’s guide (pp. 96-124). New York: Oxford University Press.

February 7-10 Wirth, K. R., & Perkins, D. (2008). Learning to learn. Available at:

http://www.macalester.edu/academics/geology/wirth/learning.pdf Lamb, B. (2011). The board chair’s dilemma (A). Seattle, WA: Electronic Hallway. (Case #3)

February 14-17 McMillen, J. C., Morris, L., & Sherraden, M. (2004). Ending social work’s grudge match:

Problems versus strengths. Families in Society: The Journal of Contemporary Social Work, 85(3), 317-325.

Hogan, M., & Wolfer, T. A. (2017). He won’t go there. [Unpublished decision case]. Columbia, SC: University of South Carolina, College of Social Work. (Case #4)

February 21-24 Congress, E. P. (2000). What social workers should know about ethics: Understanding and

resolving practice dilemmas. Advances in Social Work, 1, 1-22. Available at: http://journals.iupui.edu/index.php/advancesinsocialwork/article/view/124/107

Wolfer, T. A. (2014). Driven to drink. In T. A. Wolfer, L. D. Franklin & K. A. Gray (Eds.), Decision cases for advanced social work practice: Confronting complexity (pp. 166-171). New York: Columbia University Press. (Case #5)

Recommended: Levy, C. S. (1976). Personal versus professional values: The practitioner’s dilemmas. Clinical

Social Work Journal, 4(2), 110-120.

February 28-March 3 Hardcastle, D. A., with Powers, P. R., & Wenocur, S. (2011). Using self in community practice:

Assertiveness. In Community practice: Theories and skills for social workers (3rd ed.; pp. 182-214). New York: Oxford University Press.

Golensky, M. (1995). Conflicting agendas for the future of a youth agency (CNG No. 14). Hartford, CT: Yale University, Program on Non-profit Governance. (Case #6)

March 7-10 Dweck, C. S. (2009). Mindsets: Developing talent through a growth mindset. Olympic Coach,

21(1), 4–7. Available at: http://www.teamusa.org/~/media/USA_Volleyball/Documents/Resources/OlympCoachM ag_Win%2009_Vol%2021_Mindset_Carol%20Dweck.pdf

Dweck, C. (2006-2010). What is mindset. Available at: http://mindsetonline.com/whatisit/about/ Flaherty, A., Reitmeier, M. C., Browne, T., Dehart, D., Iachini, A., & Christopher, R. Second

time around [Unpublished decision case]. Columbia, SC: University of South Carolina, College of Social Work. (Case #7)

March 14-17 NO CLASS—SPRING BREAK

105

March 21-24 SAGE 2YC. (2016). What is self-regulated learning? Available at: http://serc.carleton.edu/

sage2yc/studentsuccess/self_regulated/what.html Franklin, L. D. (2014). Gay-for-pay. In T. A. Wolfer, L. D. Franklin & K. A. Gray (Eds.),

Decision cases for advanced social work practice: Confronting complexity (pp. 15-29). New York: Columbia University Press. (Case #8)

March 28-31 Sloan, R. (2014, September 5). The steel man of #GamerGate. Retrieved November 24, 2017,

from https://medium.com/message/the-steel-man-of-gamergate-7019d86dd5f5 Hoffman, E., & Myers, D. R. (2002). Why can’t they make this place more Jewish? In T. L.

Scales, T. A. Wolfer, D. A. Sherwood, D. R. Garland, B. Hugen & S W. Pittman (Eds.), Spirituality and religion in social work practice (pp 117-121). Alexandria, VA: Council on Social Work Education. (Case #9)

April 4-7 Dvorsky, G. (n.d.). The 12 cognitive biases that prevent you from being rational. Retrieved May

9, 2016, from http://io9.com/5974468/the-most-common-cognitive-biases-that-prevent- you-from-being-rational

Forlani, V. M., & Stone, M. M. (1996). Neighborhood agencies, businesses, and the city: Boston Against Drugs (CNG No. 17). Hartford, CT: Yale University, Program on Non-profit Governance. (Case #10)

April 11-14 Garber, M. (2017, December 15). The weaponization of awkwardness. The Atlantic. Retrieved

from https://www.theatlantic.com/entertainment/archive/2017/12/the-weaponization-of- awkwardness/548291/

Busch-Armendariz, N. B., Nsonwu, M., & Heffron, L. C. (2017). Family business. In Human trafficking: Applying research, theory, and case studies (pp. 145-156). Los Angeles: Safe Publications. (Case #11)

April 18-21 Hovis, M., & Franklin, L. D. (2014). Private, dismissed. In T. A. Wolfer, L. D. Franklin & K. A.

Gray (Eds.), Decision cases for advanced social work practice: Confronting complexity (pp. 108-122). New York: Columbia University Press. (Case #12)

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121

127

149

161

April 25-28 Cherniss, C. (1995). The first year: “I thought I’d died and gone to hell.” In Beyond burnout:

Helping teachers, nurses, therapists, and lawyers recover from stress and disillusionment (pp. 17-36). New York: Routledge.

Lee, J., & Miller, S. (2013). A self-care framework for social workers: Building a strong foundation for practice. Families in Society: The Journal of Contemporary Social Services, 94(2), 96–103. doi:10.1606/1044-3894.4289

*Permission to reprint all selections granted to University Readers by the publishers for this individual course reader. Please don’t photocopy – to do so would be a

violation of copyright law.

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179

40 Conflict on the Human Services Coordination Team

The meeting he dreads will begin in less than an hour, so Jerry Feldman reluctantly takes out the files on Arthur Harris and Frances Carpenter for one last review.

As Director of Field Services for the Human Services Coordination Team of the State Services Department (SSD), Jerry supervises both people. Arthur is Northeast Regional Director, and Frances is Arthur's specialist in inner-city problems. The team's mission is to work with citizens' groups, private agencies, other public agencies, and SSD's own program divisions; to coordinate the targeting of social services; and to increase citizen involvement in their delivery. A major part of that mission involves identifying individuals and groups that need specific services and assisting them in making claims on those best able to meet their needs. The team's activities are conducted in five regions, and the field staffs in each region average a half-dozen professionals and two clericals. Headquarters for the team is the SSD office in the capital, but Jerry spends a lot of time on the road visiting the regional offices, which are the central units of the team.

The regional directors like Arthur Harris have multiple responsibili- ties. They develop work assignments for their subordinates, maintain communication among them so they do not work at cross-purposes, elaborate headquarters strategy and priorities as well as implement them in the field, evaluate their staff and make recommendations for promotion, termination, or reassignment, and supervise the administra- tive details that arise from the constant travel of each of the field work- ers. The nature of the team's mission is such that the regional directors have to supervise their subordinates closely and give them more cor- rective feedback than is common in most social-service work. After all, the team's mission is coordination, and that means that its own staff should be the best coordinated of all.

Arthur Harris 's file reveals that he has been a member of the team since it was authorized a year and a half earlier, all that time in the

273

northe'1st region. The details reveal that Arthur is a real comer. He has a college degree, with a double major in sociology and political science, gained about five years earlier after three years in the Army. He did one year of graduate work in sociology before taking a planning position elsewhere in the department. Selected for the team because of interest and performance, Arthur receives generally good evaluations and re- flects increasing interest in "street-level" administration. Arthur is among the younger employees expected to rise to positions of consider- able responsibility in the department. He is white.

Frances Carpenter is quite different from Arthur. She is seven years older, has two children, has completed about two years' college credit, and is black. Her interest in street-level administration is not new. Be- fore joining the Human Services Coordination Team at the same time Arthur did, she was a community-relations specialist with the Com- munity Action Program in Benton, which with its sister city of Fillmore constitutes the major urban center of the northeast region. Almost everyone in Benton at least knows Frances's name, and in the black community of about 15,000 there are few people who do not know her personally. She led a well-publicized rent strike, worked for community control of the police, and helped initiate compensatory programs for the disadvantaged in Benton County Community College. Her specialty in the northeast region is working with the black communities of Benton and Fillmore.

Jerry found her to be capable at the start. She is the best person in the region for handling service delivery foul-ups, both because she knows the right people and because she is inventive at creating con- structive responses. Evaluations of her performance during the first year are positive. Arthur Harris 's predecessor as regional director was an older black man who left the job for a top position in post-release correctional services. He knew Frances for many years, and they worked well together.

Jerry feared that some trouble might develop when he promoted Arthur Harris, even though Arthur seemed to have support from each of his co-workers. But, initially, Arthur worked out well. After a couple of months, friction developed between Frances and Arthur, who began to write that Frances was resisting direction. He even entered notes in her file that she failed to carry out an assignment that he requested her to undertake. Other notes-none part of the permanent record-indicate that Frances frequently gets into arguments with other staff members, all of whom are white. And most recently, she missed two weekly meetings of the field staff without notice or explanation.

When Arthur told her that if she missed a third consecutive staff meeting he would consider giving her a written reprimand, Frances

274 Supervisory Problems

blew up, called him a racist and sexist incompetent in tones that could be heard by anyone nearby, stormed out of the office, and disappeared for a day and a half. She returned to the office in a subdued manner with a signed agreement by a voluntary agency to open a day-care cen- ter in the inner city of Benton. That was a good piece of work.

But Arthur still feels he needs Jerry's intervention, and hence the scheduled meeting to which Jerry is not looking forward.

Frances arrives first in the regional office's conference room. Jerry asks her to have a seat. "Good to see you," he says. "I heard about your blowup with Arthur the other day and thought the three of us ought to get together. You've worked together for long enough that an incident like this is cause for concern. Do you want to talk for a few minutes before Arthur comes in, or would you rather wait?"

"Oh, I don't know," she replies. "I'm sorry I yelled and got him upset, but he's really been after me. I used to think he was under- standing, but now I'm not sure. He tries hard, but he's not as grown-up as he thinks, and he's been putting on a lot of airs."

"What do you mean?" Jerry asks. "You know, playing like he's the big boss with all these evaluations.

I've worked here as long as he has, and I know my job. He should be helpful, but instead he's always trying to act superior."

"What kind of things does he do to act superior?" Jerry inquires. "Well, you know, Mr. Feldman, like always trying to pretend he

knows better than I do what's happening in Benton, like he knows the needs there. He gives me a lot of things from books and then tries to make me feel like it's my fault, not his, when they don't work."

"Like what?" "Like the time he wanted me to get young mothers organized for

prenatal care," Frances explains. "You can't change kids' habits like that. Some are 14-year-olds hardly aware of what's happening to them. I tried a little, but there are so many other things to do, it wasn't worth the effort right then. A time will come for that. If Arthur really knew the black community here in Benton, he'd understand that."

They are interrupted by a knock on the door. "Is that you, Arthur? Come on in," Jerry calls.

Arthur is a little nervous and awkward as he sits down. He smiles at Frances and then asks Jerry how things are at headquarters. After a brief reply, Jerry suggests that they get down to business. "Why don't each of you tell what you think is going on? Arthur, do you want to go first?"

"Well, if that's the way you would like to proceed," Arthur offers. "I think this is a very complicated situation with a lot of elements in it."

40 I Conflict on the Human Services Coordination Team 275

Arthur pauses and thinks for a minute. "I respect Frances a lot, and I'm a little uneasy saying some of this because we have worked together as equals before I became her supervisor."

"I have an idea," Jerry interrupts. "Why don't you talk to Frances as well as to me? After all, whatever is going on, and whatever we manage to do here today, you two are still going to have to work things out between you."

"All right," Arthur responds. "Before I became your supervisor, when the office first opened, Frances, we worked mostly on helping people caught between the cracks in social services or people getting a bureaucratic pass-me-around-you know, case kinds of things. I don't know if you have an equal around here in handling that kind of matter.

"Well," Frances says with feigned surprise, "that's the first time you have ever admitted that!"

"Hmmm," Jerry murmurs. "Continue?" "All right," Arthur says. "You know, casework isn't all that we

should be doing. Our real goal is human-services integration. I've felt that one of the reasons I was promoted, Jerry, was because you felt that I could help this region get more into programmatic activities, you know, the kinds of things where instead of helping a few people, we implement a change that will help lots of people now and into the future.

"It's been my goal to try to do that," Arthur continues. "Things like helping service-delivery agencies establish good coordinative mech- anisms between city agencies or between the county and the depart- ment, for example. We shouldn't do all the coordinating, we should be setting it up so other people do that. Isn't that right, Jerry?"

"That's one of the objectives. Yes, certainly," Jerry replies. "Well, I've tried to do that since becoming regional director," Arthur

says as he looks back at Frances. "For some reason-I don't know why--you 've always seemed to resist that idea."

"That's not true," Frances says. "You '11 get your tum," Jerry cautions. "Go on, Arthur, and remem-

ber to tell Frances your thoughts." "My feeling is that both your experience and your talents lead you

to prefer casework," Arthur continues. Frances looks upset. "Wait a minute," Jerry says. "Let's try and avoid motivations and

interpretations. Just describe what happened. We'll look for causes in due time."

Arthur agrees and goes on. "The first few suggestions I gave you just seemed to bounce right off and disappear, Frances. I suggested that you try to improve coordination between County Probation and the

276 Supervisory Problems

summer softball programs in Benton County. You said you didn't know anyone in the athletic programs and that they didn't work in the city. Then there was the business with developing support in the Fill- more City Council for community-based mental-health halfway houses, which nothing ever came of. I tried to talk to you about that and tried to get you to set down on paper your goals for the next six months. But you never did. Instead, you gave me a lot of excuses about how busy you were. Then you began getting into arguments a lot during the last two or three months and ... "

"What do you mean, a lot?" Frances retorts. "And besides, I didn't have many arguments, just a few disagreements."

"Man, if those weren't arguments, I don't know!" Arthur notes with an exaggerated shrug.

Jerry laughs. "What's an argument to you, Arthur?" "That's kind of hard to define," he says. "I guess when people start

getting heated over their disagreements." "What about you?" Jerry asks Frances. "Well, both people at least have to start yelling. If my ears don't hurt

it's not much of an argument," she responds. "OK," Jerry says. "What happened next?" "I don't know," Arthur says. "Things just started to go downhill. I

feel that Frances just hasn't kept up with the others in terms of pro- gram improvements. I tried to get her to see this at the weekly staff meetings by having other people talk about what they were doing."

"That was an attempt to put me down," Frances asserts. "Hold on," Jerry says. "Let's keep motives out of it. How did you

feel; that's the question." "Well," she says, "I felt angry. He never wanted to ... " "Tell it to Arthur," Jerry reminds her. "Man, you are something," Frances says. "All right, you never

wanted to hear about what I was doing. I was doing a lot of things. I got the locations changed on the health clinics, and I found a way to get hot meals for the old folks, and I steered a group of kids into a teen center they never knew existed, and a whole lot of other things. But all those meetings just were a lot of talk about bureaucratic I-don't- kno.w-what. I thought I was supposed to work against that, not make more of it!"

"That's just the point," Arthur says. "If we don't make these agen- cies work right, then no one will get the services they need. I know you mean well, but in the long run this way is better for the black commun- ity and all people."

"What do you know about the black community?" Frances shoots back. "Have you ever lived there? That's what I'm supposed to know.

40 I Conflict on the Human Services Coordination Team 277

If you knew anything about the blaL:k community you'd know better what is an argument and what isn't."

"Well when someone stomps around an office picking fights and contradicting everyone, that's an argument," Arthur says.

"Oh, you and your bourgeois standards," Frances replies. "What do you know? I have a right to get upset once in a while," she says assert- ively. "Besides, what am I supposed to do? There's no one in that office I can talk to. Everyone's so concerned with doing good they never bother to find out what the people are like."

"You don't have any monopoly on the people," Arthur responds. "We work with lots of different kinds of people. It's not just the black community, and you have to understand that."

"I think we are getting diverted from the main issue," Jerry pro- poses. "Why don't you tell Arthur more about his idea of programs?"

"Well, he's got some problems about black folks that need some work, but all right." She turns back to Arthur. "I never did understand all that program stuff. I remember about the softball leagues, but I don't know any of those people. When I came to you about that you just gave me some names to call. Well I already had got the names! And I tried to talk to people in Fillmore, and they gave me the run- around. They're a lot of racists over there, and you never should have asked me to deal with them. Charlie Welsh knows all those people. Why don't you ask him?"

"That's just the point. You have to expand your base of operations if you are going to become programmatic," Arthur says. "You should be able to deal with all kinds of situations. If you are going to get good evaluation reports, you have to do the same as all the other field officers."

"Who's doing the evaluations? You?" Frances asks. "How are you going to evaluate me? You don't understand the black community, and you don't know our needs. I was hired to work on the things I know best," Frances states. "And that's what I do. You got all these fancy ideas about programs and all that bureaucratic stuff, but you don't understand blacks or how to evaluate us. You don't understand me enough to help me when I ask for it, so how can you evaluate me? All you do is put me down at staff meetings, then you wonder why I don't come and threaten me with reprimands and all that."

"I certainly can evaluate you and your work," Arthur maintains. "I use the same standards that I use to evaluate anyone's work. There's no difference between black or white. This isn't a race issue, and I resent your trying to make it one," Arthur snaps.

"Well, that's where you 're wrong," Frances responds. "If you think you just go out and hang the same standards on all people, you are a racist and you don't even know it!" Frances yells. "You call yourself

278 Supervisory Problems

a supervisor and think you can evaluate me? You don't even know whi:lt I do, and you don't even care. All you care about is your so-called pro- gram plans, and I don't need any of that white middle-class stuff that's been keeping black people down for years!"

Directions:

You are Jerry. A welcome emergency long-distance call gets you off the spot for a

few moments. You steal a few more minutes to reflect on the meeting. So far, the discussion has ventilated some issues, and things are beginning to get

hot. As Jerry. where would you like to see the discussion go from here? How do you think you have handled the conflict so far, and what would you have done differently? What do you think you have done well about directing the discussion?

You tick off some of the issues. Is Arthur racist? Do you think he understands the "black community?" Do you think there is such a thing? Should Frances be evaluated or otherwise treated differently from the other members of the field staff?

You also are aware of the differences of opinion and values between Arthur and Frances. Which are proper subjects for management concern? Should you try to help find a way toward a resolution of their conflict that helps each better under- stand the other's goals and needs and still is consistent with the agency's mission and the community's needs?

With this kind of thought in mind, what is your opening intervention to be when you reenter the conference room? How do you expect Frances will respond? Arthur?

40 I Conflict on the Human Services Coordination Tearn 279

Decision Cases for

Advanced

Social Work Practice

Thinking Like a Social Worker

Edited by

TERRY A. WOLFER University of South Carolina

T. LAINE SCALES Baylor University

THC>IVISC>N

• BROOKS/COLE Australia • Canada • Mexico • Singapore • Spain

United Kingdom • United States

Chapter 1

An Introduction to

Decision Cases and Case

Method Learning

TERRY A. WOLFER

"Good judgment comes from· experience. Experience comes from bad judgment."

WALTER WRISTON (CITED IN BRUNER, 1999, p. xxi.ii)

T he case method of learning typically involves in-depth class discussions based on detailed, open-ended accounts of actual practice situations. These accounts, referred to as decision cases, require students to formu-

late the problems and decide on potential courses of action. The case analyses and class discussions help students learn to apply theory to practice and to develop important problem-solving and critical-thinking skills. Because this particular form of cases may be unfamiliar to you, we intend this introductory chapter to provide background information on cases and the case method. This chapter will do the following:

1. Consider the ubiquitous nature of cases and decision making in professional social work education and practice.

2. Differentiate cases for decision making from the more common cases for examples or illustration.

3. Help students understand how case discussions differ, both philosophically and practically, from traditional approaches to social work education.

4. Identify general learning outcomes associated with analyzing and discussing decision cases, and the importance of these outcomes for social work practice.

5. Explain where these cases came from, and how they were written.

4 PART I TO THE STUDENT

In the next chapter, we provide concrete tips for analyzing and preparing to discuss cases.

WHAT IS YOUR EXPERIENCE WITH CASES?

No doubt, you are well acquainted with the use of cases in your social work program. Many social work instructors and textbook authors provide cases to aid your understanding of social work practice. In field supervision, you likely discuss individual cases and the problems or challenges these pose for you. In your field practicum or social work employment, you may measure your workload in terms of the number of cases you carry at any point in time.

This collection of cases is similar in some ways to these various types of cases but different in other important ways. Like cases in your classrooms or textbooks, these cases were developed for teaching purposes. However, these cases have a more specific teaching purpose that probably differs from pub- lished cases with which you may be familiar. In social work education, most published cases have an illustrative purpose. They provide examples of good practice, or even exemplars for you to emulate. Such cases depict difficult prac- tice situations and show how social workers dealt with these situations. They typically show how a social work theory was applied in the particular situa- tion, providing insight or understanding, or how a social work intervention was carried out, providing guidance in use of the intervention. In short, such cases show you how some theory or intervention applies to practice or, more simply, how the theory or intervention works.

Discussing cases with your social work field instructor or supervisor also has a teaching purpose, though it might be more accurate to refer to this as a learning purpose. In supervision, your field instructor "looks over your shoul- der" to ensure that things are going well and to provide direction as necessary. When you discuss difficult cases with your field instructor, you may review what has happened, what you have tried to do, and so on. Initially, your super- visor carries important responsibility for guiding your efforts. But as you gain practice experience, you will increasingly use supervision to make collabora- tive decisions about what to do next. In these situations, your field instructor or supervisor is not directing your work so much as helping you decide how to proceed, what to try, what the likely consequences will be, and so on.This type of supervision shifts the focus from the past to the present and future, from what happened to what to do next. And it shifts the emphasis from your instructor "teaching you what to do" to the two of you (or the supervision group) collaboratively figuring out what to do. This approach to supervision is common in professional social work practice, and this set of decision cases is intended to resemble and promote it.

In direct practice settings especially, the set of cases (caseload) for which you have responsibility also provides a shorthand way of referring to your

CHAPTER 1 AN INTRODUCTION TO DECISION CASES AND CASE METHOD LEARNING

workload. In this usage, a case refers to the client system for which you have some professional responsibility. The client may be understood to be an indi- vidual, a couple, or a family unit.

In this casebook, however, the word case does not refer to cases of this type. Instead, we use case for referring to specific situations in professional practice that pose problems and dilemmas, and these situations are more like those described in the previous paragraph. Furthermore, these cases may come from any level of social work practice. As a result, the client system may include a supervisee, program, organization, community, or state in addition to individ- uals, families, or groups in direct practice. This brief reflection reveals how ubiquitous cases are in professional social work practice, and also alerts us to some important distinctions in use of the term.

CASES IN SOCIAL WORK EDUCATION

The use of cases is nothing new. For more than 100 years, social work instruc- tors have used cases in the classroom to educate students (Fisher, 1978; Reitmeier, 2002; e.g., Reynolds, 1942; Towle, 1954). Over time, these cases have taken many forms, ranging from brief vignettes only a few sentences or paragraphs long to complex book-length accounts.

Merseth (1996) identified three basic educational purposes for using cases: cases as examples or exemplars to illustrate practice, cases as foci for reflecting on practice, or cases as opportunities to practice decision making. For the first purpose, mentioned above, cases provide concrete and specific examples of how professional theories or interventions apply in practice situations. As illus- trations, cases can help students understand theoretical content and practice skills. During the past few decades, most of the available social work casebooks provide cases for this purpose (e.g., Amodeo, Schofield, Duffy, Jones, Zimmerman, & Delgado, 1997; Haulotte & Kretzschmar, 2001; LeCroy, 1999; McClelland,Austin, & Este, 1998; Rivas & Hull, 2000).

Although most cases in social work education have an illustrative purpose, the cases here have primarily a decision-making purpose. They resemble the type of cases that social workers take to their supervisors when they are un- certain how to understand a situation or how to respond. In fact, the cases in this collection troubled the practitioners who experienced and reported them. For some, the situations remain perplexing months (and even years) after they occurred.

Rather than provide good examples of how practice theories or interven- tions might work, these cases present challenging problem-solving opportuni- ties. As a result, they provide opportunities for you to practice · decision making, to refine the skills you need in social work practice. Like social work practice dilemmas you might take to a supervisor, these cases present messy, ambiguous, problematic situations that invite and merit professional thinking

6 PART I TO THE STUDENT

and intervention. Discussing these challenging cases will clarify the funda- mental importance of problem framing or formulation; they require you to bring structure to complex, ill-structured situations. Having formulated the problems, you must decide what to do about the various situations.As you will see, many social work interventions may be possible or even relevant in partic- ular cases but these interventions will vary by the extent to which they actu- ally help resolve the basic dilemmas. Class discussions will clarify the probable consequences of various formulations and strategies, and help you refine your decision-making processes.

DISTINGUISHING DECISION CASES

FROM OTHER TYPES

In defining decision cases, scholars note several characteristics that distinguish them from other types of cases. For example, Mauffette-Leenders, Erskine, and Leenders (1997) define a decision c~se as "a description of an actual situation, commonly involving a decision, a challenge, an opportunity, a problem or issue faced by a person (or persons) in an organization. The case allows [the reader] to step figuratively into the position of the particular decision maker" (p. 2). Similarly, Christensen and Hansen (1987) define a decision case as:

a partial, historical, clinical study of a situation which has confronted a ... [practitioner]. Presented in narrative form to encourage student involvement, it provides data-substantive and process-essential to an analysis of a specific situation, for the framing of alternative action programs, and for their implementation recognizing the complexity and ambiguity of the practical world. (p. 27)

These definitions highlight several key characteristics of decision cases. Like case examples or exemplars, decision cases provide accounts of social

work practice situations but they differ in several important ways (Wolfer, 2003). Perhaps most distinctively, decision cases involve a dilemma of some sort for the practitioner and the written cases end with the situation unre- solved (Leenders, Mauffette-Leenders, & Erskine, 2001; Lynn, 1999; Weaver, Kowalski, & Pfaller, 1994). As a result, students must "untangle situations that are complex and undefined and impose a coherence of their own making" (Barnes, 1989, p. 17; cited in Merseth, 1996, p. 729). By presenting incomplete and ill-structured or "messy" situations (Boehrer & Linsky, 1990), decision cases especially stimulate readers to analyze the information they contain and formulate problems, and then to decide how to intervene in the situations. In short, open-ended cases spur readers to seek resolution.

Furthermore, decision cases generally depict actual situations encountered by social work practitioners rather than generic or composite situations.While

CHAPTER 1 AN INTRODUCTION TO DECISION CASES AND CASE METHOD LEARNING

some identifying information may be disguised to protect individuals and organizations, case writers try to avoid making any changes to cases that alter case dynamics (Cossom, 1991). Indeed, ~case writers construct decision cases based on multiple interviews with key participants, usually the protagonist and sometimes other people (Leenders et al., 2001; Lynn, 1999; Naumes & Na um es, 1999; Welsh, 1999). Case writers gather detailed information, includ- ing conversational dialogue as case reporters remember it (Weaver et al., 1994). As a result, cases reflect the perspectives of case reporters, with both the strengths and limitations of their subjectivity. Well-written cases "put the stu- dent reader squarely in the shoes of the social worker" (Cossom, 1991,p. 141). They allow readers to "inhabit" or empathize with the world of the case reporter, to both know and "feel" the information that constitutes the prob- lematic situation.

Decision cases typically differ from example cases in several additional ways. They often include more background information than example cases, including details about the time period, the social service agency and other organizations involved, organizational and social policies, and the community setting. In this way, cases better reflect the "complex, messy, context-specific activity" of professional practice (Merseth, 1996, p. 728). As experienced prac- titioners recognize, such information often plays an essential role in situations and their possible resolution (Doyle, 1990; Shulman, 1992). However, some of . the included case details may be extraneous and potentially distracting, requir- ing readers to sort through the data, just as they must do in actual practice (Weaver et al., 1994).

Typically, decision cases also include more information about the protago- nists than example cases, because this information also plays an essential part in the situations (Weaver et al., 1994; Wolfer, 2003). Where example cases often invite readers to identify with a generic social worker (i.e., "Ms. Green"), deci- sion cases provide details about the social worker that may be relevant for case dynamics. Putting this information on the page helps readers to recognize and consider how the self of the social worker may interact with problems and

· their resolution. Further, it encourages readers to reflect on how their own selves may also have consequences in professional practice.

Usually, decision cases do not include much theoretical content, except when case reporters explicitly mention it themselves. In professional practice, most situations do not present with explicit theoretical frameworks (Lynn, 1999; Sykes & Bird, 1992). Decision cases simply reflect that lack of explicit theory. As a result, the raw case data requires that readers supply theory for understanding the situations and helps them come to understand the critical need to do so (i.e., theory provides a "handle" on case situations). It also allows instructors considerable latitude in discussing cases from different theoretical perspectives.

These cases may provide little new information about topics you have been learning in other courses (though you may learn about particular social

8 PART I TO THE STUDENT

work settings, interventions, or problems with which you are unfamiliar). Instead, they emphasize the use of previous learning, especially in novel situa- tions. In that way, these cases resemble social work practice, and discussing these cases resembles peer supervision. The cases themselves seldom make clear what theory or interventions might be suitable. You must decide about that, drawing from what you have learned up to this point. Hopefully, by pro- viding opportunities for you to practice decision making in complex and challenging situations, analyzing and discussing the cases will also help you to refine your decision-making skills and to become a more self-reflective deci- sion maker. Some of the things you will learn from discussing these cases would likely have occurred during your initial years of social work employ- ment. But by discussing these cases, you can accelerate your learning and aid your successful transition to professional social work practice.

For these reasons, this collection of decision cases is especially well suited for use in capstone courses or integrative field seminars. For all students, these cases help provide a bridge between theory and practice, between the class- room and their agency settings. For students nearing completion of their edu- cational programs, these cases may assist their transition from student to practitioner as they assume greater decision-making responsibility.

OUTCOMES OF DECISION CASE LEARNING

In part, the differences between novices and experienced practitioners may have less to do with what they know than with how they use their knowledge (Livingston & Borko, 1989). Business educators Barnes, Christensen, and Hansen (1994) argue that case method instruction helps to develop in students an applied "administrative point of view" (p. 50). In other words, case method instruction helps business students to develop the perspective of experienced business administrators or practitioners. In social work, we could refer to this as "thinking like a social worker" (hence the title of this book).

Barnes, Christensen, and Hansen suggest that an administrative point of view includes several components. These are (1) a focus on understanding the specific context; (2) a sense for appropriate boundaries; (3) sensitivity to inter- relationships; (4) examining and understanding any situation from a multidi- mensional point of view; (5) accepting personal responsibility for the solution of organizational problem; and (6) an action orientation (pp. 50-51). These components reflect a thoroughly systemic approach to understanding practice.

Furthermore, the latter component (6) above, an action orientation, includes several dimensions acquired through practice experience. These dimensions are (a) a sense of the possible; (b) willingness to make decisions on the basis of imperfect and limited data; (c) a sense of the critical aspects of a situation; (d) the ability to combine discipline and creativity; (e) skill in

CHAPTER 1 AN INTRODUCTION TO DECISION CASES AND CASE METHOD LEARNING

converting targets into accomplishments; and (f) an appreciation of the major limitations of professional action (Barnes et al., p. 51). Together, they distin- guish expert practitioners from novices. In short, the concept of an adminis- trative or practitioner point of view redirects our attention from what students know to their ability to use their knowledge judiciously. From this perspective, theoretical knowledge and technical skill are essential but insuffi- cient for competent practice. Not only must competent professionals have knowledge and skills, they must know how to use them, and exercise good judgment in doing so.

Although the knowledge, skill, and value bases differ significantly between business and social work, we think there are some important parallels between how business and social work professionals need to think and act in profes- sional practice.As Barnes and his colleagues argue, competent practice requires profoundly systemic ways of thinking and deciding. Hopefully, analyzing and discussing these cases will help you to acquire some of the attitudes, knowl- edge, and skills that experienced social workers identify as critical to their pro- fessional success.

Several teacher educators identify other outcomes of case method learn- ing. At the most basic level, cases convey information or declarative knowl- edge, that is, what to know. For example, education researchers have explored the effectiveness of cases for introducing multicultural perspectives, pedagogi- cal theory, and mathematics content (e.g., Merseth, 1996). At a deeper level, cases can promote different ways of thinking or procedural knowledge, that is, how to know and do. For example, education researchers have begun to explore the effectiveness of cases for developing problem-solving and decision-making skills, beliefs about professional authority and personal efficacy, more realistic perspectives on the complexities of practice (and new ways oflooking at prac- tice), and habits of reflection (Merseth, 1996).

Lundeberg (1999), another teacher educator, provides an alternative con- ceptual framework for understanding case method learning outcomes. Based on empirical research, she reports benefits in five categories, most of which relate to different ways of thinking. The first category, theoretical and practi- cal understandings, combines two kinds of knowledge that researchers have often separated. She combines them because of the ways instructors can use cases for generating theory from practice, encouraging students to apply the- ory in practical situations, and for helping students discover when and how theories may be useful (p. 4). The second category, improved reasoning and reflective decision making, reflects a basic purpose of case method instruc- tion. Decision cases are specifically designed for helping students develop their abilities: "to identify, frame, or find a problem; consider problems from multiple perspectives; provide solutions for problems identified; and consider the consequences and ethical ramifications of these solutions" (p. 8). As another teacher educator notes, "Many students see problems as no more

10 PART I TO THE STUDENT

than common-sense, obvious difficulties. They have not developed the idea that problems are constructed and can be constructed in more and less fruit- ful ways" (Kleinfield, 1991, p. 7; cited in Lundeberg, 1999, p. 9). Case discus-, sions provide significant opportunities for developing more sophisticated decision-making abilities. The growth of reasoning relates to a third category, metacognition, the process of reflecting on one's own thinking processes (Lundeberg, 1999, p. 12). While awareness of thinking and learning processes is obviously important for classroom teachers, it has an important parallel for social workers. Thinking and learning processes are part of a broader category of change processes. Case discussions may help students better understand the nature and difficulty of change processes, especially as they become more self-reflective regarding their own learning. For education students, metacog- nitions are closely related to a fourth category, beliefs about learning (p. 14). Early literature on cognitive change suggested that awareness of one's own beliefs and how they conflict with empirically based ideas about learning would lead to change in beliefs. More recent literature reveals that cognitive change is less rational and more dependent on social interaction. Applying this insight to change processes more generally, case method may provide experience and insight regarding the importance of relationship dynamics in social work interventions, whether at the micro or macro level. Lundeberg refers to a final category of benefits as social, ethical, and epistemological growth (p. 15). Her colleague, Harrington (1994), wrote:

The knowledge of most worth is brought into being dialogically. It is said and heard in multiple ways-transformed in the sharing-enriched through multiplicity. Dialogue allows students to become aware of what they share in common, as well as the uniqueness of each of them as individuals. (p. 192; cited in Lundeberg, 1999, p. 16)

Deep appreciation for dialogue, as a means of comprehending similarity and difference, represents a profound type of growth fostered by case method. Dialogue is relevant for social work practice with clients but also for interac- tion with colleagues, agencies, and communities. And it leads to greater appre- ciation for the ethical context of practice. In their book, Lundeberg and her colleagues review the empirical evidence for these benefits of case method learning (Lunde berg, Levin, & Harrington, 1999).

Although originally identified in the context of teacher education, these benefits of case method learning seem highly relevant for social work practice as well. Competent practice requires both theoretical and practical knowledge, reasoning and reflective decision-making skills, metacognitive awareness (especially regarding change processes), appropriate beliefs about change, and social, ethical, and epistemological growth. Unfortunately, these significant benefits of case method learning are sometimes overlooked in social work education, or at least not addressed in formal ways. In that respect, case method may prove to be a valuable supplement to the traditional classroom.

CHAPTER 1 AN INTRODUCTION TO DECISION CASES AND CASE METHOD LEARNING

CASE METHOD TEACHING

To most fully exploit the teaching potential of decision cases, instructors must use a "case method teaching" approach (Barnes et al., 1994; Cossom, 1991; Erskine, Leenders, & Mauffette-Leenders, 1998; Lundeberg et al., 1999; Lynn, 1999;Welty, 1989). Because this approach may differ from what your instruc- tors normally do, it may be helpful for you to have some advance warning about what they may do differently and to be aware of their reasons for it. Case method teaching relies heavily on discussion, and case method instruc- tors essentially lead discussions by asking questions (Boehrer & Linsky, 1990). The overarching questions are twofold: What is the problem? And what would you do about it? In classroom discussions, however, instructors may not actu- ally ask these two basic questions. Instead, they ask many more specific ques- tions designed to explore these two questions. Instructors formulate and select questions based partly on their instructional goals, what background knowl- edge students bring to the discussion, and the direction and flow of the imme- diate discussion. As discussions develop, instructors may encourage individual students to elaborate on their perspectives, seek divergent viewpoints from other students, and ask about connections or dis'crepancies between new com- ments and previous comments. Although it sometimes frustrates students, case method instructors consistently refrain from providing their own perspectives or opinions about the cases. Rather than identify possible errors of fact or judgment themselves, instructors promote critical thinking by asking good questions. Indeed, case method instructors consider students' increasing ability to pose good questions, as importance evidence of their learning (Boehrer & Linsky, 1990).

Much like group therapists, case method instructors must also attend to the level of discussion process (Lundeberg et al., 1999; Welty, 1989). For example, instructors seek to distribute speaking turns, steering the discussion away from overly talkative students toward quieter students. They monitor perceptions of classroom safety, and consider the effects of their own and students' contribu- tions. In their questioning, they sometimes push students to express disagree- ments and at other times allow students to go more slowly. More than some other teaching approaches, case method teaching requires that instructors lis- ten well (Christensen, 1991; Leonard, 1991), to maintain simultaneous aware- ness of both discussion content and discussion process.

THE CASES

This book includes a diverse mix of cases, some involving predominantly micro settings and issues and others involving predominantly macro settings and issues. In ways that may surprise you, however, you will come to see how micro and macro issues are frequently intertwined, how the traditional

12 PART I TO THE STUDENT

distinction between micro and macro practice does not work well at times in actual practice. These cases make clear the systemic nature of reality and pro- vide support for the widespread emphasis on systems thinking in social work education. We created the mix of cases to reinforce this point.

Occasionally, some students object to the mix of cases. Students who may be focusing on micro practice, for example, may not understand why they should know or care about political intrigue in policy making at the state level. Or students who may be focusing on macro practice may not under- stand why they should be familiar with controversial practice interventions for .·· individual clients. Hopefully, this collection will help you to see common threads across these situations, to develop your skills of assessment and decision making, and to better understand the interactive nature of systems. Discussing these cases will also help you to return to your own area of specialization with increased insight, :flexibility, and creativity. These assertions may prompt you to wonder about the intended benefits oflearning with decision cases.

WHERE THESE CASES CAME FROM,

AND HOW THEY WERE WRITTEN

Most of the cases in this collection were originally developed for a case- based capstone course at the University of South Carolina's College of Social Work (Wolfer, Freeman, & Rhodes, 2001). Because we intended the cases for students in the final semester of the MSW program, the cases all involve MSW-level practitioners. Most of the cases were reported by doc- toral students, faculty members, field instructors, or recent graduates of the college. As a result, the cases come disproportionately from the southeastern United States. But because many people at the college, in each of those categories, have moved to South Carolina from other areas of the United States, the cases come from other parts of the country as well. To qualify for use in the course and inclusion in this case collection, cases must have met several criteria:

1. The situation may be drawn from any field of social work practice.

2. The situation may be drawn from direct practice with individuals, families or groups, or indirect practice with organizations or communities.

3. The situation must include a social worker with some critical decision- . making responsibility (the social worker serves as the protagonist).

4. The situation must involve some type of dilemma for the social worker. The dilemma may include, for example, conflicting values or ethical principles held by individual clients, their families, the social worker, the social work organization, or social policies. In the best cases, competent social workers may disagree about appropriate responses to the dilemma.

CHAPTER 1 AN INTRODUCTION TO DECISION CASES AND CASE METHOD LEARNING

5. The social worker must have '(or be working toward) an MSW degree, so that MSW students can reasonably identify with and learn from his or her dilemma.

6. Finally, the social worker must be interested and willing to report the situation in confidential interviews with a case writer.

As implied by these criteria, the cases were all field researched. That is, they were all based on in-depth interviews with individual social workers who agreed to report their experiences. More specifically, the cases were researched and written using a conjoint, repeated interview process developed by Welsh (1999). It typically consisted of several steps.

First, before the case reporting sessions, case reporters prepared brief writ- ten accounts of a problem or decision they actually faced in social work prac- tice. These accounts helped case writers determine the likely appropriateness of a case dilemma before they began in-depth research.

Second, during the reporting sessions, case reporters told case writing teams the story behind their accounts. In addition to the cas~ reporter and case writer, each team typically included one or two additional social workers from the case reporter's field of practice to assist with questioning. Following Welsh (1999), we have found that conjoint interviews broaden and deepen the case writer's understanding of the case situation. We audio taped these interviews to collect detailed descriptions and numerous direct quotes from case reporters.

Third, after the reporting session, the case.writer(s) prepared a working draft of the case that included a title, an opening paragraph or introductory "hook," necessary background sections, and the story line with descriptions and quotes.

Fourth, case writers sought additional information from case reporters as needed, exchanged working drafts with the case reporter, co-interviewers, and editors for editorial feedback, and returned a final draft to the case reporter for confirmation. Case writers did not release cases for publication until case reporters signed release forms indicating they felt satisfied that the written cases accurately reflected their experiences and adequately disguised the situation.

In consultation with the case reporters, we disguised the cases to protect them, their clients, and their social service organizations. In most cases, the dis- guise involved changing names of people, organizations, and places, and selected details. As much as possible, however, we avoided changing case data that would alter essential case dynamics. For example, we did not change the gender of case reporters or clients, or the geographic regions in which cases occurred. In subtle ways, these and similar factors influence how the case situations developed and how they may be interpreted, and we did not want to undermine the reality of what the case reporters experienced. As suggested above, learning to take account of such details distinguishes expert practitioners from novices.

Whatever you think of particular decision cases in the collection, avoid jumping to conclusions. The case reporters have been generous and coura- geous in telling about particularly challenging, even troubling situations they have faced in professional practice. For that, we are most grateful. For some

14 PART I TO THE STUDENT

case reporters, the situations continue to frustrate, perplex and concern them, and that was part of the reason they agreed to report their cases.

READING THE CASES

The decision cases in this collection can be read on several levels. On one level, they simply depict a variety of settings that employ social workers and the types of situations that occasionally crop up in those settings. Obviously, the cases rep- resent only a small sample of practice fields (e.g., homelessness, mental health; wife abuse, public education, and international community development).

On a second level, the cases depict specific challenges that individual social workers encountered in certain settings and at certain points in time. From a systems perspective, the multiple and overlapping factors will be quite evident, though the specifics vary from case to case. In various combinations, these fac- tors include client needs and values; social worker needs, values and skills; needs and values of other individuals related to the client(s); organizational philoso- phies, policies and procedures; professional social work values and ethics; and government policies and laws. These multiple factors create the complex and particular environments in which social workers must function, and which they must carefully consider when attempting to resolve the dilemmas.

But on a third, more abstract level, the cases also reflect common chal- lenges of social work practice across settings (and, we might add, of human experience). These include, for example, balancing client and organizational needs, resolving contradictory policy requirements, making decisions with incomplete information, identifying the appropriate limits of professional intervention, anticipating unintended consequences of decisions, and resolv- ing value or ethical dilemmas.

As you read, try to consider the cases on each of these levels. You may begin by asking yourself, "What is this case about?" Repeatedly asking and answering this question can help you reach for deeper levels of understanding. The next chapter goes further in suggesting ways to read and analyze the cases and to prepare for discussing them.

REFERENCES

Amodeo, M., Schofield, R., Duffy, T.,Jones, K., Zinunerman, T., & Delgado, M. (Eds.). ( 1997). Social work approaches to alcohol and other drug problems: Case stud- ies and teaching tools. Alexandria, VA: Council on Social Work Education.

Barnes, L.B., Christensen, C.R., & Hansen, A.J. (1994). Teaching and the case method (3rd ed.). Boston: Harvard Business School Press.

Boehrer,J., & Linsky, M. (1990). Teaching with cases: Learning to question. In M. D. Svinicki (Ed.), The changingjace of college teaching (pp. 41-57). San Francisco: Jossey-Bass.

Bruner, R. F. (1999). Note to the student: How to study and discuss cases. In Case studies in.finance: Managingfor corporate value creation (3rd ed.; pp. xxiii-xxvi). Boston: Irwin McGraw-Hill.

CHAPTER 1 AN INTRODUCTION TO DECISION CASES AND CASE METHOD LEAR.NING

[Also available online at http:/ !faculty. darden. virginia. edu/brunerb I resources_ studentnote.htm]

Christensen, C. R. (1991). The discussion teacher in action: Questioning, listening, and response. In C. R. Christensen, D.A. Garvin, & A. Sweet (Eds.), Education for judgment: The artistry ef discussion lead- ership (pp. 153-172). Boston: Harvard Business School Press.

Christensen, C.R., & Hansen,A. (1987). Teaching and the case method. Boston: Harvard Business School Press.

Cossom,J. (1991). Teaching from cases: Education for critical thinking. journal ofTeaching in Sodal VV<:>rk, 5(1), 139-155.

Doyle,W (1990). Case methods in the edu- cation of teachers. Teacher Education Quarterly, 17(1), 7-16.

Erskine,]. A., Le enders, M. R., & Mauffette- Leenders, L.A. (1998). Teaching with cases (3rd ed.). London, ONT: Ivey Publishing, Ivey School of Business Administration, The University of Western Ontario.

Fisher, C. F. (1978). Being there vicariously by case studies. In M. Ohmer and Associates (Ed.), On college teaching: A guide to contemporary practices (pp. 258-285). San Francisco:Jossey-Bass.

Harrington, H. (1994). Teaching and know- ing.journal efTeacher Education, 45(3), 190-198.

Haulotte, S. M., & Kretzschmar,]. A. (Eds.). (2001). Case scenarios for teaching and learning social work practice. Alexandria, VA: Council on Social Work Education.

LeCroy, C. W (1999). Case studies in social work practice (2nd ed.). Pacific Grove, CA: Brooks/Cole.

Leenders, M. R., Mauffette-Leenders, L.A., & Erskine,]. A. (2001). Writing cases (4th ed.). London, ONT: Ivey Publishing, Ivey School of Business Administration, The University ofWestern Ontario.

Leonard, H.B. (1991). With open ears: Listening and the art of discussion lead- ing. In C. R. Christensen, D. A. Garvin, & A. Sweet (Eds.), Education for judgment: The artistry ef discussion leadership (pp. 137-151). Boston: Harvard Business School Press.

Livingston, C., & Borke, H. (1989). Expert- novice difference in teaching: A cogni- tive analysis and implications for teacher education.Journal efTeacher Education, 40(4), 36-42.

Lunde berg, M.A. (1999). Discovering teach- ing and learning through cases. In M.A. Lundeberg, B. B. Levin, & H. L. Harrington (Eds.), VVho learns what from cases and how? The research base for teaching with cases (pp. 3-23). Mahwah, NJ: Lawrence Erlbaum.

Lunde berg, M.A., Levin, B. B., & Harrington, H. L. (1999). VVho learns what from cases and how? The research base for teaching with cases. Mahwah, NJ: Lawrence Erlbaum.

Lynn, L. E.,Jr. (1999). Teaching and learning with cases:Aguidebook. New York: Chatham House.

Mauffette-Leenders, L.A., Erskine,]. A., & Leenders, M. R. (1997). Learning with cases. London, ONT: Ivey Publishing, Ivey School of Business Administration, The University ofWestern Ontario.

McClelland, R.W,Austin, C. D., & Este, D. (1998). Macro case studies in social work. Milwaukee: Families International.

Merseth, K. K. (1996). Cases and case meth- ods in teacher education. In]. Sikula, T.J. Buttery, & E. Guyton (Eds.), Handbook of research on teacher education (2nd ed., pp. 722-744). New York: Simon & Schuster Macmillan.

Naumes,W, & Naumes, M.J. (1999). The art and creft ef case writing. Thousand Oaks, CA: Sage.

Reitmeier, M. (2002). Use ef cases in social work education. Unpublished manuscript, University of South Carolina, Columbia.

Reynolds, B. C. (1942). Learning and teaching in the practice of soda[ work. New York: Farrar & Rinehart.

Rivas, R. F., & Hull, G. H. (2000). Case stud- ies in generalist practice (2nd ed.). Pacific Grove, CA: Brooks/Cole.

Shulman, L. S. (1992). Toward a pedagogy of cases. In]. Shulman (Ed.), Case methods in teacher education (pp. 1-30). New York: Teachers College Press.

Sykes, G., & Bird, T. (1992). Teacher educa- tion and the case idea. In G. Grant (Ed.),

16 PART I TO THE STUDENT

Review of Research in Education (Vol. 18, pp. 457-521).Washington, DC: American Educational Research Association.

Towle, C. (1954). The learner in education for the professions: As seen in education for social work. Chicago: University of Chicago Press.

Weaver, R.A., Kowalski,T.J., & Pfaller,J. E. (1994). Case-method teaching. In K.W Prichard & R. M. Sawyer (Eds.), Handbook of college teaching: Theory and applications (pp. 171-178). Westport, CT: Greenwood.

Welsh, M. F. (1999).A technique for cross- cultural case research and writing. In H. E. Klein (Ed.), Interactive teaching and the multimedia revolution: Case method and

other techniques (pp. 3-9). Madison, WI: Omni.

Welty,W M. (1989). Discussion method teaching: A practical guide. To Improve the Academy, 8, 197-216. [For a briefer version, see Welty, WM. (1989). Discussion method teaching: How to make it work, Change, 21(4), 40-49.)

Wolfer,T.A. (2003). Decision cases for Christians in social work: Introduction to the special issue. Social JiV<Jrk & Christianity, 3 0(2), 103-116.

Wolfer, T.A., Freeman, M. L., & Rhodes, R. (2001). Developing and teaching an MSW capstone course using case meth- ods of instruction. Advances in Social JiV<Jrk, 2(2), 156-171.

Chapter 2

[I]

Tips for Learning

from Decision Cases

TERRY A. WOLFER T. LAINE SCALES

W hat you get out of reading, analyzing, and discussing a particular case depends largely on the method and thoroughness of your prepara- tion. The following provides sequential tips regarding effective

processes for reading and analyzing cases and for participating in decision case discussions. Some sections are drawn directly from a "Note to the Student" (Bruner, 1999), written by a master teacher for business students, while other sections were written for social work students specifically.

READING THE CASE

There are many ways to read cases.You can increase your reading effectiveness and efficiency by deliberately using different ways at various points in the process. From the very first reading, you can maximize your learning with a decision case by active, purposeful, and discriminating engagement. Bruner (1999) suggests:

The very first time you read any case, look for the forest not the trees. This requires that your first reading be quick. Do not begin taking notes on the first round; instead, read the case like a magazine article. The first few paragraphs of a well-constructed case usually say something about the problem-read those carefully. Then quickly read the rest of the case,

18 PART I TO THE STUDENT

seeking mai~y a sense of the scope of the problems, and what information the case contains to help resolve them. Leaf through the exhibits, looking for what information they hold, rather than for any analytical insights. At the conclusion of the first pass, read any supporting articles or notes that your instructor may have recommended. (pp. x:xiii-x:xiv)

This brief, initial review of the case will quickly orient you to the situation and its overall context.

DIGGING INTO THE CASE SITUATION:

DEVELOP YOUR II AWARENESS"

Reading the case a second time will deepen your understanding, as Bruner (1999) reminds case readers:

With the broader perspective in mind, the second and more detailed reading will be more productive. The reason is that as you now encounter details, your mind will be able to organize them in some useful fashion rather than inventorying them randomly. Making linkages among case details is necessary toward solving the case. At this point you can take the notes that will set up your analysis. (p. x:xiv)

While your instructor may provide questions to aid your preparation for particular cases, you can promote your own analytic skills by learning to pose and answer questions of your own. To begin this process, try to keep the fol- lowing generic questions in mind:

1. Who is the protagonist in the case?Who must take action on the problem? What does he or she have at stake? What pressures is he or she under?

2. What is the field of practice? Who are the usual clientele?What is the demand for services? How are services funded? What are the professional affiliations and qualifications of staff? What services do the social workers provide?

3. What are the organizational auspices (e.g., public, private nonprofit, private for-profit), and who has primary authority in the organization? With whom does it collaborate or compete? Is the organization comparatively strong or weak? In what ways?

4. What are the organization's goals or desired outcomes? If not a social work organization, how does social work contribute to its goals? What are the primary intervention methods used by the organization or, if not a social work organization, the social workers who work for it?

5. How well has the organization performed in pursuit of its goals? How clearly does the organization identify its goals?

CHAPTER 2 TIPS FOR LEARNING FROM DECISION CASES

At the outset, this may sound rather daunting. There is so much to consider! Understand that thinking of these factors will become more natural and rou- tine as you become more acquainted with the process of analyzing cases. The goal here is to develop greater awareness of fundamental and perennial issues, and a routine habit of attending to them. As Bruner suggests, awareness is an important attribute of successful practitioners.

DEVELOP EMPATHIC UNDERSTANDING

When reading the case, seek empathic understanding of the situation from the protagonist's perspective. It may be helpful to imagine yourself as a personal consultant to the social worker in the case. As such, you need to "start where the social worker is," to paraphrase an old cliche. Take account of the social worker's background, experience, skills, thoughts, biases, and emotions, and also of your own. Because the particular case dilemmas often involve these very factors, it is not possible or appropriate to simply replace the protagonist with your self in the case situation. These factors cannot be wished away. Any solution must take account of them, much as a consultant or supervisor would do in actual practice.

Having read and reread the case-to get a sense of the story, develop your awareness, and empathize with the protagonist-you are ready to begin more deliberate analysis.Analysis may begin with an initial statement of the problem but beware of simply adopting the perspective of the protagonist or other par- ticipants in the case.

DEFINING OR FORMULATING

THE PROBLEM

Defining or formulating the problem represents one of the most important and challenging aspects of case analysis and discussion.

A common trap for many [practitioners] is to assume that the issue at hand is the real problem most worthy of their time, rather than a symptom of some larger problem that really deserves their time. (Bruner, 1999, p. xxv)

Students tend to take the "presenting problem" at face value, whether it's posed in the case by the client or the social worker protagonist, and assume that it represents the real problem.

Students who are new to the case method tend to focus narrowly in defining problems and often overlook the influence which the larger setting has on the problem. In doing this, the student develops narrow

20 PART I TO THE STUDENT

specialist habits, never achieving (a broader systems perspective]. It is useful and important for you to define the problem yourself, and in the process, validate the problem as suggested by the protagonist in the case. (p. xxv)

At this point in your analysis, it is also wise to define the problem tentatively. Treat your problem definition as a hypothesis to guide further analysis, a way to provide some structure for your thinking and questioning.

ANALYSIS: IDENTIFYING THE KEY ISSUES

AND HOW THEY RELATE

The next, most time-consuming stage involves careful analysis of the case. There are several things to understand here. First," case analysis is often itera- tive: an understanding of the big issues invites an analysis of details-then the details may restructure the big issues and invite the analysis of other details. In some cases, getting to the 'heart of the matter' will mean just such iteration" (Bruner, 1999, p. xxv).

Second, when doing analysis, mental experiments often help to develop insight. For example, if the client is a man, you might consider how the case might be different if the client were a woman. Or, if the client is a person of color, consider how the situation might differ if she or he were white. Alternately, you can sometimes determine a factor's relevance by mentally subtracting it from the case and considering whether the problem goes away. If there is still a prob- lem, then the particular factor has limited relevance. Compare contrasting defi- nitions of the situation offered by people in the case, and ask yourself how else it may be construed. Consider the client system and whether it could be defined differently. Brainstorm possible factors, on other system levels, that may cause or influence the situation. Identify what organizational policy may be relevant, unclear, or absent. Determine whether multiple ethical standards may be rele- vant. In short, play with definitions, comparisons, and contrasts.

Third, as you analyze the case, be prepared to revise your initial problem definition. Ask whether your emerging insights fit the problem definition. If not, try to redefine the problem in a way that accounts for your new insights. Redefining the problem requires that you reconsider other aspects of your analysis as well.

Fourth, understand that problem definition both guides analysis and also captures or reflects analysis. For most people, writing concise problem state- ments represents a major challenge. Skill in problem definition comes with practice and experience. "The best case students develop an instinct for where to devote their analysis. Economy of effort is desirable. If you have invested wisely in problem definition, economical analysis tends to follow" (Bruner, 1999, p. xxv). Carefully consider what belongs in the pro bl em statement, versus what is important but not central to the problem, and therefore only belongs in

CHAPTER 2 TIPS FOR LEARNING FROM DECISION CASES

the contextual analysis that supports it. Although these analytic processes can be tedious and time consuming, with practice you will become faster and more efficient.

PREPARE TO PARTICIPATE: TAKE A STAND

Eventually, you must shape your analysis of the situation into an argument for action.

To develop analytical insights without making recommendations is useless to [practitioners], and drains the case study experience of some of its learning power. A stand means having a point of view about the problem, a recommendation, and an analysis to back up both of them. To prepare to take a stand, remember the words of Walt Disney: "Get a good idea and stay with it. Dog it and work at it until it's done, and done right." (Bruner, 1999, pp. xxv-xxvi)

Developing an argument for action requires courage; it represents a test of your case analysis. Often, there are many things at stake--especially for the client and social worker directly but also for the client's family members and associates and the social worker's organization, program, and coworkers. Despite these risks, you must choose how to act. In the world of practice, analysis that does not lead to action has limited value and may even be counterproductive.

Recognize, however, that if all students take stands, as they should, this will likely produce vigorous disagreements. Many students feel uncomfortable tak- ing a stand, especially in the face of such disagreements. Having a strong desire to get along with their peers and instructors, they may downplay differences in their analysis or recommendations in order to reduce interpersonal tension. But this undermines the potential benefit of the process, for the group and also for the individual student. Without vigorous debate, the group may not consider diverse perspectives and students miss opportunities to practice intro- ducing and defending their ideas. Developing the confidence and skill to assert yourself in group contexts will increase your effectiveness in family and group treatment settings, supervision sessions, meetings of professional teams, committees, or boards, or advocacy situations. In many situations, social work- ers will often agree and disagree. The case discussion process helps you prac- tice doing so in direct and respectful ways.

THINGS TO AVOID WHILE PREPARING

When preparing for case discussions, there are several things to avoid. Skipping or shortchanging preparation will limit your ability to participate effectively in the discussion and, more importantly, will limit what you personally can learn from the discussion. You may find that reading decision cases for comprehension requires more careful and focused reading than you typically do with textbooks.

22 PART I TO THE STUDENT

Endorsing the presenting problem may seriously bias your analysis of the case, while ignoring the presenting problem reflects a failure to understand an important per- spective in the case. Focusing on either details or the big picture, to the exclusion of the other, undermines your analysis.Jumping to conclusions without adequate evi- dence prematurely ends your analysis and risks gross misunderstanding of the case. On the other hand, not drawing conclusions about the problem and its resolu- tion circumvents the challenge and purpose of decision cases, reducing the opportunity to exercise and develop your decision-making skills.

ACTIVELY SUPPORT YOUR CONCLUSIONS

IN THE DISCUSSION, BUT STAY OPEN

TO EMERGING INSIGHTS

As a result of preparing, you may come to the discussion having already for- mulated conclusions, sometimes very firm conclusions, about the nature of the problem and appropriate responses. ~haring your conclusions can benefit both you and your classmates but you must remain open to their conclusions and further insights that will emerge in the discussion.

Of course, one can have a stand without the world being any wiser. To take a stand in case discussions means to participate actively in the discussion and to advocate your stand until new facts or analysis emerge to warrant a change. Learning by the case method is not a spectator sport. A classic error many students make is to bring into the case method classroom the habits of the lecture hall (i.e., passively absorbing what other people say). These habits fail miserably in the case method classroom because they only guarantee that one absorbs the truths and fallacies uttered by others. The purpose of [decision case method] is to develop and exercise one's own skills and judgment. This takes practice and participation,just as in a sport. Here are two good general suggestions: (1) defer significant note-taking until after class and (2) strive to contribute to every case discussion. (Bruner, 1999, p. xxvi)

In short, active participation is critical for your learning. But thoughtful responding to new insights, whether these come from you or other partici- pants, will be important, too.

LISTEN CAREFULLY

Because considering what others contribute is so important, effective partici- pation in case discussion also requires that you listen carefully and actively. Concentrate on what others say, and on what they mean. Focus on their explicit content but also try to discern their underlying assumptions and values.

CHAPTER 2 TIPS FOR LEARNING FROM DECISION CASES

The active listening skills you may have learned for social work practice can apply in the case discussion, too. You must gain adequate understanding, through careful listening, before you can make a fair evaluation. But do evalu- ate what you hear, comparing it with your own ideas. Do you agree? Why or why not? (Mauffette-Leenders, Erskine, & Leenders, 1998, p. 94). At the same time, guard against focusing on what you will say next because that under- mines your ability to listen effectively.

MAKING CONTRIBUTIONS

During the case discussion, students may make either content contributions or process contributions (Mauffette-Leenders et al., 1998). Content contribu- tions include separating facts from opinions, providing analysis, identifying reasonable assumptions, or offering an action plan. An example of a content contribution would be "The immediate issue is ... and the basic issue is ... " (p. 86). Process contributions, in contrast, refer to the structure of the discus- sion. They require careful listening and obseryation of how the discussion unfolds. Process contributions include clarifying questions, suggesting that a certain area of the case needs to be explored further, linking points raised ear- lier, or summarizing the discussion thus far.An example of a process contribu- tion would be "We need to spend more (or less) time on ... "or "We should hear from Harry because ... " (p. 86).You may recognize that process contri- butions are similar to comments an instructor or group facilitator makes. Ideally, you will learn to make both content and process contributions and also learn to recognize when either would be most appropriate and helpful. As you practice thinking like a social worker, you are practicing roles as an active member of a task group, or even as the facilitator. The point here is to contribute in various ways that move the discussion forward.

THINGS TO AVOID IN CASE DISCUSSIONS

When participating in case discussions, there are several things to avoid (Mauffette-Leenders et al., 1998, pp. 89-90). For example, simply repeating case facts contributes little to the discussion unless there is some confusion about the facts. Repeating someone else's comments reflects a failure to pay attention. Inconsequential interjections such as saying, "I agree;' without explaining why contribute very little to the discussion. Likewise, asking questions that divert the discussion such as asking the instructor for his or her opinion may only delay or derail the discussion. Other digressions include irrelevant or out of place com- ments such as personal anecdotes that have little relevance to the situation. Monopolizing the discussion reflects an unwillingness to listen and learn from others. Sometimes students believe they have special understanding of case situ- ations because of previous experience, and they actually do. Nevertheless, their

24 PART I TO THE STUDENT

understanding may be limited and biased by those insider perspectives. In such cases, they may benefit from the comments and questions of others having less experience. In sharp contrast, disengaged students rarely contribute to the dis- cussion or, when they do jump in, tend to make superficial or irrelevant com- ments. Finally, undvil behavior such as attacking, ridiculing, or putting down other participants or their views can have a damaging effect on case discussions.

Though in different ways, students exhibiting dominant, disengaged, and uncivil behavior all limit the diversity of viewpoints available in a discussion. Dominating behavior limits the opportunities others have to participate, while uncivil behavior may frighten and discourage others from participating. Disengaged students simply withhold their own contributions.

TRUST THE PROCESS

Case discussions may be complex, unpredictable, and bewildering. As a result, you may wonder at times where a particular discussion is headed or what you are gaining from the process. Brune~ (1999) offers some good advice:

The learnings from a case-method course are impressive. They arrive cumulatively over time. In many cases, the learnings· continue well after the course has finished. Occasionally, these learnings hit you with the force of a tsunami. But generally, the learnings creep in quietly, but powerfully, like the tide. After the case course, you will look back and see that your thinking, mastery, and appreciation for [social work] have changed dramatically. The key point is that you should not measure the success of your progress on the basis of any single case discussion. Trust that in the cumulative work over many cases you will gain the mastery you seek. (p. xxvi)

With that in mind, you can hopefully maintain the kind of openness and engagement that contributes most to your learning and growth.

FOCUS ON HERE-AND-'NOW PROCESS,

AND RESULTS WILL FOLLOW

Bruner (1999) reminds us that the case method helps you develop and prac- tice new ways of learning and thinking:

View the case method experience as a series of opportunities to test your mastery of techniques and your [professional] judgment. If you seek a list of axioms to be etched in stone, you are bound to disappoint yourself. As in real life, there are virtually no "right" answers to these cases in the sense that a scientific or engineering problem has an exact solution. Jeff Milman

CHAPTER 2 TIPS FOR LEARNING FROM DECISION CASES

has said, "The answers worth getting are never found in the back of the book."What matters is that you obtain a way of thinking about [social work] situations that you can carry from one job (or career) to the next. In the case method it is largely true that how you learn is what you learn. (Bruner, 1999, p. xxvi)

MAINTAIN PERSPECTIVE

Because case method learning may be quite different from what you've expe- rienced before, it's helpful to know that you may respond with strong emo- tions. These emotions may stem from unfamiliarity with the method and uncertainty about what to expect and how to participate, the unsettling nature of some case dilemmas, profound differences and conflicts that emerge in the case discussions, and the ambiguity of solutions and their likely consequences.

FINALLY, FOCUS· ON

LONG-TERM OUTCOMES

At the same time, remember the learning outcomes identified in the previous chapter. These outcomes of case method learning can be quite significant overall, but less obvious for individual cases. In fact, the specific content you learn from a particular case may seem to have little value for you personally and professionally. But even when cases seem irrelevant, you can still gain experience in understanding and resolving novel situations. It's the process of analyzing the situation, more than the situation itself, that generates the learn- ing. The case analyses and case discussions can help develop and refine your abilities for analyzing and resolving difficult situations.And that is good practice for learning to think like a social worker, and for the world of practice.

REFERENCES

Bruner, R. F. (1999). Note to the student: How to study and discuss cases. In Case studies in finance: Managing for corporate value creation (3rd ed.; pp. xxiii-xxvi). Boston: Irwin McGraw-Hill. [Also available online at http:/ /faculty.darden. virginia. edu/brunerb I resources_ studentnote.htm]

Mauffette-Leenders, L.A., Erskine,]. A., & Leenders, M. R. (1998). Learning with cases. London, ONT: Ivey Publishing, Ivey School of Business Administration, The University ofWestern Ontario.

Inside or Out1 Diane Rhodes and Terry A. Wolfer

Sexual Assault Counselor Rebecca Collins and client Lauren Peters approached the locked

door into the Pflugerville police station. As Detective Rogers put her keycard up to the scanner,

she lifted a staying hand to Rebecca. “Okay, well, you’re good.”

“This is as far as I can go?” Rebecca asked.

“Yeah,” the officer continued offering a staying hand gesture.

“I need her in the room with me,” Lauren spoke up.

“That’s not what we do.” The detective had not yet scanned the lock. “I’ll be in there with

you.”

“I want her in the room with me,” Lauren indicated Rebecca. “Is it possible?” Lauren stayed

back from the door.

“Is it possible? Well, I don’t know. It might be interfering,” Rogers explained. “The DA

might not like it.”

“Maybe this could be an opportunity to try and find out,” Rebecca offered. “I’m not here to

interfere with the investigation.”

“I don’t feel safe unless she’s with me.” Lauren added.

Detective Rogers dropped her hands and faced Lauren, eyebrows raised, “Are you telling

me you don’t feel safe in the police department?”

Austin, Texas

In 2016, Austin was an urban community of 947,890 people sprawled across Travis County

and spilling into Hays and Williamson Counties. The fourth most populous city in Texas,

Austin was growing fast, often appearing on national ‘best of’ lists. Austin’s story was one of

rapid growth accompanied by persistent structural and spatial socioeconomic and demographic

separations. Also home to the flagship campus of the University of Texas System, the city was

well educated, with more than 49% of adult residents holding a bachelor’s or higher degree.

While there was a core liberal center in Travis County, its neighbors were significantly more

politically conservative, consistent with the state’s conservative climate.

Austin and its surrounding counties had a large and well-connected network of agencies

that provided social services. As the Texas state capital, Austin was home to social services

operated at the federal, state, county, and local levels. Pflugerville was a small city of nearly

60,000 people north of Austin that overlapped both Travis and Williamson Counties.

1 This decision case was prepared solely to provide material for training discussion and not to suggest

either effective or ineffective handling of the situation depicted. While based on field research regarding

an actual situation, names and certain facts may have been disguised to protect confidentiality. The

authors wish to thank the case reporter for cooperation in making this account available for the benefit of

trainers and professionals in the field of sexual violence. Development of this case was supported by a

grant from the Office of the Governor, Criminal Justice Division (Contract No. UTA14-001266).

Williamson County social service included a small domestic violence and sexual assault shelter

program.

Stop Abuse For Everyone (SAFE)

One of the largest local agencies, Stop Abuse For Everyone (SAFE) had helped victims

recover from child abuse, sexual assault, and domestic violence for more than 40 years. While

SAFE was one of the few programs in the state with a shelter built using public city bond

dollars, the responses to sexual assault victims across the metropolitan area were varied and

uneven. Like several other local social services agencies, SAFE was the product of the mergers

of smaller programs over the course of its long history in the community. In 2016, the agency

had more than 200 paid staff, a counseling and administrative building, a shelter for 120

families, a state-of-the-art hotline call center, a shelter for children, a transitional housing

complex, a daycare center and school, and more than 1,000 active volunteers. SAFE provided a

continuum of services ranging from emergency shelter to individual counseling. Services

included basic needs provision, legal advocacy, referrals, hospital and court accompaniment,

and prevention initiatives. In addition, SAFE offered extensive educational, advocacy, and

prevention programs to Travis County. The agency owned and operated several buildings on

two campuses in East Austin. The sexual assault services were housed in a non-residential

building at an imposing twelve-acre campus with visible security.

Potential clients accessed SAFE services by first calling the hotline. In an initial call, a hotline

advocate screened callers by gathering brief demographic and background data and some

information about their relationships with perpetrators on a one-page call record. From there,

the advocate and potential client worked together to plan for safety and discover what services

would be most useful to the situation. When a caller was interested in scheduling an intake for

in-person services, the hotline advocate used an online agency-wide scheduling calendar to

arrange the next available intake appointment.

Rebecca Collins

Rebecca Collins grew up the older of two girls, with parents who worked long, hard hours.

There was a history of mental illness in the family. Rebecca’s mom had a diagnosis of borderline

personality disorder that resulted in frequent hospitalizations. The family had moved a lot,

primarily around the Gulf Coast region.

An outgoing child, Rebecca saw her role as taking care of her little sister after school and

making her sister’s way easier. When she was young, Rebecca wanted to be an architect and

planned to attend Rice University in Houston, Texas. While she was in high school, however,

the family moved to the Ft. Worth area and Rebecca stumbled upon journalism and writing. She

worked on the student newspaper and was the editor during her junior and senior years. Those

experiences led her to Journalism School at the University of Texas at Austin in 2006. Then, also

interested in studying religion, Rebecca added a second major to her degree program. However,

she graduated in 2010 still unsure what profession she wanted to pursue. She moved with an

intimate partner to a small town and took an administrative job while she continued searching

for professional direction. Her boss, observing that Rebecca was extremely good at listening to

others, suggested she become a counselor.

It was not the first time. Rebecca had been told repeatedly she would be a good counselor

throughout life. She spent many high school hours in the girls’ bathroom hearing confessions of

friends who were having trouble in school or at home, coerced into sex, abused by boyfriends,

or other stories. Then she’d go home and look up resources to help. After looking at several

programs she chose to attend the University of Texas Masters in Counseling Psychology

program. At SAFE, she was the first intern assigned exclusively to the Sexual Assault program.

Following the internship, Rebecca knew she’d found the work she wanted to pursue. After

Rebecca graduated in 2013, SAFE hired her part time and she supplemented her income with

another position at the local Mental Health Authority. She learned a lot from her second job, but

didn’t like working in a setting that was less client centered and empowering. When a full time

position opened up at SAFE, she immediately applied for it and got it. In the new position, she

used her fluency in sign language to do outreach and counseling for clients with disabilities.

She loved her work, but still really wanted to be a sexual assault counselor.

After a one-year wait, she finally got the job she wanted as the Senior Sexual Assault

Counselor. Part of Rebecca’s role was to provide intake assessments for sexual assault survivors

several times a week. Each Monday, the call-logs for the week’s upcoming intakes arrived in her

mailbox. She glanced at the logs for the week, made notes about the scheduled clients in her

calendar, and prepared to conduct the intakes as part of her work week.

Meeting Lauren Peters

On Thursday, Rebecca answered a call from the receptionist. “Hey, your 11 o’clock intake is

here.” Rebecca confirmed that the client was the one she was expecting and went to the front of

the building to meet her. The public waiting room was busy that morning and Rebecca quietly

asked the receptionist to point out Lauren Peters before stepping into the waiting room.

“Ms. Peters?” Rebecca asked.

Lauren Peters made eye contact with a nod as Rebecca crossed the room.

“Hi, my name is Rebecca, I’m a counselor here, and you have an appointment this morning.

Does that sound right?”

Rebecca practiced an informal manner in her professional interactions with clients but was

cautious about public conversation. On the way out of the lobby and into the hallway, she

asked Lauren about the notorious Austin traffic and the humidity. In the privacy of the hallway,

Rebecca asked whether Lauren had been to SAFE before. Rebecca went on to describe the

layout of the large building and how they would get to the counseling rooms.

Lauren Peters was a white woman in her early 40’s, older than Rebecca, but dressed down

in casual clothing. She lamented the awful traffic and the heat. Lauren and Rebecca both had

several visible tattoos, and Lauren complimented Rebecca’s body art. She spoke with a

forthright manner. She asked if Rebecca was queer. Rebecca answered yes. As they turned a

corner and approached the client lobby, a private waiting room, Rebecca asked Lauren if she

needed the bathroom, or would like some water. Knowing they were headed to one of the

smaller counseling rooms, Rebecca also picked up a box of tissues and a spare pen. Rebecca

assured Lauren that although they weren’t meeting in her office, they would be meeting in a

comfortable, private space further into the building. “It will just be me and you.”

The counseling rooms were located near the center of the large building. Each room was

small and windowless, yet at the same time cozy, private, and intimate. The women made

themselves comfortable in the chairs. As they settled, Rebecca introduced herself again.

“I understand you made this appointment with the hotline.” She went on to describe the

current session as a registration intake, not counseling. “I talk fast, I might skip some things. If

you have a question just let me know. Stop me right there, nothing’s off limit and nothing is

TMI.”

“Cool – I’ll do that,” Lauren answered. And, based on the ease and directness of their

conversation in the hallways, Rebecca had every indication she would.

Together, they went over the agency confidentiality policy, signing and dating the

document for Lauren’s file. Then they tackled the demographics form that touched on what

brought Lauren to the agency, what her reactions were, what services she might want, what her

goals were, and what services were available.

“Have you been in counseling or therapy before?” Rebecca asked.

“Yes, but not in Texas,” Lauren offered. “It was in another state.”

“Was it for this same event?”

“No, it was about other abuses I’ve had before – other trauma.”

Rebecca noted Lauren’s use of the term trauma, which wasn’t common for clients in a first

session. “The first couple of forms might seem familiar if you’ve been in counseling before.”

“Okay, sounds good.” Lauren smiled.

They companionably plowed on through the forms and explanations. Rebecca covered

issues of informed consent and detailed the second parts of that form which described the rights

and responsibilities of a client at SAFE. Rebecca made sure to explicitly state those rights rather

than assume Lauren read them. “You have the right to refuse services, you’re not promising us

anything, all services are totally up to you, we’re not going to come looking for you. You have

the right not to be discriminated against because of your race, ethnicity, gender, orientation,

religion, national origin, gender, or ability.”

“So,” Lauren lifted her hand, “do you see men here?”

“We do – we do see men and children and non-binary folks. Why do you ask?”

“Because I used to work at a trans hotline and a lot of people don’t serve men or don’t serve

the trans community.”

“No, we do.” Rebecca assured.

“That’s great,” Lauren’s relief and approval evident in her voice.

Rebecca continued with an outline of client responsibilities. “Don’t be violent with anyone.

Keep everyone’s information confidential.” She explained the exceptions to confidentiality

involving child abuse, elder abuse, and a present danger to one’s self or others all of which must

be reported by law. “Another exception to confidentiality – if you want us to talk to someone –

if you have anyone you want us to be able to talk to, then that will take a Consent to Release

Form which is coming up.” Rebecca also explained about the rare instances that a session might

be recorded for supervision or educational purposes and how that was kept confidential. She

wrapped up with a description of the agency grievance policy and procedures.

Lauren listened to everything carefully. “Okay. Sounds like y’all take this really seriously

here.” Lauren wanted two release of information consent forms on file. One was for her

roommate, Ashley, and a second was for the Pflugerville Police Department.

With the critical service documentation taken care of, Rebecca sat back a bit and repeated

her original question to help Lauren get started talking. “Can you tell me about what brings you

here today? What experience resulted in you calling?”

“I had a really horrible experience. I was raped by this guy who worked for me.” Lauren

became tearful while she spoke. “I was his boss at the restaurant. He came over, and it was

terrible, my roommates saw it, I don’t know if they saw it, they were outside – I was smoking

pot. Is that okay? The cops didn’t think it was. I still smoke pot.” Lauren’s beginning was a bit

of a jumble.

“We’re not going to judge you,” Rebecca said. “It’s okay.”

“We’re smoking, then I went to sleep. I was on medication for anxiety. Then I called the

cops, but I didn’t call them right away like I’m ‘supposed to’,” Lauren made air-quotes. She was

getting wound up, the tears increased with her distress, “which is why they gave me sass . . .”

“We’re gonna pump the breaks here, take a breath,” Rebecca leaned forward. “Let’s just

slow things down.” She offered Lauren more tissues.

“I’m sorry, I’m sorry,” Lauren gulped a little and swallowed.

“It’s fine,” Rebecca said. “Can you tell me what happened when, slowly? When did this

happen?”

To Rebecca’s surprise, the incident of Lauren’s rape was only days in the past. It was not

unusual for new clients to seek services for sexual assaults from months or even years past.

With immediacy, Lauren offered a detailed moment-by-moment account of being raped by an

employee. Her true distress however, was with how the responding police officer handled her

report, leaving her feeling as if she couldn’t make a police statement in the near future with any

hope of being taken seriously.

“I did not like the way she looked at me,” Lauren said. “I didn’t like her tone, I felt like I

was being judged. I thought, ‘This is fucked up.’ But, this is what I had. This is who I had to talk

to. I was going to walk her through everything but she just immediately started asking

questions. Like, ‘Are you sure this wasn’t consensual?’ ‘I don’t see any bruising?’ ‘Where’s the

evidence?’ I’m like, ‘Are you fucking kidding me? No. He is not my boyfriend.’ She goes, ‘Then

why was he staying on the couch? ‘Because we’re nice people and he’s my employee?’ We

didn’t want him to be homeless,” Lauren sounded sarcastic. “‘Okay,’ she says. ‘Calm down,

ma’am.’ She asked, ‘Did you swab yourself? Did you go to the hospital? When did this

happen?’ She counted off hours on her fingers and said, ‘You can’t get a rape kit.’ I go, ‘What?!’

because I had Googled some information about sexual assault investigations earlier in the day,

and that didn’t sound right. She says, ‘You showered and didn’t swab yourself—that’s not good

for the case. Because you were high—and you shouldn’t be smoking pot—that’s assuming you

even recall who he was.’”

Interrupting her story, Lauren asked Rebecca, “Have you ever seen that YouTube about If

Burglary was Investigated like Sexual Assault (Kao, 2015), where two officers do everything

wrong? It’s like she watched that video and decided, ‘This is the way I’m gonna talk to

people.’”

“Then, she goes, ‘Can I see the bed? Did you change the sheets?’ ‘Yes,’ I told her, ‘but I kept

them.’ So I brought out the sheets. And she wanted to know if there was any evidence on the

sheets. I said, ‘Isn’t that your job?’ She wants to know, ‘Why are you keeping your doors open if

you know there’s a strange man in the house?’ ‘I was strangled!’ I was getting so mad. ‘You

don’t have any bruises,’ she says. ‘Yeah, well I don’t bruise easily and wouldn’t have visible

bruising yet.’ She seemed skeptical, so I told her how Cole had held me down. She didn’t seem

to understand, so I put my hands on my neck to show her. Then, she reaches her hands and

touches my neck, like the assault. Shit! I jerked out of her reach. After that, I just wanted her to

leave and lied about having to go to work. ‘What needs to happen next?’ ‘Well,’ she goes, ‘there

could be an investigation, and you would need to make an official statement.’ I’m like, ‘What?! I

thought that’s what we were doing.’ I was so tired of talking to her, I didn’t pursue the subject.”

Seeking More Help

“After she left, I called the Women’s Center, hoping to get some answers about procedures

and perhaps complain about the report she’d just made. But that person was no better! She

goes, ‘Why do you want to call the Center if you’ve already called the police?’ I didn’t like her

either, so I hung up on that bitch. Next I called RAINN,2 – and talked to an advocate there. I

asked her, ‘Where else can I go? I need to talk to somebody who’s not going to be a judgmental

prick and I need to talk to somebody who can do something.’ She connected me to the SAFE

hotline.

Rebecca listened closely while Lauren talked, taking few notes. As Lauren wound down by

repeating how badly she’d been treated by the responding officer, Rebecca set her pen down.

“Thank you for telling me what happened,” Rebecca said.

“Can you believe this shit?” Lauren asked.

“I’ve heard similar stories,” Rebecca responded. “What are you looking for here? What

would you like to do now?”

“I want somebody to tell the police they fucked this up,” Lauren said, “and they shouldn’t

do that to people.”

Rebecca described legal advocacy and asked if Lauren was also interested in counseling

services.

“Yeah. Whatever you’ve got,” Lauren agreed. “This is bringing up other stuff for me.”

“Do you want to talk about that now?”

2 Rape, Abuse & Incest National Network (RAINN) is the nation’s largest anti-sexual violence

organization. RAINN created and operates the National Sexual Assault Hotline (800.656.HOPE).

“Nah,” Lauren shook her head. “I experienced some abuse as a kid and spent some time in

foster care. I spent time on the street, and was raped when I was tricking. But I dealt with that at

the time, you know, just charged it to game.” Lauren paused, “I have a job now, I have

insurance, I’m doing what I do. Now this.”

“It’s normal,” Rebecca offered softly, “for trauma to trigger past trauma. I recommend you

think about both group and individual counseling.” She took time to describe the waiting list

for counseling as well as how to contact a victims’ advocate at the Pflugerville Police

Department.

“Yeah, but I’m wondering,” Lauren asked, “if you could help me if I have to deal with the

Pflugerville police again, or if I want to make a complaint about the police?”

“That makes sense, although that’s not usually what we do here,” Rebecca responded, “but I

want to be sure you get the help you need. Let me know if I can help with that.”

As their conversation came to an end, Rebecca made sure Lauren had her card and walked

her back to the lobby where they said good-bye.

Lauren’s Request

The following Monday, Rebecca had a long voicemail message from Lauren:

Hey, Rebecca. This is Lauren. Listen, Detective Rogers called to ask me to come in for an

official statement. I asked her, ‘Can I have my counselor come with me, because I met

with her and she wants to come with me to do that statement?’ She said you can come,

but won’t be allowed in the room with me, but you can be outside. In the building. I told

her, ‘I need to call my counselor and see when she’s available.’ And I told her you would

call her to make an appointment. While I had her on the phone I asked her who that first

cop was. ‘Can she give me her name?’ I told her, ‘She was unprofessional, she touched

me, she was judgmental and blaming. Someone needs . . .

The message cut off, too long to record. So Rebecca returned Lauren’s call to get the rest of the

information.

“I told Detective Rogers that the first officer told me not to get a rape kit. She was surprised

by that. Detective Rogers didn’t seem to know that I gave her my bed sheets. She also asked me

to look at the mattress pad to see whether I could find any blood. I told her I already washed

the mattress pad but took photos of the stain with my phone. That officer fucked up—she could

have had a rape kit done and evidence that could’ve been collected wasn’t. Do you think any of

this sounds right?”

“No,” Rebecca replied. “I believe you. I’ve never heard an officer asking a victim to wash

evidence. But, there are bad encounters. So, I believe you, but I haven’t had this happen before.

I’ll call Detective Rogers and make an appointment for us.”

After several rounds of phone tag, Rebecca was blunt with Detective Rogers: “Ms. Peters

wants me to accompany her to give her statement.”

“Okay,” Rogers responded, “I told her that you can come, but you won’t be allowed in the

room.”

“I’ll be in the lobby?”

“Yeah.”

“What’s the point of that?”

“Well, you’re still there . . .”

“Lauren wants me in the room with her,” Rebecca repeated. “She prefers me to be in the

room. Is that an option?”

“I don’t think so,” Rogers said. “I don’t see how that would work.”

Rebecca realized she wasn’t getting a hard no. Rogers explained she had no real ability to

schedule an appointment, but Rebecca proposed a day and time for the statement.

Rebecca called Lauren back to confirm. “I’m going to try to see if we can work around the

situation and I can be in the room with you.”

“Given how awful this has been—I need someone in the room with me.” Lauren said, her

voice cracking. “I’m not talking to anyone without you in the room.”

“I’ll find out what we can do,” Rebecca assured. “But you and I will meet before the

appointment and we can talk about what I’ve found out about being in the room with you.”

“You need to be in the room.”

“I understand. I’ll find out what we can do. I’m here to support you regardless of what you

decide.”

With the appointment for Lauren’s police statement looming, Rebecca talked with the

attorneys and legal advocates at Texas RioGrande Legal Aid and at Legal Aid for Survivors of

Sexual Assault. She also put in a call to the Texas Association Against Sexual Assault. She

wanted to find out what the options were. She was looking for any resources to bolster her

argument for being present with Lauren when she gave her formal statement.

The SAFE consulting attorney listened to the details of the situation and commented that it

was not a clearly defined circumstance. “We’re not explicitly allowed in the room, but we’re not

‘not allowed’ in the room either. The Crime Victim’s Bill of Rights is extremely clear about a

victim’s right to have an advocate present in the hospital and in court, but it’s silent on any

portion of the investigation in between. You can try citing the Crime Victims Bill of Rights3 and

carefully use the words, ‘I’m not here to interfere with the investigation.’ The conversation

might take some creativity. You know, good advocacy requires adhering to the rules and if

there’s no rule, keep pushing on behalf of the victim until you find a rule. But don’t get too

adversarial, because that could ensure failure.”

At the Police Station

Rebecca arrived at the Pflugerville Police Department several minutes before the meeting

with Lauren. As their appointment time passed and Lauren wasn’t at the agreed upon meeting

3Victims of crime are guaranteed certain rights and participation in the criminal justice system under

Texas law. The Crime Victims’ Rights are within the Texas Code of Criminal Procedure arts. 56.01 –

56.021. https://www.tdcj.state.tx.us/divisions/vs/victim_rights.html

spot, Rebecca called her.

“Sorry, I’m about ready,” Lauren was still at home, her voice was reedy and unsure. “I had

a hard time getting out of bed this morning. I’m feeling really nervous.”

“I can go back to work,” Rebecca offered, “if you’re not feeling ready.”

“Please wait,” Lauren pleaded, “I’m walking toward the station now.

Lauren’s house was only a few blocks from the police station, and she arrived shortly. The

two women sat outside the station on a park bench and went over what Rebecca had learned

about using the Crime Victim’s Bill of Rights. Rebecca did not want to influence Lauren to do

something she didn’t want to do.

“If it’s okay with you,” Rebecca said, “I will cite this – I will not lie – but . . .”

“I’m not going in the fucking room if you’re not with me,” Lauren interrupted.

“Okay, let’s try this,” Rebecca responded.

They went in to the station and Rebecca let the receptionist know they had arrived. While

they waited for Detective Rogers, Rebecca continued to clarify with Lauren, “They don’t have to

let me in. How much bargaining are you willing to let me do?”

“Do whatever you gotta do,” Lauren insisted. “Inside the room. Not out.”

Rebecca and Lauren were the only people in the station lobby when Detective Rogers met

them. “Hi guys, good to see you. Are you ready?”

Both women stood up and approached the locked door into the station. As Rogers put her

keycard up to the scanner, she lifted a staying hand to Rebecca. “Okay, well, you’re good.”

“This is as far as I can go?” Rebecca asked.

“Yeah,” the officer continued offering a staying hand gesture.

“I need her in the room with me,” Lauren spoke up.

“That’s not what we do.” The detective had not yet scanned the lock. “I’ll be in there with

you.”

“I want her in the room with me,” Lauren indicated Rebecca. “Is it possible?” Lauren stayed

back from the door.

“Is it possible? Well, I don’t know. It might be interfering,” Rogers explained. “The DA

might not like it.”

“Maybe this could be an opportunity to try and find out,” Rebecca offered. “I’m not here to

interfere with the investigation.”

“I don’t feel safe unless she’s with me.” Lauren added.

Detective Rogers dropped her hands and faced Lauren, eyebrows raised. “Are you telling

me you don’t feel safe in the police department?”

Reference

Kao, C. (2015). If a robbery report was treated like a rape report. Retrieved from

https://www.youtube.com/watch?v=A0L4V5BWITM

6 Unusual Appeal

Rachel C. Parker and Terry A. Wolfer

" YOU KNOW, (do ign your paycheck."

ynthia Sanders was taken aback. he knew she was a good mitigation in-

v ·tigator. Hut had Diane Epp . her boss, a dedicated and talented lawyer, just

threaten d her job? Diane often joked around, but thi5 time ynthia sensed

anger as well.

Diane adamantly believed that the dea th penalty was wrong aod llad

dedicated her are r to preventing execu tions. Cy nthia al o oppo ed the

death penalty, l.>Ut ~he argued that their ·lient might have a right to lf-

determination.

Their lient, a death row inmate named Jose Aranda, wanted to waive hi

right to appeal his death sentence. He preforred to die. Hut Diane didn 't want

to allow it; ~he planned to do everything In her power to keep Jose alive. Di-

ane not only vehemently opp< ed the death penalty but also believed that

] se wa innocent.

Dewlupmeni nf 1hl decision lase wu 'upporttd In p.trt by the rro1c t \ln Dealh In ml'rka and the University ol outh rollna C:ollc!(c of Soclnl Work. 11 wa prepared solely 10 provufr material for class discussion a nd not to ~uggcst either dtective or mefft>ctlve hamllinll of 1he •i tuat ion depiocd . Although the Cl! e ts based on fiekl re,ea1 h wgardtng an actual •l tuntion, names and rertairi f,1ct . may hove been 1ll~gui ed IO protect confidemiality. The authors wl\h to thank the cu\· rer>ort.cr lor cooperat ion In making thi s account avall~hl~ Jor th e benefit nf \Oda I work ~1 ud.,ms dnd practitioner~.

UNUSUAL APPEAL I 89

Florida Project for Human justice

Cynthia worked at the Florida Pr ject for Human Justice, a nonprofit agen y

in downtown Tallahassee that provided le•al s rvices to inmates pro bono.

The agency's primary mission was to rcpre ·ent death-sentenced Inmates

across the late who were appealing their sentences. It also advocated for life

~enten e for clients and for a change In state law to end th death penalty. Th ultimate mi sion wa.s to protect and ustain the lives of those on death

row. l"he agency received funding through the f deral Indigent Defense Fund,

ourt allocations, a nd donations from a tar e private law firm.

eve n e mplo ee · taffed th agenc , in ludlng Diane Epp , e, ecutive di-

rector; J e Moran, the other lead attorney (and the only African American on staff); a legal fell wand two other lawyers; ynthia, the mitigation investiga-

to r; and n ac ountant. However, the employees were constantly hanging.

l'be work was stressful, staff turnover was high, and the agency operated on

a hoe Iring budg t.

The agency was prlmarll devoted to appellate work . As Diane e plained

during the hiring interview, "Ap pellate work involv appealing death en-

te nces. When a person is sentenced to death, he has three appeals . The first is

a tlir c l appeal, which Is filed immediately after the ·entencing. Thi cur

automatically, and the inmate do n' t need a privat lawyer becau e the state app Hate defense division automatically pur ·ue it. The second appeal is post-

con iction r v iew, which i where we come in . We loo k at three thing : first,

did the client 's attorneys neglect omething or do something th ey houldn't

have that ca used their c lient to lose the ase? econd, wa there juro r mis-

conduct, such as watchin new about the case on TV, drinking, or fee.ling

pre ured to make a erta in de I ion? Third, are there psychosocial mitigat-

ing factors that pre ipitated the crime, omething In the person's background

that helps to ex plain why they did what they did? The third app aJ, which

o ur a •en al ·o work on, go s to the upreme court."

iane Epps

Diane Epps, a fifty-five-year- o ld Cauca ian woman, had dedicated twenty-five

years o f her career to the agency. Diane was no-nonsense and sh t traight

90 I UNUSUAL APPEAL

from the hip. She was fair, intelligent, and had a grea t wit. She was Immac-

ulately d ressed and always appeared professional, whether meeting a death

row inmate or a supreme court judge. Raised in the hills of centra l Alabama,

she was a true Southerner. She was sharp as a tack and smarter than many of

her coUeagues, but would defer to them and let them take credit. When !>he

did take a stand, it was for either her beliefs or her clients' weU-being; then

she could be hard-no~ed and inflexible. Years ago, she had believed in execu-

tions, but during law school, her sense of justice broadened and deepened.

She changed her mind and had not looked back. At the time of Jose Arant.la's

case, she was known nationally for her work; the media often called her re-

garding death row stories.

Cynthia Sanders

Cynthia Sanders was a petite twenty-eight-year- old Caucasian woman. She

had an intense presence about her; ~he talked with great energy dnd confi-

dence. With a sharp, active mind, she was always questioning and, seemingly

at the same time, answering herself. Feisty and self-assured, she cou ld hold

her own with lawyers, even the long-timers.

Cynthia knew th.e fob was made for her the moment she interviewed for

it. Although fresh out of an M.S.W. program in 1998. she had significant

life and work experience. She had worked as a waitress and a menta l health

aide, and met count less charac ters in the process. As a result, ~he was some-

what fearless. She had also worked in a mental health hospital, where she

gaint!d important knowledge about mental illness, and a rnrrectionaJ imtitu-

tion, where she learned to work with disenfranchJsed and stigmatized males.

These experiences had 11elped to clarify her va lues and e thics regarding se lf-

deterrnination, mental competence, and execut ion. She had also developed

e mpathy for lnmates. As Cy nthia liked to say, "Many death row inmates have

a lot stacked against tht>m. You have to consider their experiences with pov-

ert y, education, abuse, and mental health issues when making judgments

about their character." Diane saw that Cy nthia was perfect for the position;

she hired her on the spot.

UNUSUAL APPtAL I 91

A Troubling Case

One Monday ewning after a long work day, Diane. Joe, and Cynthia sat

discussing cases over dinner. Diane began telling Cynthia about an espe-

cially troubling case, that of Jose Aranda, a thirty-four-year-old Mexican

American man.

"l:ive years ago," Diane recounted, "Jose walked Into a pawn shop. His tim- ing couldn't have been worse. jewelry was stolen, a gun tired , and the clerk

killed. Everyone inside ran . Because of his mental health history, the police

were familiar with Jos~. They had picked him up often. So he made an easy

target for them. He was arrested, eventually convicted for the murder, and

~entenced to death. The thing Is, I don 't think he really committed the mur-

<ler. Me was probably there, though.

"Not only does he claim that he didn't do it," Diane continued, "we have

a nack record here in Florida of granting death row inmates new trials if

prosecutors withheld evidence suggesting Innocence or knowingly used false

evidence. We think it's likely that Jose is yet another innocent victim of our

wonderful court system."

"Of course," Joe cut in, "here in Florida, just because you murder someone

doesn't mean you get <leath. There have to be aggravating circumstances-

rape, robbery, kidnapping, or some o ther crime, along with the murder-to

get the death penalty. Since Jose was convicted of robbing 1111d mur<lering a

man, he got sentenced to death. If he llad just killed him, he wouldn't have

gotten such a hacsh sentence. But, of course, t agree with Diane. I don' t think

he did it either."

"Untortunately," Diane resumed, "since he's been in prison , he's been ex-

tremely violent. He's gotten into several knife tights; one guy he fought al-

most died. So the guards consider him extremely dangerous. He lives on the

Q wing of the Florida State Prison In Starke, which is reserved for the most

vio lent crimina ls in Florida. Living conditions are pretty rough In there; the

guards usually don' t allow him clothes, blankets, pillowcases, or anything

else he could use to harm himself or other prisoners. There are no windows,

and the noise of the buzzing doors keeps him awake. Sometimes he sleeps un-

der his mattress because the noise grates on his nerves. He doesn't see many

people, only the guards who bring his food and check on him. And it's really

hard to get him tilings, like boo ks. You shou ld have seen the hassle we had

92 I UNUSUAL APPEAL

to go through to get Jose a picture of his mother. rhe guards really hate the

prisoners."

fhis information reminded Cynthia of how such cont.litions affeded pris-

oners. Life was dlfficult for all Inmates, but for those with mental illness,

prison conditions cou ld exacerbate their psychotic symptom s. She knew, for

exa mple, ll could worsen halluclniltions, delusions, and inability to think or

concentrate.

Diane's voice interrupted Cynth ia's thoughts. "And that brings us to what

makes this case so difficult for us. Because his living comJittons are so i11hu-

mane, he doesn 't want us to appeal his death sentence. We don't think he's

competent to make that decision because he's been diagnosed with paranoid

\Chlzophrenia. Our main focu~ Is to show he's not competent to waive his

appeal."

"Cy nthia, maybe you ought to t"Ome out and meet him," Joe .~ugge~ted.

"Me's reaUy Interesting. When you're with him, it feels like his eyes are bor-

ing holes into you. He'~ intense."

" He's not a very big man," Diana added, "but his demeanor makes him

~eem much larger than he is.H

"Sure! I'd like to meet him," Cynthia responded. "I've worked with a lot of

people with schizophren ia, so I might be able to offer some insight."

"Well," Diane offered, "we're going tomorrow; you're welcome to come

along. We' ll leave early, because it iakes more than two hours to drive over to

Starke."

'' I'd love to," Cynthia replied.

The Meeting

fhe next day, in the car on the way to the prison, Diane and Joe told Cynthia

more about Jose to prepare her ror her first visit .

Oiane began. "Jos~ ha~ been diagnosed with paranoid schizophrenia. He

thinks he's Chae, a Mayan god. According to ancient Mayan religion, Chae is

the rain god. Jose believes that when he dies, he will fall on the whole world

as rain and bring peace and prosperity. He thinks that thi s heroic an will cause everyone to worship him, and he will no longer be the long-fo rgotten

god that he Is now. Because he's paranoid, he doesn't trust professionals, and

UNUSUAL APPEAL I 93

he tests them. When you meet him , be sure to maintain eye contact. ff you

don't, he won't trust you. He' ll also test you by putting h.ls leg against yours

under the table. Don't move . lf you do, he won' t trust you."

"Yeah, and remember," Joe joked, "don't flirt with him, because he thinks

he's a Casanova."

Cynthia tried to digest all this information. She was determined not to

undermine the rapport Diane and Joe had worked so hard to build with Jose,

especially because trust was hard to rebuild with people who had paranoid

schizophrenia.

lnside the prison, the guard led them to a dusty room furnished with a

battered table, mismatched chairs, and old odds and ends. Two small win-

dows placed nigh in a concrete wall provided tile on ly connection to the

outs.ide world. Jose was brought in, dressed in pajamas and slippers. Shackles

were clasped aroum.1 Ills ankles and chains ran up the sides ()f his legs, then

attached to the shackles on his wrists. Although, as she had acknowledged

previously, Diane did not feel comfortable being alone with Jose, she felt suf-

ficiently safe with Joe and Cynthia present to ask the guard to take a shackle

off one of Jose's wrists.

Wt tat first struck Cy nt hla was Jose's regal demeanor. After they had settled

into their chairs and greeted one another, Jose looked intently into Cynthia's

eyes and, with a dignified air, asked, "So, Cy nthia, how did you come to be a

socia l worker?"

As Jose looked intently at her, waiting for her answer, his back straight and

hands folded, Cynthia felt as though she was being Interrogated. Tllen she

fell something more physical. He had leaned his leg against hers. HI~ move-

ments had been slow and deliberate, and he continued to hold her gaze, as

if waiting for her next move. Ca reful not to flinch, she tried to respond as lf

nothing was awry.

"l have always enjoyed working with people. I like talking to them, and

learning from them ," Cynthia answered evenly, wondering whether she had

passed his test.

IJiane and Joe allowed Jose to control the sessio n. They knew if they

didn't, he might lose trust in them, something they needed desperately and

worked hard to maintrun. Any information they needed from hlm had to be

extracted from whatever he wanted to talk about.

94 I UNUSUAL APPEAL

When Joe asked Jose if he had any issues he wanted to discuss, Jose's

countenance changed. A shadow fell over his face and he began to fidget in

his seat.

"Yeah, l have something to discuss, all eight . This morning, they busted

into my cell, threw me on the bed, yanked my pants down, and shot me in

the ass. It really pissed me off."

Cynthia felt a pang of empathy for Jose; it was clear he felt violated. She

shared his anger with the prison system that treated people like a nimals. She

had seen it fail so many. The rest of the meeting, he voiced other nagging con-

cerns: he was cold, he wanted a book on Mayan gods, and he wanted to discuss

his art. Joe offered to post Jose's art in a prison newsletter for other inmates to

see. Cynth.ia noted that Jose seemed very intel ligent. She couldn't imagine the

double hustration of being cooped up in a small cell and trapped in his own

psychosis. She knew that it was going to be hard for Joe to get Jose a book.

An Informal Staff Discussion

During the ca r ride back to the office, Diane steamed. "We had a court o rder

that Jose was not to be medicated against his will. Who ordered this, right

before t he compe tency hearing o n Thursday'? We need to find out what that

~hot was aad how It will affect him. We may need to seek a postponement

until the meds clear his system."

Cynthia offered, "I could look into that for you. From what I know, I bet

it was a long-acting, time-released Haldol shot, an anUpsychotic drug. The

guards were probably just afraid of him. It's easier to give him a shot than to

have to deal with him. It will probably take a month for it to wear off."

Joe replied, "That would be great, Cynthia . I think you should get more

Involved in this case. Your psychiatric background sure would be helpful."

L)lane added, "Actually, I think we need you on this case. Why don 't you

plan on coming to the competen cy hearing on Thursday?''

''Sure, but how can we have a competency hearing now, if he's been

drugged?" Diane replied, "Well, we probably won't complete the hearing now. I' ll

request that we postpone It for a month or so. But I'm sure the judge will still

want to meet with Jose."

UNUSUAL APPEAL I 95

The Hea ring

The following Thursday, Cynl hla accompanied Joe and Diane to court. The

fudge began by asking Jose. "ls II true you don't want to appealt"

Jose replied, »Ye~, sir, that is true. I would rather die than live like an

animal."

"For you, what docs it mean to die?" tbe judge asked.

Jose replied, "I would be ~trapped into a machine, and be given three in-

jections." Jose explained each of these injections, what they were for, and

how long it would take him to die.

The fudge then asked, "What happens when someone dies?"

Jose ~aid. "When you die you are buried, and your family has a funeral.

If you believe in God you may go to heaven or hell, and if you don't you just

get burled."

The judge then asked, ''Mr. Aranda, your doctors said that you have some

beliefs about Mayan gods. Would you mind telling me about those?"

Jose straightened his back and held his head high. "Those are my personal beliefs and I don't want to discuss them."

As the judge continued his questioning, Cynthia wondered whether Jose

really believed what he was saying about death. He could just be repeating

what he knew others believed. It was clear that Jose knew he had to seem as

rational as possible. From the judge's reaction, Jose had accomplished this; the

judge was impressed. Still, he agreed with Joe and Diane to allow a month and

a half for the shot to wear off, and then hold another competency hearing.

A Month and a Half Later

Afte r the medication had worn off, Cynthia .ind Joe visited Jose again. Now

fami liar with Cynthia, Jose was more personal, eve n flirtatious. He talked

more freely about Mayan culture and, without pause, reminded Joe that he

wanted to waive his appeal

Joe t rled to talk him out of It by asking questions. "You're not going to let

the state government fry another innocent person in Old Spa rk y, are you"!

You aren't going lo let them get away with that, are you? Aren't you going to

stand up to them?"

96 I UNUSUAL APPEAL

Jose responded, "Look, man, l already told you, I' m livlng in a ce ll, and

those door buzzers keep me awake. Half the time I'm naked, and the guards

walk by staring at me. It's like being an animal. I'm sick of it. If I could l1ave

the drugs l need, I might be able to muddle through it. But they won't give

those to me. They say it's too expensive. They don't think I' m worth it . AJI

they give me ls that poison, and I know it's all part of their plot. I hate Hal-

dol! It makes me stiff, and I drool like a damn mad dog. I can't have anything

to read. l can't even get a clarnn photo. I don't want to live like this any-

more, man."

Jose was so adamant, so sincere, that Cynthia began to wonder about his

right to self-determination, and basic human dignity. She wanted to tell Joe

to just stop pressuring Jose. It made her stomach twist to hear him have to

argue about why he wanted to die.

Th e Argu ment

Back at the office, Cynthia brought up her concerns. "Muybe we shou ld let

Jose waive his appeal." Diane and Joe looked at her Incredulously.

"But he doesn't think he will die." Diane insisted. "He thinks he's going to

fall as rain on the whole world and reinvigorate the world's worship of him."

Cynthia replied, "l agree. He might not know what will really happen to

him when he dies, but he does understand that his life will continue to be

hell if he lives. He doesn't want to live like that anymore, Diane. He feels

degraded, he is degraded, and he knows he's d egraded. I'm not sure I would

want to live llke that either."

Diane's voice began to rise. " I don't think he is compt'tt•nt e nough to make

lhat decision. Plus, I think he's innocent."

Cynthia could feel her own adrenaline kicking in. "Still, doesn't he have a

right to have a voice in the matter and have his reasons considered? He's ob-

vious ly miserable lo that cell. He cou lu live like that for another thirty years

or more. I'm not sure that we have a right to make that decision for him."

Diane's face was red . "Cynthia, we have got to present a united front to that

judge next week." She paused briefly. "You know, I do sign your paycheck."

Cynthia felt confused and frustrated. She knew Diane and Joe believed

they had Jo.se's best interests at heart. She had seen their dedication over the

past year; they often visited former clients, even when their professional work

UNUSUAL APPEAL I 97

wa' done. fhey would put a few dollars into inmates' accounts so they could

buy cigarette). They had made huKe sacrifices in their personal relatiomhips.

rhey got to know their clients and developed compassion for them. They

held scrupulously to their own ethics.

llut would she be able to reconcile her ethics with theirs! They l>elieved

Jose was not competent to make the decision to waive his appeal. 8111, she wondered, Jww rnmpete11L is w111pete11t e11cmglr! Sllo11/d11't he hallf! a rigl11 lo l1t1ve

llis wislu·s \erim1sly co11sitlered? Wlrat i( it'ss 1101 j11s1 c1 dedsio11 11lx.111t life but a

decision c1bo11t quality of life? Wlmt is my re~pcm~ibility as 11 social worker lo lllis

dimt?

This case was prepared by Bruce Lamb, while a candidate for a Masters in Public Administration, at the Evans School of Public Affairs, University of Washington, under the general supervision of Associate Professor Jonathan Brock. This is a fictitious case based on real situations in several non-profit organizations concerning interactions on boards of directors. It is not intended to show effective or ineffective handling of the situation described. All rights reserved to the contributors. The Electronic Hallway is administered by the University of Washington's Daniel J. Evans School of Public Affairs. This material may not be altered or copied without written permission from The Electronic Hallway. For permission, email [email protected], or phone (206) 221-3676. Electronic Hallway members are granted copy permission for educational purposes per Member’s Agreement (hallway.evans.washington.edu).

The Board Chair’s Dilemma (A)

The meeting started as usual, with the board members arriving one by one in the small upstairs room of the Lutheran Church in downtown Pacific City. The first to arrive was Nancy, the executive director and founder of the organization, which was now in its sixth year. She was accompanied by a staff member. Next to arrive was Peter, the longest continuously serving board member, in the middle of his fifth year on the board. He had stepped down as board president four months earlier, after serving for two years. A large, worn wooden table with 14 chairs barely fit in the small room, and each board member had to side-step around it to the nearest empty chair. The spring sunshine still shone through the only window, painted shut, as the 6:30 p.m. meeting time approached. It was uncomfortably warm in the room, though no one complained. Of the 12 members of the board, eight made it to the meeting. They came from diverse backgrounds: activists and middle-class professionals. About half were from the Latino community that the organization served. Board composition was a nearly equal number of men and women. The mission of the nonprofit they served, El Dormitorio, was to empower homeless Latinos. The board members shared a deep personal commitment to the mission of the organization, and they were all tired from long days at their regular jobs. Peter had agreed to chair the meeting that night as a favor to Ted, the new president who said he would not make it because of a “conflict of interest” involving an issue on the agenda. Peter felt like he had grown into his leadership role in the organization. He was comfortable, even confident, as he called the meeting to order, 10 minutes after it was scheduled to start. The last arriving board members had just walked in, bringing the group to 10 in all. A few minutes into the meeting, anxiety and confusion replaced Peter’s confidence as Carrie, the organization’s volunteer coordinator, led a handful of people that Peter didn’t recognize into the room. Squeezing between the wall and the seated board members, the unexpected entourage made their way to the last empty chairs scattered around the table. One had to remain standing. Peter knew Carrie from numerous organizational functions over the years. She had always been pleasant to him and had a good sense of humor. Peter did not recognize any of the other new arrivals, though. “Who are these people and what are they doing here?”

The Board Chair’s Dilemma (A)

asked Juanita Moreno, one of the newer and more outspoken board members. Carrie, in a challenging tone that Peter had never heard from her before, responded that they were there to oppose Nancy’s decision to eliminate the volunteer coordinator staff position and “testify” about why the position should be retained. Carrie happened to be the live-in girlfriend of Ted, the new board president, who had purposely, (and wisely, Peter now thought) missed the meeting. He must have known about this walk-in “protest.” Peter wondered why Ted had not given him a heads up. Serving as a Nonprofit Board Member One year after its start-up, El Dormitorio’s executive director Nancy asked Peter to serve on its board of directors. Peter was a litigation lawyer in his mid-thirties working in a private practice who had done pro bono work representing refugees from El Salvador and Guatemala in political asylum cases for another nonprofit. As Nancy told him about El Dormitorio’s mission and programs, Peter was moved and wanted to help. He had never served on a nonprofit board, but he believed in the mission of the organization and said yes—not knowing how he was going to be able to help. At the time, El Dormitorio had a budget of about $48,000, with a paid staff comprised of one full-time director and a part-time outreach worker. A VISTA volunteer and an Americorps volunteer coordinated its classes and programs. All of its teachers were volunteers. Its programs served over 100 clients. As a new member of a small board of about seven members, Peter first served as secretary, which helped him to learn names and organizational issues. Realizing he had a valuable role to play, he researched nonprofit law and the duties of board members. He chaired a committee that authored the organization’s first personnel manual, and he contributed 1 percent of his own income and did some fundraising. He learned about strategic planning, and helped the director coax the organization to be more intentional about its planning. He helped draft job descriptions for each of the officers on the board, and recruited and helped train new board members. The Making of a Board President After two years, Peter was asked to serve as board president. He was primarily concerned with mitigating organizational growing pains by formalizing procedures and policies: He set higher expectations of board members to make the board function more efficiently and effectively. During his five years on the board, the organization grew to have 14 full- and part-time paid staff positions. It had added programs and now served over 1,000 clients per year with a budget of close to half a million dollars. Peter felt that the organization’s success was due in very large part to Nancy. He thought she was an exceptional executive director who had learned, grown, and evolved along

The Board Chair’s Dilemma (A)

with the organization. He admired her leadership and tireless dedication to the organization. He was amazed at how many responsibilities she had and how she seemed to perform at such a high level in all of them: program development, personnel management, grant writing, fundraising, event planning, public relations, external advocacy, and board development and training, to name a few. Peter had visited all of El Dormitorio’s programs at one time or another, but relied on the executive director to keep him informed of the issues and needs of the clients, the organization, and its staff. He occasionally met some of El Dormitorio’s volunteers at fundraising events, but knew only one or two on a first name basis. Not being responsible for the day-to-day operations of the organization, Peter had time to think and reflect between meetings. The organization needed someone who would study, learn, and then act with the confidence that the board’s actions were consistent with “best practices” and their legal obligations. Though he wished he could spend more time visiting the programs and getting to know the staff, there was only so much time he could devote to his volunteer role on the board, and he didn’t want to interfere with the executive director’s responsibilities. At times the importance of the decisions regarding the direction of the rapidly growing organization would cause emotions to run high. Under pressure, Peter was tactful and diplomatic and could act as a detached facilitator. This approach had served him well in the past. Now Peter was faced with something he had never expected. A staff member who had left on her own to take another job, and who was involved with the present chair of the board, was there to challenge the director’s decision not to replace the volunteer coordinator position. She had also brought a group of volunteers and staff to support her in this. As he listened to Carrie announce the purpose of her appearance at the meeting, Peter began to feel the heat in the room. He was confused. He had noticed the more frequent written reports from Nancy, but thought they were signs of progress toward better communication and documentation in an organization that was outgrowing some of its informal ways of doing things. In anticipation of chairing this meeting for Ted, whose style he knew was different than his own, Peter had met the week before with Nancy with whom he had developed a close working relationship over the years, but no longer had frequent contact. They had talked about the volunteer coordinator issue over coffee. Nancy had told him that she had decided to eliminate the position to make room in the budget for another paid position. Carrie, who done her job well, had already accepted a new job in another organization, and this was a good time to make the move. Peter agreed. It involved some re-structuring, and they both agreed that the decision should be run by the full board. There, decisions were normally made by consensus, and Peter anticipated no objection to this decision.

The Board Chair’s Dilemma (A)

Several emails went back and forth in the weeks preceding the meeting between Nancy and Carrie debating Nancy’s decision. One or both of them had copied the board members on their debate. Carrie and the volunteers were not on the agenda, and no one expected them to show up. Peter had read the emails and remembered Nancy telling him that Carrie disagreed with her decision to eliminate the position. Peter remembered thinking that Carrie’s disagreement mattered little, because she was leaving, and he had seen no reason to inquire further. Although not on the agenda, Carrie was loudly demanding an opportunity to address the board and to allow other volunteers who were with her to do the same. Peter looked at the faces of his fellow board members and realized that most knew even less about what was going on and were looking to him to restore order to the situation. He wondered if he should let Carrie and the volunteers speak their minds, which would be consistent with what Peter thought was the traditional open nature of the organization’s board meetings. Just as he was about to open his mouth, Juanita declared that the staff member and volunteers had no right to be at the meeting at all, let alone interrupt it. They should leave, and would be informed of the board’s decision later. Peter’s blood pressure rose along with his sense of indecision. Noting how uncomfortable the newest board member, attending his first meeting, looked staring head down at the far end of the table Peter tried to clear his head and decide in the next few seconds, what he would do.

The Board Chair’s Dilemma (A)

Attachment 1: The El Dormitorio Board of Directors

Board Members Present  Peter Marks—attorney, longest serving board member, former board president  Sebastian Ramirez—first generation Mexican immigrant, founder of another

Latino nonprofit service organization; currently doing sales work for high- tech communications company

 Juanita Moreno—middle-class professional and activist  Sebastian Hernandez—first generation Mexican immigrant, team leader at

software company  Elsa Peterson—teacher  Miguel Sanchez—Costa Rican immigrant, hospital administrator  John Trabolsi—small business owner  Jose Dominguez—Carpenters’ Union representative, activist Also Present  Nancy Burns—co-founder and executive director of El Dormitorio  Conchita Ramirez—development assistant for El Dormitorio, staff

representative at the meeting; also a former client of El Dormitorio; wife of board member Sebastian Moreno

Board Members Absent  Jose Orosco—co-founder of El Dormitorio  Marta Hughes—daughter of migrant farmworker parents, second generation

Mexican immigrant, manager at high-tech firm  David Hughes—husband of Marta Hughes, also manager at the same high

tech firm  Ted Guillen—current board president, high tech entrepreneur

He Won’t Go There! 1 Maria Hogan and Terry A. Wolfer

In April 2012, field instructor Ellen James and field liaison Julia Cathcart visited

Calvin Ellis at his field placement with Champion Academy, an alternative school in

Jackson County, Georgia. Before bringing the end-of-year field visit to a close, Julia

asked Calvin, “What was your greatest challenge?”

“One night after field,” Calvin answered, “I had to drop by a student’s house to

make a home visit. I wanted to check on a student because he didn’t show up to

school that day. It was dark when I pulled up and got out of the car. When I got to

the door, there was someone standing there with a gun.”

“What?! Did you call the police?” Ellen asked, incredulous. “What did you do?”

And why, Ellen wondered, are you mentioning this now?! I gave you every opportunity to

tell me that this horrible thing happened. Glancing sideways at Julia, Ellen’s mind was

racing, What do we do with this information now?

Jackson County, Georgia and Champion Academy

With just over 60,000 residents, Jackson County’s population consisted of over

80% Caucasians, 12% African Americans, and 7% Hispanics. About 13% of its

residents were below the poverty line, and the county continued to struggle with the

effects of the 2008 recession that occurred four years before. Pockets of impoverished

areas scattered the county, and crime was rampant. Because of budget cuts, Jackson

County schools had eliminated social work positions, leaving fewer resources to

address student problems.

Located in the town of Jefferson, Champion Academy served as Jackson

County’s alternative school for students expelled from the three other high schools.

The school was going through a transition to make it more therapeutic, including

hiring an on-site psychologist. The school had also recently changed its branding by

using vibrant colors and renaming the school to instill more positivity. This new

branding included the principal broadcasting positive affirmations across the PA

system throughout the day.

Despite the recent changes, the school building itself remained dark, dirty, and

run-down. It was old and very small, and the narrow halls lacked the typical team

spirit that tended to fill the hallways in a high school. Security guards stood at the

doors, and students were often accompanied by staff as they walked the halls. The

school’s census ranged from a few dozen students to more than 100 students at any

given time.

Dr. Christopher Haines was one of the key people behind the rebranding. As

Champion Academy’s principal, Dr. Haines was kind, generous, and welcoming.

1 This decision case was prepared solely to provide material for class discussion and not to suggest

either effective or ineffective handling of the situation depicted. While based on field research regarding

an actual situation, names and certain facts may have been disguised to protect confidentiality. The

authors wish to thank the case reporter for cooperation in making this account available for the benefit

of social work students and practitioners.

Standing 6’4” tall, he was a 55-year-old Caucasian man with blonde hair. He always

wore khakis, a belt, and a white dress shirt. A long-time educator, he had a passion

for working in difficult educational settings, and people perceived him as an

innovator.

The academic support staff at the school included guidance counselor Trina

Brown. Trina was a quiet, reserved, modestly-dressed African American woman in

her early 60s. Small in stature, she always appeared proper and hospitable. Trina

had a Master’s in Guidance Counseling, and had worked in the Jackson County

School District for 22 years. As a guidance counselor, she worked closely with

Champion’s students to help them plan their futures and overcome obstacles. She

missed collaborating with school social workers.

Social Work Placement

To replace the missing school social workers, Jack Thomas strategized with

Kristen Dane. Jack was the dynamic and gregarious fundraiser, grant-writer, and

developer for Jackson County schools. Kristen was Dean of the School of Social

Work. Together, they wrote a successful grant to create three new social work field

placements for the 2011-2012 school year. Because there were no on-site social

workers at Champion, Dean Dane arranged for the School of Social Work’s Field

Office to provide an off-site field instructor for the social work students placed there.

After the grant was awarded, Dr. Haines and a team of staff members

interviewed several social work students for the three new field placement positions.

Dr. Haines was looking for students who were independent and knowledgeable. He

eventually selected Calvin Ellis, an older African American man, and two women in

their early 20s, one an African American and the other a Caucasian.

School of Social Work Team

The Field Office selected Ellen James, a social worker with extensive practice

experience, to provide off-site supervision for the social work students at Champion.

Ellen was a 48-year-old Caucasian woman, about 5’2” tall with short brown hair.

Originally from Georgia, Ellen moved to Chicago to get her Master’s in Social Work

from Loyola University. She stayed there for 12 years doing federal grant-funded

street outreach with individuals experiencing homelessness and who appeared to

have mental illnesses, developing a strong commitment to social justice and people

on the street. In 2008, Ellen returned to Georgia to begin her doctoral program at the

University of Georgia’s School of Social Work. While taking classes, Ellen also

worked for the Department of Mental Health funded by the same grant as her

Chicago position.

In 2011, Ellen left her job at the Department of Mental Health to focus her time in

the academic setting. She earned income and reduced tuition by teaching two classes

per semester and providing field instruction while she worked on her dissertation.

Though Ellen had been the field instructor for one student at the Department of

Mental Health, she became an off-site field instructor for the first time when she took

on the three students placed with Jackson County schools.

Ellen worked closely with Julia Cathcart, the field liaison for the Champion

Academy students. A 41-year-old Caucasian woman, Julia had worked with more

than 25 students as a field instructor. However, this was her first time serving in the

role of field liaison. Julia held a Master’s and PhD in Social Work, and began

teaching at the University of Georgia as an adjunct instructor in 2004. Julia and Ellen

knew each other from teaching some of the same courses and were both supervised

by Dean Dane. Because the Jackson County schools were a new field placement,

Ellen and Julia put extra effort into ensuring that they succeeded.

Calvin Ellis

At age 60, Calvin Ellis was a tall, thin, and light-skinned. He had green eyes, long

manicured finger nails, and a gold tooth. Calvin was always meticulously dressed,

wearing ironed suits, big rings, and gemstone jewelry. He always carried a leather

folio from his time as a military chaplain. With his Master’s in Divinity, Calvin had

served as a military chaplain for 25 years, and he attended a local church where

Trina was a member. Calvin returned to school in 2011 to obtain his Master’s in

Social Work from the University of Georgia. As a foundation-year student in the

two-year MSW program, Calvin demonstrated great interest in leadership and

maintaining a presence in the College of Social Work, including taking part in the

Dean’s advisory council. It was very typical for Calvin to drop by a professor’s office

to just say hello.

Despite his military experience and interest in leadership, Calvin remained

without a placement as the Fall semester approached. Several agencies interviewed

him for a possible placement, but each chose another student. Finally, Calvin

interviewed with Champion in July 2011, and Dr. Haines thought his confident,

outgoing manner made him the perfect student for the new social work placement. It

was a match!

Getting Underway

Calvin began his placement, with Dr. Haines assigned as his task supervisor.

Calvin also started meeting with Ellen, the off-site field instructor for all three

students.

A few weeks after the placement began, Ellen stopped by Julia’s office to give her

an update. “The other day, I told Calvin that I was working on my dissertation, and

he responded, ‘Oh so you’re not a professor?’”

“How rude!” Julia responded. “Did he say anything else that seemed odd?”

“Well,” Ellen replied, “I’ve asked him several times why he chose social work,

only to get incomplete answers that never quite made sense.”

Additionally, in her role as liaison, Julia checked in with Calvin to see if he

needed any help advocating for anything as it related to developing his learning

contract and preparing for his first liaison visit. Julia found that her offer of

assistance seemed to open the door for Calvin to stop by and see her spontaneously

from time to time throughout the year. Their conversations often followed the same

pattern.

“Hi, Dr. Cathcart,” Calvin would begin, “I was in the area and thought I would

stop by and say hello.”

“Hi Calvin. How is the field placement going?”

“It’s going well. I love working with these kids. How are you doing?”

“I’m doing well, Calvin. Thanks for asking.”

Typically, this exchange was followed by a pause, and a big smile from Calvin.

Julia would usually conclude with, “Well, I appreciate you stopping by to check in,

Calvin.”

A couple months later, Ellen returned to talk with Julia. “He just seems like a

loose cannon to me,” Ellen stated.

“Why’s that?” Julia probed.

“Every time I meet with him in supervision,” Ellen explained, “he hardly

participates. It seems like he’s keeping information from me, and I never know what

to expect with him. He never tells me his feelings or insights. I can’t figure out how

to rein him in or get him more involved in supervision. It’s like he thinks he has

everything figured out whenever he comes for supervision and he does not need me

to help him along.”

“Do you need me to intervene?” Julia asked. “Or meet with the both of you?”

“No,” Ellen replied, “I think I’m okay. I just wanted to keep you updated.”

As the semester wore on, Ellen tried everything she could think of to get Calvin

to engage.

“This is not going to go well,” she said to him directly during one meeting, “if

you don’t respond when I ask you questions.”

In response, Calvin shook his head affirmatively but pushed back from the table

without comment.

No matter how hard she tried, it seemed Ellen could not get him to participate in

supervision.

On several occasions, without advance notice, Calvin did not show up for

supervision meetings. How can I do better, Ellen wondered, get him better engaged, and

get him working harder? Calvin did not fit her expectations of a social work intern.

While foundation-year social work students often do not know what they are

supposed to do in their field settings, Calvin never appeared to hesitate and never

expressed uncertainty. In fact, Ellen had to admit, as best she could tell he performed

competently, meeting expectations for foundation-level performance. He carried out

his social work role with confidence, immediately meeting with high school students

and building relationships. However, he often called Ellen about technical matters:

to ask how he should keep his files, what to do with his time sheets, and the rules

about taking client information home. When Calvin raved about his positive

feedback from students and staff at Champion, Ellen wondered, I would love to hear

what the students have to say about Calvin. He seems severe and conservative.

As the Fall semester progressed, Ellen noticed that Calvin occasionally

referenced his military chaplaincy. One day, Ellen told the three students she

supervised, “All of you are learning to practice social work, and whatever you were

before, you have to let that go.” Knowing that this directly impacted Calvin, Ellen

was surprised that he did not say anything in return. Most people love that

conversation, Ellen thought. They want to become social workers. I’m not sure he wants to

be a social worker.

Ellen expressed her concerns to Julia about Calvin’s chaplaincy, unsure about his

ability to keep an open mind.

Later, when she again raised the issue with Calvin, he responded, “In chaplaincy,

you are trained not to be any one religion, but you are well-versed in them all and

you take a neutral approach.”

Having an ex-husband who was a chaplain, Ellen was not convinced. She felt

uneasy with the golden cross around Calvin’s neck and the way he talked about his

wife staying home to cook and clean all day.

Calvin’s polite disagreement with Ellen’s feedback bothered Ellen well into

Spring semester. She strongly desired the placement to succeed, so this new

initiative could continue. She felt honored to be chosen as the field instructor in this

new setting, and she wanted to make Dean Dane proud. However, with little

response from Calvin, working with him reminded her of working with reluctant

clients.

Taking another approach, Ellen tried to involve Calvin with the other two social

work students working in Jackson County schools, but Calvin never interacted much

with them either. Ellen occasionally encouraged, “I really want you guys to bounce

ideas off each other.” But as far as she knew, it never occurred.

Feeling stymied by Calvin, Ellen stopped by Julia’s office and knocked lightly.

“How’s it going?” Julia asked

“Good, good,” Ellen replied. “It seems like my field students are mostly doing

okay. But I have some concerns about Calvin. When we’re in supervision, the other

two students engage with me and, when I ask, tell me more about what’s going on.”

“But not Calvin?” Julia guessed.

“Right. When I say something like, ‘Let’s talk a little bit more about that,’ they

open up. But Calvin typically says, ‘That’s really all I need.’ I might respond, ‘But I

want to hear some more. I am concerned about what you said.’ But Calvin always

shuffles me along, ‘No, that’s okay. Let’s move on.’”

“Do you think it’s something that I could help facilitate between you two?” Julia

asked.

“No,” Ellen replied, “I think it’s okay at this point, but thank you for offering.

Maybe Calvin just feels difficult by comparison to the other two.”

An Email from Dr. Haines

Ellen and Julia made a joint field visit in late January 2012 to check up on Calvin

and the two women at Jackson County schools. While students tend to have one

field visit per semester, Ellen and Julia liked to make more visits to new placements

to make sure the placements were going well, and especially for placements where

social workers were not on-site. During this first spring visit, Calvin mentioned that

he was not getting a lot of referrals. Ellen thought that was odd but didn’t say

anything in the moment.

On the car ride home, Ellen and Julia talked about their concern for Calvin. “Is

there something that he’s not telling us?” Julia asked.

“I get that feeling, too,” Ellen replied. “Calvin used to rave about how many

referrals he was getting in the Fall, so why is he suddenly not getting quite so

many?”

“You’re right,” Julia responded. “I got a weird feeling that Calvin was not telling

us everything, could be about the referral situation. Has he said anything to you

about it or anything else in supervision?”

“No, I haven’t heard anything about a lack of referrals,” Ellen said, “or much of

anything else for that matter. Should I ask him about it?”

“We should probably look into it,” Julia stated, “but I don’t want Calvin to think

that we’re questioning him, so let’s ask Dr. Haines first to see what he knows about

that.”

“Maybe it’s just a January slump,” Ellen offered, “you know, getting back to

school after Christmas break.”

“Maybe,” Julia agreed, “but it seemed like something was off.”

When they returned to campus, Ellen emailed Dr. Haines. The next day, she

received a response:

Calvin is doing a terrific job. As for the low number of

referrals, our census is down from over 100 to just over 30.

Maybe a lower number of students is resulting in less

referrals to Calvin.

“Interestingly,” Ellen reported to Julia a month later, “Calvin has called me

several times a week to check in and asked a few small questions. I am glad he’s

doing that, at least, and want to encourage him to use me more often.”

Field Visit

Having made three prior visits together, Julia and Ellen knew right where to

meet for Calvin’s final field visit in early April 2012.

“I have just felt so discouraged about my supervisory relationship with Calvin,”

Ellen confided during the ride there, “and I know you may not want to hear this, but

I am just glad that this placement is almost over.”

“I know this has been a challenging situation for you this year,” Julia responded.

As they drove together, their conversation moved on to another student on the

schedule that day, and whether they would have enough travel time between the 45-

minute sessions they had planned with each student.

Calvin was their first visit of the day, and they arrived on time, eager to begin.

They both knew what to expect from the visit because, the week before, Ellen had

seen Calvin in supervision and Calvin had stopped by Julia’s office as usual to say

hello and report that all was going well. Ellen had also been in contact with Dr.

Haines, who always reported Calvin was doing a great job.

Calvin had his own office, and students came to him on a regular basis. Calvin

had even made himself a name plate and business cards. When Ellen and Julia

reached Calvin’s office, they found him waiting for them at his desk. Wearing his

usual suit, Calvin stood up and shook hands. Then, he went to get Trina and Dr.

Haines from nearby offices. They entered the conference room and sat around the

table, with Julia and Ellen on one side, Calvin and Trina on another, and Dr. Haines

at the head of the table. After some initial pleasantries, they discussed some

therapeutic changes at the school.

“The reason I’m here today,” Julia said, turning her attention to Calvin, “is to

review your learning contract and progress towards your year-end goals.” Julia went

through a list of questions that she asked at every field visit, including questions

about competency attainment and how classroom learning fit with what Calvin was

learning in his placement. She also asked questions about supervision and how it

had gone throughout the year. “Are you getting everything that you need from

Ellen?”

“Oh yes, ma’am,” Calvin responded. “We’ve been meeting regularly.

Everything’s been going okay.”

“What about the supervision you’re getting here?” Julia probed.

“Oh yes, ma’am, Trina is always here and we have been working together.”

“He’s been great with the students,” Trina responded. “We’re really going to

miss him. The students are really going to miss having him here.”

Dr. Haines remained quiet through the discussion.

“Ellen,” Julia turned to her colleague, “what can you say about Calvin’s

progress?”

“I’ve been impressed with what I’ve heard about Calvin’s ability to engage with

students,” Ellen responded. “I’ve also been impressed with his professionalism.”

Because it was the final field liaison visit, Ellen did not want to bring up any

negative aspects of supervision. Instead, she tried to think of positive things she

could say about Calvin.

Julia continued asking about competencies, and termination with clients.

Beginning to wrap up, she asked Calvin, “Looking back, what do you think was

your greatest success?”

“My greatest success has been engaging with the students,” Calvin replied. “One

student in particular comes to mind. He came to my office often to talk about his

awful home life, and I tried to give him hope for his future. A few months ago, he

went back to the regular high school. I was so excited and encouraged to see him

develop his full potential through my work with him. Over the course of the past

year, I like to think I helped empower students so they can break the typical cycle of

going directly to Department of Juvenile Justice after leaving Champion.”

“That’s great!” Julia replied. Before focusing on the transition to next year, she

asked, “And what was your greatest challenge?”

“One night after field,” Calvin answered, after a brief pause, “I had to drop by a

student’s house to make a home visit. I wanted to check on a him because he didn’t

show up to school that day. It was dark when I pulled up and got out of the car.

When I got to the door, there was someone standing there with a gun. I left and did

not get to see the student. It turns out that the student was fine and returned to

school the next day. I must have had the wrong address.”

“What?! Did you call the police?” Ellen asked, incredulous. “What did you do?”

And why, Ellen wondered, are you mentioning this now?! I gave you every opportunity to

tell me that this horrible thing happened. Glancing sideways at Julia, Ellen’s mind was

racing, What do we do with this information now?

“No,” Calvin replied. “I just made sure that I parked in backwards so I would

have an easy out. It wasn’t a very big deal.”

This is not in your learning contract! Ellen blushed. You know you’re not supposed to

do home visits! Ellen noticed Julia scan the room and saw Dr. Haines was bug-eyed, in

apparent surprise. In contrast, Trina appeared unsurprised.

You misled me! Ellen felt anger rising. But almost immediately she wondered,

What do I say in front of all of these people?! What are they thinking about me?

DRIVEN TO DRINK

Terry A . Wolfer

As a social worker at Jackson County Hospital (Missouri), Lisa Silver had grown accustomed to a certain amount of commotion at work. But this was annoying. Lisa thought she recognized the voice of Carol Davis, a social worker from jackson County Division of Family Ser- vices (DFS), in the registration area. For some reason, she had been talking and laughing, loud enough to be heard above the usual din for at least ten minutes.

As a service to busy DFS workers and police officers, Lisa allowed them to bypass registration and come directly to her office for as- sistance with abused and neglected children. Finally, Lisa went out

This decision case was prepared solely to provide material for class discussion and not to suggest either effective or ineffective handling of the situation depicted. AI· though the case is based on field research regarding an actual situation, names and certain facts may have been disguised to protect confidentiality. The author thanks the case reporter for cooperation in making this account available for the benefit of social work students and practitioners.

and reminded Carol that she didn't have to stand in line with the other patients.

Carol laughed, "Oh, yeah! I got mixed up!" That was when Lisa first suspected Carol had been drinking.

JACKSON COUNTY HOSPITAL

Located in downtown Kansas City, jackson County Hospital was a huge facility sprawling across two city blocks. As a major teaching fa- cility for the University of Missouri at Kansas City and a Doctor of Os- teopathy Medical School in Kansas City, the hospital offered numerous stand-alone residency and fellows programs in addition to rotations for medical students. For example, after four years of medical school and earning an MD, a physician might do a three-year residency to develop a specialization in pediatrics. Aher completing the residency, the physician might specialize even further by completing a fellowship to become a pediatric cardiologist. Both residents and fellows earned salaries for this additional on-the-job training. As a teaching facility, the hospital also provided many services through specialty clinics, in- cluding pediatrics. Over the years, several Jackson County Hospital physicians had gained national recognition for their published research on physicians' roles in child abuse investigations. As a public-health facility, the hospital served many indigent clients, who increasingly, be- cause of changing local demographics, were Mexican American.

Lisa's office was located near the main registration desk at Jackson County Hospital, where some four hundred patients checked in each day for their clinic appointments. Children often arrived crying and upset; sometimes staff hollered patients' names. The registration area was always very busy and often noisy, especially in the morning. People waited in line for as long as thirty minutes. It was very often smelly with unwashed patients. Because the registration desk was right inside the main hospital entrance, there was additional traffic unrelated to outpatient registration. Although the walls were painted with colorful murals, they couldn't hide how worn the linoleum was or how old the desks and computers were. The computers inevitably went down once a day.

167 DRIVEN TO DRINK

LISA SILVER

Since earning an MSW at the University of Missouri at Columbia, Lisa Silver had worked for seven years in the Pediatric Clinic at Jackson County Hospital. As the pediatric social worker, she was also assigned to the Pediatric Emergency Room, a specialized unit designed to pro- vide: emergency services for children. About 2.5 percent of Lisa's social work cases required making routine referrals for resources (e.g., food, diapers) or helping undocumented people deal with the Immigration and Naturalization Service or seek US residency. But 75 percent of her cases involved allegations of child abuse and neglect. For these cases, Lisa was part of a team that evaluated children for abuse. Her role in- cluded coordinating hospital services. Lisa typically collaborated with a medical resident: she interviewed the child regarding his or her abuse while the resident completed a medical assessment. Many abused or neglected children were brought to County Hospital by DFS workers for expert assessment, usually by appointment, but sometimes as watk- ins. Other cases of abuse or neglect were found during routine medical care. When DFS or the police were not already involved, Lisa had to ensure that both were appropriately informed of these cases. She some- times had to advocate on behalf of child patients with either DFS or the police and often made outpatient referrals for follow-up services.

As the social worker in the Pediatric Clinic, Lisa reported to Diane Hughes, supervisor of the hospital's Social Work Department. Lisa in turn supervised Denise Ulmer, the BSW assistant in the clinic.

Some of Lisa's relationships with DFS workers and police were more than professional. They occasionally socialized outside of the hospital after hours. For example, Lisa's best friend for several years was a sex crimes detective who also coached her soccer team. As a result, she saw him several times per week outside of the hospital.

A DISRUPTIVE SOCIAL WORKER

One day in mid-November 1998, soon after 9:00 AM, a commotion in the registration area caught Lisa's attention. Carol Davis, a DFS work- er about the same age as Lisa, had transported a three-year-old foster

DRIVEN TO DRINK 168

child to the hospital for a walk-in assessment. That in itself was not un- usual. But something about Carol's manner was. She was talking very loudly and with more animation than usual; she slurred her speech and laughed a bit too hard at her own jokes. In fact, Lisa thought, she's act- ing drunk. And when she called Carol into her office, a more confined space than the registration area, she smelled alcohol on Carol's breath.

Lisa had never before had reason to suspect problems with Carol. Although never close, they had known each other for several years and always got along well. In fact, Lisa believed that Carol did her job ad- equately, unlike some DFS workers. An African American, she kept her long hair straightened and was consistently well dressed.

While Carol waited for a physician to see the child she had deliv- ered to the hospital, Lisa asked Denise whether she smelled alcohol on Carol's breath. She did. But several nurses said later that they had not noticed alcohol on Carol's breath.

At any rate, Lisa did not confront Carol with her suspicions. Fol- lowing completion of the medical assessment, Carol drove the child back to the emergency shelter. Almost immediately, Lisa regretted let- ting her do this. As she remarked to Denise, "It was bad enough that she was driving at all, let alone having a foster kid with her!"

CONFRONTING THE PROBLEM

Unlike the supervisor she had been hired by, Lisa believed that her cur· rent supervisor, Diane Hughes, was "not so good." Now with seven years of practice experience, Lisa didn't want help from her very often. In this situation, though, she was not sure what to do. So that after- noon, Lisa went to talk with her supervisor.

Lisa started by saying, "I think I screwed up." Then she described the morning incident and her concerns.

After some discussion, the two women agreed that Lisa should call Carol's supervisor to report her concerns. Lisa promptly tried to reach Carol's supervisor, Randy Burgess, but could only leave a telephone mes- sage with his secretary, saying it was urgent that she speak with him today.

When Randy returned Lisa's call the following day, she described the incident in detail. Uncertain about what to do, Randy said that he

169 DRIVEN TO DRINK

would consult with his own supervisor, Dale Bailey. Because Randy did not seem surprised by Lisa's report, Lisa wondered whether Carol had done something like this before.

Later that day, after talking with Dale, Randy called Lisa back to suggest that she talk with Carol herself. As Randy explained, "You're the one who observed the problematic behavior, so you really ought to confront Carol about it."

"She's your employee!" Lisa disagreed. Randy suggested that Lisa, Diane, Randy, and Dale meet to dis-

cuss it. " I'll think about it and get back with you," Lisa said. Now the ball

was back in her court. Lisa knew she probably should have said some- thing to Carol the day before, when she first became concerned. But Lisa realized that she hadn't confronted Carol because she didn't know how.

After hanging up the phone, Lisa felt stuck. The more she thought about it, the less she liked how this was going. On the one hand, she was deeply concerned about a DFS worker (or any social worker, for that matter) drinking on the job. In this case, it only further jeop- ardized the health and well-being of an abused child. On the other hand, talking with the person herself didn't seem to be the appropri- ate response. Despite what Randy said , this issue still seemed to her to be something the social worker's own agency needed to address -a supervisor's problem. Besides, she wondered, what difference would talking with Carol make, anyway? If she was drunk, she isn't likely to admit it. So then what? At the same time, Lisa knew that other things smelled like alcohol (e.g., certain medications, mouthwash). Lisa thought, I'm pretty sure that Carol was drunk, but what if I'm wrong? Lisa was used to making tough decisions-daily-but this one stumped her. And she really did not want to deal with it.

As the day wore on, Lisa grew angrier about the whole situation. While driving home that afternoon, she fumed aloud, "I'm pissed that I've been put in this position-pissed at Carol, Randy, Dale! It's not my job to be supervising DFS workers! This job is stressful and crazy enough as it is. How could a social worker screw up like this?" Finally, she felt angry with herself for endangering a child's life . " I messed up. Screw Carol."

DRIVEN TO ORIN K 170

Although Lisa felt angry with Carol, she also knew about second- ary trauma and understood how it could undermine a professional's performance. She had experienced it herself. Especially during the first few years at Jackson County Hospital, it seemed that she had cried over a case either at work or at home at least once a week. She dealt with the horrors she saw at work-babies starving to death, children beaten so badly they had one big bruise from the back of their knees to their waist, babies with third degree burns from being dunked in a hot bath- tub as potty training, children tortured by automobile cigarette lighters, a five-year-old doubled over in pain saying, "I'm such a bad boy" (he was in the hospital six months for internal injuries), a fourteen-year- old girl sexually abused by every male in her extended family-more and more by forgetting about the child. She obviously couldn't forget them all. But sometimes only a week after interviewing a child with a resident, the resident would ask if she'd heard anything more about the child, and Lisa would respond, "I don't know who you're talking about." She had neither the time nor the energy to follow up on patients they saw, anywhere from six to twelve children per day.

The next day Lisa went to talk with Diane again. As Lisa suspected, Diane confirmed that it was not Lisa's job to confront Carol now. It was now an issue for Carol's superiors. Having worked at DFS for sev- eral years herself, Diane knew Randy Burgess and Dale Bailey person- ally, so she called them . The supervisors, both of whom were white males, reportedly told Diane they were afraid Carol might "pull the race card" if they confronted her about drinking on the job. When Dale asked whether he and Randy could meet with Diane and Lisa at the hospital, Diane agreed.

At this meeting the following day, Diane and Lisa basically reiterat- ed that it was Randy and Dale's responsibility to deal with Carol. They encouraged the two men to consult their policy people. But it seemed apparent that Randy and Dale had no_ intentions of following through.

What should I do? Lisa felt responsible but wasn't sure that she was. She had tried to bring the problem to DFS's attention. But they aren't going to do anything about it!

171 DRIVEN TO DRINK

Conflicting Agendas for the Future of a Youth Agency

Martha Golensky

Cases in Nonprofit Governance

CNG No. 14

September 1995

***********

Martha Golensky, Assistant Professor, School of Public Administration, Grand Valley State University, Grand Rapids, MI 49503. Phone: 616-771-6569.

This case was prepared as a basis for discussion rather than to illustrate either effective or ineffective handling of governance issues. It is one of a collection of cases edited by Miriam M. Wood. For teaching purposes, the case may be reproduced in full in multiple copies. However, an extract of more than 100 words requires the author's permission.

***********

In the interest of fullest possible circulation of information and ideas, the Program on Non-Profit Organizations and the Institution for Social and Policy Studies reproduce and distribute each Governance Case or Working Paper at the request of the author(s) affiliated with PONPO or ISPS. Papers are not formally reviewed, and the views are those of the author(s).

A list of Case Studies and PONPO Working Papers Box 208253 (88 Trumbull Street), New Haven, CT publications is available on request from ISPS, (77 Prospect Street), New Haven, CT 06520-8209.

can be obtained from PONPO, P.O. 06520-8253. A list of ISPS P.O. Box 208209

Program on Non-Profit organizations Institution for Social and Policy studies

Yale university

Conflicting Agendas for the Future of a Youth Agency by

Martha Golensky

Summary Having avoided self-scrutiny for most of its sixty year history, a youth agency is forced to take a hard look at its future when finances begin to decline. The executive director and the board president hold differing views on the appropriate course of action, and the reader is asked to decide which position is in the best interests of the organization.

It was the night before the September meeting of the board of

directors of the Youth Service Network (YSN), a mid-sized social agency

providing educational and recreational programs to youth in a major

metropolitan area. Margaret Stover, YSN's executive director, was trying

to fall asleep but with little success. Thoughts of the next day's meeting

kept intruding: How would the board react to the Strategic Planning

Committee's report? How would the latest financial report, which

projected a substantial deficit for the fiscal year unless the reserves were

tapped, affect the discussion? While she was already on record as being in

favor of the committee's recommendations, should she adopt an active or

a passive role in the debate?

The situation had become more complicated after the phone call she

had received earlier in the day from Sal de Marco, the board president.

During the last several months as the strategic planning committee was

meeting, de Marco had been noncommittal about YSN's future, which

was surprising in view of his long association with the organization.

Whenever Stover had pressed him for some kind of reaction to the

minutes of the committee meetings or to the preliminary findings that

had been distributed prior to the June board meeting, his only response

was: "Let's let the process proceed." Today, however, de ~v.larco had

informed her that he did not feel he could support the committee's

recommendations and was preparing a statement to present to the board.

Judging by the cool tone of his voice, Stover deduced that de Marco's

statement would not only find fault with the report but would also be less

than complimentary of her.

How had their relationship, which had seemed so strong when she

was hired, deteriorated to the point that they were this far apart on such a

critical issue?

History ofYSN

The Youth Service Network is a nonsectarian, not--for-profit

organization providing camping, educational, social, recreational, and

cultural programs and services to young people ages 6 to 24 in a major

northeastern metropolitan area. As articulated in its mission statement,

"the purpose of the organization is to improve and further the well-being

and happiness of the boys and girls who participate in its activities by

helping them develop needed skills, a system of personal values, and a

sense of self-worth in order to meet the challenges of the present and

future, and to become productive, constructive members of society."

YSN was founded in 1935 by Trevor Clinton, who envisioned an

organization that would use recreation as an incentive for engaging boys

in positive activities to help prevent juvenile delinquency. At first,

programs were provided at several storefront recreation centers: scattered

around the city. A few years later, an overnight camping program was

started at a nearby state park. In the early 1960s, YSN entered into an

agreement with the local housing authority to operate community centers

in housing projects. Early on, the organization began to organize citywide

tournaments for various sports, notably track and field and boxing, which

generated considerable publicity and attracted the attention and support of

major sports figures. Although girls participated in certain activities

almost from the beginning, they were not fully incorporated into YSN's

programs until the mid-1980s.

YSN's founder was somewhat of a visionary in securing financial

support for the organization. Drawing on his connections in the sports

world, Clinton organized one of the first direct mail campaigns on behalf

of a nonprofit, and interestingly enough, sent solicitations playing on the

theme of preventing juvenile delinquency to a national mailing list rather

than confining the effort to the immediate area. This approach proved to

be very successful; it generated virtually all of the orga:nization 1s

operating money for most of its history and also yielded numerous

bequests over the years, allowing YSN to develop a modest portfolio of

investments.

For close to fifty years--first as executive director and then as a

member of the board--Clinton dominated the organization. For the initial

board of directors he selected friends and acquaintances who were

expected to rubber-stamp his decisions and maintained further control by

not having rotational terms. The rare vacancies were filled by personal

friends and/or business acquaintances of the current members, with all

selections subject to Clinton's final approval. In recent years the board

has included second-generation family members of the original trustees

and a few former program participants. Election of the first woman board

member occurred in the early 1980s.

When Clinton retired as executive, he named his associate director

as the second CEO. No other candidates were considered. The new

executive's main attributes were his loyalty to the founder and the

personal relationships he had developed with certain board members.

Clinton also installed his son as YSN's director of development and

director of camping and arranged that his son would report directly to the

board, of which the founder was now a member. This unusual

supervisory arrangement continued even after Clinton's death in 1982.

In 1988, the second executive director was forced to resign due to

illness. As the third executive director, the board selected an individual

whose athleticism seemed to embody the very essenc:e of the

organization's mission. Although the new executive had limited senior

management experience, the search committee believed his knowledge of

fiscal monitoring gained during his previous work at United V.lay would

be a major advantage.

The new CEO soon noticed senous irregularities in thB way the

direct mail campaign was being managed. In fact, the evidenee showed

that the founder's son had been defrauding YSN for several years for his

personal gain. Faced with this information, the board had no ehoice but

to ask the founder's son to resign and, on the advice of legal counsel,

initiated a lawsuit against him. As a group, board members felt a certain

amount of discomfort in having to assume a more traditional governing

role. But for a number of longtime members whose fondness for the late

founder still ran deep, the legal action was very painful indeed. Although

these members understood the necessity for the lawsuit, both to restore

YSN's good name and to demonstrate their own fiduciary responsibility

as trustees, they were unable to separate the "message" from the

"messenger" and consequently never quite forgave the executive director

for forcing them into such a difficult position.

In the second year of his tenure the executive director inadvertently

offended a powerful trustee, a former board president who had had a

particularly close relationship with the previous CEO and was now

serving as chair of the Finance Committee. When the finance chair

returned to active service following major surgery, he aceused the

executive of withholding important negative financial information from

other members of the finance committee in his absence. After two more

years, the third executive resigned, worn down by the finance chair's

constant sniping, continuing fallout from the direct mail scandal, and

YSN's deteriorating fiscal position.

Toward the end of 1992 a search committee was formed, chaired by

Sal de Marco. A relatively new board member, he was the nElphew of a

former YSN senior staff member and had himself been a program

participant. Initially, a male candidate proposed by the second CEO

through his remaining friends on the board seemed to be the front-

runner. However, the final choice was Margaret Stover, who had

extensive prior experience as a nonprofit executive. In announcing the

board's decision, de Marco said, "We selected the best person for the job,

one whose proven skills in organizational development, long-range

planning, and fiscal management, along with a background 1n

community center work and camping, offer the right combination to

provide the kind of leadership YSN needs to move steadily forward."

Leadership was exactly what YSN needed, especially since the

third executive director, drawn into crisis management, had had little

opportunity to address long-term issues. The new competitive

environment for nonprofits demanded careful planning and informed

decisions by both the CEO and the board. Stover faced the challenge of

dealing with an organization that had been rudderless for some time.

The Executive Director's Perspective

The new executive director focused on YSN's fiscal problems and

soon realized that the decline in the organization's financial position was

a symptom of broader issues related to mission and governanee. These

matters were brought into clear relief through a confidential letter Stover

received from a consultant who had been engaged to help YSN promote its

sixtieth birthday celebration:

The basic problem with YSN is the fact that it has at its core a faulty premise. What we basically are is a neighborhood group ... with rather large pretensions of being more. This is not to say we don't do a good job---we do in that area. But it's small potatoes, and there must be dozens--maybe hundreds--around the city doing exactly the same thing.

Times have changed, and the fact that we've reached sixty years is more a testament to the good services and the good luck of our predecessors than anything existing today. I've told you--perhaps too often--that you have to get rid of the majority of your board. They simply are unimportant people and, mostly, uninspired. The elements of success are simply not there.

I do think you should address these problems as quickly as possible for the continuance of the organization. The competition is just too fierce and severe out there to warrant doing anything else.

While these were harsh words, they had the nng of truth.

Beginning with the death of the founder, the organization had. begun to

slide. During those ten years, no new programs had been developed, and

somE~ of the older programs, such as the tournaments, had been

discontinued for lack of support. In addition, no new funding sources had

been cultivated. Even though the third CEO had been able to revive the

tournaments and had attempted to inject some enthusiasm into the

organization, his general lack of administrative experience and plain bad

luck in being caught in the scandal over the direct mail program were his

downfall. Furthermore, the board was top-heavy with white males over

the age of fifty clustered in a few industries. (Exhibit 1)

The YSN bookkeeper quickly befriended Stover and became a

primary source of information. One of the more disturbing revelations

concerned the search process. Stover learned that her job had been all but

promised to another candidate recommended by YSN's second executive

director and that de Marco had tipped the balance in her favor, possibly in

order to embarrass the second executive, against whom de Marco

harbored a personal grudge.

Stover also received a full report from the agency's bookkeeper about

the direct mail situation and the scandal involving the founder's son. In

light of the board members' reactions when the former CEO had brought

bad tidings about the direct mail scandal, the bookkeeper advised Stover to

avoid this issue as much as possible--a difficult task since the lawsuit

against the former staff member was still pending--or risk encountering

the same fate as her predecessor. Additionally, the bookkeeper was able to

provide some insights into the difficulties the outgoing executive had with

the then-chair of the finance committee, and this information proved

valuable when Stover subsequently was invited to lunch by this board

member and was treated to his version of the conflict.

In the course of this lunch meeting, the board member suggested

that Stover reach out to YSN's second executive as someone who could

provide her with a sense of the organization's history. The feeling Stover

got was that this trustee wanted to wipe out the last few years--his

disagreements with her predecessor, the scandal over the direct mail

program--and renew the ties with the past when YSN was so prominent

in the youth services field. Since Stover wanted to establish a positive

relationship with the board member, she followed his advice and was

pleasantly surprised to discover she rather liked the former CEO, despite

his gratuitous criticism of her predecessor's attempts to "modernize"

YSN.

All in all, Stover's tenure had an ausp1c10us start. The staff

seemed reenergized, and the board appeared to be happy in thE~ choice of

their new CEO. Most important, it was possible to put aside monetary

concerns for a while when YSN received an unexpected bequest of over

$800,000 from a direct mail donor whose average gift never exceeded $100

during her lifetime. In Stover's second year, however, declining revenue

again became a central issue. Since she believed the organi2:ation had

erred historically in putting so much reliance on a single source of

income, she began to explore other avenues for generating income.

Stover viewed the one remaining community center--down from the

three sites YSN had managed some years back--as the organization's

biggest resource. Looking for opportunities to expand the center's

program, she was successful in obtaining three large grants from three

new donors interested in school dropout prevention, which she saw as a

link to YSN's original focus on juvenile delinquency prevention.

She was more than a little dismayed, therefore, when the board

greeted these funding coups with minimal enthusiasm. For the majority

of the trustees, summer camp was still YSN's centerpiece, even though

the organization had steadily been losing campers to other, more modern

facilities. Since only a small number of the youngsters attending camp

participated in activities at YSN's center, they did not have the loyalty to

the YSN organization of campers in the past, when it was common to see

the same faces involved in the program year-round. Moreover, many of

the current campers came from unstable home environments and thus

brought emotional and psychological problems that were bE~yond the

therapeutic skills of the counselors YSN was able to recruit. The board

did not seem to grasp these major changes. While they wanted to see

camp flourish, they were unwilling to invest the dollars Stover requested

to upgrade the camping program.

Stover was also dismayed by the board's continuing belief that the

direct mail program could be revived. She did not share their optimism,

but at the urging of the finance committee, she switched consultants in

hopes of achieving better results. When there was no appreciable

improvement, she made yet another change, which did bring a slight

upswing.

Increasingly Stover believed a complete overhaul of YSN was

necessary, and she decided it was time to get at the root causes of YSN's

problems and to develop a strategy to secure the organization's future.

With the support ofthe board president, she was able to convince the board

to enter into a strategic planning process. While the ostensiblE~ goal was

the need to strengthen the funding base and to determine which of the

current programs were most viable, Stover's long-term hope was to

include a serious examination of the governance structure. The strategic

planning committee was formed toward the end of 1994. It wa:s expected

to meet through the first half of the new year and then submit its

recommendations to the full board prior to the September 1'995 board

meeting.

Earlier 1n 1994 Stover's concern about governance had been

heightened when Sal de Marco, who had headed the search committee

that selected her, became the new board president. Initially Stover had

been very pleased when the Nominating Committee suggested de Marco.

With YSN's sixtieth anniversary coming up, naming a former program

participant to the top board spot had great public relations potential;

moreover, Stover knew de Marco had been very influential in her

appointment as executive director and felt they had maintained a cordial

relationship ever since. Unfortunately, de Marco's style was much

different from that of his predecessor. He did not see the value of frequent

meetings with the executive director but finally agreed to a once-a-month

session if Stover would travel to his place of business, which was over an

hour's drive from the YSN office.

However, even with monthly meetings, Stover did not feBl she and

de Marco acted as a team. Often, when she would bring an issue to his

attention and ask for his input, he would respond: "Do what you think is

best. After all, you're the girl I brought to the dance." Even worse, when

de Marco did consider a matter to be important, he was apt to phone a few

of the other board members for their opinions before discussing the matter

with Stover. Yet, in his own indirect way, de Marco was supportive of

her, if a bit patronizing. Stover made the best of the situation, although

she felt nothing much would change until rotating board te:rms were

adopted and people were selected for the board on the basis of merit rather

than personal or business ties.

Much would depend on the outcome of the strategic planning work.

Stover had influenced the selection of an excellent committee that

included the best thinkers on the board. The group's growing enthusiasm

about the process gave Stover confidence that they would be able to "sell"

the plan to the other trustees. To Stover's delight, the committee even

proved receptive to discussing possible changes in governance. When the

committee's interim reports were well received at the February, April and

June board meetings, she felt much better about the chances of helping

YSN overcome its problems and move forward. The full committee

report, with recommendations on changes in programs and services,

finances, staffing, and plant and equipment, was sent to the board :for

review prior to the September board meeting. (Exhibit 2) The cornerstone

of the plan, and probably its most controversial aspect, was a proposition

to use YSN's reserves to cover deficits until new sources of income could

be cultivated. The crucial vote would take place at the meeting.

The Board President's Perspective

Sal de Marco could not remember a time in his life that he was not

connected with YSN. He was only five when his father died and Uncle

Lou had stepped in as the man of the family. Since Uncle Lou was

director of programs for YSN, young Sal found himself enrolled at camp

during the summer and active in sports at the community center the rest

of the year. He was still close with several boys--men--who had

participated with him in these activities.

There were many good times in those early years. De Marco

remembered the excitement of taking part in the citywide track meets

sponsored by YSN and then seeing his picture in the paper the next day

for anchoring the winning team in the relay race, his specialty. And he

loved camp. Getting out of the hot city for the summer, swimming in the

lake, watching the Indian ceremony where Uncle Lou played the chief

were wonderful memories.

Yet de Marco also associated one of his worst experiences with

YSN. When YSN's founder, Trevor Clinton, announced his plans to

retire, Uncle Lou confided to the then-teenaged de Marco that he wanted

the job and had submitted his letter of interest. Shortly afterwards, de

Marco came home from school to find his uncle in the living room,

crymg. Clinton had sent a memo to the YSN staff stating that the

associate director of the agency would succeed him; Uncle Lou was never

even interviewed for the position. De Marco considered this a great

injustice, for the associate director, in his opinion, did not match his

uncle's skills.

While Uncle Lou remained with YSN until he retired some years

later, de Marco resented what had happened. He turned his attention

more and more to his studies, and ultimately became a banker, an

accomplishment that sadly his uncle did not live long enough to see. It

was thus somewhat of a surprise when the third executive director, who

had followed Clinton's hand-picked successor, reached out to de Marco

and invited him to join the YSN board. With mixed feelings, de Marco

agreed.

Old habits die hard. De Marco discovered his belief in the

importance of the agency's work was still strong. Furthermore, he felt he

had something to prove to the other trustees, although he was never quite

sure what that was. As YSN neared the milestone of its sixtieth birthday,

the nominating committee decided it would be fitting to name a former

program participant to be board president, and de Marco was selected. He

wished that Uncle Lou could have been there to see his nephew receive

this honor.

In the time since Stover had been hired, de Marco had not had

much contact with her outside of board meetings. Overall he was pleased

by her performance although he had hoped she would have achieved more

success in reviving the direct mail program by now. One quirk of hers did

bother him a bit, though: Stover always seemed to be waiting for the board

to show overt approval of her actions and had difficulty hiding her

disappointment when the trustees failed to acknowledge her efforts to her

satisfaction. For example, when Stover announced to the board that she

had obtained a government grant of $75,000 a year for the next two years,

she obviously felt that securing the grant was a major accomplishment.

True, it was the first Federal grant YSN had ever received, but the

amount was chicken feed compared to what the direct mail campaign

generated. In the best years, direct mail had raised close to $800,000

annually, and even now it brought in over $400,000. When there was little

reaction from the board, Stover looked truly crestfallen. De Marco saw

her reaction as a sign of weakness; he'd never let his board at the bank

know his feelings so openly.

After becoming board president, de Marco discovered that Stover

expected to have frequent meetings with him to discuss agency business,

as she had done with his predecessor, Ben Shank. She didn't seem to

realize that he couldn't be as free with his time as Shank, who owned his

own company and could come and go as he pleased. As a compromise, de

Marco agreed to monthly meetings if Stover would drive to the bank early

in the day so that his schedule was not disrupted. But these needs of

Stover's were minor irritants. She had been his choice for executive, and

he still felt she brought many strengths to the organization. Thus, when

she suggested the idea of strategic planning, he saw no reason not to go

along with her or to question the process once begun.

Upon receiving the strategic planning committee's report, however,

he wondered whether he should have been more directly involved in the

effort. Some of the recommendations were fine, such as the idea of trying

to integrate the programs and involve the kids on a year-round basis.

That arrangement had worked well for him, certainly. But he had trouble

with the heavier emphasis on the community-based programs at the

center. Even though camping was discussed, it seemed to him that the

camping program was of secondary concern. Moreover, the plan's

suggestion of combining school work with camp activities had no appeal

to him at all--camping was about having fun!

Being a fiscal conservative, de Marco also had trouble with the

concept of dipping into the reserves in the hope of realizing future gains.

This seemed to him a dangerous step to take since the implication was

that if YSN could not identify and secure new monies, the organization

might not survive. Perhaps to Stover, whose history with the agency

amounted to only a couple of years, it was sensible to consider such a

possibility. However, de Marco knew that for himself and the majority of

the board members with long-standing ties to YSN, no plan that even

suggested the end of the organization could be taken seriously.

Finally, the recommendation that the board become more actively

involved in fund raising was almost insulting. De Marco wondered how

Stover had managed to convince the committee to go along with her on

that one. It was that same business of expecting more of the trustees than

was warranted. This was a hard-working board, in de Marco''s opinion,

and Stover would just have to accept the fact it was her responsibility to

raise more money. If she was not up to the challenge, perhaps she wasn't

the right person for the job after all.

Knowing he would not be able to support the committee's report, de

Marco dialed the YSN number to inform Stover he would be making: a

statement at the board meeting advising that no sweeping changes be

introduced at this time. Really, he didn't think the organization's

problems were so great; more direct mail revenue would resolve a lot of

the present concerns. Maybe they could develop the center programs

along the lines suggested in the report, but camp should keep :its

traditions. As he well knew, a two-week stay was long enough to provide

memories for a small child that would last forever. His message to the

board would be that the winning formula of the past was just as viable

today. Tampering with the basic programs was not a course of action he

could endorse.

Questions for Discussion

1. Based on YSN's history, which perspective--Stover's or de Marco's--

do you find more viable? Support your position.

2. Evaluate the merits of the strategic plan. If you were on the YSN

board, how would you vote on the plan and why?

3. How would you assess Stover's management style and her

relationship with de Marco? What steps might Stover have taken to

involve de Marco more fully in the planning process?

4. Besides the partnership model, what other kinds of relationships

between the CEO and board president are equally valid? What

circumstances would dictate the choice of one kind of relationship

over another?

Exhibit 1

Board Profile (N = 18)

By gender: Male Female

= =

14 4

By ethnicity:

By age:

Caucasian = African-American =

Under 21 = 0 21-30 = 0 31-40 = 0 41-50 = 4 51-60 = 9 Over60 = 5

By occupation: Accounting = Banking = Corporate exec. = Financial cons. = Govt. employee = Insurance exec. = Nonprofit mgr. = Sm. bus. owner = Travel writer =

By years of service: 1-5 years = 4 6-10 years = 3 11-19 years= 5 20+ years = 6

15 3

2 2 2 4 2 2 1 2 1

Exhibit2

Recommendations of the Strategic Planning Committee

(Excerpts)

To the Board of Directors of the Youth Service Network:

The members of the Strategic Planning Committee are pleased to present for your consideration a series of recommendations that offers a vision of the organization that we believe the Youth Service Network can become over the next five years.

YSN must step boldly into the future, using all available resources, both human and financial, to make this vision a reality. One of the premises of the five-year plan is that the organization's reserves will be applied to support its operational needs as long as it proves necessary, that is, until the current income streams can be strengthened and new funding sources developed to make YSN deficit free.

Further, the committee feels board and staff alike must have eonfidence that what we are doing is good and important, that we know our business and have a firm base on which to build. It must be recognized that an organization cannot stand in place, for surely that leads to mediocrity and then decline. If we are unable to realize our goals by the end of the five- year period, it may be necessary to close our doors, but we will be secure in the knowledge that we have spent our money wisely, and the thousands of young people helped through the years will remain an achievement of the highest merit.

An Overview

To achieve its mission, the Youth Service Network will over the next five years implement a sequential, developmental program that emphasizes education and employment services.

a. While YSN will continue to serve children, youth and young adults, ages 6 to 24, the primary target group will be 10- to 18-year-olds.

b. To emphasize the developmental nature of the program, there will be an integration of services between the year- round effort and summer camping.

c. There will be a variety of programs to meet the educational, employment, social, recreational and cultural needs of the service population.

Exhibit 2 (continued)

d. YSN will build on its history of successful community··based services by seeking opportunities for establishing additional community centers, using its current site as the model, and for the replication of individual programs, such as the dropout prevention program, in other areas of the city.

e. Because of the emphasis on the integration of services, tournaments will be eliminated as a separate program component. Recreation will continue to be an important part of the community-based and camping programs.

Specific Recommendations

Programs and services: The areas of concentration will be community- based services and camping. The initial focus will be on new and/or expanded efforts at the present center. At the same time, there will be an exploration of communities both in the same area of the city and in other sections where a similar type of center might be established. Educational programs and job-readiness training will become part of the camp offerings, along with the traditional activities. The expectation is that YSN will continue to rent campsites at the state park; however, a feasibility study will be conducted within the next twelve to twenty-four months to determine whether to purchase our own site.

In the early days of the camping program, YSN for the most part served its own youngsters from the various storefront centers we operated around the city. Over the years, this pattern changed as the number of year-round facilities dwindled. Although it could be said that the significant returning-camper population from previous years is 11 0urs, 11

the organization really has minimal impact on these young people even though the program is of very high quality. Given the range of problems experienced by many of the campers, a two-week exposure (the typieal camp stay) is too short a period to make much of a differenee. Furthermore, while computers have been introduced at camp, outside of sports and recreation, the activities offered have little connection to the year-round battery of services.

Therefore, the committee recommends that the camping program and year-round effort become more integrated, both in terms of the children served and the types of programs provided. To accomplish this, there will be a move back to the past toward an increase in serving youngsters who also participate in center activities. More educational and employment- oriented activities will be introduced at camp, even to the extent of obtaining Board of Education approval to run a sanctioned summer school, to be combined with traditional camping. The five-year goal is to have almost the entire camp population composed of young people from

100

Exhibit 2 (continued)

our year-round effort, perhaps attending in longer time segments, such as a four-week session.

Finances: A broadened base of support is a major goal for this five-year period. Our recent experience with direct mail has taught us that it is unwise to depend too heavily on any one funding source. Therefore, efforts will be made to increase the support derived from foundations, a likely avenue for program start-up assistance, and from all levels of government, where continuation funding might be secured. For center programs, the kinds of support currently in place will be maintained and expanded where possible. For the camping program, fees will be raised judiciously over the next several years, and additional income sources will be explored. Finally, board members will be called on to increase their personal efforts to secure financial support, such as sponsoring a special fund-raising event.

Projected Revenues ($000)

Base Year Year Year Year Year Year 1 2 3 4 5

Government 276 283 295 300 312 320 Foundations/U.W. 135 150 175 195 200 200 Dues and Fees 244 265 275 300 327 340 Direct Mail/Bequests 400 410 446 501 528 539 Reserves 134 127 111 49 21 9

Total 1189 1235 1302 1345 1388 1408

Revenues (Percent)

Government Z3 Z3 Z3 Z2 Z2 Z3 Foundations/U. W. 11 12 13 14 14 14 Dues and Fees 21 22 21 22 24 24 Direct Mail/Bequests 34 33 34 37 38 38 Reserves 11 10 9 4 2 1

Total 100 100 100 99 100 100

Note: The percentages for Year 3 do not equal100 due to rounding.

In the direct mail area, the hope is that the new consultant's approach will result in at least the stabilization of the campaign and even modest growth.

101

Exhibit 2 (continued)

Adding a special fund-raising event to the overall package should be explored, recognizing that such an approach normally requires three to five years to begin generating a profit.

Corporate support will be explored for the educational and employment services, taking into account that success in this area would necessitate a change in our relationship with United Way since its policies preclude direct solicitation to corporations.

The key to the success of this strategic plan is the degree to which everyone can, and does, embrace the underlying growth strategy of using present assets as an investment in the organization's future. Clearly the implementation of such a far-reaching plan will require a board of directors that is fully committed to putting forth the time, effort and financial support necessary to assist the staff in this undertaking. As its final recommendation, the Planning Committee charges the Executive Committee with the responsibility for developing guidelines on the expectations for a prospective board member and for those individuals already serving as trustees.

102

Bibliography

Hall, P. D. "Conflicting managerial cultures in nonprofit organizations." Nonprofit Management & Leadership. 1 (2), 153-165, 1990.

Provides insights on conflicts between board members and executive directors due to different interpretations of organizational mission as well as differences in values, background and training.

Herman, R. D. & Heimovics, R. D. Executive Leadership in Nonprofit Organizations: New Strategies for Shaping Executive-Board Dynamics. San Francisco: Jossey-Bass, 1991.

Chapters 3 and 5 are especially helpful--the first dealing with models of governance, contrasting the hierarchical model with an alternative approach in which the executive is the organizational leader, and the second providing specific strategies for board development.

Mathiasen, K. III. Board Passages: Three Key Stages in a Nonprofit Board's Life Cycle. (Available from National Center for Nonprofit Boards, 2000 L Street, Suite 411, Washington, D.C. 20036), 1990.

Presents concept of following and leading boards as the key element of the organizing stage. Delineates dangers when a founding executive fails to share power with the board.

Middleton, M. "Non profit Boards of Directors: Beyond the Governance Function." In W. W. Powell (ed.), The Nonprofit Sector: A Research Handbook (pp. 141-153). New Haven, CT: Yale University Press, 1989.

Discusses board composition, structure and behavior and the board- executive relationship.

Schein, E. H. "Organizational culture." American Psychologist, 45 (2), 109-119, 1990.

Defines the term organizational culture and then suggests techniques for understanding and analyzing the culture of a given organization.

103

Second Time Around1 Andrew Flaherty, Melissa C. Reitmeier, Teri Browne, Dana Dehart,

Aidyn Iachini, Rebecca Christopher & Terry A. Wolfer

Social worker Jadah Johnson’s heart started to accelerate as Felicia Cooke kept

talking, “I know I keep asking you, Jadah, but if you could enroll them, my parents, I

mean, you’d really help us out! We sisters need to stick together . . . It’s how we get by

in this community, we’ve got to help each other.” Felicia paused to take a bite from her

cream cheese bagel.

Jadah’s head spun, as she unpacked the coded message, a veiled signal for

community fidelity. I know what she’s asking me to do . . . and I really feel for her situation. . .

. I don’t know.

As Jadah raised her eyes to meet Felicia’s, Felicia shrugged in expectation, “Well?”

Jasper, South Carolina and the town of Ridgeland

Jasper County was the southernmost county in the state of South Carolina. Located

in the low country portion of the state, an area of distinct geography and cultural

heritage running through several of South Carolina’s coastal counties. Jasper was a rural

county, with stagnant economic growth and a median household income of just $30,777,

well below the national average. Jasper was predominantly African American, with

African Americans comprising 53% of the population.

The county seat of Jasper was Ridgeland, a charming yet older town marketed as the

High Point of the Low Country. Not because it had an extensive range of entertainment

and eating options, but rather Ridgeland was literally the highest point between

Charleston and Savannah. The town was founded in 1894 as a railroad stop between

these two cities. The original name of the town had been Gopher Hill, after the gopher

tortoise, a type of tortoise distinct to the low country region and unique in the way it

burrowed to avoid predators and spent most of its life underground. However, the town

moniker was changed to Ridgeland when the original name was not considered suitably

dignified. The train between Charleston and Savannah still passed through Ridgeland

but no longer stopped there. In 2017, the town had about 4100 residents, was

economically ailing, had a slightly higher than average crime rate and limited social

service infrastructure. Extensive local government effort was focused on developing the

town’s economy.

1 This decision case was prepared solely to provide material for class discussion and not to suggest either effective or ineffective handling of the situation depicted. While based on field research regarding an actual

situation, names and certain facts may have been disguised to protect confidentiality. The authors wish to

thank the case reporter for cooperation in making this account available for the benefit of social work

students and practitioners. The case was completed under the ICARED grant XXXX

105

Aging Matters and Meals on Wheels

Located in the town of Ridgeland SC, Aging Matters was a nonprofit organization

that coordinated services, provided interventions and facilitated individual support so

that Jasper County’s senior citizens could remain independent. Aging Matters programs

included its flagship Meals on Wheels, home visitation, active seniors, and health

education. Aging Matters was intended as the safety net for seniors living in Jasper

County and offered all services for free or at a greatly reduced rate.

The Meals on Wheels program delivered hot and nutritious meals to eligible elderly

residents across the county. A team of caring volunteers with oversight from staff social

workers delivered meals to seniors five days a week. Typically, those seniors receiving

Meals on Wheels were at or below 200% of the national poverty level. Without support

from Meals on Wheels, most of these seniors would be forced to choose between paying

for food and paying for other essential expenses such as medication. Meals on Wheels

was subsidized on a generous sliding scale. While some recipients paid a nominal

amount, no senior was ever denied a meal on the basis of income.

It was a struggle for Aging Matters to keep Meals on Wheels and other programs at

full funding capacity. The funding for their programs came from a variety of sources,

with almost 85% of the funding from grants and donations from foundations and

corporations, with only a paltry 3% of funding in the form of federal block grants.

Jadah Johnson, Director of Services and Programs

Jadah Johnson was the director of social work for Aging Matters. She was a 54-year-

old African American woman who had spent most of her life in Ridgeland. Jadah was

5’7” tall, with medium build, and short natural hair. She described herself as graceful

and poised, a carry-over from her time in the U.S. Army. Others described her as

generous and an open and honest leader.

In her mind, Jadah had always been a social worker. Jadah’s father died when she

was twelve, and because of her mother’s work commitments, her grandparents became

a vital part of her upbringing. As a result, she became comfortable around seniors,

having spent long hours as a girl in the social world of her elderly grandparents.

Jadah’s route to the social work profession was nontraditional. After graduation

from high school she decided to join the Army. Jadah had served in the Army for several

years, where she met her husband, an infantry sergeant also from South Carolina. Jadah

was as an accounting specialist, a role in which she excelled. However, with Jadah

settled into her career and her husband preparing to leave for Germany, disaster struck.

An automobile crash took the life of her husband while she was pregnant with their first

child.

Jadah felt she had no choice but to wrap up her military career and head back to

rural South Carolina for support from her family and community. Soon after her return,

Jadah completed her undergraduate degree in Sociology with a minor in Social Work.

Jadah’s undergraduate experience sparked a deeper passion for social work. She felt a

definite connection with social work, and the idea of working with older adults really

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appealed to her, which led her to complete a MSW degree at the University of South

Carolina. In her first year, Jadah completed a field placement with Aging Matters, and

she really enjoyed the experience. During her second field placement, she went to the

Veterans Administration, where she showed an aptitude for working with veterans.

Jadah excelled in the MSW program, and at the end of her second-year field placement,

she had a difficult decision to make. Jadah received offers from both the VA and Aging

Matters. She was deeply committed to working where she would be most effective and

would make the biggest impact, so she chose the lower-paying Aging Matters over the

VA position.

After 15 years at Aging Matters, Jadah was the director of social work. Accountable

directly to the agency CEO, she supervised a team of seven social workers in various

programs, as well as line staff and the volunteers who contributed to the success of

Aging Matters.

Meeting Felicia Cooke

Every fall, various local or regional agencies provided a series of trainings to expose

local human service professionals to the most current social work services and

innovations, as well as to provide CEUs for licensure. Every social worker in Jasper

attended; the trainings were like social gatherings. Jadah relished these trainings as an

opportune time to catch up with social workers and other human service professionals.

The first training Jadah attended was for gerontological social workers at the senior

living facility in Ridgeland. The facility was a relatively new building with a great

conference room; it was light and airy with a high ceiling and large windows flooded

the room with light. Jadah felt a sense of expectation, scanning the room for familiar

faces.

Jadah noticed a gaggle of old social work friends milling around a refreshment table

in the back of the conference room, and she bounded over with quick hellos and hugs

amidst pleasantries such as, “How are you doing? How are things at the Council? How

is your Mabry—he must be two now?” Given the smallness of the town, understanding

and knowing everyone’s births, divorces, and other matters was always a part of

catching up!

As she made her way to the rear of the conference room, a petite and stylishly

dressed African American woman in her early 30’s suddenly approached Jadah and

assertively stuck out her hand.

“Hi, I’m Felicia, Felicia Cooke,” said the woman. “Nice to meet you.”

“Nice to meet you, Felicia. My name is Jadah Johnson. What do you do?”

“I’m a health social worker at Jasper County Primary Health Care clinic,” Felicia

explained, “and I just returned to Hardeeville a few weeks ago. I’ve been working in

Savannah, GA, after getting my MSW degree from the Savannah State University, but

am returning to help care for my family here. You know the Jenkins, right? That’s my

family.”

Felicia explained that she was at the training because the primary care center where

she worked was treating seniors with extensive needs, and she had secured federal

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funding to support the clinic’s senior health outreach program.

That sounds impressive, Jadah thought. That’s just the type of innovative thinking the

aging population in Jasper County needs. The conversation between the two of them was

pleasant and flowed back and forth. Jadah enjoyed listening to Felicia’s description of

the many and varied ideas that she had for writing grants to expand work with seniors

in the county. Felicia seemed particularly interested in hearing all about the resources

that were offered by Aging Matters.

Jadah was eager to encourage a new social worker and was impressed by Felicia’s

ambition to obtain resources that would help people in their small town. Felicia seems

very motivated. She’s a real go getter. She reminds me of myself when I was first in the field. It’s

going to be great having a new and dynamic addition to the work force in Jasper County. Jadah

beamed with excitement imagining the possibility of collaborations with Felicia. Felicia

would be a great community partner to the Aging Matters team, especially with her skills in

grant writing.

As the excitement of their initial meeting was winding down, the tone suddenly

became serious, as Felicia looked down sadly and, with a strained longing in her voice

said, “My parents still live in the house that I grew up in. . . . They could really benefit

from some services.” Felicia paused, then continued, “Umm, my mom is pretty

incapacitated right now, and my Dad tries to take care of them. It’s a real struggle for

them most days if I can’t stop in and see them, and they are on the other side of the

county. And you know how busy we are in this line of community work.”

Jadah just listened, wondering where this was going.

Felicia hesitated, with wet eyes and a tear escaping as she continued, “I’m trying to

make a difference in the world, but it’s so difficult having to take care of my parents. But

I feel so responsible for them. They are older, and yet they supported me through

college and grad school, looking after me. It’s hard to be a single mom and to go back to

College. They’d let me drop Jarel off for weeks at a time.”

A swell of empathy rose up in Jadah’s chest. She genuinely felt for Felicia and was

transported back to her own experience as a single mother while attending college and

needing the support of her parents. “Felicia this seems like a tough situation,” Jadah

replied compassionately, “I know what it’s like to need support from your parents, and

then need to care for them as well. You feel an intense sense of responsibility to pay

them back for supporting you.”

“When I went back to grad school,” Jadah continued, “I was a single mom just like

you, and my parents-in-law were a source of great support. They really shouldered a big

burden, and I continued to take care of them for the rest of their lives. I had such an

intense sense of gratitude to them, so I understand, Felicia.” Jadah felt a surge of

affection for the young woman. She was usually reserved when it came to verbal

affirmations, but she felt such a strong connection to Felicia that she felt obligated to

verbally support her.

“Jadah,” Felicia responded, “you know what it’s like. There’s no small-town

markets anymore. They’ve got to drive all the way to the Walmart in Hardeeville, and

then it takes a lot for them to manage all the food for a week. I try and bring them meals

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when I can.” Felicia became emotional as she continued, and her voice cracked with

emotion.

She probably doesn’t get to talk about this very much, Jadah thought, it’ll really help to

affirm her and encourage her through this. “Maybe there is something Aging Matters could

do to help?”

As Jadah said those words, Felicia’s face lit up.

“We have a Meals on Wheels program and home visiting,” Jadah continued.

“That would be wonderful!” Felicia replied, eagerly.

Jadah took a moment to educate Felicia about the Meals on Wheels and the sliding

scale so that seniors were never turned away because of income.

“It’s great that you don’t ever turn anybody away!” Felicia responded, relief evident

in her voice. Then, more hesitantly, “I’m not sure about the other eligibility

requirements, though.”

“Oh, okay,” Jadah felt a sense of uncertainty about the direction of the conversation.

“Well, what concerns do you have?” Noticing Felicia’s apparent disappointment, Jadah

continued, “Well it’s not that we won’t turn anybody away, but eligibility depends on

the fact that the seniors must not be able to make nutritious meals for themselves, and

there can be no other person living with them who could make them a nutritious meal.”

With this information, Felicia grew quiet, her countenance sullen.

Oh no, what did I say? Jadah’s mind began to race. There’s probably an issue with

eligibility, but I don’t want to dash her hopes when that may not be the case. And besides, it

would be best if she at least applied and somebody else could convey the bad news—if there is bad

news. She’s clearly emotional, so might not have heard me correctly. Best let someone in

eligibility handle this.

In an attempt at reassurance, Jadah added meekly, “Hey, just give us a call, and

somebody can talk you through the application for your mom and dad.”

Felicia nodded awkwardly. Then, as the trainer called for everyone to take their

seats, she asked with a tinge of desperation, “Is there anything you can do to make sure

this application process runs smoothly? You know, to speed it up? Can’t you just add

their names to the list if I give you their details? We are literally all family, here.”

“Felicia, why don’t you call the office and complete the application next week, and

we can see if you qualify,” Jadah’s words tailed off to a noncommittal ending, as the two

women made their way back to their seats for the training.

Bye, Felicia

Jadah felt a nagging sense of guilt for the rest of the training. She avoided Felicia

during the break in the session, but caught herself taking furtive glances towards Felicia

just to see how she was doing. Jadah recalled and replayed their conversation while

driving back to the office later that afternoon. I probably shouldn’t have just come out and

said, Jadah reflected, ‘I’m sure there is something Aging Matters can do to help.’ I’ve been

practicing in this town for a long time, and I’ve worked really hard to make sure everything we

do here at Aging Matters is above board given all of the dual relationships. But Felicia is so

vulnerable. I know what she’s going through in a way that other people probably don’t. It’s

109

natural of me to want to help, right? Jadah tried to reassure herself. She’s a good social

worker, and she’s just trying to help her family like we all do.

A Second Opinion

As Jadah pulled into her parking spot, she pondered, What if I run this situation by

Latoya to see if she knows Felicia? If she does, maybe there’s another way we can help. Latoya

was the assistant director of social services and had been at Aging Matters for six years.

She was a MSW graduate of the University of South Carolina like Jadah. Latoya was an

African American woman with long dreadlocks and a pleasant disposition. Jadah

pensively poked her head into Latoya’s office.

Latoya looked up and asked, “So how was the training?”

“Good . . .” Jadah replied.

“Good . . . but?” Latoya recognized this was not Jadah’s usual demeanor.

Jadah sighed. She really didn’t like talking about people, but she felt the need to

confess this messy situation that she seemed to have stumbled into. I trust Latoya, Jadah

reassured herself. She’s not going to judge me. Then, realizing a moment of silence had

passed, she proceeded, “Do you know Felicia Cooke? She’s a new social worker over at

the Jasper County Primary Health Care.”

“Yes, she came home after being in Savannah for a few years” Latoya replied. “I’ve

known her family for years. She just wrote a grant for them to start a senior health

outreach program. Sounds like a great idea. Why?”

Before Jadah could respond, Latoya probed, “Did something happen?”

“It’s probably nothing,” Jadah said, trying to reassure herself again. “Felicia seems

really nice. We met for the first time today. We really hit it off, in fact. She’s very

knowledgeable—seems like she’ll be a great colleague. But she’s going through a really

hard time caring for her parents.” Jadah relayed the gist of their conversation, and then

concluded, “I may have given her the impression that we’d help her, when I’m not sure

if we can. But then I didn’t want to disappoint her when it seemed like her folks weren’t

eligible. But I felt like she was trying to persuade me into just signing her parents up for

the Meals on Wheels program.”

“Are you sure?” Latoya asked. “This sounds like a complicated situation. You’re

usually really clear in situations like this.”

“I know!” Jadah exclaimed.

“Hopefully, she will call,” Latoya responded, “and we can determine her eligibility.

You never know. They might qualify if the father isn’t home all day.”

Jadah never called.

A Second Encounter

A couple of months had passed since the first training, when Jadah—along with

several staff members—was planning on attending another training. Jadah and her co-

workers happily signed in, looking forward to being in a different environment for the

morning, and then headed to a table with coffee, bagels, and juice. Just as Jadah was

110

pouring herself a cup of coffee, she realized a person was approaching on her left side

from the blind spot in her vision. Anticipating this, she turned to say hello.

“Jadah, it’s me, Felicia,” Felicia said before Jadah could speak. “How are you?”

After exchanging pleasantries, Felicia shifted the conversation topic. “Well, there

may be some eligibility issues with my folks and your Meals on Wheels program. But

you said you’d help us, and it’s much more complicated than I first thought.” Felicia

was speaking quickly, as if to keep Jadah from talking. “During the day my dad works,

but my sister and her teenage daughter are living with them, too, but they are hardly

there.”

Jadah remembered how it was when she first returned to Ridgeland with her boy

and how strained everything was with her parents-in-law. It really tugged at her,

because the strength of Jasper was community and family across generations. That was

the beauty of rural Jasper, even though outsiders might not see it.

“I’m the only one providing for the entire family. My sister’s been trying to move out

for years, and it’s almost as if they aren’t there.”

Jadah’s heart started to accelerate as Felicia kept talking.

“I know I keep asking you, Jadah, but if you could enroll them—my parents, I

mean—you’d really help us out! We sisters need to stick together,” she winked at Jadah.

“It’s how we get by in this community. We’ve got to help each other,” Felicia paused to

take a bite from her cream cheese bagel.

Jadah had grown silent.

“It’s how we get ahead as a people,” Felicia continued, “especially out here in the

country. You know this! We’ve got to help each other along. We’ve got to look out for

each other,” Felicia’s voice rose in desperation, “Don’t you care about your

community?”

This is such a confusing situation, thoughts tumbled through Jadah’s mind like clothes

in a washing machine. She’s so desperate, and I know what that’s like. It’s so uncomfortable to

see her struggling like this. She’s right—I did say we would help. She’d really appreciate the help.

I could have used the help, but not like that, surely? I know what she is asking me to do . . . and I

really feel for her situation. . . . I don’t know.

As Jadah raised her eyes to meet Felicia’s, Felicia shrugged in expectation, “Well?”

111

2 GAY-FOR-PAY

Lori D. Franklin

The Proud Youttt teen group was scheduled to meet in a few minutes in a discreet group room at the far end of the second Boor of the building. Max, Marcus, Stacy, Nikki, and Dalton were gathered in the lobby of Wichita Center for Families, waiting to be led back. But their group leader, MSW student Alicia Hall, was still in her office, waiting until the last minute.

As she looked back through her group notes from the previous week, Alicia thought, The kids deserve a response from me, but I still don't know what to do about what they're saying in group! How am I supposed to react professionally to these stories of wild

Development of this decision case was supported in part by the University of Okla- homa School of Social Work. It was prepared solely to provide material for class discussion and not to suggest either effective or ineffective handling of the situation depicted. Although the case is based on field research regarding an actual situation, names and certain facts may have been disguised to protect confidentiality. The author thanks the anonymous case reporter for cooperation in making this account available for the benefit of social work students and instructors.

113

drag shows, kids cutting themselves, and all the other stuff they're telling me happens at another agency? Should 1 be doing something about it?

GAY IN WICHITA

Wichita, Kansas, was a midsize city with beautiful parks and museums, running rrails, a farmer's market, and Wichita State University. But it struggled in its acceptance of lesbian, gay, bisexual, and transgender (LGBT) people. Living in Kansas, as in much of the Midwest, brought with it a strong assumption of heterosexuality from the general public and an often vicious opposition to same-sex relationships. Almost 70 percent of Kansas voters had voted for the constitutional amendment to ban same-sex .marriage in 2.005.

The community had very few services for the LGBT population. There was an agency that provided HIV/ AIDS advocacy and case man· agement, and Kansas Pride operated a small office, staffed mostly with volunteers. Kansas Pride provided some social events, classes, and sup- port groups that were usually poorly attended and usually for adults. Wichita's Annual Pride Festival often had more than one thousand at- tendees, proving there were LGBT people in the area, but it inevitably drew protestors. Wichita was a short drive from Topeka, home of the most famous of gay bashers, Fred Phelps, whose followers always at- tended the Pride festivities with protest signs with messages such as "Fag sin = 9-n" and "You're going to hell."

There were also very few services for LGBT youth. Two agencies identified themselves as serving this vulnerable population. Wichita Center for Families was a large agency that had a reputation for being "'LGBT affirmative." Rainbow Alliance for Youth was the only agency designed specifically to serve LGBT youth.

WICHITA CENTER FOR FAMILIES

Wichita Center for Families (WCF) provided a large variety of ser- vices for at-risk families and youth. Philosophically, the agency

GAY- FOR-PAY 16

promoted family collaboration, was strength-based, and provided an environment that acknowledged and appreciated diversity. The agency provided on-site emergency services at the Kansas State De- partment of Human Services {KSDHS) youth shelter and a twenty- four-hour hodine for youth in crisis. Family counselors saw clients in the office but also provided services on-sire in the schools. WCF also worked in collaboration with the Office of Probation and Parole to provide case management and counseling to youth involved with the justice system.

Among its services for youth, WCF had several initiatives specifi- cally for LGBT youth as well as those questioning their sexual orien- tation. It worked in collaboration with the KSDHS to identify youth who were in need of LGBT-affirmative services. One program focused especially on homeless youth, and for several years WCF had provided a "coming out" support group.

WCF had also recently implemented an employment nondiscrimi- nation policy to protect LGBT employees. That was unusual in the area, but the agency director felt strongly that it was an important way to show the agency was committed to doing what was right for the LGBT community.

RAINBOW ALLIANCE FOR YOUTH

The Rainbow Alliance for Youth (RAY) was a grassroots organiza- tion created by a male couple who shared great concern for LGBT youth. Their stated mission was to "promote the physical, mental, emotional, spiritual, and social well-being of sexual minority youth so that they can openly and safely explore and affirm their identi- ties." But RAY was not just for LGBT youth. It welcomed youth who were questioning their sexual identities as well as friends of LGBT youth. It provided social opportunities on Saturday nights, which were often dances and drag shows featuring the youth. These events sometimes required a small cover charge, but the money was used to operate the agency. RAY also offered social opportunities on Wednesday nights, usually a dinner followed by discussions and supportive small-group activities.

17 G AY· F O R· PA Y

114

ALICIA HALL

Alicia Hall was a petite white woman and had just turned twenty-five, although people often assumed her to be younger than that. She loved long-distance running and cooking healthy foods and was an avid fic- tion reader. She usually experienced surprise from others when they found out that she had a girlfriend instead of a boyfriend.

When Alicia,entered the Wichita State University MSW program, she had two years of bachelor's level case management experience with adults with mental illnesses. Because her memories of growing up as a gay youth in Wichita were recent, she also had a passion for work- ing with the LGBT community. Although Alicia had lived in the re- gion most of her life and thought of it as her home, she had often felt confused and unwelcome in the difficult climate there. She didn't hide being a lesbian, but she didn't speak openly without first having a feel for the social context. She knew she had good boundaries about when and how to discuss her own sexual identity with clients and coworkers.

FIRST IMPRESSIONS

Alicia had heard about RAY while growing up in the area but had never been there. But early in the MSW program, a fellow student, Melanie Shelton, offered to give her a tour. Melanie had been volunteering at RAY and wondered if Alicia might like to do so as well.

"Hey," Melanie said, "I'd like to show you around this place where I was volunteering. I'm too busy with school these days, so I quit, but I really think they could use someone like you with a bit more of a background in social services and all. They have good intentions, but there's a lot of kind of strange stuff that goes on there-you know, like smoking and all."

As the two women entered the unmarked building, Alicia first no- ticed the black walls and the large open room with a stage at the front. This looks like a club, she thought. Noticing some office space with a couch that had a pillow and a blanket on it, she wondered, Do people sleep here? As she continued to look around, she saw that was about the extent of the sp~ce. There was a unisex bathroom with several

GAV- FOR · PAV 18

stalls and another room wi'h a closed door. Out the back door, Mela- nie pointed to a dumpster in the alley behind the building where the kids went to smoke. Alicia remembered that Melanie had mentioned previously that youth as young as twelve participated at RAY. Unsure of Melanie's impressions of the agency, Alicia kept her reservations to herself.

"What do they do here?" she asked. "Well," Melanie explained, "the kids watch movies, hang out, and

there are lots of drag shows. It's really a lot of fun for them, you know, to dress up and play around. Look at this!" Melanie opened the door to the last room and led Alicia inside. "It's the dressing room." There were wigs and dresses hanging on the walls, high-heeled shoes on the floor, and a countertop cluttered with makeup and cosmetic mirrors. There were full-length mirrors along the walls and a chair surrounded by hair-styling products. Drag shows seem to be what this place is about, Alicia thought. I'm not srtre if I like that or not.

PRACTICUM PLACEMENT AT WCF

After completing her foundation practicum at her place of employ- ment, Alicia wanted to work with LGBT youth during her concen- tration placement and knew that WCF had a good reputation. WCF was quite familiar with student social work placements from Wichita State. Several departments at the agency utilized bachelor's as well as master's level students. But Alicia's placement involved a new set of tasks for a student. She was supervised weekly by the clinical director of the agency, Pete Anderson, but she was housed within the "youth at risk outreach unit" and had a preceptor, Nancy Gerard, to supervise her day-to-day practice. With a master's in counseling, Nancy was a licensed professional counselor.

Alicia not only provided family counseling with LGBT youth and their families bur also assumed leadership of a "coming out" support group for youth. She served as a liaison between the agency and the Gay-Straight Alliances (GSA) clubs in all of the Wichita public schools. She was especially excited about this parr of the job, where she felt she could provide support and cultivate leadership among youth all over

19 G AY· FO R- PAY

115

the ciry and help Wichita's fragmented and uncoordinated services for the LGBT communiry unite and work together for some of the ciry's most vulnerable youth.

The placement was very independent, but the supervision structure was designed to support Alicia's learning. When she saw families or youth in the office, she would have easy access to Nancy and the other therapists on site. But the group met in the evenings after Nancy had left for the day. And, of course, the outreach at the schools involved travel away from the faciliry without a supervisor nearby. But Pete made it clear that he would always be available by telephone if Alicia needed him.

FIRST DAYS IN THE PLACEMENT

On Alicia's first day at WCF, Nancy showed her around the office and introduced her to some of her new coworkers.

"Jack!" Nancy called loudly, trying to get the attention of the mid- dle-aged white man at the end of the hall. He turned and walked to- ward Nancy and Alicia.

"I'd like you to meet our new MSW student," Nancy said. Alicia shook Jack's hand.

"Alicia will be working with the coming out group and the GSA project while she's here this semester," Nancy explained. "This is Jack McCormick, the Outreach Program director."

"It's nice to meet you," Alicia responded. "I'm glad we'll have some fresh ideas in that group," Jack said. "It's

been run by lots of folks. Most recently it was run by a fella who just shared too much of his personal stuff. He was talking about his dates and all, and it just turned into a chat instead of a group, you know? And then we had Kelly do it for a while, but she has other things to do."

"Thanks," Alicia said, "I'm looking forward to it." "And who knows," Jack continued, "it might turn into a job for

you when you're done. We've been looking to hire us a gay-for-pay for quite a while. n

What? Alicia thought, alarmed. Does he not know the origin of that term? Where on earth did that come from?

GAY-FOR-PAY 20

"What do you mean?" she finally asked. "Well, you know," Jack said, "a full-time gay person to really focus

on the gay issues here in this agency." "Oh," Alicia responded, "well, I look forward to working with you."

THE RAY OF HOPE

A few days into her placement, Alicia shadowed a family counselor as part of her orientation to the practices at WCF. Victor Clark had worked in the family-counseling program for more than a year and invited Alicia to watch him interview a new client. Alicia pulled a chair in from another room and sat facing the young woman, Sasha, and her mother.

Alicia followed along on her own copy of the intake paperwork while Victor interviewed Sasha and her mother. The paperwork asked for the client's sex (male or female ) and orientation (heterosexual, les· bian, gay, or bisexual ), and then there was a checkbox if the client was transgender. Alicia looked ahead and saw that later in the form the client was asked, "Is there anything related to your sexuality that you wish to discuss in counseling?" Wow, Alicia thought to herself. I am not sure how I would ask those questions, especially since the kids will often have their parents in the room. If I were doing this, I might save some of those to the end and ask to speak to the child alone. I wonder what Victor will do with those.

"Sasha," Victor asked hesitantly, "you are female, right?" "Well, yeah," she answered. Her eyebrows lowered. "And do you like boys or girls or both?" Victor continued. "Girls," Sash a said slowly. She seemed uncomfortable to Alicia.

Sasha, Alicia, and Victor glanced at Sasha's mom. Her facial expres- sion seemed tense but didn't change as Sasha spoke.

Alicia noticed that Victor skipped the transgender question. "Do you have a religious affiliation?" he asked. "They are Southern Baptist," Sasha stated flatly, looking toward

her mother. Victor continued with questions, and Alicia listened intently. I

probably would have asked her to say more about her struggles with

21 GAY· FOR - PAY

116

coming out as a lesbian in such a conservative religious family, Alicia thought. That seems important.

Victor moved on to the mental health history portion of the assess- ment form.

"Have you ever had thoughts of suicide?" he asked. "I guess sometimes I just thought things would be easier if I were

dead. But I never really was going to do it." Sasha spoke more easily and shrugged her shoulders. "·But whenever I've felt like that, the only people that really understood me were the guys at RAY. They really are the only people who seem to get what it's like to be a gay kid."

"I do not want her going to that place full of sinners anymore," Sasha's mother quickly interjected. "That is not what Jesus wamed for her life, and, plus, they are smoking and doing all sorts of stuff over there that is just not right."

"No one is ever going to understand someone like me," Sasha con- tinued, "especially not my family." Looking at her mother, she added, "It's a place where they accept you like no one else in society ever will."

Alicia felt a strong empathy for Sasha and anxiety about the extent of the mother's resistance about her daughter's sexual orientation. She knew too well that there were parents in Kansas who could become violent with their children or kick them our of the house when they found out their children were gay.

PROUD YOUTH

A week into her p lacement Alicia met with Kelly Lander to discuss the group that Alicia would soon be leading herself. As Jack had men- tioned, Kelly had been facilitating the group but did not want to con- tinue. As the agency's health educator, she had focused more on health education and in the group had mostly discussed psychoeducational material on safe sex and HIV prevention. Alicia asked Kelly for a little background on the group members.

"Sure," Kelly said, opening the first chart on the stack. "Max is six- teen, biracial, white and African American and has been at the shelter about six months. He's in the job skills program here and does some janitorial stuff in the building for that." Alicia immediately wondered

GAY · FOR·PAY 22

whether he was the friendly kid she had seen talking to the receptionist earlier that morning.

"Marcus is seventeen," Kelly continued, "African American, and came to the shelter after a string of failed foster placements. He's been with lots of foster families that have kicked him out for being gay. It's really sad. He just got out of the hospital after his most recent foster mother found him hanging in the garage. He was okay, but they said they couldn't keep him anymore, so now he's here at the shelter. I know he had one foster family who was Southern Baptist, and they tried to take him to one of those religious programs to try to 'cure' him before they gave up on the placement."

"That sounds awful," Alicia said. "Poor kid." "Yeah," Kelly went on, "then there's Dalton, who is sixteen and white,

kind of upper middle class and at some private school. His folks are going to family counseling with him, and that all seems to be going along okay."

"Then there's Stacy, who is seventeen, lives with her mom. Her folks got divorced when her dad came out. She gets into fights at school a lot and identifies as a lesbian, bur I'm not really sure where she's at with her identity."

Alicia nodded and kept on listening. "And finally, Nikki," Kelly said as she pur the last chart on the stack.

Alicia noticed the chart said "Nicholas." "Fifteen, white and Creek, transgender, run away from at least four different foster placements, and now refuses further placement. His mom drank and abused the kids, so Nikki was removed at age ten, and there are some older sib- lings who are now on their own. It never has really worked out, I guess, to place Nikki with one of them."

"So there you have it, Alicia," Kelly said. "There's your group! I am really glad you are here. I think it will really help these kids to have a leader with a social work background."

THE GROUP MEETS

In t heir fi rst few sessions, Alicia quickly tried to revita lize t he group and get it back on track as a support group with a psychoeduca- tion component. She was bothered by the name of the group-LGBT

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117

Support Group--and encouraged the kids to select a new name. They came up with "Proud Youth."

She soon implemented some activities in the group. For example, she asked the kids to draw questions out of a hat about their experi- ences of coming out; they played a trivia game about famous LGBT people; and they watched Brokeback Mountain and discussed it as a group. She divided the group meetings into a discussion activity sec- tion and a psychoeducation section with presentations about safe sex, relationship skills, self-esteem, and other issues that seemed relevant for group members.

The group members were actively engaged, seemed interested in the topics, and participated readily. They seemed to trust Alicia and talked freely about their lives. Sometimes before sessions, for example, they chattered about attending "parties" at RAY.

"They were so hot at that drag show the other night," she overheard Max saying.

"Yeah," Marcus answered, "did you see that dude taking those pills in the bathroom? Don't know what that shit was he was raking."

"I didn't see that," Max said, "but I saw that one emo girl with the red streaks in her hair in there cutting her arms up. Seems like the emos are multiplying over there. Then later she was out in the smoke hole making out with that new girl like nothing ever happened."

"I don't think they should play all that emo music," Stacy chimed in. "It just attracts them, and they show up there to do all that cutting and stuff. It's gross."

"Well, they aren't going to fir in anywhere else but RAY," Marcus responded. "Most of them are bi anyway, so RAY understands them."

Is RAY allowing this kind of stuff to happen? Alicia worried. Are they encouraging it? She knew a little about the "emo" culture and how difficult it was to treat someone who thought cutting themselves was not only cool, but an important way to express emotion. But surely RAY is not allowing these kids to take pills and cut themselves without doing anything about it!

She wasn't sure what. to say to the kids because they were just talk- ing among themselves outside of the group. It wasn't group time yet, so she wasn't sure how to intervene. Bur she could see that Max looked over at her and seemed to be waiting for her to say something.

GAY - FOR - PAY 24

COLLABORATION ATTEMPTS

As Alicia got used to her direct practice work with the youth at WCF, she began to move more into the GSA liaison part of her placement. She had an idea to create a conference for the leaders and members of local GSA dubs in the high schools. She started working with leaders of Kansas Pride, the agency that organized the events for the annual Pride Festival. Kansas Pride had undergone community criticism for its lack of attention to youth issues, so its organizers welcomed the opportunity to collaborate with Alicia. They were adamant, though, about not even attempting to collaborate with RAY.

"We have asked them before about their board of directors, and they won't even tell us the names of the members," Assistant Director Kiara Junger cold Alicia. "We have asked about their policies, if there is anyone with any kind of credentials on their staff, and all of that. They will not even answer our questions. The last thing that Kansas Pride needs is any more conflict with RAY."

"Why doesn't anyone do something about them?" Alicia asked. "Isn't there somewhere to report them?"

"Well~" Kiara said hesitantly. "I don't know what it would do to the gay community to have the stuff that goes on there exposed. It might just confirm so many stereotypes that we are always trying to overcome, you know?"

Alicia agreed not to attempt to collaborate with RAY on the confer- ence. I'm not sure what I can do as a student, anyway, she thought. This sounds like a rift that's been there for quite a while.

Alicia began canvassing local high schools to hang posters about the conference and asking to talk co principals about encouraging their LGBT students to attend. She was quickly discouraged by the response. She felt unprepared for the looks from staff when she showed them her poster and asked if she could hang it up. She was told several times that she could not hang her poster and was asked to leave. She had principals tell her they were unavailable to meet with her or that there was no reason to meet because there were no gay children in their schools. Maybe this wasn't the right placement for me, Alicia thought. I'm taking this rejection way too personally. I'm still too sensitive right now to serve gay clients in such a conservative community. Bttt I have

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to see this practicum through at least. I just don't want to ruin my professional reputation before my career even starts!

When the day of the conference rolled around, mostly adults showed up. The conference went well, with great speakers, a live band, and great food, but a very disappointing attendance. Even some youth that Alicia herself had talked to didn't show up.

The following Monday morning Alicia saw Max in the hallway out- side her office space. He was mopping the floor, so she stepped out to talk to him.

"Max," she asked, "do you know why the kids from group didn't show up for the conference on Saturday?"

"RAY scheduled a party for that night. It was a special event, a drag show contest, and they elected Miss RAY that night." Max looked at the floor.

"Right, I thought RAY just did stuff on Saturday nights?" Alicia responded. "This was all on Saturday morning and afternoon, so couldn't they have gone to both things?"

"They pushed the start time to noon, just to make sure there was time for everyone to do their number." Max looked up at Alicia.

Great, she thought. Music, food, and education will never be able to compete with wild parties.

IS THIS GAY·FOR-PAY7

One afternoon for group Alicia began with an exercise, hoping to cre- ate more feelings of commonaliry among members. She had left the previous session feeling concerned that Stacy didn•t fit in well with the other kids.

''If you could be a superhero, who would it be?" Alicia began. "I don't know, I guess I'd just want to have the power to be liked

by people for who I am and not have to hide myself," Marcus said. "I think I might be trans, but how do you know if you want to have a sex change? My DHS caseworker is really cool, and she was telling me she could help me start doing hormones and stuff if I wanted to. Since I had that bad suicide attempt and all last year, I probably could never even get anyone to do hormones for me."

GAY·FOR·PAY 26

"I don't know how you know, you just know," said Nikki. "It's good you go to RAY because they really understand all that. They can help you, you know, they really get it there. They have really been cool with helping me and showing me how to do my hair and makeup."

"Do you think we 'get it' here at WCF?" Alicia asked. "Well," Nikki began. "When I first met my counselor here, he was

like, 'Do you like boys, or do you like girls?' I mean, I'm a girl, so if I like boys, was he going to write down I was straight or what?"

"I didn't know what to say," Nikki continued. "Then he was like, 'Do you like chickens? I mean, boy, those feathers!' I didn't even know what he was talking about. I don't think I ever even answered his question because I really don't know if I like boys or girls. Was that like a joke, or what?"

"] would have just told him to shut up," Stacy responded. "What a moron." She slugged Nikki on the arm, friendly but too hard. Nikki shot her a dirty look.

"I mean, people have always said I seem like a girl, the way I act, and I'm just glad that RAY was there to help me figure out that stuff," Nikki said.

"Yeah," said Marcus, ''they've helped me learn a lot about how ro do my makeup and dress up and stuff. It's fun there. The other night, though, I tried to walk over there with my boobs on and my dress and high heels. It was several miles, and I got pretty lost. It's hard to find them in the dark."

"Wait a minute, Marcus," Alicia interrupted. "I didn't know that you were wanting to start dressing like a woman. You've never men- tioned that before."

"Well, sure. You know, it's fun," Marcus responded. "The drag shows are fun, and we get tips. It's kind of a way to make a little money. And I mean they are so cool and all. I know there was that one guy whose parents kicked him out when they found out he was queer, and the guys at RAY just let him stay there so he'd be safe. That was great, you know, I mean it sure beats coming to a shelter."

"Was this late at night when you were out walking?" Alicia asked. "Were you supposed to be back at the shelter? Did you feel safe?"

"Yeah, it was all fine," Marcus answered. "So it's pretty fun there at RAY?" Dalton asked. "Do you think I

should go sometime? I mean, what do you think, Alicia?"

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119

"It is cool there, but I don't go anymore," said Max. "I mean it's cool to go there to party and all, but I don't know. lt just seems like •.. I don't know ... "

"Well, I don't know either. What do you guys think?" It was the best response Alicia could think of at the moment. But she wondered, What is going on over there at RAY?

SEEKING SUPERVISION

The next morning Alicia went to see Pete. In luck, she found him in his office, and he had time to talk. As soon as she mentioned issues with the group, Pete recommended asking Kelly to come join them. He thought that as a former group facilitator who knew the kids she could offer some insight. Alicia summarized her concerns about activi- ties going on at RAY.

"How am I supposed to react when they say this stuff in group?" she asked. "I mean, I don't want to tell them I think they shouldn't go there because they like it so much; I'm afraid they'll just go there and never come back here again for legitimate services. And we could just forget about ever collaborating with RAY or really getting referrals from any kids in need that show up there."

"Well," Pete said, "you're right that we don't want to burn bridges and tell the kids not to go there. Maybe you could just talk about safety more generally and try to get them to talk about safety issues with each other. See what they think of RAY, like you started doing. As the group leader, you don't want to come in and say that RAY is bad, but maybe you can help them figure out for themselves what they think."

"That's what I want to do," Alicia said. "I want to figure out how to use the group process to help them evaluate it for themselves. I just don't know how to respond in a way that's professional."

"No way," Kelly said. "Don't talk about RAY in your group at all. Just change the subject if they bring it up. We already have a turf war here. Just stay away from that subject."

"Well," Pete responded. "I get what you're saying, Kelly, and I think Alicia needs to think about that." Then, turning back to Alicia, "I still think there's therapeutic value to this, and you can use it to _facilitate

GAY· FOR · PAY 28

some important d iscussions with the kids. Just try it in your group next time. You can do this!"

"Thanks, Pete," Alicia responded hesitantly.

ONE WEEK LATER

As Alicia prepared for group, she looked back through her notes from the previous week and remembered Pete's encouragement. The kids de- serve a response from me, but I still don't know what to do about what they're saying in group! How am I supposed to react professionally to these stories of wild drag shows, kids cutting themselves, and all the other stuff these kids are telling me happens at RAY?

Great, Alicia fretted, I've thought about this a lot but still don't know exactly what to say! How am I going to use our time in group today? Do I have an obligation to do anything about what they say? If so, what?

29 GAY- FOR·PAY

120

Spirituality and Religion in Social Work Practice

Decision Cases With Teaching Notes

T. Laine Scales Terry A. Wolfer David A. Sherwood Diana R. Garland Beryl Hugen Sharon Weaver Pittman

Council on Social Work Education Alexandria, Virginia

121

13 Why Can't They Make This Place More Jewish? Evelyn Hoffman and Dennis R. Myers

"Mother is feeling so alone here. She's begging me

to let her go back to New York. I don't know how to

help mv mother laugh again and meet new frieuds

and stop missing home so much." It was the under-

current of desperation in Jean Rubin's expression

of concern for her mother, Mvra Golden, that mo-

mentarilv called Tom Harris's attention awav from

his routine case planning as a county geriatric social

work<'!" at the Central Arkansas Mental Health and

Mental Retardation Center. Since his first encoun-

ter withjean over 6 months ago, "I om was not an·us-

tmncd to hearing this level of frustration in hCI

voice. He thought he had helped in resolving at

least some of these kclings around the unrelenting

phvsical decline experienced bv her RH-year-old

mother. but never had her words contained such

sheer hopelessness.

"J(mJ knew that a seamless transition h·om a

cosmopolitan setting like New York to a southern

area like central Arkansas, where there was a very

small Jewish communitv. would be difficult for a

Jewish older person who was also f~lCing frightening

phvsical challenges. 'lom recognized that. in spite

of Mua 's depression and resistance to the idea. it

was time to facilitate her involvement in a setting

that would provide peer contact and the possibilit)

of supportive h·iendships. A~ he thought about this

proposition, Tom had an uneasv feeling that Mvra's

culture and religion. so different from most of those

who lived in central Arkansas. would present a sig-

nificant barrier for her. Part of him wanted Mvra to

minimize these differences for her own good. But

Mvra would soon show Tom how her religious be-

lids and practices would become a catalvst for en·

riching comrntmit\ social services and. at the same

time. present Tom with a ditlicult dilemma regard·

ing the rok of religious diversitv in public life.

Myra Golden's Relocation

Jean was awan· that the local countv Mental

Health and Mental Retardation Center had a Geri·

atric Care Unit and she decided to seek assistance

there. Torn, the unit's only geriatric social worker,

recalled his first encounter with Jean. when she told

him, 'Tm moving mv mother here to Plainview from

New York City. and I need vour help to know what's

available to make hn happv. She absolutely does

not want to come. This is a verv diflicult move for all

of us. Ijust know it has to be, because so much will

be different for her."

As a loving Jewish daughter, Jean's passion was

to live out the teachings of Torah: "Do not forsake

me in mv old age." For her. that meant placing

herself, her husband David, and their home in

the center of anv plans for her mother's care.

The htct that Jean herself was recovering fr·om

cardiac bv-pass surgery and was battling diabetes

did not detract from her resolve. However, she

was facing one of the most difficult challenges of

her life. "I thought I would be a shtarkn (strong,

tireless person), but this situation with Mother

overwhelms me. ..

117

122

knew rl!at the act of

home in the New York Citv bor~

o! lluccns would the support of

pt ok,~i!mal. Jean needed sonwone who could

her rnother~s relocation and who W<~>

about resources in Plainview.

where Jean herself had moved so long ago. 'l(Hn wa-.

quite comf(>rtable with such requests. just as he wa'

also to work with adult children regarding

the guilt and the unfinished business that often

attaches itself to the role of

Presenting Issues and Gerontological Assessment

Tom's initial impression ol Jean and David

Rubin was that they were a mutually supportive

couple who had n'cently celebrated their !"lOth

wedding anniversary. Thev w<·n· both motivated to

provide within their home the care that Mvra would

need. Even though Tom had only recentlv completed

his MS\A,', his two years of gerontological work with

families and carcgiving issues had taught him that

such relocations were complex. This one seemed no

diflerent in that respect. For most of her HH vcars,

Myra Golden reveled in the web of relationships in

her congregation and neighborhood in Queens.

"At home in Queens her davs were so full," Jean

explained. "Always on the phone with her friends

or involved in nonstop bridge games at the Jewish

senior center. Seems like if she wasn't at the cemcr

she was off with her friends to a Broadwav show. She

could always be found at weeki\· Sabbath obsn~

vances and, of course, there were celebrations of the

High Holv Davs and Passover.''

Mvra had been outspoken in her disapproval ol

Jean's decision to leave the advantages of life in the

Big Apple to mm·e to Plainview upon her marriage

to DaYid, her ~World War IJ sweetheart. Now .Jean was

insisting that Mvra make the same move she had

made over 50 years earlier. How ironic it was that

Mvra herself would be traveling the pathwm· that

created so much friction between her and Jean so

long ago.

The decision to move Mvra into the Rubin's

home was triggered bv a stroke that brought with it a

severe decrease in Mvra's abilitv to manage inde~

pendcntlv in her apartment. According to the gen~

atric assessment that 1(nn received from her

intemist in :'\Jew York. her Cnchral Vascular Acci~

118 Spirituality and Religion in Social Work Practtce

dent (C\'.'\). or stroke, aflected her ability to pre~

pare her own meals and indepcndcntlv handk

hvgiene. Her comprehensive assessment

noted that hct "instrumental activities of dailv living

(IADL) scores rel1ected moderate impairment and

that she had defkits in short~tcrm memorY and in

the use of her right hand.'.

Tcm1 also uoticed in the assessment that she

"was a confident woman who f1ourishcd when slk

had rich human interaction available to her and

who highlv valued her religious lili.·.'· Given that she

could no longer care lor herself and that carcginT

support f!·om a Eunilv member was unavailable in

New York, 'l(nn concurred with Jean's plans to rclo~

cate her mother and agreed to facilitate a healtln

transition f(n- all concerned.

lt did not take very long fi.lr 'J(Hn to understand

ckarlv that the answer to the caregiver question

could never be a nursing home. He knew Jean

would say to that possibility, "Not on your lif(·: It will

be a nn:htag (dark night) bef(m' I would allow such

a thing to happen." Jean\ desire to assume the

primary caregiver role for her mother was based on

more than an adult child's love and gratitude to~

ward her parent. At the hnmdation of her feelings

lav the rich traditions of "caring f<lr your own'' and

"honoring parent:;" which are markers ofjewish

family life. Although Torn understood that the trall~

sition would be diflicult, neither he nor Jean antici~

pated the devastating efrect-; that the change in

geography, culture, and religious surroundingco

would have on l'vlyra ·s wcll~being.

The Warren Senior Center

The move itself went extremelr well. Jean and

David had lovingly prepared for Mvra a bedroom

with a private bath within their home and had en~

couraged her to furnish it with treasured items from

her New York apartment. For Myra. however, this

change was a mchtag indeed. She longed for her

home and expressed her outrage, frequentlv won-

dering aloud what she had done to deserve such a

hlte as this. Tom recognized the hun and fear that

lay below the anger and helped both the mother

and the daughter express the grief, sense of loss,

and helplessness both were experiencing in their

own wa\. Torn also knew that he must help Mna

hlrm meaningful relationships in the commtmit\.

123

Because Mvra was so active, sh e wo ul d n eed a

pl ace to interac t a nd becom e involved with age

peers, a place wh ere recognition, fa mili arity, and

laughter abounde d, and a p lace wh ere she co u ld

pursu e he r enjoyment of brid ge. Locatin g this re-

trea t was essentia l if the re would be anv ch ance fC:>r a

change of heart about the move. Eve n more th an

food , Myra n eeded daily doses of social nou ris hm ent.

Tom recomme nded th at Myra tt-y th e Wa rren

Sen ior Ce nte r an d schedul ed an initial vis it wi th

Saman tha Ross, the director, who ve rified man ~ ·

reaso n s whv the senio r center e nvironment would

be a good fit for Myra. Its m e mbe rship , in large pa n ,

included very ac tive adult~ who te n ded to be highl y

educated. Th e program was en ri ched by a nmrition

program th at inclu ded a noon m e al Mond ay

th roug h Friday, ed u cation al offe r ings in p a rtn er-

sh ip with th e loca l com munity co ll ege, d ay tri ps to

scenic and interesting areas of cen tral Arkansas ,

interge nerati o n al experiences with smdents from a

n earby e le m entary sch ool , and ga mes and crafts. At

th e Wan-en Sen ior Ce nter, th e domi n o gam e "42"

was th e main ta bl e game, and Torn th ought th at it

had many of th e feat ures of bridge. The Wan -e ll

Ce nter received its primary publi c su pport through

the O ld e r Am e ri can s Ac t. with fund s ch a nn e led

th rough th e local Area Agency on Agin g o n a co n-

tra c t. basis to th e Ce ntral Arkansas Sen ior Ministry,

wh ic h operated th e se nior cente r as a private , not-

for-profit age n c:y of the First Me thodist Churc h in

Plain view.

Religious Insensitivity

Ini tially, Myra's decision to give the Warren

Center a try seem ed to be affirm ed by h e r recep tio n

th ere. At first , she e njoyed h e r n e w friends and th e

varie ty of ofl erin gs a t the center, bu t it was not long

bef (Jn~ unanti cipated features of the program began

ch anging th e sen ior cen ter in to an uncomf(H·tabk

an d ali e n se tting . In th e beginn in g, th e unsettlin g

feature s were on ly mino r irri ta tion s, for in stance .

th e ce nter staff's co mplete di sregard h>r Jewish

holid ays, such as Passover. It seem e d to Myra th a t

sh e was the only J ewish pe rson coming to th e ce tt -

ter. One day site ca m e home, a nd when _l ean asked

her about her d ay, she replied. "Very stran ge! Arc

peop le of their fa ith given in struction on who th eY

can dan ce with or sit next to ? lt seems to m e th at

cvt>ryo ne in th e cen ter has a bovfricnd o r girlfri e n d

and I feel li ke l shou ld go elst:whcn ··-

With tim e, oth er reli giouslv in sensitt \T hK top;

becam e in creasi n g ly obvious , in clu d ing d ilfc re n ces

in d ietary requirement~ for obse rvant J ews and the

meals served a t th e cen ter. Christian pra vcrs an d

hymns were dom in ant durin g m ealtimes am i sin g-

a lo n gs. To Myra, th ese e lements appeared 1.0 pi a\' a

major role in th e li fe of th e center. Fina ll y, there was

th e issue of scheduli n g th e center dances-on e o f

Myra's favorite ac tivities-on Friday evenin g, th <'

very time of worship ser\'ices at the syn agogue .

Making It Better for Myra

Myra wondered alo ud to Tom , "Couldn ' t there

be something done to make th e p lace more Jew-

ish? " It was o bvious to Torn th a t so m e thin g n eed ed

to h a pp en . AJthou gh he had some co n cem a bout

th e cu ltural and r e ligious ditfe rences Myra migh t

experience wh(~ ll h e made th e referral, h e neve r

im agin e d th at th is publicl y-fund e d se nior centn

wou ld be so difli cult for non-Christian parti cipa n L~.

"We reall y want to be as res ponsive as we can to

our participan ts' individual tastes , but you h ave to

remem ber th at we have our limits ," Samantha Ross

said in respo nse to Tom·s attemp t to start a co n versa-

ti o n about his conce rn s. Neverth e less , she agreed to

a m eeting with Tom, .Jean , and Mvra ''to see wh at

cou ld be don e to make thin gs berte r." She li stened

inte ntl v to Myr a's complainL~ :

'Th e Friday ni g ht d a n ces are a t the same tim e

as synagogu e services and th at kee ps m e from go ing

and I don't thin k that 's righ t~··

"Cou ld th e bridge players h ave the use of at

least on e of th e tab les?"

"Please provid e some lun ch es for peop le li ke

m e who have re li g ious restri cti ons on what th ey can

eat. Maybe havin g somethin g .J ewis h around here

wouldn 't be so bad '"

Samanth a told Myra th a t sh e n ee ded to allo\\·

m o re time for "eve1-yone to ge t to know her better'·

a n d to ·'realize th a t central Arkansas can n ever be

like New York City. " She ex p lained further th at arw

c h a nges in th e p r ogram would need the appm\'a l o f

th e ce nter 's coun cil , an electe d body composed ol

five ce nter participants , two m e mbe rs from tlte i\rc~t

Agency on Ag in g Advisory Committee, and Ms. Ross

h e rs elf. Sh e agreed to discuss th ese conccms wit l1

Why Can't Th ey Mak e This Pl ace More Jewi sh? 11 9

124

the council as part of the f(>r the upcoming

week's

Mvra seemed relieved bv the opportunity to

express some of her concerns, but Tom had an

tmeasy that the road to making the center

more accommodating to ethnic and religious dillcr-

ences would be long and hanL

"How can a senior· citizen program that is receiv-

ing Older Americans Act monies be so supportive

of one religious viewpoint and so unresponsive to

those who hold other be lids)" was Tom·, rhetorical

question to his supervisor as thev reviewed what had

become known as "The Mvra Case."

Tom's supervisor reminded him that the

center's program mirrored the values and prefer-

ences of most older people from cemral Arkansa-,,

and, in that sense, the center was being responsivt'

to the needs of the majoritr.

"But to what extent must Mvra be denied the

richness of her personal and religious tradition?'

T<nn asked himself. He was more detennirwd than

ever to do what he could to assure that Myra would

have an environment that would embrace, rathn

than ignore, the traditions and beliefs that contrilr

uted so much to her quality of life.

Congregational Solutions

Tom's supervisor recommended that he ex-

plore other options for social connection and aC!iY·

itv for Myra. Tom thought to himself, "How are older

persons who do not attend the Warren Senior Cell·

ter addressing these needs?" A~ he made the ar-

rangement-; for a meeting of the Rabbi, Jean, Mvra,

and himself, Tt)J11 hoped that the local Jewish con-

gregation would have some answer~.

Rabbi Rebekah Crystal of Congregation Rodef

Shalom listened attentively as Myra and Jean surn-

marized their encounters at the \\'arren Senior

Center, the most exaspei·ating of which were the

increasing number of subtle and not so subtle d~

forts to persuade Myra to convert to Christianity. It

seemed to M\Ta that the future of some of her new

friendships depended upon her acceptance of this

new religion.

"None of this is a surprise to me,'' observed Rabbi

Crystal, "as frequent attempt~ at conversion are a wav

of life for Jews in the South. Some of the local group

have even had the chutzpah to try to convert me,.

120 Spintuality and Religion in Social Work Practice

Then Rabbi Crystal addressed Myra's predica-

ment. "Though our congregation is relativelv smalL

v;e have at least 10 older members who. like Mvra.

need some outlet for their social needs and have

not felt welcome at the center."

"'What about the possibility of the congregatiou

funding a program for its seniors that would in-

dude kosher meals, celebrations of the High Hoh

davs and Passover, bridge and mah:jongg games.

Jewish dances, and anvthing else Jewish;'· 'I om

a~kcd Rabbi CrvstaL

Jean mentioned that she had heard of a simi-

lar program. called Chavarah, that had been de-

veloped in Texas and that could serve as

model. The main challenge to establishing such

a program wonld be funding for a director, a van

and driver, and someone to oversee meal prepa·

ration. Rabbi Crystal thought that these monic~

could be provided bv the congregation and th<·

local chapter of Hadassah, the Jewish welfa1 c

council. There would be enough funding to

provide a program for three days per wecL

"Tom, we will need to relv on you prett\

heavily if this is to become a realitv,'' Rabbi CI·vs-

tal observed.

How to Proceed?

Following his initial excitement over the new

program, Tom began to reflect on what his next

steps would be in the quest to help Mvra and Jean.

His patience with waiting to hear from Samantha

Ross was rewarded by a message that reported, "The

center council has decided to move the dance to

Thursday night and approved some changes in the

menu for her benefit. Please call me so we can di~

cuss this!'

The realization that tltc centc1· council wa'

willing to consider wavs to accommodate Mvra gen-

erated a deep sense of satisfaction fm· Tom and

stimulated his dreaming about many other substan-

tial changes that could open Warren Senior Centn

to the whole communitv. There could be life aftc1

New York Citv for Myra! Tom thought of her and

how pleased she would be with the changes and the

sense of empowerment she would feel as a result of

her speaking up . .Jean had alreadv indicated that

Myra appear to fed a bit better about the center and

her relationships there,

125

"!om knc\v that this dilemma was one of those

"'soul searching"' times in his social work career. It

sounded as though the possihilitv of inaugurating <l

Jewish senior actiYitv program was vcrv real. How-

ever. the request for more cultural and rcligiow.

sensitivity at V\'arrcn Senior Center had not fallen

on deal ears. and there were signs that Myra was

becoming mmT integrated there. "How should I

invest the limited time and skill resources I have"'

was the question most 011 Tom's mind as he contem·

plated the dillicult choice bd(m· him. He won-

dered, "\Vhat would be be'it liH· her? For present

;md future Jewish elders~ For other religious and

ethnic elders~ For the communitv:"

Why Can't They Make This Place More Jewish? 121

126

Neighborhood Agencies, Businesses, and the City:

Boston Against Drugs

Victor M. Forlani and

Melissa M. Stone

Cases in Nonprofit Governance

CNG No. 17

August 1996

***********

Victor M. Forlani, Lecturer, Department of Management, University of Dayton, Miriam Hall 114, Dayton, OH 45469-2235; phone: 513-229-3556; e-mail: [email protected]

Melissa M. Stone, Assistant Professor of Management Policy, Boston University School of Management, 595 Commonwealth Avenue, Boston, MA 02215

***********

A list of Case Studies and PONPO Working Papers Box 208253 (88 Trumbull Street), New Haven, CT publications is available on request from ISPS, (77 Prospect Street), New Haven, CT 06520-8209.

can be obtained from PONPO, P.O. 06520-8253. A list of ISPS P.O. Box 208209

Program on Non-Profit Organizations Institution for social and Policy studies

Yale university

127

Neighborhood Agencies, Businesses, and the City Boston Against Drugs

Victor M. Forlani

and

Melissa M. Stone

Summary Boston Against Drugs was a partnership among the city, business corporations, and neighborhood groups united in opposition to drug and alcohol abuse. In this case, the reader is asked to analyze BAD as a collaboration, paying particular attention to assessing the role of the corporate partners. Readers must make recommendations regarding future funding options necessary to keep BAD alive as well as administrative and governance changes necessary to strengthen BAD's operating effectiveness.

Boston Against Drugs was known throughout the city of Boston as an

effective contributor to the war against substance abuse. Created in 1986,

"BAD" was a partnership among the City of Boston, business corporations, and

neighborhood groups united in opposition to drug and alcohol abuse. Activities

were conducted through sixteen neighborhood task forces, knows as TEAMs, an

acronym for Through Empowerment and Mobilization. City staff provided

support to the TEAMs and each TEAM had its own corporate partner and

Business Representative on the TEAM.

In the fall of 1994, BAD was entering its last year of federal funding. The

half million dollar grant the program had been receiving annually since 1990

had done much to support the neighborhood TEAMs' efforts to prev1ent people

from using drugs and abusing alcohol. In FY '94, the federal moneys had been

apportioned so that support for BAD's central office in City Hall had been

thirty-six percent of the $475,000 (personnel received $159,300, while $6,300

and $5,000 went to travel and supplies respectively). The rest, $304,000, went

to the TEAMs and was divided equally among them. Although prospects for

128

additional funding were good in the long term, it was doubtful that another

federal grant could be secured soon.

John Riordan of Blue Cross/Blue Shield of Massachusetts was BAD's

corporate director, the senior representative of the corporate partners in BAD's

operating structure. He was concerned that if he and his colleagues in City Hall

failed to develop a solution to the impending loss of funds, important activities

that were already planned by the TEAMs and the efforts of City staff would

cease. Riordan was considering several options but was uneasy about each:

He could try to obtain a bridge grant from one or several foundations. That solution might be ideal but was not likely because competition for local foundation moneys was extremely high from worthy causes that did not already receive substantial corporate support;

He could seek agreement from the corporate partners to increase their average yearly cash support of individual TEAMs from $5,000 to $10,000. He worried that such a request would be viewed as a shift in the kinds of resources partners would be expected to make in the future and would lessen their overall commitment to BAD. Moreover, it might undercut the non financial but essential contributions of the Business Reps;

It might be possible to ask the neighborhood TEAMs to conduct local fundraising. Such activities, however, could easily detract from their ability to conduct programs directly related to drug and alcohol abuse prevention, and few had fundraising skills.

Without funds, numerous neighborhood seminars, plays, awareness

programs, forums, parades, rallies, sports tournaments, and fund-raisers -- all

of which served to engage and unite people's energies in the cause of substance

abuse prevention -- would have to be dropped or severely curtailed. Those

events had spread the message in all sixteen communities that something was

being done neighbor-to-neighbor about addiction.

129

Antecedents of Collaboration

In the mid 1980s, Boston Mayor Ray Flynn and City Hall staff had

determined that drug and alcohol problems were rampant in all areas of the

city. The mayor decided to do something about it and called on the Boston

Chamber of Commerce to convene individuals who ran the major corporations

in Boston. This group, known as "The Vault," was asked by the Chamber and

Flynn to confront Boston's drug problem through direct involvement. The Vault

acceded to the request and appointed a Special Task Force on Drugs headed by

Gerhard Freche, then president and CEO of New England Telephone, long a

sponsor of community reform activities.

The concept of partnerships with specific neighborhoods sprang from

Flynn's emphasis on services to neighborhoods. The local emphasis also built

on the work of the Boston Compact for Education, another Vault project, which

involved sponsorship of individual schools by corporations. BAD broadened the

concept of "adopt a school" to "adopt a neighborhood." One of John Riordan's

predecessors as corporate director put it this way:

The concept of partnerships with neighborhoods really sprang out of the partnerships that we do in the school system. New England Telephone has had for years a partnership with Dorchester High. Ours was the first, in fact. Other corporations have adopted a nearby high school. We just thought that it might work to adopt a neighborhood. BAD's initial pilots were companies who all had had partnerships with high schools. And what we really asked them to do was take the same neighborhood where their high school partnership already existed.

Building the Model

Freche made it clear to the mayor that he was interested in doing

something other than merely writing a check, although financial support could

be part of the package. Freche wanted to address substance abuse in ways that

led to lasting progress. That goal required a long term and comprehensive

approach on the part of the corporations. He also wanted to create a structure

that would exist over time, no matter what the vagaries of politics or corporate

leadership happened to be.

130

Although some neighborhood arrangements jelled quickly, others took

longer to establish. Community organizations in the various neighborhoods

feared that BAD would deflect both attention and funds from their causes. It

took careful persuasion to get local groups to look beyond their own individual

missions and approach BAD as a complement to what they were already doing.

Cooperation, therefore, was often slow in coming.

To address those undercurrents, the city and businesses encouraged the

four initial TEAMs to come together and sponsor activities so that all the

parties could get acquainted and build trust. These endeavors engaged

neighborhood leaders and created awareness of BAD's leadership and what

they were trying to do. Only afterwards did the separate TEAMs begin

discussions about goals and strategies. Early energy also centered on

determining what resources companies and other participants would commit.

That work involved doing a lot of inventorying -- finding out who was doing what

and who could contribute what resources.

Pat Purcell, the publisher of the Boston Herald and the Corporate

Chairperson following Freche, lent the resources of his newspaper to the

program's publicity efforts, developing a media campaign that made Boston

Against Drugs a more familiar name. He also used the Herald's extensive

mailing list of community and business leaders, politicians, and

administrators in the health care field to keep key stakeholders informed of

BAD's activities. To further the public relations effort, BAD sponsored public

events. During the late '80s, there were forums on drugs in the work place,

programs on AIDS, and the first "Big BAD Weekend," featuring the Reverend

Jesse Jackson. "We just kept hammering at it and that was where we were

effective," recalled a corporate director.

During Purcell's term, the city sought and was granted a $~t5 million

federal grant from the Office of Substance Abuse Prevention to assist the BAD

effort over a five-year period. The grant had four noteworthy provisions: 1) it

mandated broad-based TEAM composition and supported recruitment efforts;

2) it provided funds for a program staff in the city's Neighborhood Services

131

Department; 3) it furnished resources for training and evaluation to equip

TEAM members with skills needed to perform their work; and, 4) it provided

funds to the neighborhoods to sponsor events.

In the early 1990s, BAD's third Corporate Chair, Robert Fraser from a

major city law firm, recruited experts from diverse fields to address various

organizational needs essential to the achievement of BAD's goals. The intent

was to infuse both staff and volunteers in the neighborhoods with the

knowledge and skills they needed. It was naive to believe that such

participants, while competent and dedicated, would have all that was needed to

perform well on their TEAMs. Drug and alcohol abuse were tied to issues such

as family violence, inadequate education, health problems, and so forth. The

insights of specialists could be helpful.

In the end, three facets of BAD's organization and operating procedures

seemed to be critical to its success:

Collaborative Model

The seriousness of the drug problem and inability of any one sector

(private, public, or nonprofit) to effectively remedy it made cooperation with

many stakeholders necessary. BAD, therefore, worked from a coalition-building

model that identified and then used the unique contributions of each

collaborator.

Neighborhood Focus

Corporate engagement with BAD was based in the neighborhoods rather

than at the citywide level. Neighborhoods were thought to be more manageable

arenas from which to collaborate. Therefore, while the Corporate Chair ran the

Oversight Board (which examined issues from all the neighborhoods), each

Business Rep was responsible to an individual neighborhood. The

neighborhood TEAMs diagnosed an area's particular substance abus'e problem.

The Reps then customized and funneled each corporation's contributions

directly to the people and groups in that community. As a result, less red tape

was involved than if approval of specific activities had to come from City Hall

or a corporation's headquarters.

132

Empowerment Model

A key facet of BAD's approach, related to its neighborhood foeus, was a

community empowerment model -- BAD sought to equip residents with the

capabilities to deal with their own issues, rather than seeking outsiders to

solve problems for them. Commitment to empowering residents to establish

and maintain autonomy over their affairs enabled the Business Reps to

establish and respect boundaries for the corporate role. The specifics of the

neighborhood programs were decided by TEAM members, not by BAD

administrators or Business Reps. BAD's corporate sponsors wer€) only one

voice at the table.

Governance and Administrative Structures

To support the tripartite partnership among the City of Boston, the city's

major corporations, and the people, agencies, and institutions in the

neighborhoods, BAD had a complex administrative and governance structure.

The Board of Oversight

The Oversight Board, which was not formally incorporated but existed as

a committee of the Chamber of Commerce, was chaired by the CEO of a

corporate partner. He or she served a three year term and recruited additional

corporate partners by soliciting CEOs he or she knew. Those executives or their

delegates constituted BAD's board. The board did not hold formal meetings

but the chair met with members in order to inform them of BAD's progress and

problems, to present ideas regarding solutions, and to solicit corporate

partners' suggestions. Further, the Corporate Chair was a liaison and advocate

for BAD with other sectors of the community. As the CEO of a corporate

partner reported:

Generally, the way organizations develop in the corporate community is that you have a champion, somebody who believes in the cause. Then he either calls or writes to others -- there is a letter and then a phone discussion. You know, 'Here's the problem and here is how we think we can solve it. We need to get kids to understand that using drugs is bad.' And, I was just convinced that it was worth a shot at trying to help.

133

The City

Using the prestige and clout associated with his office, Boston's Mayor

personally called on business leaders and convinced them that involvement in

civic projects was necessary to their being good corporate citizens. The Mayor

also committed city government resources to the project. As one of Riordan's

predecessor's put it:

The Mayor's office carried an awful lot of weight. There's an office within the Mayor's office specifically for BAD. With that came a lot of things. We were able to get technical assistance, get the streets cleaned after BAD events, get the police when we needed them.

In 1987, Mayor Flynn established the full-time position of executive

director for BAD in the Neighborhood Services Department. Thereafter, BAD

was one of the examples he frequently cited ofhis administration's campaign to

curtail drug and alcohol abuse.

As a member of the City Hall staff, the executive director administered

the federal grant and arranged for technical assistance, guidance, and

coordination. The executive director also worked closely with the manager

appointed by the Corporate Chair as corporate director to plan for BAD as a

whole and for the work of the Citywide Support Group (see below). For example,

in the Big BAD Weekend promotions, the executive director arranged for parade

routes and police escorts while the corporate director arranged for

transportation of youngsters from the neighborhoods to the downtown parade

site.

The executive director also designated certain city employees as

community liaisons who were charged with supporting the organizational

efforts of the neighborhood TEAMs. Community liaisons provided linkages

between city agencies and neighborhood TEAMs and amon;g various

neighborhoods. These liaisons facilitated cross-fertilization of ideas and

programs. All were experienced in community development.

134

The Neighborhoods

There were two types of neighborhood representatives on the TEAMs.

Some represented various agencies or constituencies within neighborhoods as

required by the federal grant, including religious, parental, health, local

businesses, youth serving, alcohol/drug treatment, education, law enforcement,

media, recreational, civic and voluntary, and grassroots citizens groups. The

other type of member was the individual volunteer, willing to donate time and

talent to make the locale a better place to live and work. Meeting at least once

a month, neighborhood TEAMs devised and carried out activities to prevent

drug and alcohol abuse. Activities were formalized in a work plan, written after

a community survey had been completed and analyzed by the TEAM. (Exhibit

The Citywide Support Group

The Citywide Support Group (CSG) was mandated by the federal grant

to be the policy-making body for BAD and city staff provided its on-going

support. Representatives from each neighborhood TEAM sat on the CSG to

insure that the direction of BAD was firmly in the hands of nei~~hborhood

residents. Fifteen other people, mostly heads of other city departments, were

also voting members, although this was controversial with the TEAM

representatives, many of whom felt they alone should be able to vote. The CSG

met once a month and its functions included:

• Long-term planning for BAD as a whole entity;

• Policy direction for programming;

• Review of evaluation processes and outcome measures;

• Short-term planning for citywide activities.

The Corporate Partners

Corporate partners were the corporations and other large entities in

Boston that agreed to provide resources to assist a particular neighborhood in

its efforts to prevent drug and alcohol abuse. Firms participated in BAD

because they sensed a need to establish and maintain mutually beneficial

relationships with various players in the local community. For example,

Gillette Corporation, located in South Boston, sponsored South Boston BAD;

Bull Worldwide Information Systems, located in Allston/Brighton, sponsored

135

that area's BAD; and John Hancock, adjacent to the South End, was corporate

partner to that neighborhood's BAD.

Firms knew they depended on a healthy environment for their

businesses. One CEO described his corporation's involvement this way:

These kids eventually had to go to work. They came to us and we couldn't hire them; they couldn't pass the tests. They had to know how to read and write. So, it was good economic sense for the businesses to jump in and say, 'let's go, let's do something.'

Businesses need the city to be healthy. In a diseased city, a business goes under. And with no business, there is no city. People leave; it's empty.

Moreover, businesses acted to maintain good relations with specific groups or

individuals, to garner public relations value from civic involvements, and to

accommodate politically influential people who asked firms to participate.

Corporations also participated to honor informal agreements, such as those

established with the Vault. One CEO expressed his commitment this way:

What is a city? A city is more than bricks and mortar. A city is more than a golden dome. A city is more than a mayor and city council. A city is made up of human beings and institutions and how you blend those together. So, the business community has an obligation, its seems to me, looking down the road, to promulgate its own future. It is in my best interest to reach out and help so that the city remains vital.

In addition, many business leaders and their employees were concerned

citizens who cared deeply about the Boston community and the effects of drugs

and alcohol on it. In order to carry out that commitment, they acted

strategically by choosing projects, such as substance abuse, that fit into or

affected their ability to achieve corporate goals. They did so both from a sense

of sympathy with those dealing with drug or alcohol problems and from a sense

of duty to do their part in addressing the issues, as a former corporate chair

observed:

I think from the corporate level they thought it was a good thing for the company to be affiliated with simply

136

because there was so much attention being focused on drugs. And, I believe it was a demonstration that thesE~ companies were willing to commit resources to address a problem in the community and city. I think there was some degree of altruism in their involvement. A lot of them did not get direct or major publicity out of it, but rather got some recognition from a small segment of the city that they were involved in.

Evaluation

From the corporate perspective, evaluation of BAD's effectiwmess was

difficult to measure. Nonetheless, firms employed a variety of measures, such

as levels of attendance at TEAM meetings, numbers of people at events,

anecdotal evidence of success, and so forth. Firms continued to commit to BAD,

it seemed, so long as these appraisals and assessments proved credible. As

one Business Rep explained:

We really don't do any kind of formal evaluation process, measuring anything. It is hard to do. Basically, it is really my judgment of how things are going. If I really thought that this TEAM did nothing in the community, had no impact, then I would report that back. We would have to decide, is this something we want to continuE~ doing? So, a lot of it has to do with my reporting back because I am the one who is there to see what is going on.

Despite the lack of concrete measures, it was thought that involvement

in BAD provided firms with favorable cost/benefit ratios compared with other

types of direct cash contributions they made to charities. Firms provided goods

and services to BAD at prices much lower than what it would cost TEAMs to

obtain them. The expense involved was minimal to firms, constituting an

incentive to continue the partnership.

The Business Reps

The key resource committed to BAD by companies was the Business Rep,

a middle manager who worked directly with a neighborhood TEAM. The Reps

determined the corporate resources to be contributed based on the individual

neighborhood's needs. Services such as typing and mailing minutes of TEAM

137

meetings, meeting notices, reminder phone calls, providing meals at meetings,

photocopying, assisting in advertising, and PR for TEAM events were all

examples of the kinds of resources the Business Reps provided from their

corporations. These resources allowed TEAMs to concentrate on programs

rather than on administrative details. Substantial, direct financial support

was not given-- typically, a corporation donated between $5,000 and $10,000 a

year to support its TEAM. (Exhibit 2)

As key resources, the Business Reps needed to have the confidence of

their superiors, knowledge of their corporation's assets that could be used by

their TEAM, and an understanding of their firm's rationale for being involved.

They also needed to have the ability to gain the trust of TEAM members to help

them form an effective group. The CEO of Bull Worldwide Information Systems

described the role Bull's Business Rep played:

First of all, because of who he was, Jimmy Bingel pretty much had poetic license. Almost a blank check. He and. I would spend some time periodically doing a gut check as to where we were. He would talk to people here~ because he is that kind of person, particular people from the Allston/Brighton area. He had a network of local merchants and people who had an interest. So, it wasn't just Bull being the private sector, but there was a network of people. He listened to what was going on in other parts of the community. So, he could get the reall scoop. And then he just went out and worked with thE~ kids and with the different institutions in the private sector. He created himself quite a network.

Another Business Rep described his role this way:

Primarily the role now has evolved into that of a major facilitator. I communicate with the chairperson on a regular basis around issues that the TEAM is facing. I communicate with the community liaison occasionally to find out what is going on at BAD in City Hall And I am involved with maintaining relationships with other Business Reps.

138

The Current Situation In 1993, William Van Faasen, CEO of Blue Cross/Blue Shield of

Massachusetts, became the fourth Corporate Chairperson and appointed John

Riordan as BAD's corporate director. As Corporate Chair, Van Faasen was

interested in: 1) strengthening the Citywide Support Group (CSG), BAD's

central coordinating unit, to insure an effective administrative mechanism was

in place should federal funding no longer be available; and 2) finding partners

for BAD as a means of enhancing its effectiveness and its future funding

attractiveness. (Exhibit 3)

Van Faasen was worried about the future, despite BAD's suceesses. In

early 1995, he telephoned Riordan. After the usual greetings Van Faasen said,

"John, I've been thinking about BAD's funding problems and thought I'd give you

a call to get your recommendations."

Questions for Discussion

1. Whose interests are served by BAD? What do they get and what do they

give? Is BAD truly a collaborative effort as it claims?

2. Assess its administrative and governance structures. What are they

designed to achieve? Are they effective? In what sense?

3. What recommendation would you make concerning future funding for BAD?

What consequences does that recommendation have for the BAD model of

collaboration? What changes, if any, would you make in BAD's

administrative and governance structures?

139

Bibliography

Frederick, William C. "Theories of Corporate Social Performance." In :S.P. Sethi and C.M. Falbe (eds.), Business and Society: Dimensions of ConRict and Cooperation. Lexington, MA: Lexington Books, 1987.

A lucid discussion of three major theories of corporate social performance: corporate social responsibility with its emphasis on the charity and stewardship principles; corporate social responsiveness with its more pragmatic attention to action and reform by corporations; and, eorporate social rectitude that develops a values and ethics component.

Gray, Barbara. Collaborating: Finding Common Ground for Multiparty Problems. San Francisco: Jossey-Bass, 1991.

Defines collaboration and stakeholders and suggests two kinds of opportunities that foster collaborative efforts: resolving conflicts and advancing shared vision. See chapter 1, "Collaboration: the Constructive Management of Differences."

Handy, Charles. "Balancing Corporate Power: A New Federalist Pap€~r." Harvard Business Review, Nov-Dec.: 59-72, 1992.

Describes the fundamental principles of "federalism" as they apply to the modern corporation and to the growing popularity of alliances. Governance ultimately democratic in these structures and accountable to all U.S. interest groups.

Preston, Lee E. and Post, James E. Private Management and Public Responsibility. Englewood Cliffs, NJ: Prentice Hall, 1975.

Seminal work describing "interpenetrating systems" in context of a systems approach to social problems. See especially chapter 1,. "Issues and Definitions," and chapter 2, "Models of Management and Society."

140

Waddock, Sandra A. "Public-Private Partnerships as Social Product and Process." In J.E. Post, and L.E. Preston, (eds.), Research in Corporate Social Performance and Policy, Vol. 8. Greenwich, CT: JAI Press, 1986, pp. 273-300.

Uses federal job training program to show importance of specific elements of a public-private partnership, including: mandate, networks, brokering organizations, common vision, crisis, and visionary leadership.

141

Exhibit 1

BOSTON AGAINST DRUGS

TIIROUGH E1\1POWER1v!ENT AND MOBILIZATION

1995 WORKPLAN

T~AM: SOUTH BOSTON AGAINST DRUGS

Cc ntact Person: Spokesperson Phone: ________ __

A1 dress: __ ..::..-...... -..:.--

1. Summarize_ your TEAM's overall Drug Prevention Plan COMMUNITY AWARENESS and EDUCATION

:ununarizes SO. BAD's Prevention Plan. Through continued collaboration with

.ocal schools, youth serving agencies, civic groups, and local ~~~ ve · •ill continue efforts to provide prevention, education, and resources to

·esidents of all ages in the area of dru~s. al cobol. tobacco. use /ahusp

2 Describe the status of your TEAM: (i.e. where & when TEAM meets, meeting frequency, number

v.1oattend) SO. BAD meets at the Tynan Community Center on Tuesdays 5:30p.m.

J~etings are held as frequently as once a week. depending on a~enda items and

~ EAM activities· Average attendance is 17-20 members p¢r meetin~. and the

~ illette representative (corporate sponsor) actively participates by either

. ~ ttending or through regular telephone contact. as yell as helpin~ at most eyenrs

3 How does your ~AM define membership?: Any concerned citizen in the South Baston

~ eigbborhood is invited to join. SO. BAD By-Laws define membership as consisting

~f 15, no more than 35 members at any given meeting. The nymber of associates 16

~ nlimited. Active TEAM membership is defined as atten_ding all meeting<· arid

Jarticipating at events/activities. TEAM meetings are open.

15 142

Exhibit 1 (continued)

4. Describe the demographics of your TEAM: Representation from agencies, local law

enforcement, clergy, DOA counselors, and residents of all ages:comprise the TEAM.

Every age group is adequately represented. as well as most demographic neighborhoods.

5. Describe the demographics of your neighborhood: Recent demographics indicate tb~t··

onr community is approximate] y 96% whi-te. TEAM efforts focus targetting the

BHA developments in the neighborhood to infonn the 4% minority n~sidents who·

are new to the community.

6. Describe your plan to ensure that your TEAM reflects the diversity of your neighborhood:

Please see attached statement. Advertisement and publicity of all TEAM

opportunities/activities in the local newspaper to ensure that all areas

are fully informed.

7. Please summarize the results ofCommunity Survey IV: 328 individuals ·responded to the

Community Survey UIV, with a slight increase in male respondents. 537. suggested

more youth activities and drug education. 737. responded that parents should take

the lead. More than 277. indicated an increase in senior citizens having substance

abuse problems. 507. indicated that both drug and alcohol use bad increased.

A high number of respondents indicated that SO. BAD should not only continue.

but increase education/prevention activities for residents of all ages

. 8. How are these results reflected in your workplan?: SAFE DAYS and drug and alcohol

education in.:the schools will continue in an attempt to reach more youths.

Educational outreach prevention strategies, and resources will be available

to teens. parents. and senior citizens in the community. Community awareness

and education for all residents will be on-going through workshops. events,

and specific activities to address the growing needs and concerns in our

neighborhood on drug, alcohol, and tobacco use/abuse.

16 143

Exhibit 1 (continued)

9 Please summarize the :strengths & weaknesses of your current years activities:

Strength's of this year's program lies in the dedication and comnitment

of the TEAM members. Outreach to senior citizens has increased through our

_volunteer efforts. Community awareness for both teens and parents has received

_more attention, and all initiatives will· remain on-~oine. Due to ser:lous illness,

_promotion, and retirement, our three key people in charge of the Care1•r Exploration ...... _ ... -~-

& Support curriculum has been put on hold. No other weaknesses/probhms exist.

1 ). What are the TEMfs primary goals for 1995?: -----------------

To address the increase in substance abuse (drugs, alcohol, to~acco) in our

neighborhood. Youths are drinking at an earlier aee Education and nrevention

initiatives will increase for residents of all ages. Community awareness is

also a priority and will target parents and senior citizens. Our AO: counselor

~ill be working with as many schools as possible for the remainder r~ Year 4, and

throughout Year 5 reaching hundreds of school age children (ages 6-:7).

ll. Please· describe the process that was used to develop this workplan:

Priorities for Year 5 in the CSAP grant were discussed, ident:: :ie!d, and

approved by the TEAM. More attention on workshops and educat~on for

parents will be a major part of this year's focus. In additi,n, SO. BAD

can provide referrals and resources to those identified as m~st 1n need.

144

Exhibit 2

Budget Narrative

Community Awareness Breakfast: $500.00 The goal of this activity is to bring together the business community,

community organizations, and neighborhood residents to acknowledge people strive to make our neighborhood a drug free community. Friends and neighbors will nominate those that they feel are working to better the community and each will be recognized at the breakfast. Approximately 150 people should attend this event and it will be evaluated by the number of participants, press coverage, and number of elected officials present.

Read Aloud Program: $100.00 The goals of this activity are to increase the visibility of our neighborhood

BAD in the community, to model for students our BAD members' love of reading, and to present a prevention message to students in our schools. We target 300 students in grades K-5 and twenty teachers in the Spenser school. We will evaluate the activity by the number of students participating and the number of parents and teachers joining our TEAM's efforts.

Community Outreach: $300.00 This activity seeks to provide the community with information about drugs

of all kinds as well as doing outreach in the community. In accordance with the Community Survey, information about tobacco prevention will be a major focus. We will evaluate its success by the number of flyers distributed, the number of new TEAM members, and the amount of interest generated in our activities.

Neighborhood BAD Retreat: $1800.00 The retreat's goal is to provide training for TEAM members to increase

skills and build TEAM cohesiveness. This year's training will focus on practical skills and information concerning drugs, alcohol, and tobacco abuse. The goals will be to develop better training skills within the TEAM itself, thereby increasing the likelihood of post-grant continuation of community prevention activities. The retreat will target 25 TEAM members and will be evaluated by the number attending and the number of community training sessions held in the neighborhood subsequent to the retreat.

Neighborhood Family Day: $1800.00 The Family Day provides a forum in which our residents can gather

together to discuss issues of alcohol, drug, and tobacco abuse in our community and also celebrate our community, families, and children. It is a substance free field day held at the end of our community's parade where all community organizations are invited to set up information tables and awareness materials are distributed to all participants. The target group is the 500 people who attend the parade, and we will evaluate its success by the number of organizations and people participating in the field day activities.

145

Exhibit 2 (continued)

Parade: $1100.00 The goal of the parade is to increase our neighborhood BAD's visibility and

to strengthen ties to other community groups. It is the single most visible event in which we participate. We work together with the Merchant's Association and the Parade Committee. Our corporate partner marches with us. We will evaluate its success by the number of BAD members marching in the parade.

Parent Training: $1800.00 Parent training provides parents with increased options to help teach their

children, peers, and community to prevent drug, alcohol, and tobacco abuse. We sponsor bilingual/bi-cultural training to forty parents. Children's activities and social events bring together parents of both English and Spanish cultures to share their parenting experiences. Success will be evaluated by the number of parents trained and by a parent evaluation to be completed at the end of training.

Neighborhood BAD Line: $0.00 The voice mail line creates immediate access to information about our

activities. The company providing this voice mail account had donated the service to us. We will evaluate its success by the number of telephone calls and number of participants in our events.

Poster Contest: $1000.00 This is a poster contest in our grammar and middle schools that provides a

positive way for children to express their thoughts and feelings about alcohol, tobacco, and drug abuse. Six winners will be chosen and given $100.00 US Savings Bonds. Evaluation will be the number of contest entries.

Family Walk: $600.00 Working with other community organizations, our TEAM will organize a

sponsorship walk to encourage the participation of all segments of our community. Funds raised by the event will be divided among the various community groups. We are targeting 100 residents as walkers and at least five other community organizations. We will evaluate its success by the number of organizations participating, the number of walkers, and the funds raised.

Note Card: $0.00 The goal of this activity is to begin private fundraising to increase our post-

grant sustainability. Using posters that win this year's Poster Contest, the META [Massachusetts Bay Transportation Authority and this TEAM's corporate partner] advertising and printing departments will render posters on blank cards that will then be sold throughout our community to raise funds.

146

N 0

~ • IIOS1'011JGAicSTOA..CS B. A.D. is partially funded by a grant from the Cenrer for Substance Abuse Prevention.

+. ~ BlueCross BlueShield ~ of Massachusetts . I!IReQistered~orlheBiueCros.sandBiueShie'dAssociaiJOn.

0 1994BiueCtos.sarodBiueSJ'I;eldoft.Qss.ac:husens.loc

Printed at Blue Cross aM Blue Shield o1 Ma~ SP-4-t75 {1194) 30M

B.A.D. Helps Boston Fight Substance Abuse

Boston Against Drugs (B.A. D.) is an active coahtion of concerned nerghborhood residents, local government, and the business community. Simply put, B.A.D. promotes community health by working to prevent alcohol, tobacco, and other drug abuse.

Since 1985, B.A. D. has been bringing this viral message to Boston through its unique TEAM approach. TEAM stands for "Through Empowerment and Mobilization" and means that only by involvmg residents, business, and government can Boston work to solve the problem of substance abuse on our streets and in our nerghborhoods.

The TEAM approach enables neighborhood teams to design alcohol, tobacco, and other drug prevention programs that are targeted to the specific needs of their neighborhood. Family members, police, clergy, health care providers, and teachers work together to help their community combat substance abuse.

How B.A.D. TEAMs Work in Your Neighborhood

A ll across Boston, members from 16 B. A.D. neighborhood TEAMs are workrng to develop short- and long-term strategies to

address their communities' specrfic prevention needs. They develop the plan and put it to work

Each TEAM is free to come up with ItS own creative approaches to reducmg substance abuse in its neighborhood. Some examples of B.AD. TEAMs at work include:

• Sponsoring alcohol, tobacco, and other drug prevention courses at a nerghborhood branch library for parents and youth

• Training youth sports league coaches who. 111 turn, educate their teams 3b<.)U[ substance

abuse prevention. • Exposing teens firsthand to the harmful

consequences and risk factors associated with substance abuse by having them attend a drug court trial.

• Working with senior outreach organizations to identify and help isolated senior citizens avoid substance abuse and over-medication problems.

t!:l ~ :r' §: ..... (.;.)

147

B.A.D. at Work With the City of Boston

'"he Cny of Boston has been a critic;,! partner m rhe success of the B.A.D. program. In 1990, rhe C1ty secured a federal grant from

liw C:enrer for Substance Abuse Prevention I( :SAP) ru fund prevent1on acr1vnies and ~~__·r\'tccs for Bus(on's nc1ghhorhoods.

The C1ry of Boston has mcorporared B.A. D.'s . tlcuhol, tobacco, and or her drug abuse onuiauves 111tu ns overall community health <~genda. Today, 111.111y C1ry <~gcnc1es help support B.A.D. 11c1ghhorhood TEAMs by providing expertise, ~u1d:mce. and Invaluable support and services.

N Glenola Milcltell, Parent and MaHapan Agalnsl Drugs TEAM Member

R 1\ n !Inti n .. ci----

Partners: TEAMing Up

f"' ach B. A.D. neighborhood TEAM is paired *''"'with one of Boston's Sixteen largest and most ·:;t_ acuve husmcsses. lr's JUSt one of the un1quc clements of the B. A.D. program, and It's proven successful enough ro he replicated throughout rhe country. B.A. D. BuSiness Partners, with rhe~r neighborhood TEAMs, create and implement mnovac1ve cducarion and prevention 1nitiat1vcs . B.A. D. Busoness Partners mclude:

1•1"111:1.~----· Blue Cross and

·slue Shield of !'lassachusetts ·

Bank of Boston·· B~st.an'l:ciiso~ ·· B~.~~~n Gas ··:·· · Bull worldwide .. ~ ~t~.:.; ~ ;'. ' . ':'

lnf.orrnallon: Sf$1ems· ..... :: ....

Brigham ~Women's Hospital··

FauJkner Hospital····· Fl~el Bank·······:···

~11!i:~~::···~;···i:_··· :.~II!Surance·company.-...

.. -. .. .. ~:~~~~:·.L:.·:~:;.·.·.·.

g!fJ15.~!:'~; .. + .. ·+· -~gland}; ·. ;;;

• 77i,;f'.::.~~~~-)2~· :}:· .. ~!:·· ~;~~~l!Je~d~o~.P t·· Wlf"~~~~!~'tt ··-:~., ... ,, .. ·

B.A.D. Partnerships Are Good Business

B .A.D. Bus mess Partners are raking an active stand. They're helping Boston's neighborhoods reduce substance abuse, and

they're helping rhe1r own companies create meaningful volunteer opportunities for rhe1r employees. B.A. D. Business Partners provide support through a variety oUinancial and m-kind serv1ces.

• A teen business bureau was set up by one B.A.D. Business Partner to train teens in marketable skills as an alternative to becoming involved in rhe drug economy.

• One Business Partner included educational materials designed by irs TEAM in a mailing ro 10,000 of its Boston clients.

• Each year, one Business Partner hosts a gala to honor rhe positive work being done by B.A. D. ream members.

And while Boston businesses are working hard lor B.A. D., B.A. D. can give back by working with these businesses to educate their employees and combat workplace alcohol, tobacco, and orher drug abuse. B.A.D.'s "Focus on the Workplace" program helps businesses develop ways to identify substance abuse problems and cur down on accidents, absenteeism, and other problems associated with workplace substance abuse.

How Can You Get Involved?

W herher you're a concerned individual wanrtng to make a difference or you represent a small business, a large

business, or a community group, B. A.D. needs you. The best way ro get involved IS ro )Otn your neighborhood TEAM. No matter how much or how l~tde rime you can commit ro our misSIOn- there's a way for you to help.

• There are short-term volunteer opporrun1r1es at B. A.D. community events.

• If you've got more time, explore becommg an active member of your local B.A.D. TEAM

• And if you can make a long· term commitment, B.A.D.'s coordinated citywide effort needs your help.

Call us today ar (617) 635-3283, or stop by our offices in Room 708 at Boston City Hall We need you to help make a better Boston.

(J'. value mr mental and·. :· .. ph~tslcal health. Through .. ·alcohol and drug abuse · · ·.prevention training B.A.D. has given me a head start on a drug.free

.. life:•·

Eraslo Mercado, Jamaica Plain Against Drugs Youth Peer Leader

t!:l X :::::- 0" -· ..... ~

..-.._ (")

0 ::s =· ::s ;::: rtl 0.. .._,

148

4. Decision Case

Family Business1

As the telephone conversation with her client ended, novice social worker Araceli Aguilera felt stunned by new information. Araceli's client, Maria Perez, was a victim of sex trafficking. She had left her two daughters-Isabella and Jimena-in the guardian- ship of her father, Xavier Perez, when she fled sexual abuse by other family members. Now, Xavier was dead and the two girls were at risk of trafficking themselves.

As Araceli walked down the long hallway to her supervisor's office, she wondered, How do we keep the girls safe while processing the paperwork for reunification? And who will help us with that now?

International Organization for Migration (10M)

The International Organization for Migration (IOM) was established in 1951 with a mission to advance awareness about migration and increase economic and social sustainability for migrants globally. IOM was the leading intergovernmental organiza- tion in the field of migration, partnering with 157 member states and operating offices in more than 100 countries. 10M worked to ensure an orderly and humane management process of migration, including the cooperation of international agencies on migrant issues and service provision for migrants in need, including refugees and internally displaced people (International Organization for Migration, 2015).

1This decision case was prepared solely to provide material for class discussion and not to suggest either effective or ineffective handling of the situation depicted While based on field research regarding an actual situation, names and certain facts have been disguised to protect confidentiality. The authors wish to thank the case reporter fur coopera· tion in making this account available fur the benefit of students and practitioners (Wolfer & Scales, 2006, p. 29).

149

146 •:• SECTION II A HOLISTIC APPROACH AT MICRO, MEZZO, AND MACRO LEVELS

World Assistance of North Carolina

Established in 1944, World Assistance of North Carolina (WA) was the leading local nonprofit social service agency that provided services to refugees who resettled in North Carolina. With branches in High Point and Winston Salem, WA sought to provide services to refugees and other displaced persons "fleeing persecution" based on race, religion, nationality, and social and/or political affiliation. Through the Ending Human Trafficking (EHT) Program, WA worked with local law enforcement agencies to provide 24-hour support to identified survivors. This support included short- and long-term services to ensure the survivors' safety and success.

Additionally, WA offered services for unaccompanied children (UAC), counseling, immigration assistance, social adjustment services, job readiness training and place- ment, medical case management, and English language training services. All of these services were available to any WA clients.

WA was the initial referral center for victims of trafficking identified by law enforcement within the state of North Carolina. WA provided an initial assessment and screening to determine whether a client was appropriate for the EHT program.

To seek permanent residence within the United States, human trafficking victims must disclose their experiences of being trafficked The information is needed to com- plete a Trafficking Visa or T visa. Created in 2000, the T visa allowed immigrants who were victims of human trafficking or a violent crime to apply for permanent residency, so as long as they cooperated with any ongoing investigations.

Similarly, a T visa derivative provided nonimmigrant status for the applicant's spouse, children, parents, and siblings if the human trafficking victim and family members met the qualifications. Family members could qualify for T visa derivatives in several ways. Trafficking victims under 21 years of age could apply on behalf of their spouses, children, parents, and unmarried siblings under age 18. Trafficking victims 21 years old and older could apply on behalf of their spouses and children. In each case, trafficking victims needed to apply for a T visa derivative for each qualifying family member using Form I -914, Supplement A, Application for Immediate Family Member of T-1 Recipient, and needed to submit it within a time frame specified by the United States government.

Araceli Aguilera

Araceli Aguilera was a 24-year-old Mexican American from Winston Salem, North Carolina. As a bright student growing up in a lower socioeconomic household, Araceli had the opportunity to choose between a failing local school district and a more successful school outside of her district. Because education was a priority, Araceli attended prep school, a private high school located in Greensboro, North Carolina, that provided an advanced college preparatory education. Through her experience at Bishop High School, Araceli met Dr. Patrick Greene, the president and CEO of Serving Youth at Risk, a nonprofit research institute that focused on issues affecting the welfare of North Carolina children. Araceli leveraged her networking skills to obtain a

150

Chapter 5: Understanding. Disruption, and Interventions at the Micro level •:• 147

prestigious summer job working with Serving Youth at Risk, where she first learned about research addressing human trafficking.

After high school, Araceli entered the University of North Carolina as a computer science major. But, as a rising junior, she felt a faith-related calling to work in cross- cultural social work. Her initial field placement was at International High School, a three-year program where students with English as a second language could take the appropriate standardized test in preparation for higher education. After graduating with a bachelor of social work (BSW), she continued directly in the master of social work (MSW) program. As an MSW student, she had an international field experience in Central America. Through this placement, Araceli learned advanced clinical skills by providing group sessions and case management for parents of children experiencing malnutrition as well as community social work by creating the social work protocol for a local child welfare project. Her work in this international social service organization prepared her for the complexity of government systems involved with international family permanency plans.

Araceli's passion for working with international clients was reinforced when she began working for North Carolina World Assistance. Her job consisted of comprehen- sive case management with victims of sex trafficking. In addition, Araceli was respon- sible for coordinating and facilitating the permanency paperwork needed for victims seeking asylum from human trafficking.

An Outing With Maria

Araceli's initial encounter with her first client, Maria Perez, was unconventional because it occurred while the two were traveling to their first Immigration and Customs Enforcement (ICE) check-in. Araceli understood the importance of keeping her client safe and calm during this check-in, but this was Araceli's first interaction with ICE, too. She would need all of her social work practice skills for building rapport. As a new social work case manager, Araceli wanted to make sure she did everything right for her supervisor Lauren and for Maria.

First, we'll meet the officer. Araceli mentally rehearsed the checklist Lauren pro- vided. Then we'll walk through the detector. I show the papers and then we wait in the waiting room. They walked into the check-in and it was just as she was instructed. First, they met the officer, walked through the metal detectors, and found the waiting room. Everything was as planned except the papers. Was I supposed to keep the papers? Do I ask for them back? Araceli couldn't remember what happened after they took the papers. Her furrowed brow softened as she noticed Maria's concerned stare fixated on her face. Araceli reassured Maria, "I know that this is a long process, but you are doing great:'

After the check-in, as they returned to the car, hunger pangs reminded Araceli to ask, "Maria, are you hungry?"

Maria shrugged, uncertain. As they drove past a sign advertising a Starbucks at the next exit, Araceli asked

again, "Is Starbucks okay?"

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Maria nodded and agreed to stop there for a light lunch. Araceli thought this would be a good time to say more about herself and some of the services provided by WA. As they waited for their food, Araceli began, "Maria, thank you for the bravery you showed in the meeting with ICE today. You were able to explain everything so effectively. You answered all of the questions appropriately. You should be very proud of yourself.'

"No;' Maria began shaking her head in objection, "I don't want to talk about my case here:'

"Okay;' Araceli responded, "well, can you tell me what you need?" "Yes, I can tell you what I need;' Maria answered hurriedly. After the food arrived, Maria took a bite of her chicken wrap and grimaced. But

she began identifying resources she needed to become more stable and independent. "I want to have my own place. My own person, that, umm; Maria paused to find the right words, "you know, that person that talks to you?"

The person that talks to you, Araceli wondered. Who is the person that talks to you? "The counselor? Do you mean a counselor?"

"Yes:· Maria affirmed, "a counselor:' "Okay, we can see what services will be the best fit for you:' Araceli thought of all

of the counseling services available to Maria, as well as the other services she requested. As they left Starbucks and headed home, Araceli felt the tension of riding with some- one unfamiliar. Araceli wondered if she should make small talk or continue the hour- long drive in silence.

Maria appeared exhausted and finished the ride with her head against the win- dow. With no conversation, it felt like a long ride home. Araceli's thoughts were interrupted only by the low hum of the latest top-40 hits playing on the local radio station.

"You can come by the office to get the food vouchers," Araceli explained, as she pulled into Maria's apartment complex. "I'll be in contact about the therapeutic and case management referrals, and we will check about assisting with the other resources

ka ?" soon, o y. Maria nodded as she left the car.

Affidavit Sessions

Araceli would later learn about Maria's experience with human trafficking in much greater depth. Pieces of her story were revealed during subsequent ICE inter- views (different from her initial ICE check-in) and later during conversations with Maria's immigration attorney. Maria would recount several occurrences of unlawful detainment of her identification documents, forced servitude, and coerced sexual encounters. Araceli would come to learn that Maria's boyfriend told her stories of freedom and prosperity in the United States, only to coerce her into a bonded labor arrangement that made her incapable of making any decisions regarding her life. Maria was advised by an immigration attorney that they would need to gather documentation.

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Chapter 5; Understanding, Disruption, and Interventions at the Micro Level •:• 149

"Maria, in order to complete your T visa packet we need an I-914 application for nonimmigrant status, passport photographs, a personal statement of the applicant's human trafficking experience, and other documentation that addressed victimization. Today you began this process by reporting your experience with human trafficking, but the process isn't complete. Do you understand this?" the attorney asked.

"Yes:· Maria responded. "You will provide the remaining documentation to Araceli, okay?" the attorney

clarified. The immigration attorney ended the meeting by handing Maria a list of the remaining documentations needed.

In order to complete the I-914 form, Maria had to recount her incidents of sex trafficking again, this time to immigration attorney Hilda Fong. These sessions were similar to the ICE interviews, but Fong typically spread the process over several ses- sions to reduce retraumatization of clients. It had taken several weekly sessions to capture enough of Maria's story, and the 90-day application due date was swiftly approaching.

It was the fourth meeting to complete the 1-914 form. Like the others, this meet- ing would include Maria; Araceli, to provide support; and Hilda, who had worked really well with Maria in the other three interviews. Hilda showed great ability to connect with Maria and make her comfortable in sharing stories of her human traf- ficking past. In response, Maria had been very forthcoming about her experiences and Araceli was excited that she would be one step closer to gaining asylum in the United States.

To begin, Hilda reminded Araceli and Maria of the purpose for the meeting and summarized the last interview to refresh everyone's memory. "Maria, you stopped right before you met Jose Gutierrez," Hilda concluded. "Do you mind beginning when you met him?"

Araceli knew this would be a hard interview for Maria. As Araceli prepared Maria for this final interview, Maria began to disclose her initiation into sex trafficking and the grooming that took place while she lived with Jose.

"Yes:· Maria affirmed, "he had connections in Houston and Raleigh. He contacted a coyote that smuggled me from Tijuana through Juarez, Mexico. We crossed the bor- der in El Paso, stopped in Houston, and finally in Charlotte. It took just over a month to get here. I had to leave my dear father and two little daughters, but I made it:'

"Maria, can you tell why you ran away with your boyfriend?" Araceli encouraged.

"Yes. I needed to get away from my past. My mother sold me:· Maria recounted, "sold me to everyone who wanted me. That's what my family does. It's like the family business. And that's why I moved in with my father, to get away. That's how I moved from Vera Cruz to Tijuana-and that's where I met Jose. And when I met him-I fell in love:· Maria remembered.

"Thank you, Maria. This is very helpful:' Hilda interjected, "but we need a little more information about how you were trafficked and why you are petitioning to have your daughters join you in the United States. We want to ensure that we provide as much detail as possible so that your visa meets the criteria for approval:'

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With her head bowed, Maria began to describe how she was trafficked across the border and her decision to leave her daughters with her father.

"I didn't think Jose would hurt me. He said he loved me-and after being sold by my mother, for sex-1 just wanted someone to love me:• Maria stated, shifting in her seat. "He promised we would make a life together in America. He said to leave my babies and we would send for them when we were settled. But it took longer than he thought to get to Charlotte. It took a whole month to get here:'

"Okay," Hilda encouraged. "What happened when you finally arrived in Charlotte?" "He found us an apartment and I found a job. Everything was fine. I paid the bills

and began making friends. We were living the American dream-until he got mad He said he didn't like me hanging out with my friends. He made me give him all the money I made at my job. He kept saying, 'You owe me, you owe me~·

"What happened after he began taking your money?" Hilda probed. "At first he made me, you know, have sex with his friends;' Maria stuttered. "He

would beat me ifl refused, so I did it. And then he wanted me to have sex with men I didn•t know. He would offer me up like I was for sale. He'd force me in a room with a man and lock the door. I couldn't come out until we had sex-and they would pay him." Suddenly, Maria began sobbing. "It was just like my mother all

• » over agam.

Shes shaking, Araceli observed Should we keep going? Araceli questioned We need to complete the affidavit if she wants to achieve her goal of independence, and we're run- ning out of time to file the paper work. Then Araceli's social work professional skill began flashing through her brain: Ensure the client's safety. Meet her where she is. De-escalate the situation.

"Thank you for being so brave," Araceli said, leaning over to comfort her client, "thank you for trusting us with your story." This is too much for her, Araceli thought. It's too much for anyone.

Araceli and Hilda waited a few moments while Maria calmed herself. "Can you tell Hilda," Araceli encouraged, "how you got connected to WA?" "Well, one night after he forced me to have sex with some guy:· Maria confessed,

"we started fighting. He was beating me up and someone called the police." "How did that connect you to WA?" Hilda asked for clarification. "Did the police

take you to World Assistance?" "No. The police asked me for documentation and I didn't have any. They heard my

accent and arrested me for deportation. They sent me to-detention:· Maria explained. "They said I had assault, umm, charged with assault from the fight:'

Maria sunk down in her seat. "I didn't assault him. I just couldn't stay with him anymore. I never tried to assault him," Maria said weeping. "I just wanted to save my life:'

"I know it's tough, Maria," Araceli comforted. "Do you need a break?" Maria nodded. "Hilda, is it okay if we take a IS-minute break?" Araceli asked. "Sure. I'll get some coffee. Would either of you like coffee?" Both nodded. "I'll walk

slowly," Hilda whispered.

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When the door closed Araceli hugged Maria. "You're doing a great job. What can I do to help make this interview easier for you?

In a moment of clarity, Maria looked up and asked, "Can we do some grounding meditation? I have my sea meditation sounds on my phone."

"Sure," Araceli agreed, "we can do a grounding meditation while we wait. Is that one of the coping skills you're learning with your counselor?

"Yes;' Maria said nervously. "And I've been practicing my coping skills-walking, listening to music, lighting my candles-I just don't want to take any medicine:'

"Okay, we'll do this grounding exercise-and then we'll get back to the affidavit. Is that okay?"

Maria nodded. Fifteen minutes later, Hilda returned with two cups of coffee. As Maria slowly ended her grounding exercise, Araceli questioned, "Are you feel-

ing better? Do you think you can finish the interview today?" "Yes;· Maria whispered through her last deep exhale. "I can finish the interview now." "That's great, Maria," Araceli encouraged. "We're hoping that soon we'll be able to

submit your T visa derivatives, you know, the papers to bring your girls over." "I know," Maria sighed. Maria began to recount her most recent sexual exploitation at the hands of Jose.

"Maria, can you explain why you continued living with Jose, after all this abuse?'' Hilda inquired.

"He said he'd kill me;' Maria said in a muffled voice. Her head was bowed with her gaze fixed on the table, as she repeated it again. "I was really scared. I didn't have any- where I could go because he knows where my family lives. I knew that if I left him, he would really hurt my family to get to me."

"Thank you, Maria, I really appreciate you sharing all of that with us," Hilda responded, after further elaboration. "I know it wasn't easy. I just needed to clarify the force, fraud, and coercion aspect of your trafficking case and you helped me with that." Hilda added, "Thank you for being so brave." With that closing statement, Hilda con- cluded the interview and notarized the I-914 form.

Family Reunification

Araceli was excited when they received formal notification that Maria's T visa was approved and she was granted asylum in the United States. Her excitement grew because they could now finalize the application for a T-3 visa derivative to allow reuni- fication with Maria's daughters. Araceli telephoned Lorenzo Gutierrez with the International Organization for Migration (I OM) to learn the final steps needed in the permanency placement plan to include in Maria's case plan.

"I just wanted to update you on Maria's visa status; Araceli began. "We received Maria's T visa approval, so we don't have to worry about deportation anymore."

"Great, Araceli," Lorenzo exclaimed. "Do you have any recent information about the girls' documentation? We're still waiting on their passports and birth certificates. Has Maria given them to you?"

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"No. You should have received all of that information from Marias father, Xavier PereZ:' Araceli responded. "Has he not provided that information? That should have happened months ago."

"We haven't received any paperwork; Lorenzo sounded impatient. "It's holding up our paperwork and, as you know, if we miss the submission deadline we will have to start all processes from the beginning. Have you heard anything from Ms. Perez?"

"No; Araceli offered, "but she'll be coming in for a meeting, so I can ask for an updated status. Will you be in the office later for a possible conference call?"

"Absolutely. Thanks for taking care of this, Araceli. We want to ensure the safe procurement of Isabella and Jimena. I'll be looking forward to your update:'

Later that afternoon, Maria arrived on time for her case management session with Araceli. This surprised Araceli because Maria routinely arrived 20 minutes late for sessions.

"Hey Maria, come on in," Araceli greeted her client with a smile. "How are you feeling today?"

'Tm doing okay;' Maria responded. "How are you?" 'Tm good. Thanks for asking. I'm so glad you were able to come in today;' Araceli

said as she motioned Maria over to her seating area. "I know it hasn't been easy for you to get off work for our meetings, so I just wanted you to know how appreciative I am that you could make it today."

"Yeah; Maria shrugged. "We just want to make sure we can get all of the documentation to process your

daughters' T-3 visas;' Araceli reiterated. "Does that make sense? Have you been able to contact your father about the documents? If we don't get those documents it will hold up the process:·

"You didn't get them?" Maria responded with apparent surprise. "I sent my father money. He said he would send them:'

"When I asked you about this during our phone check-in a few weeks ago, you said the same thing. Did you send more money since then?"

"Yes; Maria affirmed. "I sent him more money, specifically for the birth certificates."

"Have you talked with him again?" "Yes:· Maria nodded, "he said he needed 50 dollars to get the documents." "Fifty dollars? He doesn't need 50 dollars. Lorenzo from 10M stated that because

we're using the IOM services, document processing is free." Something's not adding up. Araceli was puzzled by this information. I remember telling you that all of the services with !OM were free. That's why we chose to partner with !OM, she thought, so that it wouldn't be a financial hardship on you. Araceli caught herself shaking her head as she heard Maria respond.

"My father says that it costs 50 dollars to get the certificates," Maria reported, "so I sent him the money."

"Maria, let me check with Lorenzo. I think the processing should be free:' Araceli telephoned Lorenzo. "Hi Lorenzo, this is Araceli again. I'm with Maria

Perez. Do you have time for a conference call?"

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Chapter 5: Understanding. Disruption, and Interventions ot the Micro Level •:• 153

"Sure. Hi, Maria. How are you doing today?" ''I'm doing fine, Mr. Gutierrez. How are you?" ''I'm well. We wanted to touch base with you regarding your daughters' identifica-

tion cards and birth certificates. Were you able to contact your father to let him know that we need that information?"

"Yes. I sent him the money to pay for it and everything:' "Money? Ms. Perez, these services are free. We contacted the front desk to deter-

mine if your father dropped off any packages and his name is not in the visitor's log. Are you sure he's coming to the correct address?"

Maria assured them that she gave the correct address and showed the money wire receipt proving that she'd sent money for the purpose of securing her daughters' documentation.

"Well, Ms. Perez:' Lorenzo interjected, please follow up on your end and we will see if anything comes in the mail. Please remember that all services with 10M are completely free. No charges at all:'

"Yes, Mr. Gutierrez:' Maria agreed. ''I'll see what happened:' "Thank you. Have a good rest of your visit with Ms. Aguilera and I'll touch base

with you soon. Good-bye:' "Maria, do you think your father knows how to get to the 10M offices in Mexico?"

Araceli asked, after hanging up the phone. "Does he need the money for transportation to the office?"

"No, no:· Maria stuttered. "He has a ride. My aunt said she'd give him a ride if he couldn't get there:·

"Do you have any idea why he might need the money since we have now con- firmed that 10M's services are free?"

"No, I don't. I do know that there is a lot of corruption and violence in his area. That's why I wire the money directly to him instead of sending a money order in the mail. It's safer that way:'

"Do you think he's in any danger?" Araceli probed. "He didn't tell me that:' Maria shook her head no. "He would have told me that."

Maria's breathing became more stifled as her brow furrowed. Her gaze seemed distant, as if she were searching for something in the next room.

"What's going on, Maria?" "I don't understand how he could do this to me:' Maria nearly shouted. "I send

him money to get the documents and he doesn't even need it. Why would he take money from me when he doesn't need it?"

Araceli couldn't understand why Xavier had asked for 50 dollars but attempted to deescalate her client.

"Just contact your dad for me, one more time:' Araceli instructed, "to make sure he's safe and understands what we're asking of him. Remind him that if he uses the 10M Mexico offices, all of the services are free. Tell him to ask the 10M worker to call you when he's in the office so that you can explain all of the needed documentation. Can you do that for me, Maria?"

"Yes, Araceli. I promise, I will."

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"Thank you. You have been so helpful during this entire process:· Araceli reas- sured. "I'll follow up with our offices about next steps."

"Yes. I can do that." "Good. I'll write that into your case plan and follow up with you next week. Is there

anything else you need from us this week?" "No, Araceli. You all have helped with so much. Now that I have my visa I can get

a better job. You all have done more than enough:' "Well, you've done all of the hard work. I like the way you are progressing with

your case plan. As soon as we can finalize this reunification visa we will be on the road to reuniting you with your girls."

"Thank you so much, Araceli:' Maria could barely contain the tears welling up her eyes. "It's been five years since I've seen my daughters. I can't return to Mexico to visit and I'm afraid to try and smuggle them over."

Before leaving they summarized the list of things that needed to be completed before their next visit, Maria wrote herself a list as a reminder, and she left.

The Final Call

Over the next few weeks, with a new job and new apartment, Maria's appointments were more sporadic. But one day she came to Araceli's office in a panic. "He's dying, he's dying!"

"Who's dying?" Araceli asked, confused. "My father. He's sick. I didn't know. No one told me." The information spilled out. "How did you fmd out?" Araceli asked. "When I called to inquire about the documents:' Maria explained, "my Tia Letty

answered the phone and told me he was in the hospital" "What happened, what's wrong?" Araceli asked. "How serious is it?" "I don't know;· Maria began sobbing uncontrollably. "No one wants to tell me

anything-and I can't even go and see him. What if he dies and I never get to see him? What if he dies?" Maria's voice drifted off.

Araceli just sat with Maria as she cried. After several minutes, she asked, "Maria, why don't they want to tell you?"

"They said they didn't want me to worry. They know I can't return to Mexico because of the T visa. They know if they told me I would try to go see him. They said they didn't have money for the phone calls, so they wanted to wait to see if he got better before letting me know he was sick. They didn't want me to worry about my daughters."

She went on, "It helps to explain a lot though-about why I didn't hear from him." Maria was talking so fast that Araceli could hardly keep up. Araceli knew that

Maria was stuck in America even if her father died, as required by the T visa. Who's watching the kids? Are they eating or going to school? Araceli's thoughts quickly turned to Maria's children. Who would be the guardian of her daughters? Who could get clear- ance to keep them if Xavier is sick? We've got to create a safety plan and update contact information for Maria's relatives in Mexico, Araceli thought.

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After Maria told Araceli what she knew, they began to work on a safety plan for Isabella and ]imena and to update 10M on identifying another guardian for Maria's daughters. The safety plan would assist 10M in identifying responsible relative place- ments should the girls need to be moved. The safety plan outlined names and numbers of Marias relatives who lived in the area as well as her understanding of "fit for place- ment:' Maria was extremely concerned about placing her daughters with her maternal side of the family due to her own history of sexual abuse and sexual exploitation by those family members. After completing the safety plan, Maria left to try to contact her father and gather updated information regarding his medical condition.

Despite repeated attempts, Araceli was unable to reach Maria by phone for three weeks. Finally, Maria answered her call.

"He's dead, Araceli;' Maria announced abruptly. "What?!" Araceli replied. "My dad is dead;' Maria clarified. ''I'm so sorry, Maria:• Araceli responded. "I know how much he meant to you.

What can I do to help you in this process?" "Nothing. I'm working on it. I went to church, lit some candles, and said my

prayers. Some days it's so hard to get out of bed. Some days I think going back to Mexico is worth risking all of my residential status just to get my girls:' Maria paused, then added, "I need to get my girls!"

"That's what we're trying to do through IOM:' Araceli reassured. "Maria, who's going to care for your girls now that your father has passed? Do you have any thoughts on who might be able to take care of your girls right now?"

"I don't know:' Maria paused. "I have two aunts who might be able, Delores and Letty, but they're older and I'd have to send money to help them:'

Araceli knew that if the girls went into the foster care system there would be no way to track them in Mexico. Araceli's communication was already limited in Mexico because 10M's communication protocol required that only 10M could communicate on behalf of her client. Keeping the girls with a family member was the safest option for a fast procurement procedure, but who could keep the girls?

"You have a sister, Teresa. Could she watch the girls?" Araceli asked, recalling the family members Maria had mentioned previously.

"No, no!" Maria exclaimed. "Her husband is the one who abused me-three times! I don't want my girls with him-or her:'

"Do you have any other relatives?" Araceli asked again. 'Miyone at all?" "None other than my mother. But she will never get my girls!" Maria stated

emphatically. What do I do? How do I place these girls until the paperwork can be completed for

the T-3 visa? Do I advocate for the placement of the kids with her sister. whose husband abused Maria, if only on a short-term basis? Questions raced through Araceli's mind. If 10M would only let me do a quick home visit or at least talk to a fostering agency, I could put safety and communication plans in place to make the procurement easier. The weight of these decisions was almost too much for Araceli to bear. How do I make sure the girls are okay? What happens if the girls disappear and Maria can't be reunited with them?

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As Araceli walked down the long hallway to her supervisor's office, she wondered, How do we keep the girls safe while processing the paperwork for reunification? And how can we facilitate or support the coordination and decision making between Maria and 10M?

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PRIVATE, DISMISSED

Michelle Hovis and Lori D. Franklin

Social worker Patty Cohen listened carefully as Maria Benavides, the discharge planner, described the plan for veteran Sharease jackson. Sharease had been hospitalized numerous times since she first came to the Veterans Administration (VA) hospital in 2.009, but this time seemed different.

"I just spoke to her about discharge plans," Maria stated, "and, you know, she usually just says she'll be fine, and she's either evasive or hos- tile about services or engaging in treatment. But this time I mentioned the Mental Health Intensive Case Management Team, which I have mentioned before, but she seemed interested."

Development of this decision case was supported in part by the University of Okla- homa School of Social Work. It was prepared solely to provide material for class discussion and not to suggest either effective or ineffective handling of the situarion depicted. Although the case is based on field research regarding an actual situation, names and certain facts may have been disguised to protect confidentiality. The authors thank the anonymous case reporter for cooperation in making this account available for the benefit of social work students and instructors.

"Really?" Patty asked. Patty had previously mentioned this service to Sharease, and Sharease had said, "The last thing I need is more of you all in my business."

"Yeah," Maria continued. "She seemed sad but kind of like she knew she really needed that kind of intensive help and was kind of resigned to it. Maybe she's finally accepted that-it's time to start getting better."

"Maybe," Patty said hesitantly. "So what happens with her now?" "Because she stated she wants to go home and that she· does not

want to die and has no more plans or thoughts about suicide, she'll go home. We'll set up an appointment with the MHICM Team folks to see her Monday morning."

OVERTON BROOKS VA HOSPITAL

The wars in Iraq and Afghanistan presented a huge challenge to VA hos- pitals across the country with Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans. New technologies, improved safety equipment, and better battlefield medical care fortunately helped more soldiers survive injuries that would have proven fatal in previous wars. But VA doctors and researchers came to realize that surviving' often dev- astating injuries and prolonged combat deployments caused an unprec- edented number of psychological injuries. The government recognized the need for programs to deal with the psychological injuries and created federal mandates requiring all VA facilities to focus on mental health.

Like other facilities, the Overton Brooks VA hospital in Shreveport, Louisiana, had to do major restructuring and program development to deal with OEFJOIF veterans' needs. This VA hospital was relatively small compared to other VA hospitals in the region and had predomi- nately serVed Desert Storm, Vietnam, Korean, and World War II veter- ans. But OEF/OIF veterans presented very different needs.

RESPONDING TO VETERANS' EMERGING NEEDS

Across the country, several specialty programs emerged out of the government's recognition of the enormous mental health needs of

109 PRIVATE. DISMISSED

161

veterans returning from the Middle East. Although the Overton Brooks VA had staff who could address issues such as post-traumatic stress disorder (PTSD), substance abuse, and other mental h~alth issues, there were no specialty programs or inpatient psychiatric fa- cilities at the hospital. Overton Brooks began developing specialty programs to address not only substance abuse and PTSD, but also the dramatic increase in suicide. In fact, much of the VA and govern- ment attention nationwide was focused on suicide prevemion. When implementing a twenty-four-hour suicide-prevention hodine, the VA developed the slogan "It takes the strength and courage of a warrior to ask for help" to reduce the stigma of mental health treatment among veterans.

At the same time, the VA system acknowledged the rise of mili- tary sexual trauma (MST) and the need to address this issue. The federal government mandated VA hospitals to implement programs and processes that addressed MST. The Overton Brooks VNs answer co the mandate was to hire a registered nurse (RN) as the MST coor- dinator and require all veterans, male and female, to be screened for MST during primary-care visits. The RN provided education to VA staff and veterans about MST and held a weekly group for victims of MST.

Another major change at the Overton Brooks hospital was the creation of an inpatient psychiatric unit. It fell under the umbrel- la of the Behavioral Medicine Programs. Behavioral Medicine was charged with managing all the new mental health specialty programs as well as inpatient and outpatient mental health services. All men- tal health staff-psychiatrists, psychiatric nurses, techs, and social workers-answered directly to the Behavioral Medicine chief, who was a psychiatrist.

The VA system hired more social workers than any other agency nationally, and individuals with an MSW were in high demand. This was true of Overton Brooks VA, which had social workers employed in each of the Behavioral Medicine Programs as well as in primary care, inpatient medical care, and the emergency room. Because of the large number of social workers in each area of the hospital, administrators decided to create a Social Work De- partment headed by a social work chief. A licensed clinical social

PRIVATE, DISMISSED 110

worker, the sociam work chief was charged with managing a ll social workers in the hospital.

PATTY COHEN

Patty Cohen had been raised in New England, but her family had moved often because of her father's work. The family had eventually settled in Louisiana. Patty's father was a PhD engineer and had high expectations for her. She always knew she would become a doctor. However, life took a different path for her, and she had decided on a bachelor's in psychology and then a master's in social work. Even though Patty worked in the social work field, she always felt a strong pull toward medicine. A few years imo her MSW career, she decided to take a shot at medical school and began taking premed classes.

Not long after starting pre-requisites for medical school, Patty was diagnosed with lupus. The physical challenges of her illness and the demands of school proved too much, so she put her medical school dreams on hold and returned to the social work field.

During the nineteen years since earning the MSW, she had worked in many different fields of practice, including medical social work, hos- p~ce, home-based mental health, inpatient psych, and corrections (in one of Louisiana's toughest maximum security prisons). She held clini- cal licensure in both Louisiana and Texas.

Patty was one of the social workers hired during the restructuring of the VNs Behavioral Medicine Programs. She was hired to help open the inpatient psychiatric unit and answered to the psychiatrist, Dr. David Poindexter, who was the Behavioral Medicine chief. Soon, though, after the new inpatient unit was established, Patty was moved to the outpa- tient mental health clinic. The staff of the mental health clinic included Patty as the only social worker, a full- and a part-time psychiatrist, a phy- sician's assistant, and the part-time MST nurse. The full:rime psychia- trist, Dr. Jaul Halim, chaired the outpatient treatment team meetings and was the leader of the clinic. The other psychiatrist, Dr. Carol Dol- larhide, split her time between the inpatient and outpatient units. How- ever, because Patty was a social worker, her supervisor was Scott Corey, a licensed social worker and the newly appointed social work chief.

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162

PATTY MEETS SHAREASE

Patty had just sat down at her desk in the outpatient unit when she was paged by the emergency room staff. She walked there quickly, hearing a commotion as she neared the first exam room.

"Get the hell out of here!" Patty heard a voice yelling. As she entered the room, she saw Dr. Chen, a young male resident, stand- ing near a young African American female. Patty guessed that the woman was about five feet three inches tall, weighed about 140 pounds, and had an athletic build. The woman was swinging her IV pole like a weapon.

"Get out of my room, asshole! Don't you dare touch me!" the pa- tient yelled, her eyes looking wildly around the room. She swung and jabbed at Dr. Chen with the pole.

"I am supposed to examine you," Dr. Chen explained. But he began to back toward the doorway. Patty slipped into the room and stood to the side, just inside the door. By now, two security guards had arrived. Entering the room, one grabbed the pole from Sharease, and the other held her arms tightly against her.

"I will not be coming back," Dr. Chen told Patty and turned to walk away.

"Hi?" Patty asked gently, keeping her distance. "He's gone. Are you okay?"

The security guard still held on to Sharease, but 'she slowly stopped resisting.

"Who are you?" Sharease a~ked. Her voice quivered slightly. "I'm Patty, the social worker here. I'd like to talk to you for a while

if that's okay." Sharease nodded. "I think we're okay now," Patty said to the security guards. "I'll call

you if I need anything." The guard holding Sharease hesitated but then relaxed his grip and let her go.

"We're fine," Patty repeated, looking directly at the guards. The two men walked out of the room, and Sharease sat down on the bed.

"I'd like to get to know you a bit," Patty began. "I wonder if you need a second, tho!Jgh, first." She sat down quietly in a chair that faced the bed, noticing that Sharease still appeared shaken and nervous. She waited quietly, thinking that might be the best way to intervene.

PRIVATE, DISMISS ED 112

"Maybe you can tell me first a little bit about what things you like to do?" Patty offered when Sharease seemed calmer. "We don't have to start off with a bunch of questions," Patty said kindly.

"I love reading," Sharease shared. "I'll read anything I can get my hands on, even if it's a dictionary or an encyclopedia. And I love self- help books or anything like that. I like to write, too. I've even had a contract to publish some of my poetry. I just never got around to it."

"I'm a big reader, too," Patty responded. "I have a couple of books in my office that you might like. Maybe when you leave the hospital, you can come take a look."

Patty was soon able to move into more of her typical psychosocial assessment questions and gather information about Sharease's child- hood. I can ask her later more about what was happening when I walked in, Patty thought. I want to build rapport first.

"I was raised by my great-grandma," Sharease shared. "My mom and dad were around some, but both of them were addicts. Mom's kinda cleaned up by now, though, and she lives dose by to me. But mostly things were pretty okay. I just always wanted to grow up and join the military."

Patty continued with questions about Sharease's military service. "I was pretty good at school, so I got out early when I was sixteen. I got

permission to join the army at seventeen, just like I had always wanted." Patty waited for more details, but Sharease got quiet and looked

down. "Then by the time I was nineteen, I was discharged. I guess all that was just a dream, and that isn't going to happen for me."

OUTPATIENT THERAPY

Patty agreed to continue seeing Sharease on an outpatient basis in the mental health clinic after Sharease was discharged from the inpatient unit. Sharease attended appointments sporadically, but Patty still felt she was getting to know her.

"I've always just kinda been who I am, and people always knew I was, you know, more into women than men," Sharease stated one after- noon. "Never had been that big of a thing, but some of the guys there in the army would hassle me about it, make crude jokes and stuff."

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"Sounds like it might have been kind a big deal," Patty responded, "getting hassled about who you are."

"Well, you know, I just ignored it. They'd call me all those names and whisper behind my back. Sometimes they'd say stuff about how I just needed a man and all that. I just ignored it."

Patty was quiet, listening, suspecting Sharease had more to say. "Then that one night, they came into my room when I was sleeping." After a long silence, Patty asked, "Who came into your room?" "I don't know. There were so many of them, I could never count

them. And it just went on and on, one after the other, and I just kinda tried to get away in my head." Sharease's eyes teared up, and her jaw tightened. She looked into the distance.

"It hurt so much, and I tried to fight back, but then I just gave up. I don't even know how long they were there, but it was a long, long time. I just remember waking up, hurting and blood everywhere, and seeing· that the sun was up."

Patty was quiet, listening and letting Sharease lead the disclosure. "Then I went and told my superior officer, you know, thinking he'd

help me and all. But he didn't do nothing! Nothing! He just let them keep on saying filthy things to me and didn't do a thing about it. It just got worse and worse. I didn't feel like I had anything left to do but die. There's nothing here left for me."

All the pieces now fit for Patty. After the brutal assault, Sharease's suicide attempts had begun, and she eventually was discharged because of her instability.

THREE MONTHS LATER

Patty had told Sharease about the MST services, but Sharease refused additional appointments. The MST nurse, Kathy Fairfield, worked on Wednesdays doing a group session and a few individual sessions. Al- though Patty had tried several times to introduce Sharease and Kathy, hoping it would encourage Sharease to talk to her, the connection didn't seem co happen. They met one time for a few minutes, and Shar- ease had said afterward, "I don't want to meet with her. Just you, Patty. I don't need any more appointments." Patty didn't push her.

PRIVATE, DISMISSED 114

Sharease's reputation had built after four more hospitalizations dur- ing the three months since Patty first met her. Emergency room staff and hospital staff often said they were scared of her. During one hospi- talization, Sharease had become agitated in the emergency room lobby, and when a male staff member approached to try to detain her, she had squirmed away and taken off running through the hospital. She was eventually tackled and forcefully brought back to the intake area. On another occasion, she became angry in the lobby of the hospital and took a flagpole out of a holder on the wall and banged it on the hos- pital walls, prompting staff in other parts of the hospital to think they heard gunshots in the hospital. She was now required to be escorted by security at all times when she was on the hospital campus.

Once on the inpatient unit, Sharease would quickly be discharged, sometimes within hours of being brought to the unit. If released to the outpatient clinic, she would usually not attend her follow-up appointment.

"I don't want to see Sharease anymore," Dr. Carol Dollarhide, the outpatient psychiatrist, had told Patty. "She's been hospitalized so many times that I know she isn't taking her meds, and she's completely noncompliant. But Dr. Halim told me I can't fire her. I told him that was bullshit because she threatened to kiU me. I don't know why I have to keep working with someone who threatened me."

Patty was silent but remembered the conversation with the so-called threat that Dr. Dollarhide referred to. Feeling that having the constant security presence was making things worse, Patty had asked if she could escort Sharease to her appointment with the doctor, with the hope that she would be able to deescalate her if needed. The security guard was still there, but he waited in the hall while Patty went inside the office with Sharease. She remembered Sharease telling Dr. Dollarhide, "Get the fuck out of my face," but Patty didn't consider that a threat. That was just Sharease being herself.

"Well," Patty responded. "I'm happy to keep attending her appoim- ments with her if you think it helps. I've seen her only sporadically with all the hospitalizations, but she does call me pretty often. I think she's taking her meds, but she is still suicidal."

"She is aggressive and dangerous," Dr. Dollarhide responded. "We can't help her here. n

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"I don't agree," Patty responded. "She's traumatized and vulner- able, and her aggression comes from a place of self-protection. I'm frustrated because I can't work with the trauma when she's so unstable that I can never see her for sessions. She calls me and says things to indicate she is suicidal, and then I have to have her detained. We are just in that cycle."

"Has anything worked with her therapeutically?" the doctor asked. "Not really. She doesn't want to do any type of evidence-based ther-

apy for trauma, she won't do homework assignments, and I guess I'm not really doing therapy the way I normally do. But she stays in tou~ with me, she tells me when she is suicidal, and I get the sense that some day she might be ready to work harder in treatment. It is just tough to build trust with her."

"She needs to be referred out, Patty," the doctor responded, sound- ing irritated. "Maybe to some kind of long-term care facility or some- thing, I don't know. But what we have here is risky and not working."

"I agree that a long-term inpatient trauma program would be great," Patty exclaimed. "Unfonunately, Sharease is not service con- nected, so she's very limited in the services she qualifies for, and that's not one of them."

"Well," Dr. Dollarhide questioned, "why isn't she service connected if she's claiming all this trauma happened while she was active duty? Maybe we should concentrate on that first."

"She's tried to get a service connection," Patty explained. "She's just never made it through the interview with Disabled American Vets. I think that when she's asked to relive the rape in front of a big panel of men, she panics and runs out of the interview. She would probably qualify, but without that evaluation she's not going to get the service connection. I think for now the only option is to keep seeing her in outpatient and trving to get her to respond to treatment."

BACK IN THE HOSPITAL

Within a few days of Patty's conversation with Dr. Dollarhide and after another missed appointment, Sharease was back in the hospital, this time for another hanging attempt. She had spoken to Patty on the

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phone and told Patty she felt a lot of uncontrolled anger and sadness. Patty had become concerned enough that she had called Sharease's mother and asked her to go check on Sharease. Her mother had walked in and found her hanging in the closet but got her down before serious damage was done and brought her to the hospital. The intake staff informed Patty that the veteran had been readmitted.

Patty went to visit Sharease and took a book of poems that she thought Sharease might like to borrow. Sharease was sleeping when Patty arrived, so she just set the book on the table. Sharease had a room by herself because she was the only female on the unit.

After leaving Sharease's room, Patty stopped by the office of Dr. Carson, the inpatient psychiatrist treating Sharease during this stay.

Patty knocked softly and asked, "Dr. Carson? I wanted to talk to you about Sharease, if I could .. "

"Sure, Patty," Dr. Carson said. "We did a Risperdal Consta injec- tion last night to hopefully help her be a little more compliant on her medications. She was pretty agitated last night, so we had to do some tranquilizers, and she should sleep a while."

"OK," Patty said, "I'm just becoming concerned about how quickly she is discharged. As you know, this is her fihh hospitalization in as many months, and it just seems like she isn't here long enough to sta- bilize."

"I know," Dr. Carson responded, "but if she doesn't meet criteria, we have to let her go. It really isn't our fault that she isn't stable. She doesn't take her meds, and she isn't doing anything to help herself. We're doing the· best we can, but you can't fix someone who doesn't want to get better."

"I guess we will staff her case in our outpatient treatment team again if she is coming back soon," Patty responded. "Thanks, Dr. Carson."

TREATMENT TEAM MEETS

The outpatient staff met weekly for a treatment team meeting. As the outpatient psychiatrist in the mental health clinic, Dr. Halim Jed the meeting, but staff members of other outpatient programs, including a psychologist and a suhstance abuse counselor, were also part of the team.

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"As you know, Sharease has been hospitalized multiple times now," Patty began when her turn came at the treatment team meeting. "For now, she's still there, but they will discharge her very soon, and I think we need a plan for her. We all know that the hospitalizations haven't been going so well .... It seems like as soon as ... "

"You got that right!" psychologist Megan Anderson interrupted. "She's completely out of control. You need to get Adult Protective Services involved here and get her some kind of a guardian and in a residential facility of some sort. I don't know, maybe her mom could step up or something, but she can't be on her own. She's not competent."

"I agree, Megan," Dr. Dollarhide chimed in. "She's dangerous, and I will not see her again. I'm not going to be responsible for an antiso- cial patient who is so volatile. I'm not going to put the rest of the staff at risk again. We have security with her, and she's still agitated and violent. Nothing has gotten any better."

"But, come on," Patty implored, "she needs help. She's been so se- verely traumatized. We all know enough about PTSD to know that's affecting her behavior and that it takes some people a long time before they're ready to really do therapeutic work about trauma. I agree that she's not progressing in terms of controlling behavior and reducing her suicidality, but I do feel that I have been developing a good rappon with her. And if it were just a personality disorder, she wouldn't be complaining of hearing command voices telling her to hurt herself, so I just don't think that's all there is to it. I think we should stick with her. I am just not ready to give up on a nineteen- year-old veteran!"

"No one has even talked about substance abuse," substance abuse counselor Marilyn McLain interjected. "I mean, all this behavior could just be from being an addict. I think we need to admit her to some kind of a substance abuse treatment center and get all that stabilized before we can even start thinking about her mental health concerns. It's all too blurry right now."

"I don't think substance abuse is the issue," Patty responded. "She has major· trauma stuff going on, and the substance abuse is just a way to cope with that. And I don't even think she does anything be- sides smoke marijuana and drink on occasion. I agree that it makes her

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riskier, but it isn't the core prob!em. She needs to stay in the hospital longer or at least until we think she's safe to release."

"I read Dr. Carson's notes," Dr. Halim stated matter-of-factly, "and no one can see any grounds to keep her any longer. She appears stable today and doesn't meet hospitalization criteria. She's denying auditory hallucinations or suicidal ideation or intent. The injectable medication ought to help her stabilize, but, Patty, you better think of a different

plan with her. n

VISIT TO THE HOSPITAL

Patty tapped on the frame of the open door and entered Sharease's room. Sharease was dressed in her street clothes and looked at Patty without smiling.

"I hear you're heading home tomorrow," Patty began. "Yeah," Sharease responded flatly. "I hope you'll make an appointment with me and come in soon,"

Patty said. "I know you're tired of the hospitalizations, and I'd like to figure out a plan to keep you doing okay without the hospital."

"I don't know," Sharease stated. "I'm tired of all this. I talk to you, and I just end up here again, so I don't know what good that's doing me."

I don't know either, Patty thought. But she said aloud, "I think it's doing some good. You've made some progress in how you get along with your mom and realizing your role in how that relationship works."

"I guess," Sharease looked at the floor. "Well," Patty continued, "and I really appreciate that you keep in

touch with me and let me know what's happening with you. But let's meet tomorrow at three in my office and decide what we want to ac- complish together."

Patty stayed a while and spoke with Sharease, informing her that she would be calling her mother and asking her to check on Sharease daily to make sure that Sharease had her discharge medications and that she. knew she was welcome to see Patty when needed.

The next day, a Wednesday, Sharease did not attend her follow-up appointment. Patty left a message on her cell phone but did not receive a return phone call.

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THURSDAY PHONE CALL

On Thursday morning, Patty arrived at work promptly at 8:oo. She checked her email and fixed a cup of coffee before seeing her first vet- eran at 8:30. The veteran, Matthew Vicar, was recently home from combat and was coming in today with his wife to discuss marital issues that had arisen since his return. Patty had scheduled them a little extra time because this was the first chance she had to meet Matthew's wife.

Her session had just started with Matthew and his wife when the phone rang. Patty ignored it, letting it go to voice mail, because she didn't want to be interrupted during a session. It rang again, this time with the double ring indicating it was from within the agency instead of from an outside caller.

"Well, excuse me a second," Patty apologized. She picked up the phone, irritated.

"Patty," operator Latisha said, "Sharease has been calling over and over again. She says it's an emergency, and she has to see you. I have her on the other line."

"Tell her I can see her at 12:15," Patty said, looking at her planner. "She says she can't wait," Latisha responded, "she's coming right

now."

"Well, she'll have to just wait outside until IO:Jo," Patty said. So much {or that IO:Jo meeting, Patty thought, but I do want to check on her.

At xo:3o sharp, the security guard walked Sharease down to Patty's office. Patty was immediately struck by how different Sharease ap- peared. She was quiet, looking down, not resisting the security guard or even seeming to notice him. She was wearing oversize clothes and looked weary.

"Come on in," Patty said. "It's.good to see you." "I just came by to tell you good-bye," Sharease began abruptly. Patty

felt her pulse quicken. "What do you mean, Sharease?" she asked. "It's like I'm already dead," Sharease said without emotion. "Like

every piece of me except my physical body is dead already, and now I'm just waiting. n

PRIVATE , DISMISSED 120

"Sharease," Patty asked directly, "are you saying you're going m kill yourself?"

"No ... , " Sharease's voice trailed off as she looked around the room. "I don't think so, I just think it will happen. Death is inevitable. We all die. Sooner or later."

"Sharease," Patty pressed, "you know that when you say things like this, I can't just pretend I don't hear you. I have to make sure you're safe." Patty knew that Sharease knew the drill. But this time feels dif- ferent, Patty thought. No emotion. no yelling and screaming about not wanting to go to the hospital, different altogether.

"Patty, will you write my memoirs?" Sharease asked. Patty was silent. She thought carefully about how to respond. "Well," Patty said, "I need to think about that. I don't like to

make promises that I can't keep." Sharease is obviously trying to tell me she's serious. This is not her usual presentation; something's very different.

Patty assessed Sharease fully, finding that she did indeed present enough of a risk of suicide to require inpatient treatment again. She arranged for Sharease to go to the inpatient unit, and Sharease didn't object at all.

DISCHARGED AGAIN

The next morning Patty called the inpatient unit to see how the intake and first night had gone for Sharease. She spoke to the discharge plan- ner, Maria Benavides.

"She seems to be doing pretty well," Maria said. "She was coopera- tive, ate a good dinner, and went to sleep. She took her medications and seemed quiet and pretty calm."

"Has she said anything about thinking she's already dead," Patty asked, "or that she's going to die, that sort of thing?"

"No, quite the opposite actually," Maria replied. "I just spoke to her about discharge plans, and, you know, she usually just says she will be fine and is either evasive or hostile about services or engaging in treatment. But this time, I mentioned the MHICM Team, which I have mentioned before, but she seemed interested."

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"Really?" Patty asked. Patty had previously mentioned the MHICM Team to Sharease, and Sharease had said, "The last thing 1 need is more of you all in my business."

"Yeah," Maria continued, "she seemed sad, but kind of like she knew she really needed that kind of intensive help and was kind of resigned to it. Maybe she's finally accepted that it's time to start get- ting better. n

"Maybe," Patty said hesitantly. "So what happens with her now?" "Since she stated she wants to go home and that she does not want

to die and has no more plans or thoughts about suicide, she'll go home. We'll set up an appointment with MHICM to see her Monday morning."

This doesn~t feel good to me, Patty thought. This doesn't sound at all like Sharease. But I don't know what to do!

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168

2 The First Year "Thought I'd Died and Gone to Hell"

In the beginning they were idealistic, caring, and committed. They had lived through the tumultuous demonstrations of the sixties. They had heard the cries for social justice. Then they had decided to commit their lives to helping others. After completing years of schooling, they were professionals-teachers, nurses, therapists, lawyers.

These new professionals were enthusiastic-their time had finally come. But the real world wasn't what they had anticipated: There were unexpected frustrations, and the collegial support they hoped for never came. Their formal schooling had left them unpre- pared for the challenges they faced.

They wished for their situations to improve, and sometimes they did. But for many, the strain was unremitting. They became disillusioned. They lost much of their compassion and commit- ment. They began to burn out.

The new professionals came to their careers with unrealistic expectations, and this was one source of their difficulty. They were victims of the "professional mystique"-an overly romanticized view of professional work. It was a view built from countless media images-the competent physician, the dedicated teacher, the clever attorney. These stereotypes came from movies, books, and tele- vision programs (De Fleur, 1964), and the new professionals be- lieved them.

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18 The First Year: "Thought

Unfortunately, public service jobs didn't measure up to these images, and this discrepancy between how things were and how they were supposed to be-what Kramer (1974) referred to as "real- ity shock"-was a major source of stress.

Sources of Stress

The "Crisis of Competence"

In the movie, Stand and Deliver, a dedicated and inspired teach- er, Jaime Escalante, manages to teach calculus to a group of dis- advantaged high school students. The movie conveys an implicit message: Good teachers can reach even the most difficult students. Those who fail to do so are uncaring, incompetent, or both. This kind of heroic expectation was the burden that the new profession- als brought into their first job.

Professionals are supposed to be competent: When we refer to a thief as a "real professional," we don't mean that he received an advanced degree in stealing, or that he has a license. What we mean is that he's good at what he does.

The dictionary defines competence as "having all the natural powers, physical or mental, to meet the demands of a situation or work." One of the new professionals, Sherman Reynolds, a clinical social worker who worked in a family counseling agency, expressed it this way: "A real professional, not just someone with the title, would be someone who feels right on top of things." Sherman and the other new professionals felt that they should know what to do in most situations. They should be "on top of things."

But it didn't work out that way. The new professionals often didn't know what to do. Teachers found themselves in front of a class on the first day of school without a clue as to how to start. New attorneys knew their way around the law library, but they literally got lost the first time they entered the courthouse. The public health nurses and mental health professionals were better prepared; but they, too, felt inept much of the time.

Achieving an acceptable level of competence thus became the overriding goal for the novice professionals. Their commitment to other goals-helping the needy, working toward social change, pro- moting social justice-receded in importance. The feelings of inade- quacy that plagued the professionals during the first year made it

I'd Died and Gone to HeW

difficult for them to think about anything else. Idealism, altruism, and compassion became unaffordable luxuries. How to avoid failure and humiliation was what dominated their thinking.

Competence meant different things for each profession. New teachers saw control of student behavior as the critical measure of competence. Nothing was more upsetting than to have their students act up. Chemistry teacher Calvin Miller was typical. He couldn't stop ruminating about a student who frequently spoke out of turn and bothered other students. "This is where I feel I fail," Calvin said. "My job is to try to deal with this kid and get him to learn. . . . It has really upset me when he's disrupted the class because there are a couple of people in that class who really want to learn. And then they get upset. And then they go home and say something about how the class was just in an uproar today and Mr. Miller couldn't keep John settled down. So I get a reputation as not being able to keep control of the class."

The neophytes soon learned that reputation is important in the professional world. Poverty lawyer Jean Chalmers described how casual conversations between attorneys often turned into evalua- tion sessions. "When you talk to lawyers," Jean complained, "the first thing they say is, 'She's a bad lawyer, she's a good lawyer. He's a bad lawyer, he's a good lawyer .... ' They want to know, Are you good at what you do?"

Jean noted that it didn't matter whether you were a "nice person"; all that counted was how competent you were. And evalu- ation went on continually-in the office, after work, at cocktail parties.

A professional might fail for a number of reasons, but the inex- perienced tended to blame themselves. Sarah Prentiss was a young and idealistic public health nurse. She was especially bothered by what happened with one of her clients, an older woman who was sick, poor, and alone. During their last contact the woman had said, "I don't know why you're bothering with me. I just want to die."

This statement upset Sarah because she heard it as a testament to her own failure. "You know," Sarah said, "I think about her. I can't help it. She's in this big house, the plumbing doesn't work, no hot water ... she'll probably just stay in her house and die .... And I thought, 'Gee, what's wrong with me?' or 1What did I do?' And you know1 I might have done something wrong. Maybe I just turned her

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20 The First Year: "Thought

off. Maybe it was just a personality conflict. But I didn't see it, and that's the thing that bothered me-that I didn't have enough insight to see the problem. So yeah, it bothered me."

Even skilled veterans make mistakes. And new professionals still have much to learn. But the expectations are high, and so are the costs of failure for a nurse, teacher, lawyer, or psychotherapist. Professionals, no matter how new they may be, are supposed to be competent. But often they don't feel competent. And the new pro- fessionals weren't prepared for this "crisis of competence."

The Professional vs. the System

Professionals are also supposed to be independent. The new pro- fessionals expected that their training and credentials would give them the right to make decisions without others second-guessing them. In fact, this autonomy was one of the major attractions of professional work. They could have made more ·money in business. But they chose to enter a profession because they valued indepen- dence and believed that as professionals they would have it. 1

Autonomy proved to be elusive as well. The new professionals suffered numerous indignities and encountered many constraints in the institutions where they worked. And they became upset when others didn't treat them like the competent professionals they wished to be. Sarah Prentiss, the new public health nurse, became irate as she described a run-in she had with a public school principal.

The principal mentioned to me about a "growing-up" pro- gram. So I went down and talked to the teachers who were going to be involved in it, and I set up a date, and I told him the date ....

Okay, I walk in there last week and he says to me, "Well, we set up the program for Wednesday at 7:30." It was just like, "Okay, you do this, this, and this." And I looked at him and I. ... First of all, fifth- and sixth-grade boys and girls in two hours? He's crazy! You know, there's no way. I said, "First of all, we need more time than that," and he says, "Well, we've gone for two years like that." And I said, "Well, I know how much time I need to spend with these kids, because they have a lot of questions. Fifth and sixth grade kids know a lot; they're doing a lot of things that we weren't doing."

I'd Died and Gone to Hell" ----------------------------------------------------

And this man says to me, "Well, if they have questions, they can go home and ask their parents."

And I said, "Well, what's the whole philosophy of edu- cation?" I got into a big discussion with him. We were out in the hall, and I was just burning. I just had had it. He was putting me down.

Sarah was upset because she believed that the principal's plan might be harmful to children. But even more distressing was the feeling that he had slighted her and that she didn't have the auton- omy and respect due a professional.

Incidents like Sarah's confrontation with the principal weren't unusual. Nick Fisher, a school social worker, was even more tormented by infringements on his autonomy. Nick had taught in an urban classroom for two years. He left teaching and entered social work because he wanted to help his students overcome the personal problems that made life so difficult. When he returned to the schools as a social worker, he thought he would be a caring and compassionate helper. But administrators and teachers saw his role differently: they wanted him to help make the system run more smoothly.

"I get a lot of feeling from other people," Nick complained, "that my role is to handle discipline, which is something I don't want to do at all. I'll be walking through the office, and if there are a couple of kids that have just been brought in from a fight, the principal will say to me, 'You'd better talk to these kids.' I don't like that."

Nick thought it was inappropriate for him to get involved in student discipline, but the principal had put him on the spot. Nick resented this infringement on his autonomy, and he felt it would harm his relations with the kids if he did what the principal asked. But he worried about what would happen if he refused.

Nick wasn't satisfied with the way he attempted to resolve the dilemma. "I usually try to take that middle ground/' Nick ex- plained, "sort of doing it, but doing it my way .... I still feel uncom- fortable, like I've done nothing. It's hard because if you don't have the backing of the administration, you can't do anything anyway. The last social worker that was here got in a fight with the adminis- tration over one kid, and he just lost total effectiveness.

"It really is a trade-off. The demands put on you by the job mean

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22 The First Year: "Thought ------------------------------------------------~----

that you have to be doing things that you're opposed to. How do you do that and still remain idealistic? It's hard."

Then Nick ruefully added, "The principal here just told my boss that I'm the best social worker they've ever had. I don't know whether that's a compliment. At least it means I still have some sort of effectiveness. It really is a trade-off." There was a pause. Then he quietly added, "It means I don't feel real good."

The problems that the professionals encountered in working with complex organizations were related to their training. Not only had their teachers and supervisors neglected to teach them how to handle the constraints and dilemmas that they would face, their teachers hadn't even alerted them that such problems would occur. The professionals had been trained to do their work in ideal environments-or perhaps it would be more accurate to say that they had been trained to practice in a social vacuum. They hadn't been taught about the organizational craziness that they would encounter. And they had no idea how to deal with it.

School social workers, for instance, are often put in the position that Nick Fisher found himself in, yet he was totally unprepared when the principal asked him to be a disciplinarian. Nick blamed the principal for being "unreasonable" and "dictatorial." He also blamed himself at some level for not knowing how to deal more skillfully with the situation. But his difficulty in dealing with that incident also pointed to a basic flaw in the training program that failed to prepare him for such problems.

Even though Nick felt that he was being less assertive than he wanted to be, he eventually clashed with a principal about how to handle a student. The principal wanted to put the student in a special class for the emotionally disturbed. Nick believed it would harm the child to be placed in that class. He wanted to help the student stay in his regular classroom. Nick's anger was palpable when he said, "You know, I don't like to be put in a corner, but if I'm put in a corner, I can fight pretty good. I mean, I could really dish it out to those assholes."

But then Nick calmed down, apparently alarmed by his own feelings, and added, "But I don't want to do it because these are people I have to work with."

Matters had not improved by the end of the year. Nick still felt

I'd Died and Gone to Hell" ----------------------------------------------------

overwhelmed by the constant discord. And he now tried to avoid it rather than confront it.

"I feel a lot like I'm in a battle zone," Nick protested, "with bul- lets whizzing over my head, always keeping my head low. And I really feel like I'm avoiding problems. I often find myself not want- ing to talk to people, planning my day so that I don't have to be around the office, just trying to stay out of people's way when they're looking for somebody to be angry at."

Nick felt burned out. Laying low and avoiding problems had become the only apparent means of escape from bureaucratic obstruction and troubling value conflicts.

The new professionals valued autonomy in part because it was linked to achieving a sense of competence. When others imposed restrictions on the new professionals, it not only limited their autonomy--it also called into question their ability. Competent pro- fessionals are supposed to enjoy a high degree of autonomy. So a lack of autonomy made the novices feel less competent. 2

Lack of autonomy also made it more difficult for the pro- fessionals to do their best. When public health nurse Sarah Prentiss wasn't allowed to structure the sex education program in the way she thought best, she felt that she couldn't do an effective job. The professionals often felt they couldn't succeed unless they had more autonomy. And if they didn't succeed, they would feel terrible.

Difficulties with Clients

A third major source of stress for the novice professionals also impinged on their sense of competence. The professionals encoun- tered unexpected problems in working with clients, and these prob- lems were especially exasperating because they made it more difficult for the professionals to be effective.

At the climax of almost every good melodrama about a profes- sional, the person who has been helped turns around, looks at the professional hero, and with admiration and appreciation says, "Thanks." Such expressions of gratitude are reserved for the profes- sional helper--the nurse, the attorney, the therapist. People usually don't become so emotional when they thank the news carrier for delivering the paper on time every day. This kind of appreciation

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and gratitude from clients was something that the novices expected to find when they began their careers.

The novices thus were disappointed when they discovered that their clients usually didn't appreciate what they were trying to do for them. Many clients were resistant. They seemed to feel that the professional was an adversary rather than an ally.

Legal aid attorney Perry Curtis talked at length about the prob- lems he had with clients. Perry had just spent three years in lecture halls and law libraries. He had had no contact with a live client during that time. He had not had any instruction on how attorneys can most effectively communicate with their clients. But Perry believed that his clients would recognize his good intentions. He expected them to be cooperative and grateful. Perry's expectations were wrong.

"They just harass you and make impossible demands on you," Perry complained a few months after he began working at legal aid. "They won't follow your advice. 'Are you a real attorney?' I've had that asked. They think they know more than you do. They'll say, 'Well, my neighbor told me I could do this.' And then there's the person who, because you're not there holding his or her hand every minute, is calling everyone and complaining about the attorney who isn't doing this or that for them."

Perry identified all of the ways in which clients rankled the new professionals. First, he mentioned the "impossible demands." The new professionals found that no matter how hard they tried, there were times when they simply could not give their clients all that the clients wanted. Second, clients were resistant-they wouldn't follow advice. Third, many clients were unimpressed with the professional status that the novice had worked so hard to. attain. They didn't treat their lawyer, nurse, or teacher with the kind of deference and respect that the professionals expected. And finally, there were the clients who complained-the carping critics who could cause real trouble. It was hard for the insecure neophyte to discount client criticism.

But the hardest thing to bear for many new professionals was being lied to and manipulated by their clients. Margaret Williams was an activist poverty lawyer. She had gone to a prestigious law school with the intention of becoming an advocate for the poor and disadvantaged. She had been active in radical political groups all

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through college and law school. She was prepared to give up all of the opportunities and privileges available to a child of the upper middle class in order to help bring about social change. She initially idealized her poor, disadvantaged clients. To her, they were the van- guard of the revolution. She respected and admired them. But her views soon changed.

"Oh, let me tell you about clients lying to you," she exclaimed, rolling her eyes in exasperation. This was said in an interview that took place after she had been working in legal aid for less than six months. "They lie like crazy. I can't stand anything more than clients who lie to you. I had no idea that I would be lied to as badly as I have been."

Merton Douglas suggested that high school teachers were also lied to by students, and, like Margaret, he found lying particularly hard to tolerate. "I don't like being chumped by students," he said emphatically. "I really don't .... That's one of my pet peeves, I think, not only with my students, but in associations with people in general. I don't like to be taken, and I don't think anybody really does."

In the face of such resistance, manipulation, and frustration, the new professionals found it hard to maintain their initial idealism and enthusiasm. In their minds, they were making a commitment, even a sacrifice. And they would have done so gladly if their clients had been cooperative and appreciative. That was the way it was supposed to be. And when it turned out to be different, the new professionals became frustrated, demoralized, and disillusioned.

But even lack of appreciation might have been tolerable if the new professionals had felt more confident and secure. And achiev- ing a sense of confidence was difficult when clients lied, when clients were resistant, or when clients lacked basic skills. Difficult clients merely exacerbated the professionals' already shaky sense of self-esteem.

Boredom and Routine

Professional work in public service settings may not pay well, and it may be frustrating at times. But it is supposed to be meaning- ful and interesting. What could be more stimulating than arguing a case in court? What could be boring about helping a troubled adoles- cent overcome her problems?

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The Social Historical Context

These stresses were related to larger social forces. In describing their experiences and searching for meaning, the new professionals focused on their clients, their coworkers, their supervisors, the pro- grams in which they worked, and of course themselves. But all of these concrete entities were part of a larger culture, a culture with traditions, values, and patterns of social organization that strongly shaped the structure of the human services and, consequently, the experience of each new professional.

The Bureaucratic Ethos

The bureaucratic mode of organization represented one of those factors that were part of a larger social context. Weber (1947) de- scribed bureaucracy as a form of social organization in which abstract and impersonal rules define the responsibilities of members and the relationships among them. The purpose is to ensure that tasks are done uniformly, at the right place, and at the right time. Hierarchy of authority, in which every person has a superior, and specialization of function are'two other prominent features of the bureaucratic mode of organization.

The bureaucratic system is hundreds of years old. The Roman armies and the early Catholic Church utilized aspects of bureau- cracy. Business enterprises began to use features of bureaucratic organization during the industrial revolution of the early nineteenth century. Later in that century, when schools and social welfare programs became larger and more complex, they adopted the bur- eaucratic mode as well.

Bureaucracy has taken on negative connotations in modern life. Modern writers depict it as alienating, dehumanizing, and inimical to creative and spontaneous activity. But bureaucracy, as Weber pointed out, has some positive virtues. It is a way of coordinating diverse activity in large, complex enterprises. While it sometimes seems cumbersome, it often ensures a certain level of efficiency. In human service programs, bureaucratic rules and regulations may ensure a certain level of care. For instance, Foner (1994) has pointed out how accident reporting requirements in nursing homes, which most staff find burdensome, have promoted more humane care and prevented some of the abuses that reached scandalous proportions in the mid-seventies.

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Bureaucratic procedures can also minimize favoritism and en- sure a certain degree of fairness. Professionals and clients often become frustrated with bureaucratic routines that prevent the pro- fessional from giving a client too much individual attention. But too much concern for one or two clients may adversely affect others. If an aide in a nursing home, for instance, spends too much time talk- ing with a depressed patient and consequently falls behind schedule, the other residents will suffer. The routines and schedules that are so much a part of bureaucracy provide a way of ensuring a certain degree of uniformity that is consistent with fairness and good care.

Nevertheless, bureaucracy often seems to be at odds with com- passionate, effective helping. When speed, efficiency, and confor- mity to rules become the overarching concerns, compassionate care suffers. Foner (1994), for instance, observed two aides working in a nursing home. One was particularly callous and brusque with patients-sometimes even cruel. The other was kind and compas- sionate. But the first one received more positive evaluations from her nursing supervisors because she always followed orders and finished assigned tasks on schedule. The compassionate aide was slower and sometimes circumvented rules to help individual patients. As a result, the kinder aide was often in trouble. Her rat- ings were much lower.

This situation existed in a good nursing home with a pro- gressive, committed administration and a reputation for providing quality care. Thus it shows that even in the best institutions, a bureaucratic structure encourages a loss of perspective in which speed, efficiency, and conformity to authority have higher priority than quality of care. Means become confused with ends. 3

When human service programs are organized along bureaucratic lines, the caregiver is often caught in a dilemma. Caregivers want to be responsive to clients' individual needs. In fact, professionals usually have an ethical and legal obligation to do so. But administra- tive rules can prevent them from providing this kind of treatment.

The new professionals soon encountered these hard truths as they tried to help their clients while working in a bureaucracy. When the principal told Sarah Prentiss that she had to fit her pro- gram into a limited period of time, he was doing so out of a concern with efficiency and smoothness of functioning. He had hundreds of students and numerous academic programs to juggle each day. In order to cope with this complexity, there had to be a schedule that

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allowed for little vanatwn. To accommodate Sarah's needs, the learning program for all of the students and teachers in the school would have to be disrupted. At some level Sarah could probably appreciate the principal's concerns. But she was also painfully aware of how inadequate the time allotted was. As a public health nurse, she had been taught that her first responsibility was to do a good job of teaching health practices to the students.

It was no accident that this conflict between two sets of con- cerns-efficiency and orderliness vs. professional standards- ultimately manifested itself as a personal conflict between Sarah and the principal. In a bureaucracy, administrators are given author- ity over others in order "to unify and coordinate diverse and con- flicting organizational participants and units" (Brager & Holloway, 1978, p. 8). But people at different places in the chain of command have access to different information and are s1,1bject to different pressures. This was the case with Sarah and the principal. Not only was the principal aware of conflicting needs in a way that Sarah was not, but also he was the one who would be blamed if the schedule was disrupted. Sarah would be unaffected by the disruption; not so the principal. In such a situation, conflict is inevitable.

Similarly, Nick Fisher was caught in a dilemma that inevitably occurs in bureaucratic systems. The principal whom he described may have been concerned about the emotional well-being of stu- dents who were sent to the office for discipline or who had behav- ioral problems that made it difficult for them to learn in a normal classroom. But he was even more concerned about making the system run smoothly. The principal was concerned with maintain- ing an environment that minimally met the needs of the majority of students; Nick, on the other hand, saw himself as an advocate of the individual student who was having particular difficulty.

Sarah and Nick's problems were exacerbated by the specializa- tion of function that is another characteristic of bureaucracies. Sarah was responsible for health education, while the teachers were responsible for teaching the basics. If Sarah got more time for her sex education program, the teachers would have less time for their function. Because different groups in a bureaucracy assume respon- sibility for different and potentially competing functions, conflict is inevitable. And over time this conflict has increased, because

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specialization of function in the human services has accelerated with the growth in knowledge. As more is known about sex educa- tion, teachers gradually relinquish it to specialists like Sarah. As the number of different specialists grows, the potential for the kinds of conflicts that Sarah and Nick experienced also grows.

Bureaucracy, as well as the problems associated with it, tends to grow over time. Increasing specialization is only one reason for this growth. Another reason is that those who conform to bureaucratic values are the ones who are promoted to positions of greater influ- ence. In her nursing home study, Foner (1994) observed a supervis- ing nurse who was especially liked by the administration because she was so well-organized and efficient. Her floor was the most orderly in the institution. Foner discovered that this nurse was also aloof and mean to both residents and staff, but this did not seem to affect her status with her superiors. In fact, she was eventually pro- moted to a higher-level position where her emphasis on orderliness had an even greater impact on the setting.

Once bureaucracy takes root, it grows. But why does the bureau- cratic mode of organization take root initially? Schools, mental health clinics, and other human service organizations do not need to be organized along bureaucratic lines, but most are. Bureaucracy has come to be the dominant form for several reasons.

One is simply the effect of past abuses. There has been enough corruption, neglect, and incompetence in the human services to make some degree of regulation seem necessary, and with each new scandal, the degree of bureaucratic regulation increases. The nursing home scandals of the seventies, for instance, led to stricter govern- ment regulation, which led in turn to greater bureaucratic control and reduced autonomy for the staff of nursing homes. More recently, growing awareness of corruption in local school boards in New York City is leading to calls for increased monitoring and control by the central office. In responding to this call, the administration will undoubtedly develop additional rules, regulations, and procedures that are designed to increase accountability but that will also have the effect of increasing the deadening weight of bureaucracy.

Another source of increasing regimentation is labor contracts. Work rules that are designed to protect workers from unfair and vindictive management practices usually have the unintended

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consequence of further restricting autonomy and flexibility. But there are other factors that are even more deeply ingrained in Amer- ican society.

American Ambivalence Toward Helping the Needy

As a society we are ambivalent about supporting human service programs. We want to make sure that we receive adequate health care, schooling, legal aid, and other services when needed. We also feel compassion for others who clearly need such help, as witnessed by the prompt and generous public response when there is a hurri- cane in Florida or an earthquake in California, but we also do not want to pay for "freeloaders" (Brager&. Holloway, 1978). We become outraged when we hear stories of fraud in the provision of benefits. We want to help, but we do not want to be "taken."

Part of this ambivalence is related to Americ~ns' strong commit- ment to the value of self-reliance. We want to help people who really need help, but we are loathe to help others unless they have done everything they can to help themselves. We continually worry that if we help people too much, they will become dependent. Our discom- fort with dependency reflects our commitment to self-reliance.

Our generosity is also diluted by our belief in individualism and free will. When people become unemployed, need legal help, or develop emotional problems, we tend to see the cause as a lack of individual motivation. We recognize the influence of economic, political, or social factors, but we tend to think that people can "rise above" such obstacles if they just try.

Our desire to help the needy is also diluted-some might even say compromised-by another motivation: social control. Welfare programs, services for the mentally ill, and even public education are supported in part to maintain social order (Brager &. Holloway, 1978). We support schools partly to keep unruly children off the streets. We support mental health programs to prevent the mentally ill from creating disorder in the workplace, in the street, and in our families. The commitment to help is sometimes undermined by the social control motive.

Our support for education, welfare, and other human services is also diminished by materialism. Since the industrial revolution, our society has had an enormous surplus. Even people of modest means can afford to buy far more than they need for adequate food, shelter,

I'd Died and Gone to Hell"

clothing, and even entertainment. With this surplus of wealth, we could permit people to work much less, or we could use the surplus to provide better education, mental health care, legal aid, and other social services. But most of this surplus is used on personal con- sumption. We complain about higher taxes, even though our taxes are among the lowest in the world, because we want to keep our money to spend on things. We want to help the needy, and we want a good education system for our children; but we want even more to accumulate material possessions that will enhance our status, entertain us, and make our lives even more comfortable.4

This ambivalence toward human service has a profound impact on the work environments of helping professionals. The most obvi- ous effect involves resources. Public human services never receive sufficient resources for fulfilling their mandates. Whether teachers have 30 students in their class, or 25, or even 18, the task of provid- ing a quality education to every child is impossible. As de Grazia ( 1962, p. 361) observed, "Mass education is a contradiction in terms. There must be a one-to-one or at least one-to-a-few relationship." The same can be said for health care, psychotherapy, legal aid, and virtually any other human service that we can imagine. Foner (1994), for instance, observed that nursing home aides would be less stressed out and more responsive to the patients' needs if they had fewer residents to look after. The ideal would be just one or two patients per aide. But she could readily see that such an arrange- ment would be impossible. The public is simply not willing to invest additional billions of dollars in long-term health care to secure such an arrangement. 5

With limited resources, the sense of inadequacy that plagued the new professionals is inevitable. First, their training was less effective than it might have been because the training programs from which they came did not have the number of teachers and field supervisors necessary to provide all students with a good education. The student teachers, for example, spent a mere 12 weeks in the classroom receiving, in most cases, a minimal amount of coaching and guidance from a mentor. To provide all student teachers with better preparation would require a significant increase in the amount of money allocated to teacher training programs.

And even if they had been better trained, the new teachers would still have felt overwhelmed by the task of maintaining con-

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trol in the classroom and presenting the material in an engaging way, given the large number of students for whom they were responsible. Calvin Miller could probably have been successful in maintaining order in his class if he had only five or six students to worry about. But with more than 20 in a chemistry lab, the task seemed overwhelming. With time, of course, most teachers learn how to maintain better control in the classroom. But they often do so by sacrificing other goals, such as individualization of instruction for each student. Students may conform to the rules, but they also learn much less than·we would like.

Public ambivalence also makes the clients more irascible. Lack of adequate funding for the human services means that clients are frequently short-changed. Over time, they become increasingly resentful and mistrustful. When a legal aid lawyer meets a client for the first time, that client may have a long history of frustrating con- tacts with professionals who simply did not have the time to be warm, responsive, and helpful. As a result, the client is more diffi- cult to engage and quick to complain.

Inadequate public support for the human services also contrib- utes to the lack of collegiality. Legal aid lawyer Margaret Williams noted that her colleagues were not available to help her because they were so overwhelmed trying to keep up with their own crush- ing case loads. "I get thrown out of people's offices all the time because they're busy," she complained. When professionals do not have enough time to help many clients, it is difficult to find the time to help a new colleague.

Lack of public support also leads to greater bureaucratic con- straint. As resources diminish, more emphasis is placed on speed and efficiency. Administrators who are trying to stretch every dollar are likely to impose more restrictions on professional staff. Sarah Prentiss's principal, for instance, felt compelled to limit the amount of time she had for her sex education program because his teachers already did not have enough time to cover the basics. While Sarah blamed the principal for the limit that was being placed on her, in fact both the principal and Sarah were victims of society's ambiva- lence about supporting public education.

The Impact of Recent History

The societal factors that I have discussed thus far have been pre- sent for a long time, but in addition to these, there are others that are

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of more recent vintage. Social changes in the sixties and seventies increased the tensions that adversely affected new professionals.

First there was the growing discontent with all social institu- tions and forms of authority. Rothman (1978) has noted that until the sixties, our society was dominated by the "progressive" ethos, which included the belief that social institutions were benign and that conflicts between different groups could be resolved through rational discussion. This view began to crumble with the rise of the civil rights movement, the Vietnam War and the antiwar move- ment, the assassinations of popular leaders, and the growth of the "counter-culture." These events led to a growing belief that the various interests in society are not in harmony, that conflict is inevitable, and that groups suffer or prosper to the extent that they press assertively for their interests. The buzz word that became increasingly popular was "empowerment."

The empowerment ethos eventually spread to the human ser- vices where a powerful "consumer" movement developed. This led to increased demands for accountability, restrictive legislation, and the involvement of the courts. People working in education and the human services responded in kind: they unionized and pressed for their own interests through collective bargaining. All of these changes eventually contributed to decreased autonomy and flexibil- ity, a greater emphasis on following the rules, and reduced public support. Clients were also more resistant and suspicious as they came to believe that professionals were not there to help clients but to protect themselves.

At the same time that the public became more mistrustful of the human services, they also expected more of them. The "War on Poverty" of the sixties was intended to eradicate poverty and the social ills associated with it. The Community Mental Health Centers act, established at around the same time, was intended to do the same for mental illness, while mandatory special education legislation, which came only a few years later, had similar lofty goals for handicapped school children. The schools and other human service programs were supposed to solve many of society's problems, and when they fell short, people lost faith in them. Disillusionment contributed to a further decline in public support. Helping professionals were no longer viewed with the same respect and admiration. The heroes of the eighties were not idealistic teach- ers or physicians; they were stockbrokers and corporate executives. 6

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Economic changes also contributed to professional stress. The fifties and sixties were a period of unparalleled prosperity in this country, but they eventually gave way to the 11 Stagflation" of the seventies. People had to work harder and harder just to keep up. This put enormous strain on individuals and families, which in- evitably led to greater demands on human service programs. Clients became needier and more difficult to help, and the numbers needing help increased. At the same time, support for the human services declined. Thus professionals had to do more with less.

The professionals in my study were only vaguely aware of these larger social forces. They talked mainly about the more immediate and visible sources of stress in their jobs, such as resistant clients, inadequate resources, insufficient time, and stifling rules. Most of the people who have written about professional stress and burnout have also restricted their attention to these more proximal influ- ences. But we cannot fully understand the sources of the profession- als' frustration without considering the social context in which their struggles occurred. 178

2013, 94(2), 96–103 Doi: 10.1606/1044-3894.4289

A Self-care Framework for Social workers: building a Strong Foundation for practice Jacquelyn J. lee & shari e. miller

self-care is widely recognized as critical to social work practice, yet little empirical support or practical guidance exists

in the literature to steer social workers in its implementation. self-care may not only be crucial in preventing secondary

traumatic stress, burnout, and high staff turnover, but it can serve as a means of empowerment that enables practitioners

to proactively and intentionally negotiate their overall health, well-being, and resilience. the purpose of this article is

threefold: (a) to explore current conceptualizations of self-care; (b) to provide a clear conceptual definition of and an

applied framework for self-care; and (c) to explicate the utility of this framework for social work practitioners, students,

educators, and social service agencies’ supervisors and administrators.

impliCations For praCtiCe

• the self-care framework offers a starting place for social

work practitioners to assess their engagement in self-

care and to establish a systematic and well-considered

approach to effectively engage in a comprehensive

self-care plan.

• Using the self-care framework as a lens, supervisors and

administrators may examine if and how organizational

culture, practices, and policies ignore, discourage, or

promote self-care.

a lthough a clear and expansive definition does not appear in the literature, the concept of self-care has generally been understood as engagement in behav-

iors that support health and well-being. It is widely sug- gested that self-care offsets work-related stress (Howard, 2008; O’Halloran & Linton, 2000), and research indicates that self-care promotes resilience in practitioners whose work focuses on death and bereavement (Alkema, Linton, & Davies, 2008; Becvar, 2003; Berzoff, 2008; Puterbaugh, 2008; Schneider, 1987), mental health, and/or trauma (Bober & Regehr, 2006; Jordan, 2010; Newell & MacNeil, 2010; Smith, 2007). Though most typically discussed in relation to mental health practitioners, self-care is a criti- cal issue for the entire social work workforce. This more expansive application necessitates a broader conceptual- ization of self-care and a more inclusive discussion about the “how” of self-care, including the development of a pragmatic framework to guide practitioners in negotiating a strong foundation of self-care practices. Self-care is not simply a means to ameliorate or even prevent work-related distress—although these are relevant and important out- comes to be considered. Self-care is also an empowering tool that allows practitioners to take ownership of their health and well-being holistically and with consideration to both their personal and professional lives.

scarce attention has been paid to clearly conceptual- izing the phenomenon of self-care, which has resulted

in significant challenges in its operationalization, inclu- sion in empirical studies, and consistent integration in social work education and training beyond the class- room. This has resulted in a limited body of research that renders application in actual practice challenging. however, “a chronic lack of self-care” is noted as a fre- quent consequence for many helping professionals as they struggle to prioritize their own well-being while focusing on the needs of clients (figley, 2002; skovholt, grier, & hanson, 2001).

inattention to self-care both systematically and on the individual practitioner level may be very costly for the profession. as the sociopolitical landscape contin- ues to shape the social service delivery system, a wider scope of services is in great demand, and the availability of resources is simultaneously becoming increasingly limited. in a national study, licensed social workers reported an increase in paperwork, severity of client problems, caseload size, and waiting lists for services— and a decline in levels of reimbursement, availability of supervision and staffing opportunities, and accessibil- ity of services to clients (Whitaker, Weismiller, & Clark, 2006). These unique challenges present very real con- straints for practitioners and likely result in stressful work conditions. Whitaker et al. (2006) also found that, because of many of the reasons stated, social workers were most inclined to want to leave the profession early in their practice trajectory (generally within their first four years post-master’s degree). approaches to address- ing these workplace issues tend to focus on change at the societal, community, or agency level, without factor- ing in the individual practitioner (graham & graham, 2009). With a clearer sense of self-care and a subsequent greater likelihood of systematic application, social workers may be better prepared to cope with stressful work conditions, more actively engaged in advocating for structural changes within organizations over time, and more inclined to remain in the profession.

in addition to the context of service provision and workforce capacity, the demands of the helping role can

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Lee & Miller | A Self-Care Framework for Social Workers: Building a Strong Foundation for Practice

also be costly. although few empirical studies focus on self-care, available findings suggest a lack of self-care is correlated with risk for compassion fatigue or secondary traumatic stress (alkema et al., 2008; eastwood & eck- lund, 2008), burnout (alkema et al., 2008), and compro- mised quality of care for clients (barnett, baker, elman, & schoener, 2007). Consistent with empirical findings, Collins (2005) suggested that inadequate self-care may lead to emotional and energy depletion, which can affect the capability to actively problem-solve. These outcomes not only disrupt the potential for a healthy workforce but also may significantly impact the quality of service provision. if practitioners are limited in their capacity to fully be present and engage in their work with clients, the consequences could be devastating for those receiv- ing services. This highlights the necessity for self-care as a critical means of maintaining professional compe- tence and preserving the integrity of practice (national association of social Workers [nasW], 2009). as such, creating a “culture of self-care” may be considered a professional responsibility for both the worker and the profession (barnett & Cooper, 2009, p. 16).

importantly, commitment to the practice of self-care may not only prevent unwanted outcomes but also in- crease the likelihood of beneficial consequences for the worker personally and professionally. increased general well-being has been found to be significantly correlated with increased participation in self-care (boero et al., 2005; Coster & schwebel, 1997; richards, Campenni, & Muse-burke, 2010). anecdotally, authors have suggested that self-care increases worker effectiveness (Kaul, 2002; o’halloran & linton, 2000) and compassion satisfaction (radey & figley, 2007), which is defined as the pleasure derived from helping effectively (stamm, 2005). These potential benefits, paired with the risks of inadequate self-care, highlight the need for a framework to better understand, assess, and implement self-care strategies.

The purpose of this article is threefold: (a) to discuss current conceptualizations of self-care; (b) to provide a clear conceptual definition of and an applied frame- work for self-care; and (c) to explicate the utility of this framework for social work practitioners, students, and educators, as well as supervisors and administrators within social service agencies.

The Nature of Self-care

Much of the current literature on self-care emanates from psychology, so it is grounded in a particular set of perspectives that may not be wholly reflective of and specifically applicable to the wider scope of social work practice. The culture of social work—including its em- phasis on particular values, attitudes, and norms—needs to be considered as a contextual backdrop that may have a necessary impact on how self-care can best be de- fined and applied in social work education and practice.

Though the psychology literature has some relevance to social work, the body of conceptual and empirical self- care literature in social work, to date, is scarce.

Defining Self-Care in the extant literature, numerous authors have offered definitions of self-care, and notably, no consensus ex- ists around any one conceptualization. a considerable number of authors do not provide a clear definition of the term; perhaps this omission indicates an assump- tion of an implicit meaning (i.e., self-care means “caring for oneself ”). however, the definitions that have been offered in the literature are markedly distinct, which re- sults in a significant impact on how the phenomenon is understood and studied.

self-care has been described as a process (baker, 2003), an ability (Collins, 2005), but most often as en- gagement in particular behaviors (Jordan, 2010; Patrick, 1987; stebnicki, 2007) that are suggested to promote specific outcomes such as a “sense of subjective well-be- ing” (Pincus, 2006, p. 1, as cited in richards et al., 2010), a healthy lifestyle (Jordan, 2010), stress relief (brucato & neimeyer, 2009; sowa, May, & niles, 1994), and resil- iency for the prevention of empathy fatigue (stebnicki, 2007). Certain authors provide more specificity in terms of the types of behaviors that may lead to positive con- sequences for health and well-being. These range from those addressing basic needs to a more holistic ap- proach. for example, richards et al. (2010) defined self- care as “any activity that one does to feel good about oneself ” (p. 252), whereas Jordan (2010) suggested that self-care involves “management of vital functions” such as sleep, diet, exercise, and rest (pp. 251–252). self-care has also been understood to include “personal, occupa- tional, and spiritual activities” (Collins, 2005, p. 264). Carroll and collegues (1999) offer an even more expan- sive description of self-care, noting behaviors related to “intrapersonal work, interpersonal support, profession- al development and support, and physical/recreational activities” (p. 135). Therefore, though the term self-care may seem to obviously refer to the care of the self, a good deal of complexity is involved in how that care mani- fests and how it is contextually understood.

Growing Emphasis on the Professional Sphere a reading of the literature would suggest that self-care has primarily been characterized as a multidimensional phenomenon in which caring for oneself is achieved through the implementation of strategies in the follow- ing areas: (a) physical, (b) psychological and emotional, (c) social, (d) spiritual, (e) leisure, and (e) professional. Most authors appear to consider more than one of these dimensions, and a few include all of the dimensions in some fashion (for examples, see Carroll, gilroy, & Mur- ra, 1999; o’halloran & linton, 2000; richards et al., 2010). Though self-care practices related to one’s occu-

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pational role are often folded into a more general under- standing of self-care, a slim emerging body of literature emphasizes the particular importance of self-care strat- egies related to the use of self in the professional role.

Pointing to an inherent connection, skovholt et al. (2001) identified avenues for personal and professional self-care considered together. These strategies focus on self-awareness, attention to one’s environment, support, fun to increase one’s effectiveness, and balanced well- ness. Without the further distinction of personal and professional self-care, skovholt et al. (2001) indicated the relatedness of these phenomena with the suggestion of key integrated strategies. nasW (2009) has offered an even greater emphasis on the particular importance of “professional self-care,” citing it as an “essential un- derpinning” to sustaining a competent workforce (p. 268). acknowledging professional self-care is critical to upholding the profession’s standards for professional and ethical conduct, nasW calls for the development and implementation of practices and policies to support professional self-care within social work education and social service agencies. These perspectives acknowledge the relevance of considering both the distinction and connection between personal and professional self-care. Though this sentiment appears to be emerging, no clear conceptual distinction between the two constructs has been made in the literature.

conceptual Framework for Self-care for Social workers

The framework presented here is grounded in the rel- evant literature and structured to fit the particular cul- ture of social work in order to guide social workers in establishing and maintaining a self-care practice. The conceptualization put forth hinges on the designation of personal self-care and professional self-care as sepa- rate but related phenomena that together represent a comprehensive approach to exerting agency over one’s health and well-being.

Personal and Professional Self-Care Defined The literature supports the notion that there is a dis- tinction between personal and professional elements of self-care (Collins, 2005; nasW, 2009) and that these el- ements are inherently connected (skovholt et al., 2001). as limited clarity around how these two elements are distinguished appears in the literature, this framework offers two definitions from which self-care can be op- erationalized. Personal self-care is defined as a process of purposeful engagement in practices that promote ho- listic health and well-being of the self, whereas profes- sional self-care is understood as the process of purpose- ful engagement in practices that promote effective and appropriate use of the self in the professional role within the context of sustaining holistic health and well-being.

Underlying Assumptions The conceptual framework is grounded in a number of assumptions about the nature of self-care (see list be- low), some of which have been proffered in or support- ed by existing literature, others of which have emerged out of the authors’ development of the framework. The minimal attention to self-care within the social work literature suggests its current inchoate place in the cul- ture of the profession. and, the mention of self-care as simply a means of managing or even preventing nega- tive consequences communicates a limiting perspec- tive on the concept. both of these factors undoubtedly shape the way(s) in which practitioners engage, and perhaps fail to engage, in self-care. Clarifying the as- sumptions that undergird the presented framework is a necessary step toward shifting the profession’s un- derstanding of and relationship with self-care. This may contribute to its becoming a critical aspect of social work’s culture that is more consistent with the profession’s values and mission. • self-care is a critical foundation for effective, ethical

social work practice (nasW, 2009). • self-care is most effective when engaged in proactively

and intentionally. • Proactive engagement in self-care promotes self-aware-

ness and responsive (rather than reactive) engagement in and with an individual’s environment.

• self-care is understood as the composite of two dimen- sions: personal self-care and professional self-care (see barnett et al., 2007; hunter & schofield, 2006).

• Personal self-care and professional self-care are dy- namic, implicitly interconnected processes.

• both personal and professional self-care can be built and sustained through structures of support, which are organizing domains strengthened by specific self- care strategies.

• engaging in self-care is an individualized process in which numerous factors should be considered, includ- ing a practitioner’s own preferences, belief systems, cultural and social backgrounds, and employment context (see nasW, 2009).

• self-care empowers practitioners to exert agency over their holistic health and well-being.

• self-care is a vehicle for change in the professional cul- ture of social work.

Contingent Relationship Between Personal and Professional Self-Care given the growing attention toward self-care in the context of work, a keen focus on professional self-care, which promotes quality service provision, is important for the profession. in order to engage in professional self-care, clear lines need to be drawn between some personal self-care practices and the professional use of self. it is widely accepted that social workers need to employ appropriate professional boundaries to prac-

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tice effectively and ethically (see Code of Ethics of the National Association of Social Workers [nasW, 2008]). Placing restrictions around when and how work tasks are accomplished, and within and around professional relationships, enables the practitioner to balance work life with personal life. This may then lead to more ef- fective use of self in professional practice. The struc- turing and practical application of these boundaries may themselves hinge on effective personal self-care, which then fosters effective professional self-care. The relevance and interconnectedness of personal self-care to professional self-care, and vice versa, is a critical el- ement of this conceptualization and framework and bears further clarification.

rather than viewing personal and professional self- care as in conflict with one another or as opposing processes, the use of self invited by each may simply be different. for example, taking care of oneself personally may rely specifically on deep emotional connection in relationships or strong emotional investment in activi- ties, whereas taking care of oneself professionally may rely specifically on the ability to draw clear boundaries around the depth of emotional connection within work- related practices. recognizing the potential outcomes associated with using the self differently in different contexts may be helpful for practitioners to practice mindful engagement in self-care.

additionally, the link between personal and profes- sional self-care may have to do with ways in which these processes are contingent upon each other. That is, it is possible that, in order to engage in productive personal self-care, one benefits from engagement in produc- tive professional self-care, and vice versa. to continue from the earlier example, maintaining deep emotional connections within relationships could be considered a valuable personal self-care strategy. This personal self-care strategy may then enable one to establish and maintain the necessary emotional boundaries charac- teristic of particular professional self-care strategies. reciprocally, maintaining these boundaries while in the professional role may then better enable a practi- tioner to have the energy and space to sustain and pre- serve that depth of emotional connection in personal relationships. This example suggests that the degree to which one fully engages in professional self-care may be limited or enhanced by the degree to which one employs personal self-care strategies. based on this understand- ing, effective personal self-care needs to be in place for effective professional self-care to be enacted, and if ef- fective professional self-care is not in place, personal self-care will likely be negatively affected.

This conceptualization provides practitioners with a framework to unpack and negotiate their reactions, challenges, or tendencies related to maintaining profes- sional boundaries with clients. When a practitioner is struggling with boundaries, this framework could be

used to look at personal self-care and make changes that may more appropriately enable the practitioner’s needs to be met while allowing for negotiation and mainte- nance of necessary professional boundaries. Consid- ering personal and professional self-care as two sepa- rate but implicitly and inextricably linked processes, rather than understanding them together as either one phenomenon or discrete separate phenomena, offers a meaningful and pragmatic way of understanding self- care, one that more effectively lends itself to practical application for social work.

Structures of Support

grounded in the assumptions and conceptual specific- ity above, the framework contains two sets of structures of support, one for personal self-care and another for professional self-care. each structure of support can be understood as a series of domains within which specific self-care strategies may be categorized. Through the structures of support, practitioners can build their own self-care plan that identifies these specific strategies in any or all of the domains that apply to their individual needs, preferences, and identified contexts. any num- ber of strategies may serve to maintain each structure of support, calling for practitioners to mindfully engage in determining which strategies will be most effective in their own lives.

Personal Structures of Support The five primary structures of support for personal self-care include (a) physical, (b) psychological and emotional, (c) social, (d) leisure, and (e) spiritual. These structures of support resonate with the facets most commonly considered relevant in the literature (see o’halloran & linton, 2000; richards et al., 2010). at- tending to the needs identified by these structures of support and identifying self-care practices to locate in any or all of these structures can promote overall health and well-being of the self.

strategies that support physical care of the self are targeted to optimize physical function and safety. strategies may emphasize physical activity, adequate sleep, healthy nutritional choices, prevention of illness, intimacy, and general bodily health. Practices that contribute to the psychological and emotional care of the self focus on the capacity to maintain a positive and compassionate view of the self and negotiate the demands that arise from the intersection of individual and environment; this capacity is built through emo- tion regulation, effective behavioral choices, and an emphasis on adaptively meeting one’s needs. examples include recognition of one’s own strengths, engage- ment in stress management techniques, mindfulness about triggers that increase stress, and active problem solving. building and sustaining meaningful, support-

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ive relationships is central to the social structure of support, which may be maintained by implementation of strategies such as participation in one’s community, maintaining contact with important individuals in one’s life, and being present when in social settings. The spiritual structure of support fosters connected- ness, faith, and peace. strategies to build this structure may include meditation, prayer, reflection, or spending time in nature. last, the structure of leisure support is built with strategies that encourage participation in enjoyable activities that typically promote rest and re- laxation or encourage creativity, such as reading, knit- ting, playing in team/recreational sports, or spending time with a pet.

Professional Structures of Support The literature clearly acknowledges the relevance of an occupational component of self-care (barnett & Coo- per, 2009; nasW, 2009; skovholt et al., 2001). however, little guidance on how to specifically conceptualize this dimension is provided in the literature. as such, the framework presented identifies six primary structures of support that contribute to professional self-care: (a) workload and time management, (b) attention to professional role, (c) attention to reactions to work, (d) professional social support and self-advocacy, (e) professional development, and (f) revitalization and generation of energy. attending to the needs acknowl- edged by these structures of support and identifying individualized self-care practices in each can maximize effective use of self in the professional role and promote overall well-being.

Workload and time management. This structure is maintained by strategies that allow the practitioner to actively engage in mindful management of work tasks and time spent accomplishing work tasks. such a struc- ture facilitates organization of one’s work life in a way that encourages efficiency and balance, making the worker more available to attend to both the client’s and the worker’s needs. examples of these strategies could include taking breaks throughout the workday, taking vacations, and reserving work tasks (e.g., paperwork, emails, work-related colleague contact) for work hours only, as well as putting into place systems to organize and prioritize work tasks.

Attention to professional role. Within this struc- ture of support, practitioners can put into place strate- gies that enable them to take stock of the meaning of their role as not only a social worker but also as a social worker designated to a particular job description, in a particular setting, working toward particular goals. That is, all social workers are bound to practice from a specific values-based ethical code and benefit from giving consideration to the strengths and limitations of the context of their work environment. for example, the NASW Code of Ethics stipulates that practitioners

acknowledge whatever limits there may be to their ex- pertise in working with some client systems (e.g., par- ticular presenting issues, particular needs, and partic- ular values or ethical conflicts). being mindful of and willing to acknowledge these limitations can facilitate a much more healthful and effective professional use of self. This may contribute to professional self-care in other structures of support and may include strate- gies such as making referrals when necessary and pos- sible, seeking additional supervision, or determining if there are ways to gain additional expertise applicable to the practitioner’s role in their particular practice context. assessing the meaning and relevance of the professional role ensures not only ethical conduct but also promotes effective use of self and leads to a more grounded sense of professional well-being.

Attention to reactions to work. While often im- mensely rewarding, the nature of social work practice can be stressful and taxing in a variety of ways. This structure of support calls for practitioners to notice, honor, and manage their reactions to their work. This may take shape by attending to the cognitive, affective, or behavioral impact of the practitioner’s work with an eye toward self-awareness, stress relief, incorporation of feedback, and preparedness for practice. activities may include personal therapy, mindfulness exercises, limit- ing discussion of work stressors, journaling, targeted supervision, and debriefing with colleagues to contain explorations of reactions to work.

Professional social support and self-advocacy. Pro- fessional social support is frequently noted as a mean- ingful resource from which practitioners can solicit encouragement, constructive feedback, guidance, and education from peers and colleagues. This structure supports professional self-care by enabling practitio- ners to build a network or community of resources to support overall well-being and practitioner efforts to be effective in their professional role. strategies that sup- port this structure may include identifying supportive colleagues at one’s place of employment or elsewhere; scheduling regular time to gather with a group of col- leagues to problem-solve work-related issues; and main- taining regular contact with a developing network of colleagues met during formal education, trainings, or work-related community events. and, by extension, professional self-advocacy speaks to the ways in which the practitioner identifies, researches, and appropri- ately advocates for changes in work conditions where and when necessary. These practices might include re- questing a well-considered salary raise or renegotiating workload expectations when appropriate.

Professional development. Well-being in the pro- fessional role is contingent upon adequate knowledge about and comfort with how to best go about using the self in professional practice. a prominent structure of support to encourage attainment of both knowledge

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and skills is professional development. formal strat- egies to strengthen one’s professional development can include joining professional organizations (e.g., nasW); enrolling in a work-related course; engaging in continuing education; and attending conferences, trainings, or structured programs to build knowledge and skills. informal strategies—that is, those that situ- ate learning in a less-structured context—may include reading journal articles or other work-related publica- tions, engaging in professional research and writing for publications, and learning from colleagues by ob- servation or informal consultation.

Revitalization and generation of energy. sustain- ing energy, encouragement, and hopefulness through and about one’s work is central to maintaining both effectiveness and a sense of professional well-being. This supportive structure is built by including practic- es aimed at establishing or restoring preparedness for active engagement in and commitment to one’s work. While sample strategies are highly personalized, ex- amples may include creating a pleasant workspace; re- visiting reminders of positive outcomes achieved with clients (e.g., a thank-you note, a child’s drawing); remi- niscing with colleagues about formative and meaning- ful experiences; seeking out, creating, and trying out innovative approaches to addressing work-related challenges; and taking part in work-related social and community events.

it is important to note that though the structures of support can be separated out in conceptual terms, in practice, some of the strategies employed may serve to build more than one structure of support. for example, a practitioner may find taking vacations to be a strategy that supports both the workload and time management structure as well as the revitalization and generation of energy structure. The discrete structures of support of- fer a framework within which practitioners can begin to sculpt a dynamic set of effective strategies that will support their individualized professional self-care plan. The appendix provides a template for constructing and implementing a professional self-care plan; a similar method could be used for personal self-care as well. it is important to keep in mind that self-care practices may need to change over time and, as with most elements of social work practice, should be a point of regular critical self-reflection for practitioners. The method provided in the appendix can serve as a starting point for practitio- ners, students, supervisors, and administrators consid- ering the application of this framework.

Practitioner-in-Environment Perspective in keeping with the values of the profession, this frame- work acknowledges and accounts for individual differ- ences in how practitioners may strategize to most effec- tively practice personal and professional self-care based on their own preferences, needs, belief systems, cultural

and social backgrounds, and the context of their em- ployment. instead of narrowly suggesting particular practices, the framework consists of structures of sup- port that provide the scaffolding to assist social workers in identifying personal and professional self-care strate- gies that are best suited to them. given the broad range of social work practice applications, the framework al- lows room for individual practitioners to orient their self-care to accommodate their particular environment. in the same way a person-in-environment framework serves as a unique orienting mechanism for social work practice, it also informs the subjective application of this self-care framework; this framework factors in a practitioner-in-environment perspective.

Implications for Social work

self-care is a means of empowering social workers to ne- gotiate and offset some of the profound structural, orga- nizational, and interpersonal challenges associated with social work practice. as an initial step toward honing the profession’s understanding of self-care, this frame- work offers some implications for practice, education, research, and the culture of the profession. in the short term, it encourages outcomes such as stress reduction, worker competence, and appropriate use of self in the professional role. in the long term, the framework pro- vides a structure to potentially decrease burnout, sec- ondary traumatic stress, organizational and structural challenges, and high turnover. it simultaneously sup- ports an increase in educational and training efforts re- lated to self-care, worker well-being, service provision, and workforce sustainability. The clearer conceptual picture offered here provides a starting place for social work practitioners to assess their engagement in self- care and to establish a systematic and well-considered approach to effectively engaging in a comprehensive self-care plan. The framework provided may prove use- ful for students and educators to explore self-care in the context of socialization to the profession. doing so early on in this process may aid students in committing to engaging in self-care throughout their careers. The con- ceptualization is a lens through which supervisors and administrators may examine if and how organizational culture, practices, and policies ignore, discourage, or promote self-care.

a clearer conceptual understanding of self-care of- fers a strong foundation for future research in this area. The development of a reliable, robust instrument to measure frequency of self-care practice is needed to systematically investigate the utility of self-care. The conceptualization offered supports future investiga- tion of organizational culture and context to examine risk and protective factors for self-care among practi- tioners. This conceptualization, framework, and associ- ated measure(s) together could provide opportunities

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for not only self-evaluation of self-care practices by in- dividual workers, but also opportunities for agencies to systematically assess and address the self-care practices of their employees and the structures within the agency that support or do not support adequate self-care. addi- tional avenues for research involve the development and evaluation of education and training protocols designed to enhance self-care practices.

given the profession’s history, culture, mission, and where it is situated in societal institutions, there has been a long-standing gap in the overall emphasis on practitioner self-care. The recent increasing attention to self-care in the literature and in social work education speaks to a potential sea change in the primacy placed on practitioner self-care. by reframing self-care as a proactive and intentional process, instead of a reactive and ad hoc one, the profession can shift the very idea of how self-care fits within the culture of social work. With a shift in the profession’s values, attitudes, and norms that prioritizes self-care, as practitioners socialize to the profession, there is the potential to start from the place of an empowered, healthy workforce, rather than from the place of a workforce in need of healing. This frame- work and its underlying assumptions provide a starting point for this shift.

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Jacquelyn J. Lee, phD, lCsW, assistant professor, University of north Carolina Wilmington. Shari E. miller, assistant professor and director, Bachelor of social Work program, University of Georgia. Correspon- dence: [email protected]; University of north Carolina Wilmington, school of social Work, College of Health and Human services, 601 south College rd., Wilmington, nC 28403.

manuscript received: september 5, 2012 revised: December 26, 2012 accepted: January 4, 2013 Disposition editor: susan e. mason

Appendix. Template for Designing and Implementing a Professional Self-Care Plan Support Structure brainstorm strategies that will build

this structure to strengthen your professional self-care.

design a plan to implement the strategy. strategies should be concrete, relevant, attainable, and easy to evaluate.

Workload and Time Management

take small breaks throughout the workday.

after seeing each client, i will take a two-minute break to focus on my breathing.

Contain the amount i talk about work when i’m not at work.

after 6:30 p.m., i will not engage in work-related conversations.

Attention to Professional Role

recognize the client is the authority in his or her life.

each time i meet with a client, i will notice if i want to direct a client’s choices and reframe the situation for myself according to social work values.

identify my specific role when working in multidisciplinary teams.

at the start of each multidisciplinary team meeting, i will initiate the practice of having all participants identify their unique role and expertise within the group.

Attention to Reaction to Work

attend to sad feelings related to the experiences of the children of families to whom i provide services.

When i am feeling sad, i will find an appropriate way to honor this sadness (e.g., journal, supportive colleague) and remind myself of the clients’ resilience.

attend to instances when my work brings up my own trauma history or past stressors.

i will attend therapy once a week.

Professional Social Support and Advocacy

seek out regular supervision. i will initiate scheduling a regular 45-minute, one-on-one, supervision session with my assigned supervisor (e.g., Wednesday at 3:30 p.m.).

advocate for my own needs in my workplace.

i will contact appropriate personnel regarding organizational support for continuing education opportunities.

Professional Development

read materials relevant to professional development.

each week, i will read one scholarly article that relates to my practice.

attend a conference twice a year. at the start of each year, i will identify two conferences to attend.

Revitalization and Generation of Energy

Make my workspace pleasant. i will identify three ways to try and make my workspace pleasant for me and try them for one month before reassessing their usefulness.

remind myself of my passion for my work with something tangible.

When i am feeling discouraged, i will revisit a particular meaningful memento that reminds me of successful work with a client.

Note. The strategies presented are only select possible examples; individuals should construct a template like the one above, leaving blank spaces, to facilitate an individualized process for developing personal and professional self-care plans.

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Table of Contents (Course Calendar and Required Readings)
January 17-20

(case #0) Conflict on the Human Services Coordination Team

January 24-27

An introduction to decision cases and case method learning
Tips for discussing decision cases
(case #1) Inside or out

January 31-February 3

(case #2) Unusual appeal

February 7-10

(case #3) The board chair’s dilemma (A)

February 14-17

(case #4) He won’t go there

February 21-24

(case #5) Driven to drink

February 28-March 3

Using self in community practice: Assertiveness
(case #6) Conflicting agendas for the future of a youth agency (CNG No. 14)

March 7-10

(case #7) Second time around

March 21-24

(case #8) Gay-for-pay

March 28-31

(case #9) Why can’t they make this place more Jewish?

April 4-7

(case #10) Neighborhood agencies, businesses, and the city: BostonAgainst Drugs (CNG No. 17)

April 11-14

(case #11) Family business

April 18-21

(case #12) Private, dismissed

April 25-28

The first year: “I thought I’d died and gone to hell.”
A self-care framework for social workers: Building a strongfoundation for practice

PACIFIC INSTRUCTIONS All case analyses must include the *six* sections in the table below, although some instructors may require additional elements. Use headings to identify these sections in the case analyses. Required Components of Case Analyses
Introduction Briefly identify the major elements (i.e., who, where, what) of the case. Contextual Analysis Summarize internal and external issues that created or sustain the problem (i.e., why). Depending on the system level, these may include: cultural, economic/resource, political/legal, organizational, social, and ethical issues, interpersonal relationships, and intrapsychic and biological conditions. Use and cite professional sources (and include APA-style references). Problem Statement Give a specific and concisely written formulation of the problem to guide analysis and problem-solving. Not a question but a statement of the problem. Usually no more than two sentences. Alternative Strategies Identify three or more possible solutions to the problem. These solutions should be plausible, distinct and non-contingent (i.e., not interdependent). Briefly note advantages and disadvantages of each possible solution for addressing the problem. Recommendation Justify your preferred strategy, explaining why you selected that particular one, how it best resolves the problem, and how you will determine its effectiveness. Be sure your recommended strategy can be plausibly supported by resources available in the case context. Ways of Knowing Self-reflectively identify the source for your thinking about this case. For example, did you base it on previous experience, intuition, specific theories, personal values, authority, empirical research, previous discussion of similar problems, or something else?
Case Evaluation Matrix
Problem Statement	Contextual Analysis	Alternative Strategies	Recommend-ation	“Thinking like a SWer”	Writing Quality
Accurate, clear, specific, concise, and useful	Adequately addresses all important issues	Several distinct and appropriate strategies, with well-developed pros/cons for each	Explicitly resolves the entire problem	Reflects thorough problem-solving	Compelling, clear and interesting, with no errors

Running head: HE WON’T GO 1

HE WON’T GO 5

He Won't Go There

Diana Carter

University of South Carolina

Introduction

The case is an exceptionally great social worker, Calvin Ellis who is in a difficult working relationship with Ellen James because of perceived poor communication between them two despite working together. In addition to this, in spite the fact the Calvin does a great job according to Dr. Haines, Champion’s principal, he goes beyond the ethical provisions of his duty and finds himself in a compromising situation.

Contextual Analysis

The case is made up of a number of situations and events that mainly seem to revolve around Calvin. The champion school offers therapeutic and rehabilitative services to students expelled from other schools in Jackson County. Given the high rates of crime, poverty and the economic effects of the 2008 global recession, the county is indeed, in need of social workers who can help restore the goodwill of the country. Jack Thomas attempts this by replacing the missing social workers, and in the process, Calvin is hired to work closely with field instructor and liaison Ellen James and Julia Cathcart. As social workers, they are required to uphold certain values such as integrity, the dignity of people, social justice, and competence as well as adhere to policies of the social work program. However, Calvin being an overly concerned counselor pays a visit to one of the students, which is against the policy. The case is, therefore, about conflicting interests and an ethical dilemma of adhering to policies or disobeying some of the policies to check on the well-being of individuals.

Problem Statement

The problem with the case lies with Ellen James who feels misled by Calvin. The field instructor feels Calvin did not share factual and important information with her and she is unsure of whether to proceed on to hold Calvin responsible for breaching his contract or bury the situation since it was well intended.

Alternative Strategies

The obvious strategies that can be adopted to address the problem at hand are holding Calvin accountable for his actions since he has breached the conditions of his contract. Ignore the incidence since Calvin has been doing a great job and influenced significant change in Champion school or seek the opinion of third parties who are not directly involved in the case for unbiased judgment (Saleebey). The objective is to come up with the best strategy that lets every involved party win. Holding Calvin accountable for his misconduct discourage such and similar behavior from taking place in future but it would also result in discouragement of extending efforts to check on the well-being of students. On the other hand, ignoring the case would likely promote the unwanted behavior of Calvin in as much as it would also encourage his efforts to change the society.

Recommendation

In a case like this one, the solution is to find a solution that works best for all the involved parties, that is, Calvin, the field instructors (Ellen); school’s principal, Dr. Haines; Trina Brown, Julia and the interests of the school. With this in mind, the best solution would be not to make Calvin answerable for the actions but to provide warning and encourage transparency for purposes of facilitating a great job in the school.

Ways of Knowing

This solution has been based on a combination of numerous factors including personal values, findings, and suggestions from empirical research studies, specific theories, and intuition. It is an extensively researched and well-thought-out strategy that applies to suit the interests of all parties involved in the case to make it a win-win situation.

Work Cited

Saleebey, Dennis. The strengths perspective in social work practice. Pearson Higher Ed, 2012.

Wolfer, T. A. "An introduction to decision cases and case method learning." Decision cases for advanced social work practice: Thinking like a social worker (2006): 3-14.

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