Communication Fosters Belong

There has been some focus on adding a "B" to DEI, with the "B" standing for belonging. While some feel that inclusion includes belonging, others feel it needs specific attention. I can see the argument on both sides. However, with all the conversation around belonging, there seems to be a missing piece at the organizational level. Communication. 

I see organizations talk about belonging, but there is a lack of communication within many organizations. To help staff feel included and that they belong, there must be communication across all levels of the organization. When front line staff receive information last minute or they have to get information from outside sources, this hinders efforts to foster belonging. I've seen leaders keep information, neglect communicating information, and wait until the last minute to communicate. "Good communication is the bridge between confusion and clarity"- Nate Turner. Leaders need to be intentional about communication and information sharing because it is a foundational strategy to foster belonging. Through communication we increase inclusion and foster belonging; we communicate with those 

To improve communication, organizations need to stop:

🚫 hoarding information, 

🚫 centering knowledge,

🚫 delaying communication,

🚫 forgetting to send things out, 

🚫 neglecting communication. 

If staff are valued, then communicate. 

Do we really want parity?

 

You have heard it before - we need parity for mental health and physical health. There is even federal law that mandates insurances do not impose less favorable benefits for mental health treatment. So why do advocates still say we need parity?

Hot Take: it's not parity people want. 

Yes, people want parity in regard to payment. The United States healthcare industrial complex is big business. It is natural that mental health entrepreneurs, leaders, and providers want a piece of the action. There are many benefits for rates that are par with physical health including a more livable way for providers in the community mental health system and improved sustainability for those working with the most difficult to serve clients. 

What I don't think advocates want are the number of other things that are commonplace in physical health. We hear the horror stories of doctors not getting certain procedures approved by insurance companies and while denials happen in the mental health space it is different. With the increase in value-based care, are mental health providers ready for a reduced rate when their client is not improving? What happens when clients do not improve at the expected rate? When a client is denied hospitalization due to a 30-day readmission, what will the mental health system do? There are even more adverse implications when we talk about SUD treatment.

Parity with physical health could mean more capped sessions or dictated treatment modalities. It could mean manualized treatment and decreased provider autonomy to allow for a more robust response to client need. Parity will require some tradeoffs and those tradeoffs can fundamentally respace how mental health treatment is delivered. 

I don't know every situation and I am not saying parity is not needed. I do think the use of the word parity in advocacy efforts has become more rhetoric than getting at what people actually need. Fundamentally, mental health treatment in this country needs to be valued, funded, and appropriately compensated for what it is. Healthcare in the United States does not work for so many people. We shouldn't base our desire for parity on a system that puts profit over people. We need to question the terms we use and clarify what we mean. 

A Problem with the Profession?

Well, Social Work Month 2023 has come and gone. I had intended to post during the month, even toward the end of the month I thought "Oh I need to post something". Yet here we are. 

I am writing today to share a thought about the social work profession. Maybe not the profession so much as those coming into the profession and a trend I've noticed in my small corner of the world. By no means am I saying this thought is research based or has empirical evidence to support it. 

TW: Unpopular Opinion 

I am sure we have all noticed a trend that people are entering social work to go into private practice. I think it has been gaining traction for the past decade with more and more students saying their goals are to go immediately into private practice post-graduation. Some are even interning in private practice settings. 

I am not trying to bash on private practice, but what I see in this trend is kind of this shift from why people  are entering the profession. We have gone from this outcome focus to a more activity or process focused. Sure there have always been people who enter the profession because they "want to help help people", but we use to hear words about "change" and "justice". Now we hear people say "I want to go into private practice" or "I want to be a therapist". These are things social workers can do, but therapy or private practice is not really an outcome. 

My MSW program application required a purpose paper. I wrote about my desire to work on making organizations just - not organizations that work on social justice issues but organizations that are just in the the way they do business. That is more of an outcome that drives my work. 

I think the difference is subtle, but powerful. Our profession seems to be losing it's foundation and I think this has something to do with it. 

Missed Opportunity for Allyship

I recently applied and was interviewed for an Executive Director job which my career has been leading up to. I did very well in the interview. I was humble, competent, and committed to being honest. During the question, there were a few pointed questions about certain experiences I had not had because I had not had the opportunity to form those experiences. My response was that "everyone has there first day on the job" and I explained how these are skills that can be learned. 

I did not get a second interview. I was never informed that I was not going to get a second interview although I though I did an excellent job in the interview. There was someone I knew as part of the selection committee. This person unofficially let me know that I would not be getting a second interview and kept me updated on the process. 

They eventually selected a candidate. I was never informed that I was not getting a second interview or anything. I even sent a thank you card!

As I reflect on this experience I am angry. I am hurt. I am frustrated. I have worked extra hard my career to prove my abilities to people in power who just have a lot of assumptions about me. I have worked hard to curate a variety of experiences to set me on a track for advancement so I can have a bigger impact. None of that was recognized in my interview. What this person shared with me about my interview was that the committee liked me and wished they had a job for me, but I was "not ready" for the job I was applying for. For the sake of "fairness", this person did not challenge what the committee said. 

After the second round of interviews of two white females, the board chair really advocated for one over the other. The board chair also mentioned that while the candidate he liked lacked some skills, she could learn that and everyone starts somewhere. The person I knew. did not challenge this. He did not even draw a parallel to what I said in my interview that the board chair is now using to help justify his position. 

It is interesting that minorities are held back because they may lack a specific experience, but a white person is given the grace and it is recognized that they can gain the experience. A person with marginalized identities has to be better than good. They almost have to be overqualified to be considered remotely qualified for a position. 

I am not saying that the person who they picked is not qualified or should not have been picked. This has nothing to do with that person. I am trying to figure out - what can be learned here. I think this is a lesson in allyship. The person I know had the opportunity to challenge the other selection committee's thoughts about my abilities, but that person chose not to. Not maliciously - there was a thought to make things "fair" for the other candidates. However, we live in an unfair world and because of my intersecting identifies I am not seen as competitive or equal to white candidates. I could have amazing experience, but that experience is not seen as valuable or equal. My skill set is not the "right" combination or as good as the white candidates. 

If the person I know chose to be an ally, I do not think the outcome would be any different. I do not think I would have been offered a second interview. I do not think I would have been offered the job opportunity. Allyship is not always about changing people's minds or creating opportunities, sometimes it is hyping up someone with marginalized identities when they are not in the room. It can look like challenging thoughts about their skills and experience. There is too little representation at top positions for people to believe that a non-white person can do the job when they don't fit the exact mold. 

Again, while I am significantly disappointed about the experience and feel anger, this is not about the feelings. My feelings are valid and I can feel them. What I am calling attention too is the lack of allyship and why it is important. 

Whenever and always, white people need to be an ally for people with marginalized identities. The system is biased against them. Neutrality or trying to be fair always favors the status quo. 

DEI: Are You Listening?

I am not a DEI expert. I identify as a cisgender, gay, Latino man. In addition to having a bachelor’s and master’s degree in social work, I am a certified diversity professional. These do not make me an expert in DEI. I work in the area of health equity; I provide leadership and resources for behavioral health authorities to address health disparities in their communities. I firmly believe that DEI is a part of and a strategy to effectively address health inequities. 

While I am not an expert, I do actively learn and participate in the DEI space. Something I have noticed in the discourse on DEI, is the emphasis on hiring a more diverse workforce. Yes, we should be doing this. Absolutely. No arguments here. Yet, we don’t talk about an important area of diversity because the people leading the conversation do not readily identify with this segment of the population.

Who are these people who are often excluded from certain positions? It’s the quite people. The introverts. The people who are not loud and boisterous, but soft spoken and contemplative.  The people who may not have the charisma but are still able to lead from a place of authenticity.

There are many talks on introverts in leadership:

Angela Hucles – Why We Need Introverted Leaders

Simon Sinek – How to Leverage Being an Introvert

Carol Stewart – Introverts Make Great Leaders Too

While we are breaking away from the dichotomy of introvert vs. extrovert, a lot of our knowledge still centers around it. Barry Smith has said that ambiverts, those who fall in the middle of introverts and extroverts, make up about 68% of the population. Popular beliefs seems to still hold that if you are not an extrovert than you are an introvert.

So, what does this have to do with DEI?

I’ve heard from interviews that they were looking for someone to “take charge” of a room. That is not my style. I want to observe the room, learn who is there, and listen to what people are saying. “Taking charge” sounds like white supremacy culture and that’s what I want to actively dismantle.

Far too often those traits we are looking for in potential candidates, those traits outside the job description, hinder the potential pool of applicants. Not redefining your beliefs about leadership can curtail view of who can be a leader; it can hinder possibilities. I am not saying that charismatic leaders should be overlooked. Reverse engineering leadership to focus on traits more related to introverts is not the answer. To be clear, if we do not interrogate our beliefs about leadership and expand our views of leadership than we are overlooking quality candidates. 

Soft spoken does not mean weak

A continual critique I receive is that I am quite/soft spoken. It is an odd critique because some people are just naturally boisterous, and others are soft spoken. Concerns have been verbalized about my ability to lead because I am soft spoken and will be perceived as not confident, unknowledgeable, or incompetent. I am also not very talkative; I am an internal processor. So this comes across to some as disinterested or aloof. It amazes me that people would rather have an unknowledgeable, confident person who speaks loud and often than a knowledgeable person who is soft spoken but displays restraint and confidence. I’ve actively worked to reframe my perceived weaknesses as opportunities to quite the room and listen. I choose fewer words because what I say is meaningful and matters. I do not need to be loud or over speak because I am confident in what I am saying.  

I encourage those in the DEI space to become allies to those potential leaders who are introverts and soft spoken. Don’t just listen to the loudest ones in the room. Actively listen to and support those who are overlooked. It’s time to quite the voices of the loudest in the field to make room for those who are not as loud or charismatic – so their voices and perspectives can be heard. DEI, are you listening?

Thoughts on Social Work Licensure

I will preface this with I do have some bias. I am a licensed independent social worker in Ohio with supervisory designation. I have past the BSW and advanced clinical ASWB exam on the first time without studying. I have provided training supervision for several social workers getting their independent licensure exam and have had success in supporting them to pass the ASWB exam. 

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On Monday I listened to a panel on social work licensure that was sponsored by ACOSA. I had a number of issues with the panel. The majority of participants presented as White. One participant identified as bi-racial (Black and White). The panel also really didn’t give a strong voice of why social work licensure is beneficial with the focus of it being “bad”. Another issue is a sort of picking and choosing what is gatekeeping and what is not. There was an emphasis on how licensing is gatekeeping – which I agree – But there was not recognition that getting a college degree and having to be accepted into a major along with a certain GPA is also gatekeeping. I am not saying that the panelist do not believe that, but fundamentally gatekeeping starts at getting the right degree. From experience, I would add as a social work professional gatekeeping also involves going to the “right school”. I didn’t attend a prestigious social work program. I received by undergrad and graduate degree in social work form the University of Toledo where I was trained in an advanced generalist model. I have the highest social work licensure in my state and regularly give back to the profession. Often, I am not recognized or do not get a platform because I did not graduate from somewhere like Case Western or The Ohio State University. That’s a different topic of a different day, but it seems inauthentic when the “elite” social workers discuss professional gatekeeping when while practicing it themselves.

As I consider licensure, I reflect on the questions “what social work activities need to be licensed”? Obviously, not all of the things social workers do require a license. If social workers did not provide psychotherapy would a license be necessary at all? A point during the panel that was touched on several times was that social work is about relationship building. If social work can be distilled to relationship building, then we do we need a license or even a degree. There are a number of things that social workers are trained in, but if it just comes down to relationship building there are many other professions that can do that.

Maybe it is our social justice orientation that makes us a distinct profession? I choose social work because I wanted to see systems that were just. However, a lens of social justice or even a focus of social justice does not necessarily require a license. Training through an organized curriculum, probably – but a license to practice, I don’t think so.

So, what are the benefits to social work licensure?

• It creates a scope of practice that distinguishes us from other disciplines.  Losing the license would also likely mean losing that scope of practice which may be similar to other professions.
• There is a body to contact (licensure board) when a social worker practices outside of that scope or unethically.
• It creates a requirement for continuing education. While professionals should constantly be learning, I have met more social workers than I care to count that have forgotten to engage in continuing education to complete their continuing education requirement. 
• Finally, it adds legitimacy. Now we can argue about the extent of the legitimacy, but a license at least creates a framework for legitimacy.

The panel discussion seemed to argue two things simultaneously which seemed to weaken both arguments. First there are significant and valid issues with the ASWB licensure test so some are calling for the abolition of that test and some alternative route to licensure. Arguing the invalidity of the test (and it may very well not be a good measure) and establishing an alternative licensure route at the same time seems a bit contradictory. An alternative pathway to licensure may be beneficial, but it brings us back to asking what is the point of licensure and what are we trying to establish with it.

I am willing to engage in more conversation on the issue and I am very open to hearing from other perspectives. These are just my thoughts upon reflecting on Monday's panel discussion. 

Quick Fix to the Opioid Epidemic?

USC Researchers Suggest a Quick Fix for America's Opioid Epidemic

There is no single solution to the opioid epidemic and the solutions are not easy. However, this article shares research suggests a solution: notifying a doctor (medical doctor) when their patient died from an opioid overdose. They found that doctors who received a letter had a quicker rate of reduction in prescribing opioids. They argue it is a simple, quick solution to that can have a long term impact in the fight against the opioid epidemic. The full article is linked above.