Town Halls, Conversations, and Panels Oh My

During the pandemic, I was able to moderate and organize some great townhalls/panel discussions on some timely topics. Check them out!

The first panel I was a part of was entitled Staying Connected: LGBTQ Resource Beyond COVID-19. It was put organized by the Toledo Lucas County Health Department and Equality Toledo. I got to share some tips and information on mental health during the pandemic. This event was covered in the local news. 

 

Next was a panel I organized and moderated for the Social Justice Subcommittee of the City of Toledo's Human Relations Commission. The panel was entitled Promoting Wellness for Youth of Color and focused on ways parents and professionals can support youth's mental health. I think this went so well and even got some good coverage in the local newspaper. 

 

In October I helped to organize and co-moderate a panel with the Toledo-Lucas County Health Department and the UT Opioid Task Force. This was entitled Community Conversation: A Panel Discussion on the Opioid Epidemic. The goal of this event was to help raise aware of the current state of the opioid epidemic and provide resources for families and friends with loved ones with opioid use disorder. 

Finally, I helped to organize Color Me Latino: a conversation on anti-blackness in the Latino Community. This was with the Social Justice Subcommittee of the City of Toledo's Human Relations Commission and the Latino Alliance of Northwest Ohio. While I wasn't on the panel or moderating this event, I helped to identify panelists, develop questions, and interact on Facebook to help promote the event. The goal of this panel was to raise awareness on the issue of colorism and anti-blackness in the Latino community and to start a larger conversation around the issue.

 

Free CEUs

 I often am asked about getting free CEUs or continuing education units. There are probably a lot of places to get free or low cost CEUs, however I think of the continuing education process as an opportunity to grow professionally and not just a requirement of the license. 

During the pandemic, several organizations offered (and are continuing) to offer free, quality CEUs. From topics on telehealth to ethics to much more. I have even been able to take part in some of them such as an ASAM training through The Ohio State University College of Social Work. I don't know if this trend will continue into 2021. 

By being a member of NASW Ohio, social workers can receive all their CEUs for free through monthly trainings. These trainings are live, but are recorded for later viewing. While they really free because the membership to NASW costs money, it is a very valuable perk of membership. Free free to check out NASW Ohio for more information and to become a member. 

Free State Social Worker is a site that offers CEUs at a cost of just $5 per hour. I have not obtained any CEUs from them, but a colleague of mine mentioned them so I thought it was worth saving. 

eBased Academy offers completely free CEUs. I have taken advantage of these before and they are well designed and thought through. The site is operated by the Ohio Department of Mental Health & Addition Services. These courses are great for social works and addition professionals. 

There are probably others who offer free CEUs on a regular basis. 

Again, I believe social workers should think of continuing education as an opportunity to learn and grow professionally. They should consider areas of weakness, emerging issues, or issues already cultural competency to fulfill these requirements. While have a wide range of CEUs may meet the renewal requirements for the licensing board, it does little to help the social worker grow. I would encourage any social worker to consider their continuing education as they consider their professional goals for 2021. 

#BlackStressMatters

On November 20, 2020 I gave a talk for the YWCA of Northwest Ohio as part of there racial equity series. The talk was entitled #BlackStressMatters Understanding & Responding to Toxic Stress through Trauma Informed Care. 

It was on Zoom webinar and also streamed on Facebook Live. If you're interested check out the talk. 

My Experience Part II

Forest Bathing ~ Forest Therapy Continued...

Our next activity was to walk around and pay attention. There was no specific path so we each went our own way. The instructions were to just walk around and notice different things. We were given a magnifying glass if we wanted to observe things more closely. We walked in nature and paid attention for about 20 minutes. We weren’t supposed to “study” anything or thinking about the more scientific aspects of what we were looking at. We were just to notice and appreciate it for what it was. For example, if we say a flower we were instructed to just observe and appreciate it for what it was without considering what the exact name of the flower was.

I liked this activity a little more than the previous because I got to walk around. I took time to notice leaves and even little bugs on the leaves. I noticed where the leaves had eaten the leaves. I noticed trees and the areas with tall grass. I wouldn’t say it was necessarily relaxing, but I did notice things that I wouldn’t normally notice if I was just at the park.

After this experience, we got back together and shared about the experience. Again, I did not have anything to share.

The final experiential activity was to find a “sit spot”. The facilitator described this activity as sitting in a spot and letting the surrounding tell you a story or lead you to ask what if questions. She suggests doing this activity frequently and described how she had a “sit spot” where she would go out frequently for several weeks/months (I don’t exactly recall) and let nature just give her a story. We were given a piece of paper and a pen.

I found a bench and stared out in the distance for about 20 minutes. I struggled at first. I was getting antsy and ready to go. I was anxious that nothing would come to me. However, I noticed a broken branch and thought about broken bones. I wondered what if we processed pain differently? I also wondered what if physical pain wasn’t intrusive with our thoughts? This about how we would function if our pain wasn’t a limitation and we didn’t obsess over it or it didn’t overtake our thoughts. As I continued to sit there, I looked at the trees and how the light came through. I heard the breeze blow through the trees and the following story came to me.

The wind ruffles the leaves of a tree.

The leaves reflect the light as they move.

It reminds me of a disco ball.

Other tress rustle as the insects and birds add their music.

The tall grass dances as the butterflies’ fly.

I don’t know why I thought this or what it means, but that is what came to me.

After the activity, we came back together and shared. I chose not to share because I did not want to extend our time together. Myself and my colleague were ready to go.

Overall, I’ll say the experience was interesting. I like nature but would not consider myself a nature lover. I believe that some would benefit from the experience, especially those who need to go to a space to be mindful or those with a nature intelligence. I think if I went with a bigger group the experience would have been different.

Would I recommend Forest Bathing? Maybe.

There was a cost and for me the cost was not worth the experience. It is a very privileged activity because you have to pay a facilitator to do something that is essentially free. I do recommend getting out in nature, but this could be accomplished independently with just some mindful activities. If someone is naturally attracted to nature and has the funds, it may be a good experience for them.

Intellectual Bravery

Forbes posted an article entitled To Foster Innovation, Cultivate a Culture of Intellectual Bravery. I'm very interested in organizational culture because it really does make or break an organization. I recall my graduate school admission essay I wrote about my desire to create socially justice organizations. In my mind, this goes beyond the work product of the organization by focusing on employee wellness. I believe there are a lot of organizations out there who work towards justice, but their internal work doesn't always reflect that value of justice. I digress...

The author describes 7 ways to create intellectual bravery. The first of these steps, "take your finger off your fear button" (Clark, 2020). This is not about an individual's fear, but the fear a leader creates within a team or organization. Leaders must be aware of ways they can create fear and actively work against that. Fear can thwart progress and can cause team members to be silent and self-censor. In my mind, the opposite of creating fear is modeling vulnerability, which is the final step. 

No one wants to be vulnerable. It exposes us to the possibility of harm or loss. It requires self-awareness and the ability to expose our imperfections. Part of advanced social work practice requires the social worker to engage in reflective practice. This practice of reflection positions us to allow ourselves to be vulnerable. 

Intellectual bravery is needed organizations. Social workers are well trained to see the entire eco-system and understand how decisions can impact the eco-system. We live in a society with very complex problems and the solutions to those problems are layered and complex. The issues facing our communities require innovation. We need intellectual bravery so we can "think outside the box"; so we can address systems of injustice. 

As part of my leadership coaching, I have been encouraged to speak out more and share more. I am an internal processor by nature, but part of it is because I don't want to sound dumb. It's partly fear on my part with my own false narrative that people want to see me fail. I have been challenging myself to talk more in meetings, share my ideas (even if they are incomplete), and be vulnerable to say I don't have all the answers. I want to collaborate and to improve my thoughts by hearing from people who think differently than me. I am in spaces where it is not always safe to practice intellectual bravery, or at least I don't perceive them to be, however being brave requires that I challenge myself to practice that vulnerability even when it's not safe. 

I hope leaders can start cultivating a culture that embraces intellectual bravery, but even in our own spaces we change chose to practice bravery. 

Ready for Change?

At a private practice meet-up recently we were discussing the difference between people going to community mental health and those seeking treatment in a private practice. The first point someone brought up was a difference in payment. This person felt that in community mental health most clients aren’t paying for a service so they may not be as invested while in private practice there can be things like co-pays and deductibles. I think this is a valid point considering so many people going to CMHCs are on Medicaid and do not have to pay for services. To be clear, I don’t think paying for a service automatically makes a person more invested, but I do think for some it does.

When going to a CMHC, a lot of people have a lot of psychosocial issues or issues around the social determinants of health. Housing, employment, transportation, childcare, the list can go on and on about the challenges people face daily. These issues can present obstacles for people to engage in treatment.

We are familiar with the stages of change model. Here is a quick reference and a visual if you are unfamiliar.

It appears to me that we tend to believe that clients who come into a community mental health center are at that action stage of change. Why would someone make an appointment and then show up to an appointment if they are not ready for change? It seems logical, but that may only be from our frame of reference. A client coming into an agency may still be in the preparation stage. The task in the preparation stage (I’ve seen places call it determination) is to find appropriate strategies to help make the change. Looking at a website on an agency or research information on treatment is definitely part of that preparation stage, but I would argue that making an appointment and keeping that appointment is also part of the stage.

When I worked in psychiatric crisis, I would educate patients and families on the art and science of therapy. While it is based on science, we naturally do not “click” with everyone. If a therapist is assigned that doesn’t mean they are the best fit. It’s ok to change the agency and the treatment provider. From my perspective, an individual finding treatment provider they can work with is all part of the preparation stage.

If a client comes to you seeking services it may be that they are ready, but they may not be ready. This really speaks to the need to develop motivational interviewing skills for all staff. Reception and intake staff can start to recognize change talk and help enhance motivation. We need to do better at meeting clients where they are. That includes fully recognizing where they are in the stages of change.

Forest Bathing/Forest Therapy- My Experience Part 1

A few weeks ago, I tried forest bathing. If you aren’t familiar you what forest bathing or forest therapy is check this out (https://www.webmd.com/balance/news/20190611/forest-bathing-nature-time-hot-health-advice). Over the past month, several people have mentioned this to me and I was exploring it with a social worker I provide training supervision for. He found a local, certified guide and we scheduled our experience.

We met the facilitator and she seemed what you would expect. A nature love with overall shorts, a flannel shirt, and no shoes. She had introductions and she gave us a quick overview of our time together. We walked into the park and found a spot just off the trail.

Our first activity was a series of invitations. We stayed in this spot and experienced it with out senses. First our sight, and then we closed our eyes and listen to and felt the nature around us. We could move around however we felt appropriate like swaying or such. This lasted about 20 minutes. At the end we were encouraged to turn and find the direction that “called” us. Once we felt that direction we could open our eyes and contemplate why were we drawn to that direction and what could we learn from it.

Honestly, I didn’t feel called in any such direction. I did, however, chose a direction that was different than when I closed my eyes. I chose that direction because it was where I was able to feel the sun on my face. When we began, I was looking into trees and it was dark yet peaceful. This new direction was grassy and sunny. Maybe I did feel drawn to that direction, but I’m not sure it taught me anything.

After these invitations we sat on the ground and were encouraged to share our experience. Neither me or the individual I supervise really shared anything. He may have said something; I don’t completely recall. I know I did not say anything. Specifically, I remember shaking my head instead of actually saying I did not have anything to share. The facilitator didn’t prey anything out of us, which was nice. She did state that sharing was not required, and she maintained that throughout our time together.

To be continued…

Meeting Clients Where They Are

It was a common expression in social work school to "meet a client where they are" or "start where they client is". What does that really mean though? I used to think it refer to our language and how we spoke to those we worked with. We want to avoid professional jargon and use words that are readily understood. It also meant something else that I am struggling to find words to explain. This seemed to be an idea that was more assumed than practically taught. Over the years, I believe I've developed a more practical understanding of what it means to meet a client where they are. 

Home

This seems to be the most logical place, but it didn't dawn on me until I was in training supervision with a social worker who really believed in and practice home-based therapy. She explained that a client's home was really the place to get a better understanding of the client in their environment. It also cuts down on transportation issues which always seems to be mentioned as a top barrier to treatment. We can meet a client where they are by physically going to their home (however they define it). 

At least in my community, we seem to have a philosophy of build it and they will come. As we now see this does not work when their is a national pandemic. We need to be more mobile and flexible in how and where we meet clients. Telehealth has been great, but it's not for everyone. There are accessibility issues around technology that 

Then there is the ongoing issue of social workers just not wanting to do home-based. We need better advocacy and attention in getting social workers out into the community. 

Office 

Sometimes the home is not a space place for clients so they need to go to the office for services. We need places where we have control so we can make them safe for our clients. Not everyone client will feel comfortable with a social worker in their home. There is definitely a balance of home-based and office-based that needs to be made. 

But, can our offices meet clients where they are? I believe so. 

Include things in your office that reflects an element of the personal. Your office shouldn't be cold and sterile, but should help a client connect with you. It doesn't have to be a complete disclosure of your life, but some element that helps reflect who you are as a person. 

There are some cultural considerations to make here as well. If you work with a lot of Latinx clients, consider having some cultural elements reflected in your office. If you work with a lot of LGBTQ folx, consider having elements that reflect this group. Having elements in your office can help clients connect with the space and with you. 

Presentation

Recently in a supervision group I lead, a social worker said that we need need to present how the client feels comfortable. This makes total sense, but I don't think we often consider that in meeting a client where they are. Obviously, well maybe obviously, presentation includes our body language and attitude. We want to present in a way that is open and warm, and gives our full attention to the client in the moment; really to be present with that client. However, it could include the clothes we wear. Wearing clothing that reflects the client's comfort. If the majority of your clients are business professionals and wear that type of clothing then a social worker may do better in a suit and tie, but if the clients a social worker is working with are not wearing what society deems as professional attire then the clothes social workers wear should be more reflective of what the clients they are seeing wear. 

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Starting where a client is and meeting them where they are has to be more than lip-service. It is a multi-faceted approach. Social workers need to consider all they ways this can be done. I've listed a few here that just gives a deeper perspective than the often overused phrases. Social work schools need to consider how they are preparing the workforce to go out into the community and see clients in their homes. Insurances need more robust reimbursement so social workers can go out into the communities where their clients live. We have to move beyond office-based and utilize all the ways to meet the client where they are. 

Identifying as a Professional Social Worker

The Counsel on Social Work Education has developed Advanced Social Work Practice in Clinical Settings. I find this super helpful when providing supervision for those working on their independent license because it helps differentiate between advanced social work competencies and basic ones. 

Under Educational Policy 2.1.1- Identify as a professional social worker and conduct oneself accordingly, the first advanced competency is to readily identify as a social work professional. I've been thinking about this for some time because on first glance, the competency seems to repeat the educational policy. The clear distinction between the two is the word readily. 

I didn't want to take the time to define readily because I think that often times it is used to add some length without adding content. In this case however, a simple Google search defines readily as without hesitation or reluctance. This provides more depth into this competency of readily identifying as a social work professional. 

Often times, I see social workers identify themselves as anything but a social worker. I often hear the terms therapist or clinical therapist for social workers in private practice or other mental health settings. Some social workers tend define themselves by their role or job description such as case manager or discharge planner. This begs the question, why? Why do social workers not say they are social workers? There are probably a few reasons. 

1. Describing Role

    Let's be honest, the public can be very confused by what social workers are and what they do. Sharing the primary job function may be helpful for someone a social worker is working with to understand what they are doing. A social worker may enter a patient's room and identify as a discharge planner to allow that person to know that they are there to to plan for discharge. It can also help a person understand the difference between their case manager and therapist who may both be social workers. 

2. Stigma

    Another reason social workers may not readily identify as a social worker is because there is some stigma within the profession. Perhaps people do not want to associate with the profession or know that some people do not think highly of social workers, so they say they are something else. Social workers often get a bad reputation by some who misrepresent themselves as social workers. Some people believe that social workers just take kids away or refer people to resources. To not associate with the negative views toward the profession, some may feel it's better to say something along the lines of what they do. 

Readily Identifying...

As someone who provides training supervision, this is a topic I like to bring up with those I supervise. It is an advanced competency, but as a professional social workers who do quality work I want those I supervise to be proud of being a social worker. I challenge them to say "I'm a social worker who provides therapy" rather than just identifying as a therapist. Even in my personal life I tell people I am a social worker knowing they will automatically think I work directly with clients. I want to help the public understand the depth and breadth of social work so I explain that not all social workers work with clients and that I work in administration. In all of my roles I am a social worker first. Some jobs we take as social workers may be appropriate for many different types of professional backgrounds, however if you have a social work education you bring that with you to any job. 

As professionals, we have a responsibility educate the public and other professionals on the profession of social worker. I am an ambassador for the profession and need to conduct myself accordingly. We can help reduce stigma against the profession when professional, competent social workers readily identify as such. 

A Hard Pill to Swallow

I've been contemplating on supervision and the difference between clinical supervision and training supervision. Training supervision (in Ohio at least) has really been for social workers working towards obtaining their independent license. Although training supervision should really be for anyone who is seeking to work on developing a new skill/area of practice.

Clinical supervision on the other hand is really a requirement for those practicing with a dependent license. Ohio Revised Code 4757-21-02 defines social psychotherapy as needing supervision which includes the diagnosis and treatment for mental and emotional disorders. The Best Practice Standards in Social Work Supervision development by NASW and ASWB provides a good description of what supervision is for the purpose of the discussion of clinical supervision. In a nutshell, clinical supervision clinical supervision refers to the responsibility someone with an independent license takes to ensure practice by those with dependent licenses is ethical and follows appropriate practices; the clinical supervisor is taking on responsibility for the practice of another licensee.

I hear many social workers say that they will use their clinical supervision hours as part of the training supervision needed for obtaining an independent license. I do not this this is totally inappropriate. However, the clinical supervision has to have their supervisory designation in order to do training supervision and this plan should be discussed prior to the licensee planning to use these hours in this way. Clinical supervision and training supervision are different. Clinical supervision is necessarily about your development and may not prepare you for an independent license.

Qualifying for an independent social work license is not an entitlement. Not everyone with a graduate social work degree should be an independently licensed social worker. The training supervision requirement is preparation for independent license and should challenge the status quo of practice. It should prepare the licensee to advance their practice; it is not about developing basic skills. Clinical supervision is a job requirement and the clinical supervisor may not have the time nor the skill to attend to a licensee's advanced skill development. Going through the motions of supervision isn't enough, a licensee needs to be actively trying to develop and advance their skill.

Training supervision is an opportunity to challenge yourself and grow as a professional with the goal of being ready for independent social work practice. In Ohio, they are currently re-evaluating the rules and in the future training supervision may be more prescriptive. It is vitally important for licencees to take this time seriously as they prepare for an advanced license and supervisors need to consider their responsibility as gatekeepers for the profession and those individuals the social worker will work with.

Graduating Social Workers

It's May and another group of BSW and MSW social workers will graduate and soon enter the field of social work. It is usually an exciting time, but I am sure there is anxiety due to the uncertainty that the COVID-19 pandemic has caused. May is usually a month for celebrating a major life accomplishment, but lots of celebration has been postponed.

I have been reflecting on my MSW graduation. There were difficult times for my class because it was the year we had a lot of snow and the university closed a lot and school-based and other internships repeatedly closed. Several of my classmates were stressed with not knowing how to complete their hours. I think that stress is nothing compared to what the 2020 graduates have experienced.

In an effort to support new graduates, I am moderating a virtual career panel with experienced social workers to provide some helpful advice as new grads seek employment during a pandemic. I am not sure if anyone will even register, however, I am excited that I am doing it and I am excited that several great community leaders are helping by serving on the panel. I've never done this before so I do hope it is helpful and that new social workers find some value if they choose to participate.

Online CBT Reduces Suicidal Ideations

In continuing the discussion on evidenced based practice, the following article came into my email recently.

Online Self-Help Tied to Less Suicidal Ideation 

https://www.medpagetoday.com/psychiatry/depression/86203

As people are accessing more online interventions, especially during the COVID-19 pandemic, it is important that social workers explore the effectiveness of these tools before recommending them to clients. Although research may be limited because a lot of these tools are new and emerging, that does not mean we need to completely wait before recommending them to clients. Understanding what evidence there is, understanding what science these tools are based on, and properly educating clients on the tools are important steps before just sending the client away with whatever tool it is.

The article states, "what was surprising was the majority of the web-based therapies were self-guided, but still effective" (Monaco, 2020, para 5). Self-guided, web-based cognitive behavioral therapy can be an effective form of therapy. I don't think web-based interventions, especially self-guided, will every completely replace in-person psychotherapy. There is something powerful to be a physical safe space where there is no judgement and one is able to bare their soul so to speak. However, it is another tool social workers have to offer clients with some evidenced behind it.

Gaps In Service

My previous posts seem a little more on the "academic" side of things, so I wanted to write something that is more of an opinion piece. After reading, please share your thoughts and perspectives on the issue as well. I am not married to the opinion...yet, so feel free to try and change my mind on the issue.

Today, as the title states, I wanted to discuss gaps in service. Not a specific gap in service other than an example to illustrate my point, but rather the overall concept. I often hear the term gap in service thrown around when social workers do not find a particular resource for a client; whether the would-be resource is sustainable or not.

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Example

Every now and then I am asked about detox services for youth in my county. There aren't any. One time in 2019 someone called me at working asking about this service. I explained that it was not available in county and provide some resources throughout the state and that insurance should be contacted. The caller stated that this was a gap in service and my employer needed to do something about it. I work for the county's behavioral health authority. I explained that in the time I worked there, this was one of two calls I had gotten about the service and that if she had data to back up the need I would love to talk more about it. She explained that people asked her all the time about detox for youth so I encouraged her to keep track so we could have some data. She hasn't called me back.

Recently there was a Facebook post asking about detox services for youth. There were several replies all saying basically the same thing; there aren't any. The original poster replied, "it seems this is a huge lack of resource in the community". Again with the gap in service.
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When a resource isn't available does it automatically become a gap? From a micro perspective I get it; a social worker has a client who needs a service that simply isn't available. From a macro perspective I struggle with this. How is a gap in service determined when no data on actual need is available? How do public and private agencies fund a service when known needs go unmet due to lack of funds? How is a service sustainable when only a relatively small number of people need it?

Data is really paramount in determining need. That "one client" isn't enough to change or develop a new system. We need more than anecdotal accounts. Data helps identify and substantive the need along with helping to determine how to plan to meet the need. The NASW Code of Ethics talks about the need for social workers to engage in social and political action to ensure that people have equal access to resources, employment, services, and opportunities that help them meet their basic needs. We live in a data driven world and to be able to effectively advocate for change we have to have the data that speaks to that need.

Just calling something a gap in service is not doing anything to fill that gap or increase opportunities for people in need in the future. As social workers we need to recognize the gap, collect data on the need, and then advocate for change. 

Evidence-Based Practice

I recently read an article entitled Where Is the Evidence for "Evidence-Based" Therapy by Jonathan Shedler (2018). As the title implies, the article focused on therapy. The term evidence-based has become almost synonymous with manualized therapy which most often more scripted forms of cognitive behavioral therapy. Shedler points out that while it is accepted that evidence-based therapy is better than other forms of psychotherapy, this is not always the case and empirical research shows weak results for evidence-based forms of therapy. It is an interesting article and I am not here to offer a critique, but it did make me this about the state of evidence-based practice and what it all actually means.

I recall being in my BSW and MSW programs and there being a focus on "evidence-based" treatments and we understand the evidence for these comes from scientific, peer-reviewed journals. It my experience, which I am sure will resonate with others, if there is literature that shows the effectiveness of an intervention then that intervention is evidence-based. The more literature available the better evidence for that practice. Now this is a good starting point, but evidence doesn't end there.

This is an important venn diagram to better conceptualize evidence-based practice. You'll see in the middle of the diagram is EBM (evidence-based medicine) another term for evidenced based practice. EBM started in the medical literature and was later adopted to other areas such as therapy. In looking at this diagram, you'll see there are three areas that contribute to what evidence-based practice really is. You may remember seeing this in school, but I believe it is a good reminder that it is not just the scientific evidence/peer-reviewed literature; it also includes clinical judgement and consideration for a patient's/client's values and preferences.

What does this mean for social workers? According to the NASW Code of Ethics (2017) " Social workers should critically examine and keep current with emerging knowledge relevant to social work and fully use evaluation and research evidence in their professional practice". It is our responsibility to evaluate evidence that is presented in the literature, but also to temper this with one's own clinical judgement and the client's values and preferences. Clinical judgement is developed through practice is experience. Reading literature and attending training is important, however it does not take the place of actual practice experience. Furthermore, we social workers also need to be culturally competent. I don't want to get into the topic of cultural competence, because that is reserved for an entire discussion itself. The Code of Ethics states that, "Social workers should understand culture and its function in human behavior and society, recognizing the strengths that exist in all cultures" (NASW, 2017). Understanding culture is one aspect to understanding a client's values and preferences, it is also important to build rapport to understand the idiosyncratic values and preferences of each client. 

Employing evidence-based practice is good social work practice, but relying solely on literature to implement evidence-based practice is not the best practice. One's own clinical judgement and the client's values and preferences need to be consider in addition to the literature, but a social worker should be competent (NASW, 2017) in the services they provide and they should monitor and evaluation the interventions they use (NASW, 2017). What is not included in this discuss and may be assumed by some, is that whatever the intervention, one should monitor and evaluate it's effectiveness. Social workers need to set-up measures that look at effectiveness during the course of the intervention.

Good, ethical social work practice involves competence, critically examining literature, experience to develop one's clinical judgement, understanding of culture and the client's values/preferences and then monitoring and evaluating chosen interventions for effectiveness.

Training Supervision

According to Ohio Administrative Code 4757-23-01, Training supervision refers to "supervision for the purpose of obtaining license and/or development of new areas of proficiency while providing services to clients. The training supervisor is responsible for providing direction to the supervisee, who applies social work theory, standardized knowledge, skills, competency, and applicable ethical content in the practice setting. The supervisor and the supervisee both share responsibility for carrying out their role in this collaborative processes of professional growth and development". 

Clinical supervision is about the act of supervising those who have a dependent license in a clinical setting. Clinical supervision can be provide by licensed independent social workers and other professionals with an independent practice to license such as a psychologist, licensed professional clinical counselor, or licensed independent marriage and family therapist. Training supervision can only be done for social workers by a independently licensed social worker with supervisor designation (LISW-S). 

Obtaining training supervision is one requirement for social workers seeking independent licensure. There are minimal training standards for the LISW-S, however, they are ethically responsible for providing training supervision within their own proficiency and competencies. The NASW Code of Ethics states that "Social workers who provide supervision or consultation (whether in-person or remotely) should have the necessary knowledge and skill to supervise or consult appropriately and should do so only within their ares of knowledge and competency" (Standard 3.01). An individual I supervised asked wanted to develop competency in marriage therapy. I do not have knowledge or competency in that so I suggested some training resources and we discussed the role of communication in relationships, however we did not discuss the actual practice of marriage therapy. I could have speculated on the subject and may drew from other experiences, however it would have been inappropriate me to address this directly with the supervisee because it is not an area I am proficient in. 

Knowledge and competency come from both education and experience; there is no substitute for professional experience. As a generalist social worker and graduating from an advanced generalist program, I have various experiences at the micro, mezzo, and macro levels and in addition to some specific interventions and therapies. I wouldn't consider myself an expert in a certain type of therapy or intervention because of my generalist practice. I however have developed a framework for supervision that I share with those I supervise. The framework addresses the theories and frameworks on draw on and those interventions we may discuss in supervision. 

Another role of training supervision which is not explicitly addressed in the Ohio Administrative Code, is the preparation for independent license and advanced practice. Training supervision's role is not intended to be remedial training on social work theories, values, ethics, or interventions; it is to help supervisee's move towards advanced practice. One resource I wanted to draw your attention to was CSWE's Advanced Social Work Practice in Clinical Social Work (PDF). This is a resource that takes the educational competencies and distinguishes what a social work should be able to do and an advanced practitioner should be able to do. I provide this resource to everyone I supervisee so they can understand what advanced practice looks like and it provides some guidance on how their logs can reflect advanced competency. CSWE provides other documents similar to this which are good resources as well. The Association for Community Organization and Social Action (ACOSA) has developed a document on Advanced Practice in Macro Social Work (PDF). Whatever level of practice a social worker focuses on, developing some skill in macro practice is important for all social workers. 

Introduction

About Me

I am a licensed independent social worker with supervisory endorsement and licensed independent chemical dependency counselor in Ohio. I have been practicing as a licensed social worker for nearly a decade and have come to fully appreciate the advanced generalist framework/perspective. I completed my MSW at the University of Toledo where I am pursing a PhD as well as a DSW from Walden University. For more about my professional experiences check out my LinkedIn and let's connect. 

Purpose

I want to want to be a blogger, but I'm not very creative in my writing nor do I have the constant inspiration to come out with content. Really, the purpose of this blog, website, or whatever you want to call it is to capture some of my thoughts and ideas and provide a place to capture resources that I find helpful.