Being the Only One: Finding Connection through the Shared Experience of “Otherness”

ABSTRACT

There is a noticeable paucity of clinical resources that help clinicians of color to name and navigate the multitude of challenges in working through racial, cultural, and power differences in psychotherapy with White clients. African American therapists rarely receive adequate preparation for clinical practice in identifying, addressing, and working through transference and countertransference reactions in racially mixed dyads. The author highlights the challenges she faced early in her career with addressing racial and sociopolitical differences as an African American female clinical social worker providing individual psychotherapy to her older White male client whose traumatic experience focused on racial issues.     

Colorful Disclosures: Identifying Identity-Based Differences and Enhancing Critical Consciousness in Supervision

ABSTRACT

Managing microaggressions and marginalizing experiences while negotiating the ongoing oppression that occurs in micro, mezzo, and macro settings can be particularly challenging for clinicians of color. Thus, supervision with clinicians of color must include affirmation, empowerment, and exploration of the intracultural/intercultural dynamics inherent in the treatment-providing process and clinical supervision. Through case studies, autoethnographic studies of our supervision experiences, and interviews with supervisors and supervisees, we reflect on how axes of identity, including race, power, and privilege, inform practitioners’ clinical lenses and affect their vulnerability in treatment and the clinical supervision dyad. Special attention is placed on the clinical supervisor–clinician–client triad (the triple process) and the interpersonal dynamics of cultural sensitivity, cultural humility, and authentic responsiveness that supervisors aim to model and cultivate in the supervisory relationship. In addition to sustaining clinical growth for clinicians of color, adding this level of complexity to supervision supports equity in direct clinical practice, enhancing efficacy outcomes for clients and communities. Recommendations and pedagogical strategies are offered to support supervisors in initiating difficult dialogues and shifting the paradigm to promote this transformational perspective.     

Enactment and Dissociation: A Retrospective Journey Applying Relational Theory

Relational theory was not yet an endorsed psychoanalytic model 30 years ago. This composite case identifies a process of struggling with a classical theory education that collided with the then young analyst’s immediate clinical experience. Ambivalence about the best therapeutic course contributed to delays and enactments, and ultimately to effective interventions. This article describes the clinical growth process of the analyst progressing toward integrating aspects of what now would be mainstream relational technique. This shift was necessary to bring into open clinical discourse the dissociated self-state experiences and enactments that were paralyzing patient and analyst. The here-and-now interpersonal exchange, including identifying transference and countertransference, allows conflicts and developmental gaps to be clarified; their significance then worked to accelerate self-cohesion and self-esteem. Selective self-disclosure, authentic engagement, and self-recognition in dialogue, which would now be embraced by relational theory, are presented here as the analyst’s and the composite patient’s journey toward a core sense of self that had been sacrificed to dependence on external authority.     

Reflective Practices for Engaging in Trauma-Informed Culturally Competent Supervision

ABSTRACT

Race, ethnicity, and culture are critical components that affect and shape the supervisory relationship, yet literature about ways to acknowledge and actively engage them from a trauma-informed approach has been limited. To enhance the discussion of this issue, this article first reviews leading theoretical aspects of supervision designed to train practitioners in the field of mental health, followed by a discussion of race, ethnicity, and culture in supervision and, finally, provides reflective practices for engaging in trauma-informed culturally competent supervision.     

Social Worker Supervision with Novice and Experienced Workers

ABSTRACT

This empirical study compares the perceptions of social work supervisors about the needs of novice and experienced social work supervisees. The respondents, 211 supervisors in public welfare agencies in Israel, provided novice workers more supervisory time in 6 of the 8 content areas examined: administrative matters; inspection and control; inter-organizational communication; client issues; job-related tensions; and personal tensions. Projects in the community were given priority to experienced rather than novice supervisees, and professional development was regarded by the supervisors as equally important for novice and experienced workers. Comparisons were also made between the actual and preferred supervisory time allotment.     

Listening for and Holding Traumatic Rage in an Intersubjective Intercultural Field

This article highlights various constructs from the perspective of D.W. Winnicott, trauma theories, intersubjectivity, and intercultural practice as guides for listening on multiple levels to inform the biopsychosocial–spiritual assessment and treatment. Using a clinical case composite, the author will illustrate the working alliance with a severely traumatized client, emphasizing the intense transference and countertransference rage and enactments that occurred during the course of the clinical social work practice. The therapeutic holding environment was challenged but maintained by working through relationship breakdowns, restoring intercultural subjective space and containing powerless rage.     

Backing Barack Because He's Black: Racially Motivated Voting in the 2008 Election*

Objective. If racial considerations influenced the outcome of the 2008 presidential election, then how did they shape the campaign, why did race matter, and for whom were such considerations important? I hypothesize that various racial attitudes exert unique influences on voters' support of Obama and that the effects of these attitudes differ by race. Methods. Using a Time Magazine poll, I distinguish between “attitudes regarding Obama's ‘Blackness’” and “opinions about race relations,” and I examine such sentiments among White and African‐American respondents. Results. Regardless of race, Obama support was highest among voters who were “comfortable” with Black candidates. However, increased optimism with racial progress had no effect on Blacks' voting intentions, and it actually lowered Obama support among Whites. Conclusion. The conventional wisdom is that African Americans “backed Barack because he is Black”; I demonstrate that Obama's race mattered more to White voters than it did to Blacks.     

Race and income disparities in disaster preparedness in old age

ABSTRACT

This study investigated to what extent income status and race/ethnicity in old age interplayed with disaster preparedness. Data came from the 2010 Health and Retirement Study, a nationally representative panel survey of older Americans over 51 years old. Our sample was restricted to respondents who participated in a special survey about disaster preparedness (N=1,711). Disaster preparedness was measured as a score, which includes 13 variables. Race/ethnicity was categorized by White, Black, and Hispanic. Low income was defined as below 300% of the federal poverty line. OLS regression was used to examine the main and interaction effects of race/ethnicity and lower income status on disaster preparedness scores. We found that older adults in lower income status had lower preparedness level than those in higher income (Coef. =-0.318, p<.01). Hispanics tend to be less prepared compared to White and Blacks (Coef. =-0.608, p<.001). Preparedness of Black elders was not significantly different from that of Whites. However, interestingly, Black elders in lower income status were significantly less prepared for disaster than other groups (Coef. =- 0.622, p<.05). This study identified vulnerable subgroups of older adults for disaster preparedness and suggests that preparedness programs should target minority and low income elders.     

Widening the gap: White ignorance,race relations and the consequences for Aboriginal people in Australia

White ignorance has a critical impact on race relations and is implicated in the maintenance of Aboriginal disadvantage. Addressing this ignorance is a largely overlooked capacity-building opportunity within Australia's non-Aboriginal population. It warrants consideration as a key component of strategies targeting Aboriginal disadvantage. Despite the established links between race relations and Aboriginal well-being, Aboriginal perspectives on non-Aboriginal people rarely feature in public discourse on “Aboriginal problems.” This paper draws on data from 180 in-depth interviews with 44 Aboriginal people in Darwin on the topic of White Australian people, culture and race relations. It reports Aboriginal perceptions of White Australian ignorance across areas of great symbolic and practical significance to Aboriginal people's lives. Their experience is that most White Australians are ignorant of the history of colonisation and the complexities of its aftermath. They are ignorant of Aboriginal law, cultures and languages, and of the extent of their own ignorance. The call to address White ignorance subverts assumptions about whose ignorance and capacity must be dealt with in order to progress national goals of reconciliation, address Aboriginal disadvantage and achieve justice and equality for Aboriginal people.     

A family-centred practice supervision project conducted for a child welfare agency

ABSTRACT

This paper reports on a supervision project that aimed to enhance a child welfare agency staff’s professional competence in family-centred practice through a strength-based approach. A qualitative study was designed to explore the effectiveness and the change agents of the supervision. Purposive sampling was used. Two agency supervisors and two social workers participated the study voluntarily. The findings indicated that after the period of supervision, the staff had changed in three respects: their conceptualisation of the meaning of family work in the care context; their understanding of the importance of relationship-based interventions with families; and their development of alternative ways of practice. The agents of change from the supervision were the consultants’ modelling effect and the co-worker experience of the consultants and the social workers. This supervision approach can discern the synergistic effect of supervision on an agency’s routine supervision and balance the cultural beliefs in qing, yuan and ‘face’ embedded in the supervisory process.     

Traumatic exposure to violence: A comprehensive review of the child and adolescent literature

Abstract

This paper reviews contemporary literature on the diverse effects trauma and violence have on children and adolescents. The author emphasizes an area of paramount importance: perpetual re‐exposure to trauma through re‐enactments and risk‐taking behaviors.     

Addressing the School-to-Prison Pipeline: Examining Micro- and Macro-Level Variables that Affect School Disengagement and Subsequent Felonies

Abstract

This study examines the School-to-Prison Pipeline (STPP) by identifying individual legal and extra-legal variables and school-level factors that predict juvenile/criminal justice involvement using 2006–2012 matched data from education and justice systems (n?=?21,457). The role of school disengagement is also assessed, measuring unexcused absences that follow suspensions in the previous academic year. For the court-involved subsample (n?=?7349), after controlling for student behavior, demographic, and school-level factors; extra-legal racial differences remain a significant factor in determining higher counts of felonies with African American and Multi-racial students at increased likelihood (1.65 and 1.86 times, respectively for the higher latent class) of juvenile/criminal justice involvement as compared with White students. And, although White students were found to either be more disengaged or equally disengaged when compared with students of color, sharp differences in criminal justice involvement and outcomes exist by race/ethnicity. These findings suggest that addressing the STPP will require future research and focus on more than individual-level behaviors (school disengagement and school-based offenses) and attention to the impact of extra-legal variables and systemic implicit bias.     

Variations in the Life Histories of Incarcerated Parents by Race and Ethnicity: Implications for Service Provision

ABSTRACT

Incarcerated parents have complex life histories that often remain unresolved during incarceration, can continue to create barriers to prosocial success on release, and present similar intergenerational challenges for their children. This study examines the life histories of incarcerated fathers and mothers from the Pacific Northwest and how their experiences vary based on race and ethnicity. Five areas examined were exposure to trauma, child welfare involvement, mental health and substance abuse problems, juvenile justice and adult criminal justice involvement, and intergenerational criminal justice involvement. The sample comprised 359 incarcerated parents, and their racial/ethnic composition was 59% White, 14% African American, 11% multiracial, 8% Native American, and 7% Latino. Few differences were found across racial and ethnic groups. Mothers appeared more similar to each other across groups than fathers. Results illustrated similarities yet some surprising differences with national trends on key study variables. Implications for future research and intervention and prevention are discussed.     

Exploration of Racial Enactments in an Interracial Therapeutic Dyad to Foster the Strengthening of Voice and Identity in African American Male Adolescents

The purpose of this paper is to examine the impact of systemic racism on an interracial therapeutic dyad between a white therapist and an African American adolescent male. Leary (2000 Leary, K. (2000). Racial enactments in dynamic treatment. Psychoanalytic Dialogues, 10(4), 639–653. doi:10.1080/10481881009348573[Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]) operationalized the term “racial enactments” and made the important point that its “most common” manifestation “has been our relative silence about racial issues” (p. 647). It is the premise of this paper that the youth of color’s subjective experience of racial microaggressions and assaults experienced on a daily basis must be validated and explored prior to a meaningful intersubjective exploration in the clinical encounter. The emphasis in this paper is on the racial enactment that precedes the clinical encounter. A treatment vignette is used to highlight the intersection of social and psychic spheres of human experience and how an awareness of unconscious bias in the therapist can facilitate a more meaningful dialogue in which priority is given to the emergence of a powerful client narrative voice.     

Trapped in Poor Places? An Assessment of the Residential Spatial Patterns of Housing Choice Voucher Holders in 2004 and 2008

ABSTRACT

This study examines the residential spatial patterns of Housing Choice Voucher holders in Western New York in 2004 and 2008 (n = 4,600 and n = 4,759, respectively). It seeks to answer two questions: Has the concentration of voucher holders in impoverished and same race neighborhoods diminished overtime; and are voucher holders, particularly African Americans, relocating in patterns that would lead to reghettoization or the reconcentration of race and poverty? This type of residential pattern puts voucher holders at risk for resettling in neighborhoods that limit economic and social mobility. Data from the public housing agency contracted to distribute Housing Choice Vouchers were examined. Exploratory spatial analysis techniques were used to identify spatial outliers and to form a hypothesis on spatial patterns of relocation. Spatial clustering analyses were conducted to test the hypothesis on the reghettoization of African American voucher holders in recently relocated neighborhoods. Analyses indicate that African American voucher holders are moving out of impoverished, hypersegregated areas into historically White neighborhoods. A limited number of voucher holders are moving in clustered patterns, which lead to reghettoization. Future research is needed that highlights the role that housing assistance providers play in the residential location choices of low-income clients.     

Supervision in Social Work with the Aged and Their Families

This paper focuses on the educational and supportive functions of the long-standing practice tradition of supervision in social work with the aged and their families. It examines the way in which educational supervision extends the clinician's knowledge and deepens his or her perceptions, feelings, and self-understanding of geriatric practice. It also explores supportive supervision as a means of helping supervisees cope with job-related stress and the ethical issues and value conflicts that are likely to occur in geriatrics. A case study illustrating some of these conflicts is included.     

Experiences of Caregivers in a Dementia Simulation Program

Abstract

Objectives: Simulation-based training has been used in health care to increase clinical knowledge and skills and understanding the experience of others. There is a lack of research in exploring experiences of caregivers of people with dementia in a dementia simulation program and its potential benefits on caregivers. The purpose of this qualitative study was to explore experiences of caregivers of people with dementia who participated in a dementia simulation program, called Dementia Live?.

Methods: Fourteen caregivers were interviewed after participation in DL, and thematic analysis using NVivo 11 software was used.

Results: Three themes emerged, including: (i) the Dementia Live? as an eye-opening experience; (ii) the perceived benefits of the Dementia Live? on themselves; and (iii) recommendation of the Dementia Live? to other caregivers.

Conclusions: Dementia simulation programs such as the Dementia Live? may help caregivers to have more empathy, understand better about the behaviors and feelings of people with dementia, and to use strategies that can help when working with people with dementia. Further experimental research is needed to examine effectiveness of the dementia simulation program on caregivers and people with dementia.     

Supporting Family Carers Through Telephone-Mediated Group Programs: Opportunities For Gerontological Social Workers

ABSTRACT

Telephone-mediated group programs are an important but under-utilized medium for reaching frail or disabled older persons' family carers who are in need of support. The primary purpose and style of group programs can range across a broad spectrum–encompassing educational, supportive and therapeutic types. Gerontological social workers are the members of the multidisciplinary care team whose training, experience and supervision makes them most suitable for facilitating this broad range of group types. Drawing on the experience of training a number of group facilitators, this article provides suggestions for social workers contemplating the use of telephone-mediated groups and highlights groupwork skills peculiar to conducting group programs via the telephone.     

The Work Experiences of Social Workers: Factors Impacting Compassion Satisfaction and Workplace Stress

Abstract

In 2015, over 6,000 licensed social workers in 13?US states responded to an online survey regarding perceptions and feelings about their work, as well as numerous personal and practice issues. Specifically, this study examined participants’ levels of compassion satisfaction and workplace stress, and then determined through multivariate analyses what demographic factors, behavioral and physical health problems, practice issues, fields of practice, and workplace environment issues impacted these two variables.

The findings indicate that participants demonstrated high levels of compassion satisfaction, with a wide range of workplace stress levels. Workplace environment issues had the greatest impact on both variables, with social workers’ mental health problems, physical health status, and certain demographic factors such as race also influencing them. Over 82% of respondents expressed agreement that they were glad that they chose social work as a profession. The results appear to demonstrate that despite being a potentially stressful occupation, licensed social workers tend to experience significant emotional satisfaction from their work. On the other hand, the results also highlight the need for further research to determine how to enhance support for social workers in the workplace in order to not only reduce workplace stress, but also to increase compassion satisfaction.