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August 11, 2011 Volume 2, Issue 29
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RTP Professional Discipline
Situational Analysis Executive Summary
This week, we present the last of our five professional discipline Situational Analysis summaries. As part of the Recovery to Practice (RTP) initiative, these executive summaries are based on recently completed Situational Analyses conducted by each of the professional disciplines. The RTP Situational Analysis is a holistic description that captures unique characteristics of the current status of recovery-oriented practice within each discipline, and establishes the approach disciplines will use to advance recovery principles and practices within their profession.

The teams synthesized findings from their yearlong comprehensive assessment of both qualitative and quantitative data, collected in terms of (1) definitions and understandings of recovery used in their profession (as compared to the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Consensus Statement recovery definition); (2) evidence of recovery-oriented practices being used; (3) evidence of the concept of recovery embedded in organizational infrastructure (i.e., in formal policies and procedures); and (4) evidence of recovery-oriented content in institutional training curricula.

The Situational Analysis forms the basis for determining strengths and identifying gaps as each professional organization designs and delivers its curriculum. Factors that make up the Situational Analysis are fluid and will evolve over time, as learning and practice grow. The Situational Analysis presented here represents the current status of each discipline and its plans for the future. Readers who would like to provide feedback on these plans to any of the professional organizations involved are invited to do so using the email address at the end of the article.
Council on Social Work Education
Social work is concerned with enhancing the well-being of people, groups, and communities by strengthening the opportunities and capacities of individuals, and addressing conditions that limit human potential (Council on Social Work Education (CSWE), 2001, 2008). Social workers are engaged in a variety of settings, operating in direct practice with individuals, families, and groups, as well as practice in management, policy, and community organization. Overall, it is estimated that social workers provide almost half of all mental health services (National Association of Social Workers (NASW), 2011; Manderscheid & Henderson, 2000). Social workers may be the only mental health professionals available—especially in rural areas.

Social work literature accentuates how social work is “uniquely qualified” (Carpenter, 2002, p. 87) to employ the recovery paradigm, listing the profession’s history and contribution to the movement through the strengths perspective and investment in forming and promoting the implementation of recovery (Carpenter, 2002; Scheyett, 2005; Starnino, 2009). Sources posit the profession’s place is noticeable because it contends with environmental and societal oppression, addressing empowerment and social justice in ways other helping professions might not (Scheyett, 2005).

The Situational Analysis found that there are strong theoretical connections between social work and the recovery movement. As it formed, social work built on the existing social sciences, psychology, and biology. The resulting conceptual framework for social work practice pulled together these fields for a holistic view of individuals, termed “person-in-environment.” Social workers are expected to understand and assess the biological, psychological, social, and spiritual aspects of an individual and the environment in which she or he resides. Such a perspective is still a standard of social work practice today. In the 1980s the strengths model for case management was developed. The strengths model tied together the earlier frameworks, introduced hope and equality to the therapeutic relationship, and was consistent with recovery-oriented practice. As explained by Charles Rapp,

The importance of a strengths approach, however, is that: it is concordant with social work values; it dramatically expands the scope and venues of helping; it gives the client a critical role in the process; it redresses some of the excesses of the expert role; it summons community resources; it fulfills the obligation of the person: environment perspective by drawing upon the energies of body, mind, spirit, and environment in helping; its vocabulary is ordinary and it respects the indigenous psychology of all peoples (their theories); and it can create positive atmospherics in agency and organization (Rapp, 1987, p. 25).

Social work has made a longstanding commitment to cultural competency and social justice. The NASW Code of Ethics (2008), for example, stresses empowerment, social justice, self-determination, and the person-in-environment framework, and focuses on the individual. The Code of Ethics also identifies six core values of social work that underscore treatment and practice compatible with recovery: service, social justice, dignity and worth of the person, importance of human relationships, integrity, and competence.

In spite of many theoretical similarities to recovery, there are areas in which social work practice has fallen prey to the same persistent focus on illness, labeling, and deficits, which dominate the mental health care system and set the consumer apart to be acted on by the practitioner. The theoretical base of the person-in-environment and strengths-based perspectives (which call on social workers to empower consumers) and the Code of Ethics (NASW, 2008; which highlights self-determination and respect) are often found by the practitioner to be at odds with the day-to-day realities of social work practice in the mental health system.

Target Audience for Curriculum Development

The Situational Analysis has shown how social work is particularly well-suited and prepared for mental health recovery in many ways. Historically, social workers have had a concern for components of recovery cited in the SAMHSA Consensus Statement (2006), especially empowerment, holistic care, the strengths-based perspective, self-direction, and respect. Furthermore, the efforts of social workers to eradicate discrimination and stigma and recognize and engage differences are also consistent with the concerns of recovery. There is evidence that some social work educators and practitioners have already become involved in the recovery movement, and have started to implement it in courses and practice.

The Situational Analysis has also shown that there are some areas in which social work does not entirely embrace the full meaning of recovery, or where very little evidence exists that anything is being done at all. In particular, the components of peer support and involvement of consumers throughout the process seem to be lacking. Some of the discussions appeared to uncover a true partnership, but others indicated a paternalistic type of practice taking place, in which the consumer was not an equal partner in the process. Some individual faculty members and practitioners stood out as being particularly concerned with including the consumer voice, but these do not appear to be the norm. The other concern is that in many of the areas in which there is theoretical kinship with recovery, there appears to be some cognitive dissonance. For instance, social workers may believe in the strengths-based approach, but in practice are working from a deficits model.

To effect a paradigm shift, change must be as systemic as possible. It is with this mandate in mind that the CSWE team recommends social work practitioners, particularly those serving as field instructors, as the target audience for curriculum development.

Social work practitioners comprise a multifaceted group that intersects with the mental health system at many different points. Practitioners can have an effect on recovery through their direct service to consumers and families, at the organizational and administrative leadership levels, and/or can influence social work students when they serve as field instructors. Even if they are not immediately supervising the students in practicum placements at their agencies, practitioners can have an indelible influence on the culture of those agencies and their embrace of recovery principles, which shapes the experience of the next generation of social workers.

In social work education, all students are required to participate in field education to graduate. Field education, also called the signature pedagogy of social work, is intended to “socialize” students to “perform the role of practitioner” (CSWE, 2008, p. 8). Students must complete at least 400 hours of field education at the baccalaureate level and at least 900 hours at the master’s level (CSWE, 2008). Many programs require completion of more than the mandated minimum hours. Programs can structure the field education as they like, but typically baccalaureate students begin field education their senior year and master’s students begin one field placement in their second semester, with a yearlong placement (in the respective area of concentration) during the second year. Each year there are more than 14,746 baccalaureate and 30,037 master’s students in field placements. Of these, approximately 1,100 (7.6 percent) baccalaureate placements and 6,100 (20.4 percent) master’s placements are in settings identified primarily as mental health or community mental health. Of course, many other settings could also provide opportunities in mental health (e.g., military, family services, child welfare).

Field instructors are practitioners who are working in the field and serve as supervisors to social work students. The 2008 Educational Policy and Accreditation Standards mandate that field instructors must have a degree in social work to supervise students. Programs are also required to provide “orientation, field instruction training, and continuing dialogue with field education settings and field instructors” (CSWE, 2008, p. 10). A single field instructor could supervise more than one student, and the Annual Survey of Social Work Programs collects only data on the number of students in field placements, so it is unknown exactly how many field instructors currently serve as supervisors; however, even assuming that only one third of the placements are unique, it would be a pool of approximately 15,000 practitioners.

For the focus of the curriculum development phase, it is recommended that we use partnerships that already exist between mental health agencies and universities to target practitioners while also affecting students—the future practitioners. CSWE, through the field directors/coordinators at each accredited social work program, could promote and disseminate the training. Within a single year, there would be the potential to reach thousands of practitioners and, through them, even more students.

Thousands of practitioners serve as field instructors every year in social work education. If field education is where students are socialized to the profession, then we should take advantage of this unique existing partnership between classroom and field to infuse mental health recovery throughout social work. Although the specifics have yet to be determined, existing means of communication and structures are in place that will assist with this model.

To read CSWE’s Situational Analysis in its entirety, please visit
http://www.cswe.org/CentersInitiatives/DataStatistics/42850/51133.aspx.

For more information about this Situational Analysis, please contact the Council on Social Work Education’s RTP team at jholmes@cswe.org.

National Wellness Week/Recovery Month
Mark your calendars! The first National Wellness Week will be held September 19–25, 2011, as part of SAMHSA’s Recovery Month. The inaugural theme is “Living Wellness.”

People with mental health and substance use disorders die decades earlier than the general population, mostly due to preventable medical conditions. That is why SAMHSA—in partnership with the Food and Drug Administration’s Office of Women’s Health—has created the 10x10 Wellness Campaign to promote wellness and increase life expectancies for people with mental health and substance use problems by 10 years over a 10-year period.

Stay tuned for more information about National Wellness Week in upcoming Weekly Highlights, or receive information directly by joining the 10x10 Wellness Campaign’s ListServ/electronic newsletter at www.10x10.samhsa.gov.

For the news release, please visit http://www.samhsa.gov/newsroom/advisories/1106280601.aspx.

Set Your Watch for the 10:10 Line Dance for Wellness—10:10 a.m. or 10:10 p.m. on September 23!

Line dancing spans generations and cultures while creating solidarity through repetitive motion. At 10:10 a.m. and 10:10 p.m. on September 23, 2011, thousands of people across the country will get up and show their commitment to wellness through line dancing. We will spread the word about this special event through promotional strategies (i.e., media, social media), partner channels, and ongoing communication with our target audiences. Many community organizations, including peer-run and faith-based groups, will further support the cause by hosting 10:10 Line Dance for Wellness Parties.

National Asian American Pacific Islander Empowerment Network
The National Asian American Pacific Islander Mental Health Association (NAAPIMHA) is proud to announce the formation of the National Asian American Pacific Islander Empowerment Network (NAAPIEN), developed with funding from SAMHSA. NAAPIEN is a peer advocacy group that develops leadership among those who have personally experienced the challenges of serious mental health issues. Members have led personal journeys of recovery, which broadens their insight into improving wellness services. They are current and future leaders who will play a critical role in ensuring those with mental health problems receive the quality of care they deserve.

For more information, please visit http://naapimha.org.

Invitation to Submit Personal Stories
Personal stories are a powerful way to share information, influence others, and advance recovery-oriented practice. The RTP team would like to hear from military family members about their recovery-oriented experiences.

We are also interested in receiving personal stories about how health care reform has affected your recovery journey.

Your stories will be added to our library of resources, which will soon be available to ListServ subscribers.
The RTP Resource Center Wants to Hear From
Recovery-Oriented Practitioners!
We invite practitioners to submit personal stories that describe how they became involved in recovery-oriented work, and how it has changed the way they practice.
To submit personal stories or other recovery resources, please contact Stephanie Bernstein, MSW, at
877.584.8535, or email recoverytopractice@dsgonline.com.

We welcome your views, comments, suggestions, and inquiries.
For more information on this topic or any other recovery topics,
please contact the RTP Resource Center at
877.584.8535, or email recoverytopractice@dsgonline.com.


The views, opinions, and content of this Weekly Highlight are those of the authors, and do not necessarily reflect the views, opinions, or policies of SAMHSA or HHS.