The Social Work Podcast

Episode 55: Today's podcast is about social work with children who have cancer, also referred to as pediatric oncology social work. Although pediatric cancer is relatively rare event, making up less than 1% of the cases diagnosed annually, that single case affects the lives of countless others. From a treatment perspective, when a child is diagnosed with cancer, the whole family is diagnosed with cancer. Children are most likely to get cancer in their first year of life, and least likely between the ages of 5 and 14. If you are white kid in the United States you are nearly two times more likely to get cancer than if you are black. One in 300 boys and one in 330 girls will develop cancer before the age of 20. Every year 2500 children die from cancers with names like Acute Lymphoblastic Lukemia (cancer of the bone marrow - the most common childhood cancer), Hepatoblastoma (cancer of the kidney), neuroblastoma (cancer of the central nervous system), Ewings sarcoma (bone cancer), Hodgin’s Lymphoma (cancer of the lymph nodes), and Wilms tumor (cancer of the kidney). Notice that the most common forms of adult cancer such as lung, breast and colon are not included on this list. And it is not just that children get some cancers and adults get others. Among children, the cancers most often found in infants and toddlers are not the same as the cancers most often found in teenagers. For children today, getting a diagnosis of cancer is not the death sentence it once was. Before 1970 most children who got cancer died. Today, survival rates are nearly 80%. Currently there are about 270,000 survivors of childhood cancer. Consequently pediatric oncology social workers need to know as much about working with survivors of cancer as they do about issues of death and dying. To help me get a better idea of what being a pediatric oncology entails, I spoke with Dr. Barbara Jones, social worker and faculty member at the school of social work at the University of Texas at Austin. Dr. Jones is the immediate past president of the Association of Pediatric Oncology Social Workers, on the editorial board for the Journal of Social Work in End-of-Life and Palliative Care , and the co-director of the Institute for Grief, Loss and Family Survival at UT-Austin. Dr. Jones recently designed and taught the first social work course in the United States on psychosocial oncology. In today's podcast, Barbara and I talked about the role of a pediatric oncology social worker in a multidisciplinary team, with the child, with the family, in a hospital setting and in the community. We talked about best practices for working with kids with cancer and the role of research in pediatric oncology social work. She talked about practical and ethical issues in pediatric oncology social work such as consent and assent, how to accurately assess a child's pain, and how social workers can take care of themselves. Barbara told some powerful and moving stories about the work she's done with children who have died and children who have survived cancer. We ended our conversation with a discussion about how social workers get training in pediatric oncology social work, and what some resources are for social workers who would like to know more about working with children with cancer. One quick word about today's podcast: I recorded today's podcast using a Zoom H2 recorder on location at the Society for Social Work Research annual conference. If you listen closely you can hear the sounds of San Francisco in the background: a clock chiming, busses loading and unloading passengers, and even some pigeons congregating outside of the interview room. They don’t detract from the interview, but I wanted to give fair warning in case you were listening to this podcast anywhere were those sounds might be cause for alarm.

Episode 54: Today's podcast, Psychoanalytic Treatment in Contemporary Social Work Practice: An Interview with Dr. Carol Tosone, addresses two questions: First, is psychodynamic treatment relevant in contemporary social work practice? In other words, does it meet the needs of the clients, the agencies, and the funding sources? Second, has clinical social work abandoned social work's historical commitment to advocating for social change? I think they are questions worth thinking about. Ask any social work student today what the organizing framework for social work practice is, they won't say, "psychodynamic theory." They'll likely say "the strengths perspective," or "ecological systems theory." When my students do research papers on the best approaches to addressing mental health problems, they usually write about cognitive and behavioral treatments, perhaps because the evidence-base is dominated by studies of cognitive and behavioral approaches. When I ask my students what theoretical perspectives seem to be most consistent with their values and perspectives, they usually say "CBT" or "solution-focused." I usually only have one or two students who take a psychodynamic perspective. My students are usually surprised to hear that in the early 20th century, the social work profession adopted Freudian psychoanalysis as the organizing framework for providing direct services to clients. Social work pioneers such as Mary Richmond were psychoanalytic social workers. The dominance of psychodynamic treatment continued for decades. Even during the 1960s and 70s, when social work returned to its community organizing roots and mezzo and macro level changes were seen as the best way to improve clients' lives, most direct practice social workers identified as psychodynamic. For example, in 1982, a national study reported that even though most clinical social workers were eclectic in their practice, their preferred theoretical orientation was psychoanalytic (Jayaratne, 1982). Fast forward to 2009. Psychoanalytic treatment is widely dismissed as being patriarchal, oppressive, and out-of-touch with the needs and realities of social work clients. Insurance companies are requiring that clinicians use treatments that are short-term, empirically validated, and cost-effective. Agencies are increasingly requiring clinical staff to use prescribed treatments. Clinical social work education has moved towards teaching evidence-based practice, and learning about treatments with a cognitive behavioral, rather than psychodynamic basis. So, if students seem to prefer non-psychodynamic theories, agencies and insurance companies are mandating the use of non-psychodynamic treatments, and an increasing number of schools of social work are teaching cognitive and behavior-based evidence-based treatments, what place does psychodynamic treatment have in contemporary social work practice? Well, in order to answer some of these questions, I spoke with Dr. Carol Tosone about contemporary psychoanalytic treatment. Dr. Tosone completed her psychoanalytic training at the Postgraduate Center for Mental Health, where she was the recipient of the Postgraduate Memorial Award. She is an Associate Professor at the Silver School of Social Work at New York University, the recipient of the NYU Distinguished Teaching Award and is a Distinguished Scholar in Social Work in the National Academies of Practice in Washington, D.C. In 2007, Dr. Tosone was selected for a Fulbright Senior Specialist Award for teaching and research at the Hanoi University of Education in Vietnam. She is the editor-in-chief of the Clinical Social Work Journal, and the executive producer and writer of four social work education videos. And she is an expert in shared trauma, which is when a client and therapist experience the same traumatic event. In today's podcast, Carol and I talked about what distinguishes contemporary dynamic treatment from traditional psychoanalysis, the role of attachment theory in contemporary dynamic treatment, how talk therapy changes the way the brain processes information, and how brief dynamic treatment can be used in typical social work agency settings. Carol emphasized that contemporary psychoanalytic treatment and concrete services, such as case management, referral, or advocacy work, are not mutually exclusive. She shared how she came to see herself as a social worker first and an analyst second. We ended our conversation with information about resources for social workers in school and in the field who might be interested in learning more about contemporary dynamic treatment. Carol suggested that the best resource social workers have is other social workers and encouraged clinical social workers to write more and share their insights and experiences. I recorded today's interview at the University of Texas at Austin's school of social work. Carol was at UT to give the inaugural Sue Fairbanks Lecture in Psychoanalytic Knowledge. I want to thank the Sue Fairbanks lecture organizing committee, particularly Vicki Packheiser, for helping to coordinate the interview with Carol. You might hear the sound of children playing in the background - Carol and I spoke in an office right above a daycare center.

Trailer: A few months ago I interviewed a mother and a step-mother, Jennifer Newcomb Marine and Carol Marine, two women whose book, "No One's The Bitch: A Ten-Step Plan for the Mother and Stepmother Relationship" had just been published by Globe Pequot Press. Their book quickly became a best-seller on Amazon.com, briefly reaching the #1 spot in the family category. I was really intrigued by what they had to say to social workers - or anyone who works with families. They were saying, "do not forget about the mother / step-mother relationship, it is perhaps the most important relationships to address in a blended family." Well, their message has caught the attention of major media outlets like the Washington Post, and most recently the Dr. Phil show. Although the interview is not ready for prime time, I wanted to give you a preview of the podcast in advance of their appearance on the Dr. Phil show, Tuesday, December 1st. In this three minute excerpt, Jennifer and Carol are talking about some of the typical issues that the mother / step-mother relationship brings. Enjoy this preview, and watch them on the Dr. Phil show Tuesday, December 1st.

Episode 53: This is a re-post of the Stages of Change podcast with a link to the correct MP3 file. Much thanks to Social Work Podcast subscriber and social work professor David Beimers of Minnesota State University for pointing out that the MP3 for Episode 52 (Social Work Theories) was loading instead of Episode 53. Today's podcast is on Prochaska and DiClemente's (1983) Stages of Change Model. This model describes five stages that people go through on their way to change: precontemplation, contemplation, preparation, action, and maintenance. The model assumes that although the amount of time an individual spends in a specific stage varies, everyone has to accomplish the same stage-specific tasks in order to move through the change process (Prochaska & Prochaska, 2009). There is an unofficial sixth stage that is variously called "relapse," "recycling," or "slipping" in which an individual reverts to old behaviors. Examples include having a beer after a period of sobriety, or smoking a cigarette a year after quitting. Slipping is so common that it is considered normal. Social Workers are encouraged to be honest with clients about the likelihood of backsliding or reverting to old behaviors once the change process has started, not because we expect our clients to fail, but because it normalizes the experience and takes away some of sense of failure and shame. Although the "Stages of Change" model was identified and developed during a study of smoking cessation (Prochaska & DiClemente, 1983), the model has been applied to and studied with numerous bio-psycho-social problems, including domestic violence, HIV prevention, and child abuse (Prochaska & Prochaska, 2009). The "stages of change" model is one component of the "Transtheoretical model of behavior change" (Prochaska & DiClemente, 1983). It is called the "transtheoretical model" because it integrates key constructs from other theories. The TTM describes stages of change, the Process of Change, and ways to measure change. In today's podcast, I'm going to focus on the Stages of Change. If you are interested in learning more about the broader Transtheoretial Model, there are dozens of resources online and in print. The University of Rhode Island's Cancer Prevention Research Center website has a clear and concise overview of the TTM; I've posted the link to that description on the Social Work Podcast website: http://www.uri.edu/research/cprc/TTM/detailedoverview.htm. If you are looking for a social work-specific application of the TTM, there is an excellent chapter in the second edition of the Social Workers' Desk Reference on the TTM and child abuse and neglect. The purpose of this podcast is to provide a brief overview of the five stages of change and what intervention approaches are most appropriate at each stage of change. I drew on a number of resources in the preparation of this podcast, including a chapter on the stages of change and motivational interviewing by DiClemente & Velasquez in Miller and Rollnick's second edition of their book, Motivational Interviewing (Miller & Rollnick, 2002); A 2002 article by Norcross and Prochaska (2002) from the Harvard Mental Health Letter called "Using the Stages of Change;" and the chapter by Prochaska and Prochaska (2009) in the second edition of the Social Workers' Desk Reference that I just mentioned. All of these references can be found on the podcast website at https://socialworkpodcast.com. In today's podcast I'll talk about how to figure out what stage someone is in, and identify a couple of interventions that are most effective for the person in that stage. I'm not going to go into great detail about interventions because there is a major treatment approach called Motivational Interviewing that addresses dozens of intervention techniques. Along the way I'll provide examples of things that social workers can say to people in different stages of change. I've drawn most of my examples from situations other than addictions. I've done this because the Stages of Change model was developed out of addictions research and there are a lot of examples with addictions. Since the Stages of Change is applicable to behaviors other than addictions, I wanted to focus on some of those examples. To read more about the stages of change model, and to hear other podcasts, please visit the Social Work Podcast website at https://socialworkpodcast.com.

Episode 52: Today's podcast looks at the relationship between theory and clinical social work practice. I spoke with Joe Walsh, professor of social work at Virginia Commonwealth University (VCU), and author of the Brooks/Cole text, Theories for Direct Social Work Practice, which came out in a second edition in 2009. We talked about why social workers should learn practice theories, the differences between practice, developmental and personality theories, the difference between a theory and a model, and why there are so many different practice theories. We talked about how knowing theory makes for better social work practice and how being "eclectic" isn't about eschewing theory, but being well grounded in a few theories and making intentional choices about when and how to draw from them. Joe suggested that social workers in the field can contribute to theory refinement by thinking seriously about how well the theories they use work with the clients they serve. We ended our conversation with some information on resources for social workers who are interested in learning more about practice theories. To read more about theories for clinical social work practice, and to hear other podcasts, please visit the Social Work Podcast website at https://socialworkpodcast.com.

Episode 51: Hello, podcast listener. It is June 21, 2009, the first day of summer. By now all of the schools of social work in the United States have had their spring graduation and unleashed tens of thousands of newly minted social workers into the world. You might be one of these recent graduates. Like those who came before you and those who will come after, you've spent the last 2 - 5 years becoming socialized into the profession of social work. You've written thousands of papers, spent thousands on books, spent thousands of hours with clients (or close to it), you're your share of group projects, process recordings, video taped assignments, ... all to become skilled professionals who can provide competent and ethical social work services to your clients. Well, today's podcast is a tribute to you. And who better to pay tribute than a fellow student. Today we're going to hear Allison Anais Brunner's 2009 MSW graduation speech from Temple University's School of Social Administration. In her speech, entitled, "When in doubt, Give Hope", Allison juxtaposes the anxieties and doubts that recent graduates feel with their professional responsibility to hold hope for their clients. She describes her own doubts as a social worker, relates those to her personal moments of doubt and shares how she drew from those experiences to help her client. Using our experiences to benefit our clients rather than ourselves, is what we call "professional use of self." And as Carl Rogers demonstrated many years ago, bringing our genuine self to the clinical relationship is one of the most important things we can do to help our clients. So, I dedicate this podcast to you, our professions newest members. And now Allison Anais Brunner and her speech, "When in Doubt, Give Hope." To read the full speech and to hear other podcasts, please visit the Social Work Podcast website at https://socialworkpodcast.com.

Episode 50: Today's podcast is on salary negotiation. In today's podcast I speak with Dr. Cynthia Conley,assistant professor of social work at the School of Social Administration at Temple University, about salary negotiation skills for social workers. Cynthia takes us through salary negotiation from the application to the job offer. Today's podcast is a follow-up to our December, 2008 interview in which Cynthia spoke generally about the importance of salary negotiation to both individuals and to the profession. For more information about this podcast or others in our series, and for resources about social work salaries and references to salary research, please visit the Social Work Podcast website at https://socialworkpodcast.com.

Episode 49: Today's podcast is on social workers and depression. I spoke with Mark Meier, a licensed independent clinical social worker from Minneapolis, Minnesota. Mark and I started our conversation talking about how social workers are three times as likely to be depressed as people in the general population. We talked about the personal and professional responsibility social workers have in addressing their depression, and the role that schools and colleagues have in supporting social workers to get treatment. Mark shared his personal experience with depression, suicidal ideation, and the subsequent hospitalization. We ended our conversation with a discussion about what programs or workshops schools of social work can provide students to address the issue of social workers and depression. For more information on social workers and depression, treatment of depression, or any of the other podcasts, please visit https://socialworkpodcast.com

Episode 48: Today's podcast is on social work with Immigrants and Refugees. I speak with Fernando Chang-Muy, JD, and Dr. Elaine Congress about their new book on the topic. We talk about why it is important to have both social work and legal perspectives, how social workers and lawyers can work together to improve the lives of immigrants and refugees, how social workers can advocate for their clients on a policy level, and finally how listeners outside of the United States can use the concepts discussed in Fernando and Elaine's latest book in their own countries. For references and resources about social work with immigrants and refugees, please visit the Social Work Podcast website at https://socialworkpodcast.com Related podcast: Listen to Elaine Congress talk about using her visual assessment tool, the Culturagram, when working with immigrants and refugees on the Social Work Podcast. For references and resources about social work with immigrants and refugees, please visit the Social Work Podcast website at https://socialworkpodcast.com

Episode 47: Today's podcast is on salary negotiation. Salary negotiation is a topic that is rarely discussed in schools of social work. Yet, for reasons identified in today's podcast, the social work profession as a whole would benefit if social workers negotiated salaries. In today's podcast, I speak with Dr. Cynthia Conley, assistant professor of social work at the School of Social Administration at Temple University. Dr. Conley's research focuses on salary negotiation, the salary gap between men and women social workers, and leadership skills and social work students. Cynthia and I talk about why salary negotiation is an important topic for social workers and some tips for how to negotiate salaries. I ask Cynthia how realistic it is for social workers to negotiate salaries, especially since many social workers take jobs in agencies where salaries are tied to position, rather than the qualifications of the applicant. Cynthia provides some case examples of successful salary negotiation. We end our conversation with a discussion of Cynthia's research on salary negotiation, and some ideas on where salary negotiation fits in the social work curriculum. For more information about this podcast or others in our series, and for resources about social work salaries and references to salary research, please visit the Social Work Podcast website at https://socialworkpodcast.com.