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A comprehensive evaluation of the community-based rehabilitation services (cbrs) program at priestley mental health in idaho. It examines the program's effectiveness in addressing mental health needs, particularly focusing on the challenges faced by cbrs workers in meeting state credentialing requirements. The document highlights the importance of a person-first approach, strengths-based interventions, and the need for ongoing evaluation and improvement in cbrs services. It also explores the role of social workers in challenging white supremacy and promoting diversity and inclusion within the mental health field.
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Professional Portfolio: A Social Work Journey Through the 10 Competencies Tessa Rae Nelson School of Social Work University of Montana SW 593 Professional Portfolio Committee Members Zak Reimer, SWLC David Wiltfong, LCSW Koltn Burbank, CPRP 1st Aug 2024
Competencies Narrative Appendices Presentation
Introduction My social work journey started well before I was born. My grandmother Donna had severe mental illness for most of her life. This often went unchecked and unchallenged. Due to these challenges, Donna frequently abused her children and allowed harm to befall them from her husband as well. Her choices directly led to family and generational trauma. In fact, it even struck me very personally. My mother struggled with her upbringing and how her childhood directly affected her. This compounded against my sister and me in our developmental years. Following our typical family patterns, I married an abusive husband who treated me poorly. Domestic violence was commonplace in our home. This included coercion, manipulation, emotional and physical abuse, as well as sexual abuse. It wasn’t until I started taking courses in my undergraduate classes that I began to see the abuse for what it was. With just a little education and further maturity, I realized what he was doing to me and gained the strength to leave him. Fast forward a few years, and I received my degree in Marriage and Family Studies from Brigham Young University-Idaho. Even before graduating, I knew I wanted to pursue social work, so I worked towards a certificate in human services, which included several social work classes. I understood that family dynamics were essential to understanding trauma and helping people who had stories like my own. However, I also recognized that social work had much to offer in terms of analyzing how large macro-systems affected people and understanding the importance of advocacy. After all, if I did not have advocates, it is possible I would not be here today. I originally planned on attending Boise State University online or the University of Kentucky to pursue an MSW. However, I am glad that I attended the University of Montana.
Here, I have learned extensively about the core competencies of social work practice and feel that the assignments and practicum placements added to my extensive personal knowledge and lived experience. This portfolio investigates my projects, clinical practicum placements, and human service work at Utah State University throughout the MSW program. Within my narrative pieces, I explain how each domain informed and educated me as I worked on them in my generalist years and advanced specialization year. The Core Competencies Core Competency 1: Demonstrate Ethical and Professional Behavior Originally, I saw myself completing my practicum placement at a domestic violence shelter, helping women who had been in a similar situation as I had been in. However, I felt compelled to continue my service at Priestley Mental Health in Preston, ID. I had originally been working there as a peer support specialist. However, their community and school services further piqued my interest. My practicum placement started at school systems in the area. My ability to understand dynamics kicked in as I worked consistently with children and adolescents with mental, behavioral, and developmental challenges. I noticed that children weren’t going to adults with their concerns, and often felt misunderstood by school staff. It became clear that these children needed someone who understood them and would advocate for them. I quickly adopted the role (See Appendix A). During my specialization year, a teacher used shame-tactics on my client by comparing him to his brother during a crisis. After consulting with the program director, I was able to approach the teacher regarding her approach with my client and expressed my concerns about using shame-based methods. We discussed how shame-based tactics harm self-esteem and create
the best practices to use with my clients. I pursued this by reading the textbook Best Practices in Psychiatric Rehabilitation (Nemec & Furlong-Norman, 2014) and working on my research skills throughout the MSW program. Core Competency 2: Advance Human Rights, Social, Racial, Economic, and Environmental Justice Frequently throughout the program, I challenged my worldview and upbringing. In my home and community, I often heard stereotyping about people who had been to jail or prison. However, clients whom I had known from Priestley Metal Health and people in my life had experienced the criminal justice system, and they were not what was projected onto them. Often, they were individuals who had made mistakes in the past and needed help, not hate. As I wrote and investigated the criminal justice system, I found human rights violations in almost every aspect. I began to realize where many of the stereotypes came from—targeted messages focused on the person as a problem but failed to consider how the system failed people who experienced being criminalized. Many individuals believed in rehabilitation as a concept, but not in practice, further others people who have been to jail or prison (O’Hear, & Wheelock,
the criminal justice system prevents people from moving forward in life and why reform is so necessary to advance human rights. It reinforced the significance of the value, dignity, and worth of a person. The system appeared to have taken away his worth in the workforce. However, every person has inherent worth they can add to any situation. Without the ability to demonstrate skills, it further others people similar to my client. Throughout both my generalization and specialization years, I was exposed to the harms of the criminal justice system and realized how important it is to be aware of how it affects individuals trying to improve their lives. This informed my practice by helping me become more aware of the issues so I can better advocate for and assist my clients who are trying to move forward. One of the ways I have done this is by helping my client prepare for these challenges within an interview process and modeling how he can advocate for himself. Core Competency 3: Engage Anti-Racism, Diversity, Equity, and Inclusion One of the more significant ways I had to check my biases and worldview was through religion. I started this process when I decided to leave my life-long faith during my last year at Brigham Young University-Idaho. Many of their teachings on LGBTQ individuals no longer lined up with my more current views on humanity and morality. The incongruencies of my newfound beliefs while attending a Mormon school were difficult to manage. However, I often spoke up in classes and pushed back against the heterosexual narrative. While I attended the University of Montana, I had the opportunity to discover how to help my alma mater and the affiliated schools adhere to Title IX. My classmate and I focused on creating long-term change and culture within the universities. We focused on helping professors and academic personnel understand the importance of intersectional identities within faith and
employees become certified. They provided one textbook for the site that employees were expected to share with one another as they prepared. For my project in SW 521 Advanced Research and Program Evaluation, I decided to use evidence-based research to assist Priestley Mental Health in training and preparing their employees for the exams. To do this, I created an extensive backwards map that demonstrated how each step of the plan would aid and inform the process. This project taught me the skills of looking at an unintended result, seeing how it developed to that point, and making thought-out steps to ensure the desired result (See Appendix D). To do this, I focused on Andrea Anderson’s Theory of Change (2006) and researcher Peter Senge’s mental models and his ladder of inference (Senge et al., 2009). These theories taught me how to generate assumptions about the agency and why failure was so common by looking at a situation backwards from an unintended result. I then was able to utilize preconditions that helped employees succeed and determined what interventions would be necessary to create successful passing rates (See Appendix D). Unfortunately, I did not have the power to implement any changes from my position at the agency. What the project did for me was demonstrate the process of planting and creating lasting change for workers, help them advance their skills, and meet state requirements. When I started work at Priestley Mental Health, I did not see the challenges that the agency had. To be honest, I was just glad to have employment and a place where I could do my practicum placement and grow myself as a professional social worker. However, after a couple of years of being placed there in my practicum, I started to see larger issues. As I developed my values regarding the disenfranchisement of racial groups, I discovered that the agency does little
to challenge racism within the community. This becomes a focus repeatedly throughout my specialization year and in core competencies 9 and 10. Core Competency 5: Engage in Policy Practice To demonstrate this competency, I returned to issues regarding the LGBTQ community and the Church of Jesus Christ of Latter-Day Saints, also known as the Mormon Church. I decided to further educate myself and understand the history behind homophobic policies and practices, especially in their universities (See Appendix E). I was surprised to discover that government policies are what directly encouraged homophobic messages from the church. Church leader J. Ruben Clark worked in the U.S. government during the Red Scare. People in the government believed that queer individuals were more likely to be communists. Shortly after those messages, Clark publicly condemned homosexuality, instilling beliefs in the congregation against LGBTQ individuals for decades (Prince, 2019). This encouraged the policy that any homosexual member would not be admitted to their church-related universities (O’Donovan, 2006) (See Appendix E). After researching this material, I considered how government trends affected religion, especially around disenfranchised groups. It reminded me of conversations with my sister where we discussed how LGBTQ members were treated and why these people were handled roughly. I developed the opinion that the government and religion should not affect each other when considering the treatment of minority groups. When it does, it places any lifestyle that differs in a separate group, encouraging judgement and othering. However, I also read that as more push back from those outside the Mormon community occurred against the heterosexual narrative, the members began to become sympathetic. The Mormon leadership then changed church and university policies to be less severe. They
I have lived in Franklin County for five years. During that timeframe, there was never a victim advocate for the County. During the last couple of years of my undergraduate studies, the lack of services became an issue when my ex-husband decided to continually stalk and harass me. I needed to get a protective order. I was warned to avoid getting one where I lived because it likely would not have been granted. Therefore, I petitioned for one in Brigham City, UT where some of the crimes took place. This incident planted seeds for me to investigate this topic regarding services for other battered women in Franklin, ID. Through my research, I discovered that the county used to have a victim advocate, but there were serious issues regarding her role. These included conflicts of interest and ability to perform services (See Appendix F). I interviewed C.C. (anonymous for privacy concerns). She was the previous victim advocate for Franklin County. Upon being hired, the county expected C.C. to find a grant that would pay for her services. She was shocked that they did not already have funding. In addition, C.C. did not have any education or background in human service work and frequently felt that she did not have the proper credentials to help some of the women with the challenges they were facing regarding abuse. C.C. did a significant amount of research on her own position to be able to adequately assist these women (See Appendix F). In addition to these challenges, C.C. quickly recognized that she was not working for the abused women and their interests. Since the position was funded through the prosecutor’s office, they expected C.C. to pressure women to talk to police and press charges, even if those actions were not in their best interest (See Appendix F). These issues with power dynamics continued to grow. Jane Doe (anonymous for privacy concerns) is a domestic violence caseworker employed by a Utah shelter and placed over victims
in Franklin County. She also identified larger issues with systematic power imbalances. She expressed that a certain judge in Franklin County frequently gave minimal punishments to individuals who were of the same religion as him. She expressed that there were times when volunteers would gain more consideration and attention than her in court due to religious preferences. She said this attitude hurt community trust extensively with the court system (See Appendix F). My last interview was with B.S. (anonymous for privacy concerns). He is a probation and parole officer in Franklin County. He expressed that the lack of a position affected those in the Hispanic community directly. Frequently, abusers in relationships with Hispanic women would threaten to get them deported or in trouble with the law. He argued that if services were offered, Hispanic women needed to be taken into consideration (See Appendix F). When it came to the project, I recognized that a victim advocate position needed to be created. However, it had to avoid the pitfalls of the previous position and the power imbalances that existed within the county. In my plan, I described a situation where the community would receive educational sessions from Priestley Mental Health on what domestic violence looks like to challenge patriarchal systems common in the culture. It also would describe how Hispanic women faced diverse challenges regarding this issue (See Appendix F). I also set certain expectations for the position. For example, the position would require someone who has at least a bachelor’s degree in a human service-related field. The job would also require someone who could speak both Spanish and English to assist the entire population, being able to assist Hispanic women who may be victims of domestic violence as well (See Appendix F).
I felt grateful for the opportunity to write a court report and understand the needs of a family from a cultural lens. In fact, A New Zealand study revealed that culture is essential in mental health services. Researcher Durie wrote about its importance by explaining the cultural ties to wellbeing and four interacting dimensions:
With Susie’s case, I explored how attachment challenges would limit her feelings of safety when being vulnerable with a therapist (Malchiodi, 2020). I would begin by letting Susie choose her art intervention to make her feel comfortable. One of the therapies proposed to Susie was the “Tree of Life” activity. Susie would draw and color a tree; the roots would represent the past, the trunk would represent the present, and the branches would represent the future, helping her process her trauma while looking at it through the scope of her life (Malchiodi, 2020) (See Appendix K). Malchiodi’s writings continued to inform my practice even when an art intervention was not being utilized. Her writing on the importance of establishing relational trust and rapport helped me understand my clients and build their trust (2020). For example, while in my specialization year, one of my clients had been heavily bullied by girls at school. I could tell that he seemed nervous around me and hesitated to communicate his feelings. However, since I had discussed his past with the program director and knew of it, I was able to slowly build rapport with him. I took an interest in his hobbies and supported his likes and dislikes. This client eventually got along well with me, and it allowed my crisis interventions to be more effective when giving him suggestions. Core Competency 9: Evaluate Practice with Individuals, Families, Groups, Organizations, and Communities As I have mentioned before, Priestley Mental Health resides in Franklin County. This is a largely rural county in Southeast Idaho. The mental health agency is the only one that provides therapy and services at large. Therefore, it is extremely important that services from the various providers are fully evaluated to ensure client satisfaction.
Currently, there are no ways to ensure client satisfaction for the children who are receiving psychiatric rehabilitation or community-building skills in the school system. The agency has largely used oral reports from the children to determine their fulfillment levels. For example, if I were to assess my client’s satisfaction levels, I would directly ask him if he felt that the services being provided were helpful. There are problems with this approach. A child may not be comfortable with talking to the practitioner about their dissatisfaction. Therefore, in SW 521 Advanced Research and Program Evaluation, I decided to create a more effective system on how to accurately assess client services. I targeted two research questions regarding satisfaction levels in children that focused on effectiveness and relevance of the intervention, as well as if the child felt seen by their worker. (See Appendix I). I then proceeded to create an evaluation process that would provide the opportunity for unbiased participation. I focused on ensuring children would feel comfortable participating in it. I drew upon knowledge from research in the class as well as how surveys were utilized at other places I had worked at in human services. At the beginning of a school year, a survey was also sent out to the parents to establish a baseline that would indicate the status of services before client satisfaction questionnaires began regularly. Then, two questionnaires designed to analyze person-first approaches were distributed via email every 60 days throughout the school year to both the clients and their parents. A mixed-methods approach was used in the questionnaires and assessments because it considers both quantitative and qualitative data (Bamberger et al., 2006) while utilizing aspects of both outcome and impact-based methods of evaluation, which can be utilized to assess whether the overall program is meeting its goals and how it is affecting the target population (Fridrich, 2018) (See Appendix I).
