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Becoming a Clinical Social Worker

After close to 2 years since MSW graduation from North Carolina State University, I am only weeks away from becoming a fully licensed clinical social worker.  Transitioning from student to professional has been both challenging and gratifying. There have been moments where my clinical acumen has been tested and also times in which I feel immense joy to be doing what I love. Each experience further enriches not only my career but my personal life as well.

A few months ago, I first listened to the Social Work Podcast’s episode featuring Dr. Danna Bodenheimer, LCSW, author of Real World Clinical Social Work: Find Your Voice and Find Your Way. I appreciated Dr. Bodenheimer and host Jonathan Singer’s conversation as to what it means to become a clinical social worker. I was comforted that many of the questions I ask myself about my abilities in this profession waswere raised in the episode.

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Pondering HB2

NC House Bill 2 has raised quite a commotion and well it should. It blatantly discriminates and is a desperate reaction to the increased level of acceptance that the rest of our state and the country have adopted.

Yet I can’t help but wonder if this bill is simply a distraction. When I step back, it seems HB2 could be a ploy to keep us focused on bathrooms rather than other and potentially more egregious though less overtly visual forms of discrimination. For instance, why didn’t we all rally, boycott, mail letters and storm the legislature when our Governor decided not to expand Medicaid? Medicaid expansion would not only have significantly improved the lives of transgender individuals but also countless other disenfranchised members of our state denied the right to basic healthcare services.

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NCSCSW Supports HB516

NCSCSW announces support for ban on conversion therapies. Partnering with Equality NC, Born Perfect Campaign, and Campaign for Southern Equality, NCSCSW supports Legislation banning the use of conversion therapies with minors and adults with disabilities.

What You Need to Know About Technology Assisted Therapy

Many people would like to be able to expand their practices and the clients they serve. Providing sessions via video or telephone is an appealing option to accomplish this. Technology assisted mental health services can also serve an important purpose, including:

  • Providing access to mental health services in rural, remote areas where in person services are not available or are inaccessible due to distance;
  • Enabling those who are house bound or lack necessary transportation to not have to go to an office to receive needed mental health services;
  • Making therapy more convenient and accessible, which may make it more likely people will seek treatment;
  • Allowing continuity of care, if a client moves away from their treating provider;
  • Enabling clients to access certain specialty treatments that might not be available to them locally.

Given all these advantages, there are also important considerations and guidelines to which you should be aware. Most importantly, per the NCSWCLB (NC Social Work Certification and Licensure Board) Position Paper on Technology Assisted Services, an LCSW who chooses to provide distance services (which includes video psychotherapy) must at minimum, determine the need for licensure in the State in which the client resides along with being licensed to practice as a LCSW in NC. This means ensuring compliance with regulatory/licensure requirements for the jurisdiction in which the social worker provides services as well as the jurisdiction in which the client receives services.

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Part 2 – Racial Reconciliation: Inviting Curiosity to Resist Unintended Racism

Curiosity has served me well in my relatively short career as a social worker. Whenever I find myself deep in the mud of bias, it is a kind way back to the Rogerian stance of “unconditional positive regard.”   When practiced curiosity keeps me out of judgement. Recently, I stumbled upon the concept of the Curiosity Quotient (CQ), as compared to the Intelligence Quotient (IQ) and Emotional Quotient (EQ), it has been a helpful framework as to what was missing among my colleagues while we were discussing racial bias and white privilege.  According to Dr. Thomas-Prezuic, a business psychologist,  people with a high Curiosity Quotient (CQ) are characterized with having a “hungry mind,” and  are open to new novel experiences. These people are better able to hold ambiguity.  Dr. Thomas-Prezuic asserts that we can encourage others to develop their CQ, over EQ or IQ.

As part of a workshop, I sat in a presentation titled “Culture-Based Countertransference” with one hundred other social workers and a few other allied professionals. To call this a presentation would mischaracterize it. For the depth of our exploration, and the visceral reactions that were induced went far beyond a few PowerPoint slides with bulleted texts.  Dr. Jacalyn Claes, LCSW, a white woman, and retired social work professor, unassumingly sauntered throughout the conference room, as she provoked us to process both individually and collectively the rules and messages we had been socialized to internalize. We sat and considered how our individual culture, —learned perspective, as it was defined—had been instilled by our families, churches, communities, schools and then finally our social work profession. We were invited to consider how these conscious and unconscious views create, “cultural tunnel vision.”  We examined how this countertransference due to this tunnel vision interweaves both–positively and negatively–with our assessments and interventions with our clients.   At this point of the dialogue, the conversation was benign, non-threatening, yet engaging.

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Thank you, Wayne!

After 10 years of dedicated and invaluable service, WAYNE TOWNSEND is stepping down as the Administrator for the North Carolina Society for Clinical Social Work.  Wayne has been a guiding force for the Society, helping to steer us through good times and not-so-good times. His wisdom, dedication, and hard work have been integral in the work we have done together all these years.

Thank you, Wayne!

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ETHICS Committee Revamps! Please Submit Your Inquiries or Scenarios

In an effort to provide Ethical Practice Tips or respond to scenarios where there is an ethical question, the Board has determined that we will provide members with a monthly ethics column.  This column will provide a tip about ethical practice or it will provide a scenario that involves an ethics question and provide a guide for responding in an ethical manner!  Please submit your inquiries!  We will publish them without your name, or with your name, whichever you prefer!

This column will replace the individual ethics consults.  There are several reasons for this revamp-one is that few members used the individual ethics consults; second is that it seems that many questions are similar–often about boundaries and dual relationships and because of both of these, it seemed that we could be most useful to a large group of clinicians if we posted something on a regular basis that provided information on ethical practice.

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Racial Reconciliation: Do White Therapists Talk to their White Clients about Race?

When I first began writing this text, in the days following Charlottesville, I was in a different state of mind to where I am now. It is through a few relational transformative experiences and with the healing elements of time, I find myself more prepared and grounded to continue to complete whatever I have to offer. I cannot say that I have any less apprehension in publicly sharing this piece but I am more confident in knowing that this conversation will at least fall upon some friendly white ears.

Author Toni Morrison asserts in her discussions of race and identity that scholars have spent decades examining the question of how racism and white supremacy have affected people of color without fully exploring how these contexts have shaped the lives of white people. In a 1993 interview, Morrison stated that white supremacy and racism have as much of a, “deleterious effect on white people, and possibly equally as it does on black people.” In the shadow of Charlottesville, I have been sitting with this very notion. It reminds me that when I was in middle school, I often imagined how white people speak to each other when no people of color were around. When a news story about racial discrimination came on the television, what was said when I was not present?

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ICYMI: “Becoming a Clinical Social Worker”

NCSCSW co-sponsored with NCAAPCSW a workshop on “Becoming a Clinical Social Worker”.

This was an event about clinical social work with 4 panelists from different career areas.

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What Does it Mean to Create a Trans-Affirming Practice? Part Two

Your trans clients will be navigating front desk staff, forms, intake interviews, and bathrooms. If you have office staff, they should all be trained in things such as: how to greet people without gendering them, how to speak about sensitive information without others being able to hear it in the waiting room, how to use preferred names even if the legal name is different on paperwork.

Forms should allow people to self-identify their gender, pronouns, sexual identity and relationship structures. In intake you can ask about “chosen family” versus “people who raised you” and so on. Learn who someone is “out” to and who they might not want you to use preferred names and pronouns with. This will take practice and thoughtfulness on your part. Educate yourself on types of microaggressions gender non-conforming people face on a daily basis, their emotional impact, and recognize the likelihood of trauma histories.

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ICYMI: Ethical Considerations in Working with African American Clients

Dr. April Harris-Britt delivered a critically important message to all who attended her ethics workshop: Ethical Considerations in Working with African American Clients. She cautioned us about the possibility of unintentionally harming our African-American clients by relying on therapeutic approaches that reinforce dominant cultural values and unwittingly create an unsafe space.  She emphasized our ethical responsibility to become more sensitive and competent in our work with African Americans.


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What Does it Mean to Create a Trans-Affirming Practice?

We see a lot of providers now advertising as “safe”, “accepting”, “lgbtq-friendly” or “trans-friendly” clinicians, practices, and offices. While that’s an improvement from the past, these labels stop short of being truly affirming. There’s a difference between being “okay with” or “non-judgmental of” someone and understanding and celebrating their existence and experiences.

And one more personal opinion is that I can’t designate myself as a “safe space”. Other people with varying identities have to determine the level of safety they feel in my office and in my presence. And I have to be open to feedback about that.

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SWM17: Social Workers Stand Up

Happy Social Work Month!

This year’s theme from the NASW of “Social Workers Stand Up!” is a call to action to the field and the general public to account for the significant and meaningful contributions made by social workers to the greater society.

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Women’s March: What Next?

The Women’s March may be the largest organized protest in US History with an estimated three million participants nationwide. Women and men from across the globe gathered in sisterly solidarity as we took a stance to say, “we are watching.”  A full spectrum of feminists were present and accounted for: women wearing cat ears, little girls carrying girl-power signs, men as allies, and women who have done this before. While each person there likely had their own motivations for attendance, I truly felt the fruition of the March’s mission statement: “We will not rest until women have parity and equality at all levels of leadership in society. We work peacefully while recognizing there is no true peace without justice and equity for all.” We gathered by the millions and no one was arrested. We showed up in peace and with conviction. We made herstory and I am so humbled to say I was part of it.

My question for women, especially my social work sisters and brothers, is “now what?” Where will we take this momentum and feelings of togetherness?  The mass media would have us think because The Women’s March was a joining of a myriad of causes and not a singular, specific, call to action it runs the risk of not gaining traction. I challenge the sentiment that success should be measured by our collective ability to have a large impact on one particular thing. What if we measured success through individual action and community engagement? What if each person who attended the March chose to participate in their community in a new way? In Raleigh alone we would have about 17 thousand people participating in a variety of community agencies, each person engaging in a way that feels authentic to them. Our own community would feel a tremendous impact:

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ICYMI: Mentalization Workshop

Dr. Margaret Arnd-Caddigan, PhD, LCSW is a well-loved professor of social work at East Carolina University.  Those who attended her workshop on Mentalization-Based Therapy understand why! During the two-hour introductory workshop, Dr. Arnd-Caddigan broke down the theoretical concept of mentalization (the process of becoming aware of the mental states in oneself and others), making it accessible and explaining its importance in working with hard-to-reach clients; she provided practical, process-oriented guidance for mentalizing clients and for fostering clients’ abilities to mentalize; in the final half hour, she responded to participants’ questions. She did it all with creativity, humor, authenticity, curiosity, open-mindedness (generating alternative possibilities), playfulness, and care, modeling aspects of a stance conducive for helping clients to learn to mentalize.

Following the “inspiring” (as one participant described it) workshop, many participants lined up to participate in her research on clinical intuition, an extension of her work with mentalization.

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Mentorship Program Update

It is with much excitement that the Mentorship Committee announces our new process for applying to our Mentorship Program as either a mentor or protégé! We have worked to streamline the process in hopes that it will be more user friendly and thus easier to take advantage of this unique service the Society offers its members. Please check out our new webpage and share with any friends or colleagues you think would like to participate in our Mentorship Program as a mentor or protégé.

In the past 5 months we have successfully connected 5 protégés with their own mentor! One of these connections resulted in a new job for one of our protégés. Great things are happening in NCSCSW and we’d love for you to be a part of it.

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The Election

The election is over, and the results are in. Reactions range from grief to elation, fear to hope. Some feel exhausted, bewildered, and defeated. Others see opportunity for positive change. The election also brings a great deal of uncertainty about what to expect as we go forward. It seems all but certain that the ACA and immigration policy, to name two, will change. I want you to know that NCSCSW will be your ally as we face changes in policies, laws, and regulations that impact us and the people we advocate for. We will continue to be your voice, and we want to hear your voices too. Let us know your ideas and concerns so that we can support you better.

Laura Groshong of the Clinical Social Work Association reminded us this week that nothing should or will  change our “need to respect and fight for the value of all human lives.” That is what we do, regardless of the particular political environment of the day. Remember that activists have had to persuade politicians of both major parties to "evolve" on gay marriage. That is where our effectiveness lies – to educate and advocate. As one of our members told me, 'I am not quite ready for action, but I can see that very soon I will be.' We all will be, and we will do it together.

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Websites: Symbol of Change, Fear and Growth.

Today, I am publishing a new website. This event marks a major accomplishment in my life and work. It has been months in design and years in the making. Although I am a rule breaker, I am not a risk taker. I love to learn but I do not like to take on something that intimidates me. I work hard, but only on things I love to do. At least that was the story I told myself and I stuck to it for many years.  So when someone suggested in 2014 that I start a blog, I stated with no hesitation or doubt in my mind, that It would be impossible and that I could not possibly do it.

Just Not Possible

I was told to “Sit on the deck, have a glass of wine and write 250 words while enjoying the outside.” Again, I was ready with a great reason that would not work. The mosquitoes in my backyard are big enough to carry me away – there is no way it would be comfortable.  Overall, I was convinced this was an impossible proposition.

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ICYMI: Emotionally Focused Therapy Workshop

Lorrie Brubacher, M.Ed., LMFT, delivered an engaging training in September on Emotionally Focused Couples Therapy (EFT).  This workshop was an introduction that explained the basic theory of EFT and its goal of transforming relationships from distress to secure bonds. Through case study examples and video of sessions, attendees got clear, clinical examples of how to use EFT with couples. In the afternoon, attendees practiced the model through role-plays which provided an opportunity to apply and experience the power of using EFT with couples in distress. Work with couples is often described by clinicians as hard work, overwhelming and even emotionally draining; however, after Lorrie’s training, those who attended left feeling energized and excited to use skills learned with couples. One clinician even stated, “I hope to get more referrals for couples soon!”       

More feedback included:

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Girls and Sex

Talking to teenagers is hard work – especially for parents. But being a teenager is perhaps even more difficult.

I have a theory that we often respond to our teenagers out of our own fear and regret. Looking back with the hindsight of lessons learned the hard way, we speak to them as if speaking to our younger selves: “don’t make the same mistakes I made…you should not worry about that…make wiser choices.” This, I would argue, comes from a place of love and a desire to protect our precious children from danger, and more directly, from pain. And yet, we miss them entirely in the process. This dynamic is perhaps no more evident than when talking (or not talking) to our teenagers about sex.

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