Provides information on all things social work, including direct practice (both clinical and community organizing), research, policy, education... and everything in between.
I was excited to talk with Dr. Freedenthal because she's come up with 89 tips and techniques that you can start using right away with suicidal clients.
In today’s episode, we talk about five of them:
Tip #10 – Embrace a Narrative Approach: “Suicidal Storytelling”
Tip #35 – Know When and Why to (and not to) Pursue Hospitalization
Tip #36 – Know Why not to Pursue Hospitalization
Tip #64 – Incorporate a Hope Kit
Tip #88 – Propose a Letter to the Suicidal Self
The most basic critique of the DSM-5 is the same critique that has been levied against psychiatry for decades: that it does nothing more than medicalize or pathologize normal behavior. So is it ever ok to say that someone isn’t normal? Are there ever situations where giving a diagnosis is good? As it turns out, yes. And I’m not just talking about diagnosis as a means to finance treatment. Yes, third party reimbursement hinges on diagnosis. But I’m talking about something less institutional and more personal. There are people who like labels, who find comfort in being able to name or label what is wrong. The label draws a boundary around an experience. Labels can even draw up boundaries around a group of people. According to psychologist Gary Greenberg, “[the label] Asperger’s syndrome gave people whose primary symptom was isolation a way to belong and provided resources to those who were diagnosed” (Reese, 2013).
So, I know what you are wondering - is DSM diagnosis good or bad? Well, today’s episode won’t be the definitive answer to that question. But, it will give you cause to pause when you think about the role of DSM-5 in the professional life of social workers and the people we serve. My guest is social work faculty member from Florida State University, Jeffrey Lacasse, Ph.D. Dr. Lacasse has published several critiques of the changes in DSM-5. In today's episode, Dr. Lacasse critiques the definition of mental illness, the empirical support for and reliability of most diagnoses, the politics associated with the DSM and the implications for social workers who represent the single largest group of professionals who provide DSM diagnoses.
[Episode 98] Today’s episode of the Social Work Podcast is about Cognitive Enhancement Therapy (Eack, 2012) - a relatively new approach to addressing some of the most persistent and intractable problems faced by people with schizophrenia. In order to learn more CET, I spoke with Shaun Eack, Ph.D. Dr. Eack has been involved in most of the clinical research on CET. He is the David E. Epperson Associate Professor of Social Work and Psychiatry at the University of Pittsburgh, and the director of the ASCEND Program, which stands for "Advanced Support and Cognitive Enhancement for Neurodevelopmental Disorders.
Download MP3 [36:08]
I spoke with Shaun at the 2015 Society for Social Work and Research conference. In our interview, Shaun talks about the development of CET, the computer exercises and group therapy - the two components of the treatment, some amazing research findings, and how social workers can get trained in CET.
[Episode 91] Today's episode of the Social Work Podcast is about shared trauma, one in which the provider and client experienced the same traumatic event simultaneously. If you're not familiar with the concept of shared trauma, no worries. It is a relatively new concept, but one that has been experienced as long as there have been helpers and... helpees.
In order to better understand shared trauma, I spoke with Dr. Carol Tosone, one of a handful of scholars whose writings and research have defined shared trauma. Dr. Tosone is Associate Professor at New York University Silver School of Social Work. She is a Distinguished Scholar in Social Work in the National Academies of Practice in Washington, D.C.
In today's episode, Dr. Tosone unpacks the concept of shared trauma. She uses her personal experience of being in a therapy session on September 11, 2001, when the first plane flew over her building, and how sharing the trauma of 9/11 with her client affected her professional and personal life. During our conversation she answered many questions: How does a concurrent experience of the same traumatic event as your client affect the treatment relationship? In what ways is it beneficial to the treatment relationship? How do you know when it is detrimental? We end our conversation with recommendations for practitioners.
[Episode 90] Today's episode is about adolescence. I spoke with Laurence Steinberg, who wrote the book Age of Opportunity: Lessons from the New Science of Adolescence.He is the author of approximately 350 articles and essays on growth and development during the teenage years, and the author, co-author, or editor of 17 books. He has been the recipient of numerous awards, including the American Psychological Association’s Bronfenbrenner Award for Lifetime Contribution to developmental Psychology in the Service of Science and Society and its Award for Distinguished Contributions to Research in Public Policy, as well as the National Academy of Sciences Henry and Bryna David Lectureship. In 2009, Steinberg was named the first winner of the Klaus J. Jacobs Research Prize for Productive Youth Development. In 2013, he was inducted into the American Academy of Arts and Sciences.
In today's interview Dr. Steinberg and I spoke about the growing gap between onset of puberty and the end of adolescence; challenges facing parents, providers, and policy makers to provide adolescents with experiences and skills needed to be successful; and how reconceptualizing adolescence as an age of opportunity rather than an age risk is an essential reframe to address the needs of this youth in this developmental stage. We ended our conversation with recommendations for practitioners, educators, and policy makers.
One note, even though Dr. Steinberg and I work in adjacent buildings at Temple University, I interviewed him over Skype because he was out of the state.
[Episode 86] Hey there podcast listeners. Today's social work podcast is about addressing suicide risk in schools. When we think about suicidal youth, we tend to think about hospitals and emergency rooms, or outpatient therapy. When we think about schools we think about standardized testing, or unfortunately the increasingly common mass shooting. But schools are an ideal place to address suicide risk in schools. That's why I was so excited to talk with two of the leading experts on youth suicide in schools. Jim Mazza, Ph.D. and Dave Miller, Ph.D. Jim is at the University of Washington and director of their school psychology program. Jim is the past-president of the American Association of Suicidology. Dave Miller, is at SUNY Albany in the educational and counseling psychology program. He is the president-elect of the American Association of Suicidology and author the highly regarded text, Children and Adolescent Suicidal Behavior: School Based Prevention and Intervention published in 2011 by Guilford Press
I spoke with Jim and Dave in April 2014 at the American Association of Suicidology conference. We talked about what is known and not known about what works to address suicide risk in schools, some of the barriers to implementing effective suicide prevention programs, and the value in framing school-based suicide prevention and intervention in a broader context, both as a way of selling the idea to school administrators and parents, as well as to think beyond just addressing students in a suicidal crisis. As an example, Jim talked about a curriculum he has been developing that uses concepts from Dialectical Behavior Therapy that is intended to improve emotion regulation and other issues in all students. [Update May 2016: Now available: DBT® Skills in Schools: Skills Training for Emotional Problem Solving for Adolescents (DBT STEPS-A)]
A couple of notes about the interview. I recorded it in my conference hotel room and you might hear some street noises in the background. Right before we recorded the interview we had been in the hotel lobby talking with Marsha Linehan, developer of Dialectical Behavior Therapy. This is important, not because I like to name drop, but because you'll hear Dave and Jim reference Marsha and the conversation they were just having with Marsha downstairs. It all made great sense in the moment, but could understandably be a bit confusing if you weren't with us. Downstairs. With Marsha Linehan. At one point Jim mentions research that he is doing with his wife, but doesn't mention her name. She is Elizabeth Dexter-Mazza, licensed psychologist and expert in Dialectical Behavior Therapy.
And now, without further ado, on to episode 86 of the Social Work Podcast, Addressing suicide risk in schools: Interview with James Mazza, Ph.D. and David Miller, Ph.D.
[Episode 84] Today's episode of the Social Work Podcast is about Motivational Interviewing, Third Edition. In today's episode I speak with Mary Velasquez, Ph.D., Centennial Professor in Leadership for Community, Professional and Corporate Excellence and Director of the Health Behavior Research and Training Institute at the University of Texas at Austin. Dr. Velasquez is a trainer for the Motivational Interviewing Network of Trainers and has been involved in research that informed the changes to Motivational Interviewing, Third Edition. In today's interview Mary talks about how she became involved with Motivational Interviewing, what has changed and stayed the same in the revised version of Motivational Interviewing, DARN CATS, the four change processes, and how people can experience Motivational Interviewing in less than 15 minutes.
[Episode 83] In today's Social Work Podcast I speak with Dr. Gail Wyatt, pioneering sex researcher, award-winning teacher, mentor, and researcher, and the first African-American woman to be licensed as a psychologist in the state of California. I spoke with Dr. Wyatt in April 2010 when she was at Temple University giving a talk about her research with African American HIV serodiscordant couples. Serodiscordant couples are those in which one partner is HIV positive and the other is HIV negative. Dr. Wyatt and her co-investigators had just concluded an 8-years investigation of a couples therapy intervention that they hoped would reduce HIV/STD risk behaviors in African American HIV serodiscordant couples. They called the intervention Eban which is "a traditional African concept meaning 'fence,' a symbol of safety, security, and love within one's family and relationship space" (El-Bassel et al., 2010, p. 1596) The Eban intervention combined components of social cognitive theory, historical and cultural beliefs about family and community preservation, and an Afrocentric paradigm. If you want to read more about the Eban intervention or the results of this clinical trial I’ve posted the links to those and related articles on the Social Work Podcast website. So, you’re probably wondering, after 8 years did it work? Yes. At the end of 8 years, and 535 couples later, the couples that were part of the Eban intervention used condoms more frequently and more consistently and reported fewer sexual acts without condoms than the couples in the health promotion comparison group. And I have no doubt that when the researchers finished running those analyses, they went "Phew! Thank Goodness!"
For today's interview, Dr. Wyatt and I talked a bit about the research, but mostly we talked about two of the techniques that were used in the clinical trial. The first was a way of having couples plan and enjoy safe sex. The second had to do with addressing past histories of abuse within the context of a consensual sexual relationship. It was at this point that the conversation moved away from couples therapy into a conversation about healthy sexual behaviors. Dr. Wyatt made the point that most health and mental health providers ask about a client's "age of first sexual contact" without distinguishing between consensual and non-consensual sexual contact. She pointed out that adolescents sometimes do not distinguish between the two. She encouraged providers to be more precise in their questions, and to find out if their clients are current victims of sexual abuse. We about how to include adolescent clients in mandated abuse reporting calls if current abuse is uncovered, and how to address the issue of sex among adolescents who are victims of past or current sexual abuse. And, as usual, I asked Dr. Wyatt if she could provide some resources for people who were interested in learning more, and she was happy to oblige.
In today’s Social Work Podcast, Corey and Sandy distinguish between Participatory Action Research (PAR) and Community-Based Participatory Research (CBPR) and talk why they use PAR rather than CBPR in their work with communities. They give examples of how challenging it is to actually do PAR. They talked about the need to bridge the gap between research and practice and how that was one of their motivations for writing their text, Change Research. Throughout our conversation Sandy and Corey bring up lots of ideas that are perfect discussion points for research classes, both at the masters and doctoral level.
There’s an old saying, “What’s the fastest way to cure mental illness in an entire group of people? Get rid of the diagnosis.” The proposed changes to DSM-5 get rid of some diagnoses and add others. But that's not all. If you're like me, you have lots of questions about changes to DSM-5.
When I posted the question “what would you like to know about the DSM-5” to the Social Work Podcast Facebook page 11 people responded in less than an hour and 20 people responded by the end of the day. So, what did they want to know? Jessica, Shelly, Sandy, Spring, Paul, and Suzannah wanted to know about autism, depression, and personality disorders. Shylah and Jen wanted to know about addictions. Lisa wanted to know what was up with ADHD. Ciarrai and Lyndon posed some great questions about the merits of DSM diagnosis in social work practice.
In today's Social Work Podcast, I speak with Micki Washburn, MA, LPC-S, NCC and Danielle Parrish, Ph.D. about proposed changes in DSM-5. We talked about the cross-cutting dimensional assessment, changes in the organization of the DSM-5, and changes in diagnoses such as ADHD, Asperger’s, Autism, Depression, Substance Use, and personality disorders. We talked about some of the intended consequences such as greater accuracy for diagnosis, and some of the possible unintended consequences such as loss of funding for diagnostic-specific services. We end with some thoughts about social work’s role in the new DSM.
[Episode 74] Today’s Social Work Podcast is an interview with Shawn Christopher Shea, M.D., developer of an approach to uncovering suicidal ideation and intent called the Chronological Assessment of Suicide Events (CASE) approach. In today’s episode, Shawn takes us through the CASE approach. He explains the value of assessing for suicidal content at different time points and emphasizes that eliciting suicidal ideation and intent is a difficult and sensitive topic. He talks about how moving through the CASE approach to help establish a therapeutic alliance and rapport with suicidal clients. He emphasizes the art of the interview, using validity techniques, and how we use words as central to uncovering suicidal ideation and intent. He talks about how the CASE approach is useful for any mental health provider. Shawn makes the argument that the CASE approach is an ideal approach to for assessing for suicidal risk that doesn’t sound like a pat suicide assessment. He emphasizes that the CASE approach is one-third of a thorough suicide assessment, the other two parts being identifying risk and protective factors, and the final part being developing a clinical formulation.
This figure represents the three components of a thorough suicide assessment. The CASE approach provides a framework for assessing the information in the red square (ideation, plan, behaviors, desire, and intent).
Shawn has written that a thorough suicide assessment has three parts: 1) Gathering information related to risk factors, protective factors, and warning signs of suicide; 2) Collecting information related to the patient’s suicidal ideation, planning, behaviors, desire, and intent; and 3) Making a clinical formulation of risk based on these 2 databases. He writes that in the “clinical and research literature, much attention has been given to the first and third tasks (gathering risk/protective factors/warning signs and clinical formulation). Significantly less attention has been given to the second task—the detailed set of interviewing skills needed to effectively elicit suicidal ideation, behaviors, and intent. But in many respects, it is the validity of the information from the second component that may yield the greatest hint of imminent suicide.” (Shea, 2009, p. 1).
My interview with Shawn is a single episode in two continuous parts. In Part I Shawn and I talk about the CASE approach, including some of the validity techniques he has developed or uses to elicit suicidal ideation and intent. In the second part Shawn and I do a role play where he uses the CASE approach.
[Episode 65] Today's episode of the Social Work Podcast is on the process of Evidence-Based Practice. I wanted to do an episode on Evidence-Based Practice because it has been the subject of a lot of debate in Social Work. One of the controversies is over how to define evidence based practice. In order to get some insight into the Process of Evidence-Based Practice, I spoke with one of social work's leading experts on the topic, Dr. Danielle Parrish, assistant professor with the University of Houston, Graduate College of Social Work. In today's interview, Danielle and I talked about the difference between the process of evidence-based practice and evidence-based practices, also known as empirically-supported treatments. We talked about why social workers should use the evidence-base practice process. Danielle identified some of the limitations of the EBP process, resources for social workers interested in accessing the evidence-base, and ways that social workers could support each other in being evidence-based practitioners.
Listeners of the Social Work Podcast, followers of the Social Work Podcast Twitter feed (@socworkpodcast), and fans on the Social Work Podcast Facebook page responded to a request to vote for their preferred definition of Evidence Based Practice. The results were surprising:
[Update] Next week I'm posting an episode on Evidence-Based Practice. The interview is really nice and I think you'll really like it. With all episodes I do an intro where I introduce my guest, talk about why this topic is relevant to social workers, and then talk about what is covered in the interview. And so that's all well-and-good. Except that I've struggled with this intro because everyone seems to have a different understanding of what is Evidence-Based Practice.
So, this is where you come in. Twice.
First thing - at the top of this page you'll see that I've posted a poll. Take a minute – literally one minute – and select the definition of EBP you most agree with. I'm going to use the final tally in the introduction.
The second thing is I want to hear from you. I want to know how you use evidence-based practice in your social work practice. There's a very easy way to do this: call and leave a message on the Social Work Podcast answering machine – 215.948.2456. You can either dial the number directly, or go to make the call for free, on the upper right-hand side of the Social Work Podcast website click on the “CALL ME” button and Google will connect you to the answering machine for free. When you call, tell me your first name, where you're from, and what you think. If you can help me out with those two things – the poll and the voicemail, I'll be set for next week.
Thanks so much for listening to the Social Work Podcast, check back next week for the episode on Evidence-Based Practice, and keep on making a difference wherever you are.
Risk for suicide among gay youth has caught a lot of attention in the American media as of late. There have been a number of youth who have been bullied because they have been gay or perceived to be gay and who have consequently died by suicide. Dan Savage and friends and colleagues and supporters have put together an amazing project called "It Gets Better" (http://www.itgetsbetterproject.com/) focusing on the issue of youth suicide for gay, lesbian, bisexual, transgender, question and queer teens.
Now there is good reason for this. According to the U.S. Government’s Report of the Secretary's Task Force on Youth Suicide, gay and lesbian youth bear an increased risk of suicide, substance abuse, school problems, and isolation because of a "hostile and condemning environment, verbal and physical abuse, rejection and isolation from [peers and family]" (Gibson, 1989). Social worker and pioneer gay and lesbian researcher Caitlin Ryan, found that lesbian, gay, and bisexual young adults who reported higher levels of family rejection during adolescence were 8.4 times more likely to report having attempted suicide, 5.9 times more likely to report high levels of depression, 3.4 times more likely to use illegal drugs, and 3.4 times more likely to report having engaged in unprotected sexual intercourse compared with peers from families that reported no or low levels of family rejection (Ryan, Huebner, Diaz, & Sanchez, 2009).
So, here’s the thing. Families who reject their kids are doing their kids a huge disservice. And that’s the point of today’s podcast. Today I’m talking with Dr. Cynthia Conley about the concerns of heterosexual parents of gay and lesbian youth.
[Episode 57] Today's Social Work Podcast is on community-based prevention services for children and adolescents. I spoke with Dr. Richard F. Catalano, who along with J. David Hawkins, developed Communities That Care, a prevention-planning system that promotes the positive development of children and youth and prevents problem behaviors, including substance use, delinquency, teen pregnancy, school drop-out and violence. It is a system for identifying community needs, matching those needs to evidence-based prevention programs, and evaluating the outcomes. The system has been used in dozens of communities around the United States, and has demonstrated effectiveness in reducing problem behaviors and promoting positive youth development.
Today’s Social Work Podcast is on Suicide and Black American Males. Why suicide and Black Americans? Well, there is a belief among most Americans, and particularly among African American adults, that Black Americans do not kill themselves (Joe, 2006). When we think of violent death among Black Americans we think of homicide. Suicide is thought of as a “White” problem. While it is true that suicide was not a leading cause of death for African Americans 40 years ago, today it is the third leading cause of deaths among African Americans 15 – 24 years of age. So why Black American Males specifically? Well, among all racial and ethnic groups, the suicide rate is lowest among Black American females. Given that Black American males, particularly youth, are over-represented in social services, social workers need to be aware of the risk for suicide, and prepared to provide potentially life-saving services. One thing that makes social workers professionals is that we are trained to see things that others do not. Most of us have not been trained to see suicide as an important issue in the Black American community. It is my hope that after hearing today’s guest, Dr. Sean Joe, you will be more likely to see suicide among Black American males as an important clinical and programmatic issue.
Sean Joe, PhD, MSW, joined the Brown School in Fall 2014 as the Benjamin E. Youngdahl Professor of Social Development. His research focuses on Black adolescents' mental health service use patterns, the role of religion in Black suicidal behavior (NIMH), salivary biomarkers for suicidal behavior, and development of father-focused, family-based interventions to prevent urban African American adolescent males from engaging in multiple forms of self-destructive behaviors (e.g., suicidal behavior). When this interview was recorded, Dr. Joe held a joint position as associate professor in the School of Social Work and the Department of Psychiatry at the University of Michigan's School of Medicine. He also served as a faculty associate and Associate Director for Research and Training at the Program for Research on Black Americans at the Institute for Social Research, University of Michigan. Dr. Joe is a nationally recognized authority on suicidal behavior among African Americans. He is the 2009 recipient of the Edwin Shneidman Award from the American Association of Suicidology for outstanding contributions in research to the field of suicide studies and the 2008 recipient of the Early Career Achievement Award from the Society for Social Work and Research. He has published in the areas of suicide, violence, and firearm-related violence. Dr. Joe served on the board of the Suicide Prevention Action Network (SPAN USA), the scientific advisory board of the National Organization of People of Color Against Suicide, and the editorial board of Advancing Suicide Prevention, a policy magazine. He is the Founder and Director of the Emerging Scholars Interdisciplinary Network, a national interdisciplinary and mutli-ethnic professional development network for early career social and behavior scientist.
In today's podcast, Sean talks why it is important to look at the suicide rate among Black American males, specifically adolescent males. He talks about how recent research has started to put together a profile for Black American Males most at risk for suicide, and the factors that seem to protect against suicide. He talks about some of the social and historical factors associated with the increase in suicide rates among Black Americans. Sean gives an example of how he talks with Black Americans about suicide and stigma. We talked about recommendations for social workers who are working with Black American males who might be suicidal, including talking about faith, valuing that child, having a vision of that child as an adult, and healthy masculinity. Sean discussed some resources for social workers interested in learning more about this topic. We ended the interview with Sean extending an invitation to social work clinicians and researchers to join him to better understand suicide and suicidal behaviors in Black Americans.
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 (SSWR) annual conference. If you listen closely you can hear the sounds of San Francisco in the background: a clock chiming, buses 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. So, without further ado, on to episode 56 of the social work podcast, Suicide and Black American Males: An Interview with Sean Joe, Ph.D., LMSW
[Episode 55] Today’s Social Work 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.
[Episode 44] Today’s podcast is the second in a two part series on measurement for clinical practice and research. In today's podcast I speak with Dr. Mary Rauktis about the difference between measurement in the field and measurement in research settings. We talk about some of the ways that social workers can think about measurement as a tool to improve clinical practice, and some ways that social workers in the field can develop measures that will really benefit their clients. We talk about some of the challenges social workers have using measurement tools because of how rarely measures are integrated into social work courses. We talk about some ideas for how to better integrate measurement into social work education, particularly beyond the required research classes. We end Part II with a discussion of some resources for social workers interested in learning more about measurement.
In Part I, Mary and I spoke about about how she became interested in measurement; some key concepts needed to understand measurement including reliability, validity and error; and how to understand measures used in research articles.
[Episode 43] Today’s podcast is the first in a two part series on measurement for clinical practice and research. In today's podcast I speak with Dr. Mary Rauktis about how she became interested in measurement; some key concepts needed to understand measurement including reliability, validity and error; and how to understand measures used in research articles.
In part two of the podcast we talk about the difference between measurement in the field and measurement in research settings. We talk about some of the ways that social workers can think about measurement as a tool to improve clinical practice, and some ways that social workers in the field can develop measures that will really benefit their clients. We talk about some of the challenges social workers have using measurement tools because of how rarely measures are integrated into social work courses. We talk about some ideas for how to better integrate measurement into social work education, particularly beyond the required research classes. We end Part II with a discussion of some resources for social workers interested in learning more about measurement.
[Episode 119] Today's episode of the Social Work Podcast is an interview with Stacey Freedenthal, Ph.D., LCSW about her book, Helping the Suicidal Person: Tips and Techniques for Professionals. 
