The School of Social Work Recieves the National Child Welfare Workforce Institute Grant
The Indiana University School of Social Work is among a cadre of schools selected to provide specialized education and training to students who will work with some of the most vulnerable populations: children suffering from the trauma of abuse, transitional-aged youth, and adolescents and adults at risk of substance use disorders.
The initiatives are the result of three new federal grants, totaling more than $3 million, awarded to School of Social Work faculty. While the grants run for multiple years, some of the students have already been able to use their newly learned techniques to help foster families better understand how past trauma affects their foster children; potentially offer new services to transition-aged youth in Marion, Ind., where a recent graduate of the School of Social Work is planning a new outreach effort to help them.
The grants reflect a national concern over the needs of underserved groups, such as the transitional-aged youth, or to an ongoing effort to recruit and retain highly skilled social workers in child welfare systems.
A look at the grants and how they are helping the School provide students with training that could change the lives of their future clients:
The National Child Welfare Workforce Institute Grant: The School is using $735,000 to fund the Child Welfare Trauma Fellowship. The fund provides seven students a year with stipends of $13,650 for five years. Participating students commit to working for the Indiana Department of Child Services for two years.
The grant comes from the National Children’s Bureau, explained Dr. Barbara Pierce, an Associate Professor of Social Work and co-Principal Investigator on the grant. “They (the Children’s Bureau) has been working for many years on this recruitment and retention piece, making sure we have enough good, child welfare workers that are going to stay in the system.”
The Children’s Bureau has been carrying out a concerted effort to bring back social workers to work in child welfare. This national focus on child welfare systems previously was not an issue, according to, Pierce and Pat Howes, Director of the Indiana Child Welfare Education and Training Partnership, who also is working with Dr. Pierce on the project. They explained that before the 1970s, plenty of child welfare had MSW degrees. In fact, child welfare was the job to have. A worker with a MSW degree was the standard among child welfare employees. That began to change though as medical personnel became more cognizant of the characteristics of child abuse. “When you identify more (cases), more people come into the system, the system becomes overwhelmed.”
As the number of cases increased, child welfare workers could not handle the increased workload and the child welfare system reacted by hiring social workers with only undergraduate degrees. Then, because the system was so totally overwhelmed, they began hiring people who did not have a social work degree and then eventually, those who had no degree at all.
By the time the social work profession realized the hiring practices had been a mistake, the child welfare system was thoroughly de-professionalized, Pierce and Howes explained.
The Children’s Bureau has been working since the 1990s to re-professionalize child welfare in this country and the School’s NCWI grant is part of that effort. The School has used the grant to create the trauma fellowship. The program focuses on evidence based practices so that the interventions students learn are ones faculty know work based on research, Pierce and Howes explained.
“This whole idea of paying attention to the trauma has come out of some big national research that has been able to link biological and neurological effects (of trauma) with actual interventions with appropriate goals and outcomes and new ways of working with families,” Pierce said. The training allows the students to understand the behaviors they are seeing that can make people crazy if you don’t have an understanding of the impact of trauma, Howes added.
What’s more, research shows trauma can affect the very people who are working with those who have been traumatized, they noted. Case managers working with children and their families are subject to secondary trauma. “So we have to teach them how to work with themselves,” Pierce noted. “The training helps the students to recognize the symptoms and how to manage them,” Howes added.
What can happen is case managers become traumatized and as a consequence an entire agency can become traumatized as a result. The principles that work with traumatized families can also work within an agency. Out of the first group of students, three are in supervisory employees at the Indiana Department of Child Services.
In addition to the emphasis on understanding trauma, the students have a bi-weekly seminar with Dr. Pierce. “So they get an extra layer of supervision and contact, every other week,” Dr. Pierce noted. After graduation, the faculty will continue to work with and provide assistance to the students as they transition to a work.
Students also develop a “trauma project” as part of their coursework. A couple the students worked with foster families that were at risk for placement disruption because the kids they were caring for were acting out. Children suffering from child abuse are highly traumatized and have behavioral issues, they noted. Without the students help, the children were at risk of being moved to another home if the foster parents could not figure out ways to control their behavior. The MSW students were able to help, working one on one with the families, teaching them, educating them about trauma, about what is going on neurologically with these kids and what are some interventions they can use so the child could remain in the home. “If we can teach the foster families about the trauma concepts and about how to intervene appropriately and what it is when they are seeing this behavior, how to assess, ‘oh, that’s what’s going on, the child was triggered and this is what is going on in their nervous system right now so here is what I need to do right now’..”.
Another student had a trauma group for children who were in first and second grades. One student infused the trauma assessment piece into her supervision of her team at DCS, while another did the same for her team as well as others at DCS, teaching them ways to cope with their own secondary trauma.
The $1.4 million Health Resources and Services Administration (HRSA) Grant for transitional aged youth 16-25 years of age and their families. The grant allows for 30 to 33 Master of Social Work students a year for three years to receive special training to work with this population. Students receive a $10,000 stipend.
The grant represents a national focus on transitional aged youth and young adults, what is known about them and their particular problems, and why they are a legitimate focus of attention, said Dr. James Hall, a Professor of Pediatrics and Social Work, and Principal Investigator of the grant. Dr. Hall is assisted by social work faculty including Dr. Jeremiah Jaggers, (Assistant Professor), Carol Satre, (MSW Field Coordinator), Dr. Barbara Pierce (Associate Professor) and Dr. Joan Carlson (Assistant Professor). Dr. Rebekah Williams assists the project as the medical director (from Adolescent Medicine). The overall goal of this project is to train and expand the knowledge base of advanced clinical social work students so they can work effectively with transitional aged youth and their families.
While adolescence is a familiar concept to us today, it didn’t exist until after the industrial revolution, Dr. Hall said. “Before that there was no adolescence. You were a child and then an adult. The industrial revolution changed the type of training people needed and adolescence was created over time in the 1800 and 1900s.
“There are a whole range of young people that fall into the age group the grant focuses on, he noted. There those who are employed married and having kids to those who are unemployed, don’t have health insurance and have severe mental illness. The latter are the ones we are trying to reach,” Dr. Hall explained.
In applying for the grant, Dr. Hall found that transitional aged youth in Indiana face risks that include serious mental health issues, substance misuse and abuse, and suicide. “As youth move from high schools into an uncertain workforce or higher education, many do not have the resilience, knowledge and skills to meet challenges that lie ahead,” Dr. Hall wrote when applying for the grant. “Oftentimes, these youth may suffer negative consequences from their actions or inaction.”
While researchers can evaluate the types of problems this population faces, there are simply not enough highly trained social workers to work with this age group. Dr. Hall found that while some agencies provide services to transitional-aged youth, there was no agency that focuses exclusively on this group. What services were available were inadequate for the needs of this population, he found. “Most agencies focus on children up to the age of 18 years.
“Part of this is just awareness,” Dr. Hall said of the impact of the project. “We talk about transitional aged youth and the students are supposed to go into their agencies and talk to their supervisors about this age group and to push for activities for them, whether that is linking them up with the Affordable Care Act or providing counseling services.
Jennifer Queen-Russell was one of the 33 students selected to participate in the first year of the project and is already planning on how to provide services for transitional aged youth in Marion, Ind.
The population she wants to reach is those who may have been diagnosed with schizophrenia or learn they are bi-polar and are dealing with what may seem like to them a “death sentence” by themselves. “They hang out on mom and dad’s couch, or they couch surf (at homes of friends). It’s a lot to process and they are doing it by themselves.
“We are trying to get these kids in and explain what is going on ….that yes medication is part of it, but so is a healthy diet, exercise, socialization, and employment. We are trying to get these kids involved with a quote unquote normal life that they think they will never get to experience.”
Queen-Russell explained the problem is these young people are of an age that no one is saying you have to go talk to the doctor. Sometimes they come from broken families so the support system is not there for them. Even when the family is intact the family may not be able to provide the type of support they need.
The idea is to create an environment where you take a room and make it really comfortable with oversized couches and chairs, computers, Wi-Fi, a coffee bar, smoothies, too, where kids can come into a very relaxed environment with their peers, where there is no pressure and then we build a relationship and build rapport and then start talking about goals for them, she explained
In addition to their regular coursework, students in the project participated in special Friday afternoon seminars focused on transitional aged youth. The seminars provided the students with in-depth information about the types of problems this population so the students could be better prepared when dealing with them. For example, Dr. Hall’s seminar was on behavioral health, which touched on substance misuse, mental illness and suicide. Dr. Jagger’s seminar looked at partner violence and conflict. Dr. Carlson presented information on motivational interviewing, screening and brief interventions. Dr. Pierce gave seminars on trauma informed care and on special needs populations. And just as importantly, the seminars looked at potential approaches to dealing with the problems the students could utilize in dealing with transitional aged youth.
With the graduation, the students will now fan out at various agencies, raising awareness about transitional aged youth. The next round of students participating in the project begins in the fall and spring semester. As part of the project, students are asked to spend two years working at an agency that serves this population.
A $937,000 collaborative from the Substance Abuse and Mental Health Services Administration to develop a training program: Advancing Multidisciplinary Education for Screening Brief Intervention and Referral to Treatment (SBIRT) by the Schools of Social Work, Nursing and Medicine
The aim of the three-year project is to integrate SBRIT into Indiana’s healthcare and allied health care education systems in order to improve the health of the large number of adolescents and adults at risk for one or more substance use disorders. At least 60 social work students, 60 nursing students and 50 medical residents are taking part in the project. SBRIT is a comprehensive, integrated, public health approach for early intervention and treatment services, explained Dr. Joan Carlson of the School of Social Work and a principal investigator of project. Dr. Angela McNelis of the School of Nursing also serves as a Principal Investigator. Dr. Kathy Lay of the School of Social Work, Sara Horton-Deutsch of the School of Nursing and Dr. David Crabb of the School of Medicine are Co-Investigators.
“It’s much more effective a way of addressing issues,” said Dr. Carlson “No longer do we look at our clients and say, for God’s sake pull yourself up by your bootstraps. I mean if confrontation worked, we’d all be out of business,” she added.
Carlson explained the faculty involved in the project are half-way thorough the three-year grant. They first developed materials for the class and are now implementing it and then they will follow the students experience as the put it into practice at their practicums.
A three-step sequential curriculum was developed for the project, which includes innovative PowerPoint presentations, web-based education modules and face-to-face motivational interview training that offers students opportunities to integrate SBRIT into their clinical practica.
The Motivational Training is the key to the success of SBRIT, Dr. Carlson said. The social work students complete four hours training and receive a certificate of their accomplishment upon graduation. It’s about having a conversation instead of issuing a warning, she noted. “It’s more respectful of clients in where they are and that we are in a partnership with them.”
Primary care centers, hospital emergency rooms, trauma centers and other community settings provide excellent opportunities for early intervention with at-risk substance users and for intervention for persons with substance use disorders. SBRIT allows for quickly assessing use and severity of alcohol and illicit drugs, prescription drug us, misuse and abuse and can be done in eight to 10 minutes, Dr. Carlson said.
The goal is to identify and effectively intervene with those who are at moderate or high risk for psychosocial or health-related problems associated with their substance use. Early intervention, Dr. Carlson points out, saves lives, money, and is consistent with overall support for the patient or client’s wellness.
“We not looking at that top five percent,” Dr. Carlson said of people with severe alcohol or drug abuse and need to be in a treatment center. Instead, it’s a quick way to screen people who have come in for another reason to assess their risks of an alcohol or drug use disorder.
“If someone has a problem with alcohol, they know that. They have already heard it from family members, maybe the court system; they know they have a problem. We realize not everyone wants help, but we do recognize that there are people sitting on the fence that can go either way,” Dr. Carlson said.
So our focus is …’can you tell me why you are here today. What brought you in to see me’… It’s a way of having a conversation.” If a client expresses interest in making a change, they can be asked how ready are you on a scale of 1-10 to make changes? If they say 4, then you can ask them why not a 5? It’s very strength-based and positive in nature,” she noted.
“What we are trying to do (with SBRIT) is guide someone to make a decision for themselves.”
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