Perspectives volume 30 number 2 Newsletter of the BC Association of Social Workers june 2008

Refugee Families and Pediatric Disability

They have come to Canada as refugees. In their struggle to resettle, they are confronted by culture shock, isolation and racism. They live with memories of loss, upheaval, violence and torture. And they are raising a child with a life-long disability. A social worker is there to help them manage their complex challenges. (full article on page 04) >>

Working with disabililty

MAKING THE CHILD AND FAMILY THE CASE FOR INTERPROFESSIONAL TRANSITION SUPPORT PLANS MANDATORY PRACTICE Social workers help A planning tool created REGISTRATION When team members families with ‘new through grass roots Essential for the profession, make space for each other, 6 beginnings’ 10 community collaboration 12 essential for the public 16 new perspectives emerge makes life better for families I came for the job. I stayed for the team.

“It is very satisfying to be part of a team that makes such a signifi cant and memorable impact on people’s lives.”

Gwen B., VCH Social Worker

New Challenges. New Horizons.

To fi nd out more and to apply, visit: www.vch.ca/careers

02 Phone: 604.875.5152 Toll-Free in North America: 1.800.565.1727

Announcing the BCASW Fall Conference reimagining Social Work Politics  Passion  People November 7 and 8, 2008 • Plaza 500 Hotel, Vancouver

featuring keynote speakers Mary Ellen Turpel-Lafond, BC’s Representative for Children and Youth Bob Mullaly, Researcher, social activist, media commentator Author of ‘Challenging Oppression: A Critical Social Work Approach’ and ‘The New Structural Social Work’

plus your choice of fourteen workshops – our largest conference ever! View the conference program online at www.bcasw.org Your conference brochure will arrive with your September edition of Perspectives President’s Viewpoint Identity and Engagement

words phyllis nash, MSW, RSW, president

he current agenda of the BCASW Board is identification of an intersectoral subcommittee to Tdominated by two important issues. One pool information and promote information flow. is actively engaging members so that we hear I am very optimistic that the move to a collaborative, their voice and also benefit from their actions. coordinated effort will be a major step forward. The second is the broad issue of practicing social As I write this report, I have learned that the workers identifying with the profession and, amendments to the Social Workers Act have fallen off conversely, the fact that many paraprofessionals the legislative agenda for this spring after passing and human service professions are seen as social the first reading. It is extremely disappointing as workers or as “social working”. we were excited that we would soon have a College We have been addressing these issues of Social Workers in British Columbia. What was in a number of ways. One is actively seeking gratifying was the significant number of excellent membership for all of our committees. The goal letters written by BCASW members and sent to all 03 is to develop diversified committees so that our of the MLAs to protest this turn of events. I admit representation is balanced and reflects the breadth to being somewhat disheartened in seeing how The issue of identity is more complicated. of our profession. Contact Linda Korbin if you many of us got automated replies that suggest Many approaches have been explored from running have an interest in sitting on the Child and Family that these letters did not have immediate impact TV commercials (well beyond our financial means) Welfare Committee, Health Practice Committee, that we had hoped. However, I am very hopeful to selling T-shirts advertising our allegiance. The Multicultural and Anti-racism Committee, that the sheer volume of reaction will ensure that most promising approach to date is the meeting of Addictions Committee or a fledging Community it is on the next agenda and seen to have a higher an intersectoral group in April of this year. BCASW, Living Committee. If none of these meet your priority. along with the Board of Registration and the Deans need we are always open to your suggestions. The annual meeting of the provincial and Directors of Schools of Social Work, met to We continue to seek a broader editorial board for Presidents of Social Work Associations took place explore our common concerns. These included Perspectives. Again, the more diversity, the more last month in Toronto. It is evident that all of the raising the profile of our profession, developing a likely it is that Perspectives will have something Presidents share a concern about our professional standard Scope of Practice statement, developing for everyone. We also are anxious to hear from identity including those from the seven provinces joint strategies for attracting high quality individuals who see themselves taking leadership that have mandatory registration. The time seems applicants to schools of Social Work and mandatory on the BCASW provincial board. ripe for a concerted effort in the promotion of our registration. The outcome of this meeting is the profession. P

Perspectives is a publication of the British Columbia Association of Social Workers editor for this issue: publications mail agreement no. 1685732 Linda Korbin, [email protected] please return undeliverable canadian addresses to: British Columbia Association of Social Workers guest editor for this issue: Suite 402, 1755 West Broadway Meena Hukam Vancouver, BC V6J 4S5 editorial committee: tel 604 730 9111 web www.bcasw.org email [email protected] Molly Smith, Joani Mortenson and Meena Hukam Publication occurs four times a year. Articles up to 1,500 words will be considered, but publication is not guaranteed and copy may be edited to fit the space available, or for legal or other reasons. The views Layout, design and editing expressed in articles published in Perspectives are not necessarily those of the BCASW or the Editorial Heather MacNeil Committee. The publication of any notice of events or advertisement is neither an endorsement of the advertiser nor of the products or services advertised. For reprint permissions and back copies, please contact the BCASW office.

perspectives june 2008 04 students:cover story: Refugee Families Refugee within Disability Pediatric Understanding words they learnthattheir childhasbeendiagnosedwitha life-longdisability. when resettlement their of reality the understand to beginning just often are as challenged differentially there are are a number of issues that status are unique to their situation. refugee Refugee families under Canada in arrive who families however, roles; familial impact greatly both migration and Disability Family System as awhole, socialworkers becomeaware of indicators for stress andtrauma. adapt in the country of resettlement. It is imperative that in viewing the family torture, of experiences and violence toappear significantly hinder a migrant’ssexual assault, the ability to and ones loved of loss the as such horrors past from Memories risk. at well-being physical and emotional families’ refugee within eachfamily’s experiencesandstruggles. contextualized be to racismneed and process and resettlement the during isolation felt often are shock, Cultural resettlement. is which process the of disability. child’s their phase Post-migratorynext the begin theyaffect oftenrefugeesas experiences to adjustment their impact could resettlement and camps) refugee (ie post-migration their how understand better to order in It is integral to understand some of the histories that refugee families may have OF EXPERIENC C posed uponthemby raising achildwithdisability. challenges additional many with faced are also but country, host the to adjust to process resettlement challenging often group.social throughor the going areonly familiesnot These race,their on based nationality, membership,political religion, persecution of fear well-founded a to due migratedhave who individuals those referto to article the within ‘refugee’used is term The disability. a with child a have who families refugee their child’s therapy services. their address psychosocial needssothat they are better to able engagewith families help to is team multidisciplinary the in worker social the of role The disabilities. developmental T ONTEXTU provides multidisciplinary services to children with neuro- with childrento services providesmultidisciplinary CentreInterventionhe TherapyProgramEarly Ability’s for tesr fo pemgain hog t rstlmn cn ral put greatly can resettlement to through pre-migration from Stressors with working of complexity the highlights article This child withadisability They faceconcurrentchallengesofresettlementandraisinga Ra m ALIZING THEC a n n K . . S h a hi-kull OMPLEXITIES a r, r, B sw , MSW, RSW MSW, ,

rgoi. h calne o sca wres is n epn fmle build families helping in lies workers social for challenge The prognosis. and diagnosis child’s their of breadth the grasp to beginning are they when greatly supports these require families Sadly, systems. support familiar their self-care tobe‘selfish’andneedhelp tounderstandthatselfcareiscrucial. deem may families refugee families, many Like support. and resources limited level ofinterventionandsupportrequired. the shape factors family These resettlement. and/or experiences migratory post- to related concerns health mental have to families these for uncommon family one not also is It than household. the within illness chronic or disability a with member more is there Sometimes difficult. roles of renegotiating significantly. composition family the and relationship parent-child the shifted migration example, this In grandmother. paternal child’s the by but them by reared not difficult. One family stated that prior to migrating their three-year old child was be can case either in roles of renegotiating The roles. reinforce or roles change either to appear members family then and blurred appear may roles first at supports and strongly feel this loss. In response to the loss of interdependency, The process of resettlement forces refugee families to disconnect from disconnect to families refugee forces resettlement of process The their to due burnout caregiver for risk high a at are parents Refugee the make can members family all of wellbeing and health The family extended having to accustomed are families refugee Many perspe c tives j u ne >>> 2008 support systems that feel safe, validate their resettlement experience, and • Teach and support parents to advocate for themselves, help them to allow meaningful dialogue about their child’s needs. become comfortable with taking on the role of the expert, and reinforce that not only is it okay to ask questions — it is their right. Additional Stressors • Take on the role of the learner. Be aware of your own cultural lens, Families raising a child with a disability often experience added financial stress ethnic and cultural value system in order to respectfully learn about (e.g. extra medical expenses) and this stress appears to be further compounded grief, healthcare beliefs, expectations and practices through the for refugee families, due to limited employment opportunities and rigid family’s lens. eligibility for government support. Their limited options can leave families • Be aware of the indicators of anxiety/PTSD in adults and children and feeling disempowered. It is crucial for social workers to advocate for change so be prepared to teach your multidisciplinary team members and larger that refugee families have increased options to address their financial stress. community about the impact of these issues. Isolation is another aspect that is intensified for refugee families who • Be aware of challenges inherent in counselling through an interpreter. are raising a child with special needs. Mothers within refugee families report Locate interpreters who are absolute in their translation and be aware feeling dually isolated by having a child with a disability. One mother describes of dialectic and regional differences. how she does not feel like walking to the store because she feels that people • Be prepared to regularly review your agency’s mandate and role as treat her differently because she does not speak English and because of her families are often overwhelmed by the volume of information they daughter’s disability. initially receive. Refugees often have different perspectives on their individual rights than • Be prepared to discuss with families, the systemic and structural many Canadians and are often unfamiliar with the concept of advocacy. A key challenges they may experience and advocate to address service gaps Social Work role is to share information about these rights and support families faced by this population group. in advocating for their child’s needs within health and social systems. • Encourage safe and open dialogue amongst the multidisciplinary team to explore how we individually and collectively work across difference. Shifting Frames of Reference The experiences of resettlement and of raising a child with a disability There are elements of our practice with children with disabilities that can be 05 new for many refugee families: are both immensely complex for refugee families. They push families to Family-centred practice views families as the experts on their child and restructure their lives, re-evaluate their goals and dreams, face economic encourages families to take an integral role in goal-planning and advising difficulties, shift supports and significantly impact familial roles. When social professionals on what fits best for the family. Often this is a shift for refugee workers and multidisciplinary team members are aware of their lens, it prevents families who may be accustomed to looking to the professional for direction; them from imposing their helping system on them. however, providing information to families on the philosophy behind family- Raising a child with special needs drives refugee families to increased centred practice appears to make this shift easier. involvement with social and health care systems. Social workers are uniquely skilled and positioned to support this population group. Much of the practice Community inclusion into childcare settings and schools is a fairly new points above are elements that social workers consider to be at the core of concept for many refugee families. Families will often be surprised when their practice. preschool or kindergarten is mentioned and will ask if the social worker is Social workers are in an ideal position to educate and support team certain that their child is allowed to attend. Providing information about the members and community partners in being aware of their cultural lens: philosophy behind inclusion often leaves refugee families feeling surprised beliefs, assumptions, privileges and how these factors may impact their yet supported. practice. P

Resilience Recommended reading In spite of challenges, the resilience and inner strength of refugees is Blakeney, Jill; Dirie, Fadumo Jama & Macrae, Mary Ann. 1995. “Empowering Traumatized remarkable. Their resilience is evident in the risks they undertook in migrating Somali Women. A Support Group Model for Helping Survivors to Cope,” in Community and as they struggle to settle into a country and community that is foreign and, Support for Survivors of Torture: A Manual. Edited by Kathy Price. Toronto: Canadian Centre at times, unwelcoming. These families show courage and compassion as they for Victims of Torture. go through the day-to-day challenges of raising a child with a disability. Many Friedman, Amy R. 1992. “Rape and Domestic Violence: The Experience of Refugee families remain hopeful that life will improve in time. Women,” in Refugee Women and their Mental Health: Shattered Societies, Shattered Lives. Edited It is also amazing to see how quickly refugee parents begin to grasp by Ellen Cole; O.M. Espin & E.D. Rottblum. New York: The Haworth Press, Inc. medical terminology to describe medication, supplies and symptoms — even before they begin to exchange pleasantries in English. This is reflective of their MacLeod, Linda & Shin, Maria. 1990. Isolated, Afraid and Forgotten: The Service Delivery commitment to meet their child’s needs to the best of their ability. Needs and Realities of Immigrant and Refugee Women Who Are Battered. Ottawa: National Clearinghouse on Family Violence Health and Welfare http://www.hc-sc.gc.ca/hppb/ PRACTICE POINTS familyviolence/html/1isolated.htm Working with refugee families is a humbling and illuminating experience and Van der Veer, Guus. 1995. “Psychotherapeutic Work with Refugees,” in Beyond Trauma: one that has given rise to a great deal of learning. The following are some Cultural and Societal Dynamics. Edited by Rolf J. Klever; Charles R. Figley & B.P.R. Gersons. lessons learned: London: Plenum Press. perspectives june 2008 Making the Transition Moving their child with special needs into public school is a fearful time for families

words Hedy O’connor, msw

he transition for families and their children with special needs from the Tearly intervention therapy program and pre-educational programs at the BC Centre for Ability to the public school system can be a difficult one. It is often fraught with family misconceptions about the school system, ture: worries, questions, and concerns which can evoke many fears for families: a fear of the unknown, fear of their child ’failing’, fear of their child not being fe accepted or understood by new peers and staff. Coming from a program in which they and their children feel understood and well supported, they worry about how their needs will be met as they enter a new and complex system. This often results in their consideration 06 to delay the entry of their child into a Kindergarten program, which has implications for other younger children with special needs who are waiting lengthy periods for scarce resources in the early intervention system. As social workers at the BC Centre for Ability’s Early Intervention Therapy Program, our experience tells us that parents’ attitudes and feelings about the transition to school can significantly impact the decisions made, the course of events and subsequently their child’s experiences. Transitions involve different stages and each stage involves new feelings and processes. Bridges (1980) describes these phases as ‘endings’, the ‘neutral zone’ and the ‘new beginning’, which do not necessarily follow in this order. In the ‘ending’ phase, Bridges discusses the importance of celebrating and reflecting on the meanings of endings as old identities and connections must be “cleared away” so that the new can grow. The neutral zone is a time of Through individual and group services, our objective is to give families inner reorientation which can be the most frightening stage of transition information about the public school system, timelines, responsibilities and but important to experience the ‘lostness’, confusion, darkness, disorientation rights of families, the importance of parental involvement, the meaning of and loneliness in order to emerge into the ‘new beginning’ stage with a renewal “kindergarten readiness”, advocacy strategies, how to prepare as a family, of energy and an “inner realignment.” how to prepare child and school, the concept of inclusion and the impact of In the early intervention program, preparing for and anticipating the emotional components on transition. ‘ending’ phase begins many months in advance of the ending. Clients are told Concurrently, we maintain and foster ongoing facilitation and linkages at the beginning of our work with them that our therapy and Social Work between the family and all stakeholders in order to promote interagency services will end at kindergarten entry. People need time to prepare for the partnering and collaboration in the transition process. In conjunction with ending and to express their emotions around this. these interventions, we also organize a yearly parent panel, consisting of In the middle stage of transition, the ‘neutral zone’, parents are beginning former clients of the early intervention program who have older children the transition to the Vancouver school system. Families are gathering with special needs in the school system. Families have told us over the years information and exploring options at this stage, which can be a confusing and that other parents’ stories provide a valuable perspective for them and this frightening time and a time when they appreciate the support of Social Work information often helps to reduce their fears. Families tell us that it helps them staff. to hear from other families in the audience with similar concerns to their own Our Social Work objectives are to enable families to make informed and to feel they are not alone. It is reassuring to them that other families like decisions as well as support them around the emotional components of themselves on the panel, who are further along in the process, have found transition, helping them to better understand how their own emotions have ways to work in partnership with the school in order to make the transition an impact on their decisions and to feel more empowered and confident. successful and a school experience that is positive for their child. >>> perspectives june 2008 OUTCOMES In our pre and post group questionnaires, families’ responses showed consistent improvement in a number of areas including understanding their Bookshelf role and involvement in readiness and the transition process, confidence in their ability to advocate, understanding the expectations, awareness of the impact of their own emotions in decision making, and next steps required. Our limitation here is that we do not have the ability to measure these People, Politics and Child Welfare in outcomes again later, after children have started school, as our funding does not allow for this. British Columbia Edited by Leslie T. Foster and Brian Wharf BRIDGING OUR WORK WITH OTHER PROFESSIONALS UBC Press May 2007 (cloth) January 2008 (paper) The challenges we face in our practice include working with other professionals who may not view transition as a dynamic process involving many factors involving the child, family, school and community over a period of time. words carolyn oliver, RSW Other professionals may view transition only from the perspective of the child being ‘ready’ to enter the school system. As social workers, we consider all of these factors in relation to each f you’ve ever wondered how child welfare in British Columbia came to be as other in order to support people effectively in making this transition. These Iit is today, this is the book for you. th differences in approaches may create confusion for families during an already Starting at the turn of the 20 century, the book traces the evolution of confusing and emotionally charged time for them. We therefore strive to the province’s formal child welfare system from its origins in the community work in partnership with other agencies and families in understanding and work of immigrant women to today’s monumental bureaucracy. Drawing delivering a unified and broader perspective of the transition process. We hope extensively on interviews with key players, it tracks in detail the myriad of for an end result that is a smoother transition and a happier child and family. people and policies that have shaped the child welfare system, and examines 07 the impact of cost-cutting, restructuring, media scrutiny and political A new beginning expediency on the system’s ability to meet the needs of BC’s children. For young children, the transition to kindergarten is one of the most significant But this is more than just a history book; it also examines the competing transitions that they will experience and can likely influence their experiences philosophies underlying child welfare and offers its own thoughts on where of school in the years to come. Many children with special needs attend we should go from here. Should the system focus on public issues like poverty, integrated schools and classrooms in Canada, yet there is scarce information or private concerns like parental competence? Should it support families or in the literature about the transition needs, experiences and the adjustment of protect children? Should its reach be universal and services provided as social these children and their families. utilities or should it target the few families most in need of help? Social workers at the Centre for Ability strive to understand and to help While acknowledging that child welfare does not break down into these families articulate these needs and experiences. How we work together as a easy polarities, the book explores the impact of these philosophical debates community and in partnership with families will most importantly have an on the development of policy and practice in BC. It starts by examining the impact on children’s first experiences in school and their future. devastating failure of the earliest child welfare pioneers to include Aboriginal Transition to kindergarten from our program signals the ending of an voices in this discourse and later examines Aboriginal resistance to the child often long-term working relationship that we have with clients. In ending welfare system and the struggle of communities to regain authority for our working relationships with families and children, we hope that our work their children. The book tracks the development of the system towards with clients will enable them to see the transition as a ‘new beginning’ with managerialism and a narrowing focus on risk. An analysis of the unintended confidence in the challenges that they will take on, skills and insights that they consequences of risk assessment is essential reading for anyone currently have acquired and new ideas that they have gained. practising in child protection work. Social workers make an important contribution to making this important Chapters devoted to the Community Resource Board experiment of milestone rewarding and successful. P the 1970s, the work of Joan Smallwood in the early nineties, and an analysis of the current English system, explore the potential of a more integrated community-based approach to child welfare. Recent changes in policy and practice are acknowledged as steps in the right direction. The contributors lay out a vision for child welfare founded on universalism, community Social Work and a willingness to tackle the root causes of abuse and neglect. Read this book to be inspired by the individuals who have pursued this vision, and challenged by the question as to whether it is one that government can ever hope to achieve. P

perspectives june 2008 My South African Social Work Experience It was a life-changing way to contribute

words mary leslie, MSW, RSW l: a

frica has long beckoned me, starting with an oral composition I presented their lives, identifying the monsters in their lives (those things or people they when I was twelve on African music, and continuing through many were afraid of), drawing their tree of life, with falling leaves for all the people

tion A avenues. I had family who travelled there, stories they brought back, African they had lost, and identifying those people who were supporting them in a drumming, and chanting; each weaving another strand of connection to Africa some way now. They ended their journals by drawing a picture of how they saw for me. When Jennifer, a woman with themselves in five years’ time. Through the whom I shared my private practice office process, many stories were told and tears in West Vancouver, started speaking of her shared. Health information was given and

intern sister Heather’s dream to create a summer they learned to make beaded jewelry and camp for children orphaned by AIDS, I animals, other crafts, hairdressing, and listened with special interest. Heather had were introduced to an outward bound been living in South Africa for over twenty based climbing wall, obstacle courses, years, and she and her husband had dance classes and making gardens out of 08 started what is now called the Desmond gunny sacks, seeds and soil. Tutu Centre for Lifelong Learning or C4L Many of these young people cared (Centre for Learning) to train adults to for their parents through their deaths but run and manage their own NGOs. Heather were not allowed to be part of their funeral had consulted as a teacher for the school when they died as children are largely district in which their centre was situated excluded from funerals in this region. and heard many of the teachers lament When they first arrived at camp, they how few resources they had for their came in looking very quiet and fearful; orphaned students. In some schools in however, by the third day, their spirits their area, orphaned children comprised were enlivened as they walked arm in arm half the school population. with new friends and leaders and engaged Nick Short from North Vancouver actively in play performances, dance visited Heather and offered to help find sessions and several hours of singing each funding for her dream, and C4LC, (www. day. There were tears along the way as C4LC.org) a Canadian funded program they felt safe enough to tell their stories of week long summer camps (two each and to mourn with the support of friends summer and winter school holiday) was and leaders, interspersed with laughter launched. Camp Orchard is situated and spirited fun as well. in South Africa, four hours east of My role was to be part of the Johannesburg near White River in Mpumalanga Province. The program was leadership training week prior to the camps, and to get to know the youth first run in Zimbabwe by the Salvation Army. As Jennifer was packing her bags leaders who would be my eyes and ears as we sought to identify those to leave in November 2005, I knew that I would be following in her footsteps. campers particularly at risk who needed referral to the Social Services in their The pull was strong, and a year later, my bags were packed, my clients had all respective communities. We found homes for three children who were being been transferred to other counsellors, my dog had found a temporary home so abused that they could not return to their homes after camp. I set up a and I was taking the 36-hour journey to Camp Orchard for four weeks. recording system, worked with a local social service worker and the children to gather relevant information to forward to community social services offices. THE THEME OF CAMP ORCHARD: “FINDING YOUR DREAM” The time with the youth leaders who assisted with my interviews (many of the The children (ages 8-17) met in Dream Groups with their leaders and dream older children spoke English but not fluently enough to speak in detail about books to walk through a guided process of drawing a picture of themselves their situations) was particularly rewarding as I watched them grow in their as they saw themselves at the beginning of the program, telling the story of ability to connect with and support their campers. >>> perspectives june 2008 A LIFE-CHANGING, ENRICHING EXPERIENCE I have also become aware of a number of other opportunities and I went to South Africa to learn and to serve where that was possible, expecting programs for social workers in Africa. The Nelson Mandela Children’s Fund that this experience would be life changing, and returned deeply enriched. I and the Stephen Lewis Foundation are two very important funders of was tired by the end; however, I was also very moved by these young people, excellent programs. A friend from Ontario is leaving this fall for a program both campers and leaders (half of our counselors were also orphaned), by their in Nairobi, Kenya with three other social workers to work in a youth based resiliency, their life energy and by their incredible singing, dancing and acting. community centre, www.shauriyako.org; she found the program through I saw lots of pain and struggle but my lasting impression was of the amazing www.globalseekers.com. The International Association of Social Workers, spirit of South African young people, and their openness to letting me become www.ifsw.org/home, advertises opportunities for social workers abroad. a part of their lives, tears and laughter for those three plus weeks. While at After a year of traveling in developing countries thirty years ago, I no longer felt camp, one of our youth leaders was accepted into the School of Social Work I could travel in a resource compromised country without adding something at the University of Johannesburg — a moment of great celebration. I have back. I can truly say it is possible to contribute and it can be very life changing continued to correspond with him and to seek funding for him and several and enhancing as well. P others through C4LC’s special fund (with charitable status) to support these young people who have been well trained for the camps and have amazing Mary Leslie will be part of a panel of social workers who will talk about international gifts, to overcome huge hurdles with entrance requirements and university Social Work experiences and opportunities at the BCASW Fall Conference in November. fees that would enable them to extend their gifts and potential contributions as social workers in South Africa.

editorial 09

e are delighted to be introducing this edition of Perspectives. This is not a complete list by any WThe themes for this issue are disability and multiprofessional practice. means. Social Work is many faceted As social workers, we work in a variety of settings with multiple professionals, and covers a wide variety of skills, and this can pose challenges as well as opportunities for creative work. abilities, knowledge and fields. It Susan Hogman What value do social workers bring to multiprofessional work? We can is essential that, as social workers, we answer this question clearly and proudly. Social Work adds dimension and take the time to articulate regularly how we contribute, particularly on the depth to the understanding of the needs of our clients and families. Social front line. Work can identify the barriers to service delivery that often make intervention The articles featured in this edition cover a range of services to people less effective than is otherwise possible. affected by disability and/or chronic conditions. The contributors are social For clients and families, Social Work provides the opportunity for them to: workers employed by the BC Centre for Ability who work in a variety of • describe the impact of the disability on their family system programs. Alison Brook and Lisa Kang promote the benefits of Child and • have information/resources customized to their particular needs Family Support Plans. Raman Shahi-Kullar contextualizes the complexities of • have the opportunity to share their fears, anxieties, hopes and struggles working with refugee families who have a child with a pediatric disability. Nora both emotionally and socially in relation to their disability Lirag and Barbara Borsutzky offer their experience working with the siblings of children who have special needs. Meena Hukam For the organizations and agencies, Social Work provides: outlines a unique employment service model • insight into the systemic impediments to consistency of care • a more complete picture of the client/patient/family for adults with disabilities. And Hedy O’Conner • insight into the barriers to service delivery presents some of the issues associated with • Skilled staff who: disabled children transitioning from specialist • understand family dynamics pre-school provision to mainstream education. • are knowledgeable about systems We have an incredible profession that • are skilled in working with individuals in highly charged emotional offers many opportunities. There is not another situations one like it! Let’s celebrate our contributions. • can intervene in conflict situations that others are not comfortable Meena Hukam We hope you enjoy the read! in facing • understand diversity and the importance of factoring that in to the Susan Hogman, MSW RSW is Director, Social Work & Adult Services, and Meena service provision. Hukam, MSW RSW is Vocational Case Manager for the BC Centre for Ability

perspectives june 2008 Child and Family Support Plans They capture the hopes, dreams and goals for a child

words alison brook, msw, rsw and lisa kang, msw, rsw

aving a child with special needs can be a challenge. As the Hchild grows, the need to become involved with numerous service providers and/or agencies also grows and services can become fragmented. Service providers and agencies typically ture: have their unique paperwork requirements, protocols to follow a and required accreditation standards.

fe Common challenges encountered by families include having ‘too many appointments’, ‘too much paperwork’ and ‘telling their story over and over’. Families are frequently overwhelmed with their child’s special needs and don’t need 10 to be further burdened with agency requirements for multiple, and sometimes redundant service planning meetings. The Child and Family Support Plan (CFSP) was the outcome of a grass roots, community-based and collaborative response developed in Richmond BC to address this challenge. The vision was to design a process that would capture the addressing their and their families’ complex needs across environments. family’s hopes, dreams and goals for their child and consolidate them into one Following this workshop, a number of Richmond Early Intervention service plan with clearly defined outcomes and strategies. With the hope of making providers started meeting informally to discuss how to move forward in services more accessible and seamless, the involved agencies were challenged developing effective, collaborative, and seamless services based on shared to be flexible and open to modifying their practices. By engaging in this family centred values. This group was formalized into the Richmond Early process, all involved would literally be “on the same page”. Intervention Network (REIN) in 2002 and continues to meet bimonthly; it has been a model for other communities in Vancouver and BC’s Lower Mainland. The CFSP planning process was an outgrowth of these meetings and has Interventions flow from the family’s become standard practice with young children with special needs in Richmond. wishes for their child, respecting their Lastly, the group also embraced the value of inclusion and was committed to providing community-based services to young children in their homes, values, cultures and lifestyle. preschool/daycares and communities. In our experience, the CFSP process is particularly effective when a child The CFSP is basically a process that results in one comprehensive written has more than two service providers/agencies involved, when a child has plan. Goals are driven by the family’s priorities and concerns for their child. complex needs, and when there is a recognized need for role clarity amongst The child’s profile guides the process and all parties have the opportunity to service providers. CFSPs have been most commonly used with children over share their perception of the child’s strengths and needs. The CFSP is based on the age of three attending a child care setting; however, CFSPs can be used several theoretical frameworks which underlie the day-to-day practice of most successfully with younger children and/or those not in an early childhood professionals currently working in the field of Early Intervention. setting. The first of these, family-centred practice, ensures that interventions flow from the family’s wishes for their child, while respecting the family’s HOW THE CFSP PROCESS WORKS values, culture and lifestyle. One person, preferably identified by the family, is chosen as the facilitator. Secondly, the ‘wraparound philosophy’ inspired several Richmond Early This person is often the service provider that knows the family the best. The Intervention professionals who attended a workshop with Dr. Lucille Eber at a facilitator coordinates a meeting time with all professionals that the family Richmond School District sponsored event in 2002. The ‘wraparound’ concept wishes to invite, and then meets with the family at least two weeks prior to the was designed to support normalized and inclusive options for students while CFSP meeting to document the parents’ perceptions of their child’s strengths, >>> perspectives june 2008 interests and areas of concern. The family is encouraged to reflect upon and The agreed upon long and short term outcomes and action plans are share their dreams for their child. This conversation leads to clarifying the recorded into a formatted template, and a draft of the CFSP is circulated to the family’s goals; these will be shared with the team ahead of the meeting so that family and team members prior to being finalized and signed by the family. This those involved can come prepared to share their suggestions about writing document is then used as a basis for review approximately every six months to measurable outcomes and strategies. highlight and record progress that is made on each goal, to capture new goals/ The facilitator also reviews the meeting process with the family. Typical strengths/ concerns, and to review the family’s priorities. attendees include the speech language pathologist, occupational therapist, The benefits of using the CFSP are numerous. The CFSP captures the physiotherapist, social worker, behaviour consultant, daycare/preschool family’s goals in their own words, the family experiences coordinated, seamless supervisors/owners and aides, Supported Child Development consultants, services, and interfaces with one larger team. Transparency is gained and and Infant Development consultants. The family may also choose to invite the questions of who, what, where and why are clearly spelled out, which, a close relative, a pastor, etc., for support. The family must have given their in turn, leads to greater accountability. The family may also find themselves written consent for those professionals in attendance to exchange information. more prepared when they enter the school system and are invited to The meeting is typically held in a location preferred by the family, such as participate in the school’s Individualized Education Planning process. their home or at the child’s preschool/daycare. Goals may be written for the child to address areas such as gross/fine THE ADVANTAGES AND THE CHALLENGES FOR PROFESSIONALS motor/cognitive/emotional development; social/communication/self-help The CFSP incorporates the highest accreditation standards of the various /play skills; behaviour and/or safety issues. The family’s need for information agencies. Through the development of an agreed upon written format, the about, and access to, community resources; assistance with transition final CFSP document is produced on letterhead-free paper so the plan can be planning; and/or education/counseling may also be incorporated into the considered an internal document and thereby fulfill each agency’s need to have CFSP action plan. a “treatment” or “support plan” on file. Cooperation between service providers Long and short term desired and measurable outcomes are developed to is promoted, accountability for follow through is explicit as action plans are address the family’s goals. Long term outcomes are intended to be achieved assigned to specific people, and regularly scheduled CFSP review meetings use within approximately one to two years; short term outcomes, within three the original document as a starting point. Workload is reduced as responsibilities 11 to six months. Associated with each short term outcome is an action plan which are shared, roles are clarified, and efficiency is enhanced as fewer team outlines strategies and identifies who will be responsible for implementation. meetings are required. Opportunities to increase interdisciplinary learning This is where the collaboration of all parties involved becomes crucial. occur as teams work closely to share information and develop measurable outcomes. There can also be ongoing difficulties with the effective use of the CFSP process. For instance, keeping the meetings to a reasonable time limit (1.5 hours), incorporating professionals who come from a different philosophical base, writing measurable goals, ongoing training in facilitation, and obtaining a parent’s signature to finalize the report prior to distribution in a timely fashion, can all be challenges. Overall, however, families report that participating in the CFSP process has been a satisfying and productive experience as it meets their needs for effective, efficient and comprehensive service planning. We will continue to seek feedback from families and community partners to further develop the use of the CFSP as a valuable planning tool. P

Alison Brook and Lisa Kang are Early Intervention Social Workers at the BC Centre for Ability

Credits: The challenge of developing what would become the CFSP was enthusiastically embraced by the following agencies: Richmond Supported Child Development Program, Treehouse Early Learning Centre, Riverside Child Development Centre, the Speech- For example, a family goal related to socialization may have a long term Language Clinic at the Richmond Health Department, and the Centre for Ability’s outcome of a four year old child being able to take turns independently with Richmond Early Intervention Therapy Program. Special acknowledgement goes to a peer during free play, and a short term outcome of the child being able Kirsten Forestell, who brought the CFSP model to Vancouver, and later the North Shore, to take turns, with adult support, twice during a preferred activity. The input as Coordinator of these Supported Child Development Programs. Lastly, thank you to and ideas of family members and professionals about which strategies could the many parents who helped with the initial planning and continue to give us feedback be used in different settings to achieve this outcome is written into the through client satisfaction surveys. action plan.

perspectives june 2008 The Case for Mandatory Registration

words phyllis nash, MSW, RSW

“The International Federation of Social Workers recognizes that social work originates variously from humanitarian, religious and democratic ideals and philosophies; and that it has universal application to meet human needs arising from personal-societal interactions, and to develop human potential. Professional social workers are dedicated to service for the welfare and self-fulfillment of human beings; to the development and disciplined use of scientific knowledge regarding human behaviour and society; to the development of resources to meet individual, group, national and international needs and aspirations; to the enhancement and improvement of the quality of life of people; and to the achievement of social tion: justice.” (International Federation of Social Work) a

sk anyone. People (the public) assume that social workers have the

regul A knowledge, values and skills to help. Social Work is an internationally acknowledged term to describe a profession that serves to create change at the individual, group, 12 family and community level. Most citizens of British Columbia would be shocked that almost anyone can call themselves a social worker in their province; and that, if a social worker wants to avoid scrutiny by their peers, all they need to do is not register or drop their registration. All a person holding a degree in Social Work needs to do to avoid regulation is to call themselves a “therapist” or a “counsellor”. People believe that they are protected from unethical, unskilled and inappropriate help. Not so in British Columbia. Child protection is generally seen by the public and most others as a (the) domain of Social Work practice. The education of The result is that parents, schools and other agencies do not have the supports social workers with its focus on “person in environment” would seem to be and resources that they require to truly form a growth producing relationship the ideal background for such a role. Child protection is not and should not be with the child. about ‘child rescuing’ but rather about ensuring that the child is served by all The term “Social Work” is often inaccurately used as a verb. It is not of the systems in the environment that are needed to meet the child’s needs. The unusual to find human service professionals from all sorts of different implication is that parents are supported to nurture and, if that is impossible, disciplines including education, child care and recreation stating that they are then the child’s needs will be met by another system that is in place to ensure “social working” or “doing social work”. Generally, these practitioners have no nurturing, such as the school, recreation resources, community agencies, idea that Social Work requires specific knowledge, values and skills nor do they extended families and cultural groups. However, the reality is that many other have any concept that the title is a protected one even in British Columbia, a professions are employed in child welfare, often with a child centered approach province with weak legislation. that limits the practitioner’s capacity to target the environment and which Social workers tell us that the most important issue for their professional supports the concept of focusing solely on the needs of the child. Political Association (BCASW) to address is mandatory registration of social workers. decision makers often come from a similar philosophy. This sounds appropriate Many social workers in this province do not understand that the BC Association but often leads to attempts to “rescue” the child or “cure” the child or serve of Social Workers and Board of Registration for Social Workers are two the child rather than focusing on how to create changes in the relationship distinct bodies. Most that I meet are aware that there is a Social Workers Act of the child with the resources needed to develop to their full potential. but few have any idea that the Act is essentially limited to control of title >>> perspectives june 2008 and discipline of volunteer registrants. Although a new Social Workers Act is professional association as “elitist” and at odds with the profession’s about to be legislated, the exemptions to the requirements to be registered commitment to social justice. These practitioners do not appear to recognize will remain, albeit in the Regulations rather than in the Act itself. that this position also takes away from their clients the assurance of qualified, Because of these exemptions, most social workers are not required to competent service. register as they exempt people employed as a social worker by “Canada, or The civil service tends to build an internal loyalty. Those who work for the government or an agent of either; a board, commission or other body government have security (at least an illusion of), have the potential for any member of which is appointed by Canada or the government; promotion if they demonstrate ability to support and carry out the policies a municipality, regional district, hospital district board or board of school of the ministry they work for, always have a manager who carries ultimate trustees; an Indian band, a tribal council, the Nisga’a Nation or a Nisga’a Village; responsibility and are rewarded for compliance to policy. The concept of or a society incorporated under the Society Act and approved by the director registration suggests that the individuals are responsible for their own designated under the Child, Family and Community Service Act for the purpose of behaviour and must justify it. Many front line social workers appear to prefer to section 2 (1) (a) of the Society Act, or a society incorporated under the Society follow a prescriptive approach to practice rather than weighing their practice Act and approved by the director; or teaches or is engaged in research as a social against a set of standards. worker under an academic appointment or program in a university, college or institute.” To address this, we could point to any number of individuals, bodies and programs that might be seen as responsible for the current state of “The public has a legitimate expectation affairs. I think the situation in BC is a result of a confusing array of circumstances that I will attempt to identify. that those individuals charged with helping them have the education, THE PROFESSION IS EXTREMELY FRAGMENTED knowledge, values and skills to assist As many as fifty domains of practice can be identified. Many of these domains identify the practitioner as a protection worker, an employment them to solve their problems” worker, a marriage counsellor, a district supervisor, a shelter worker, a mental 13 health worker, a hospital worker and the list goes on. To make it even more WHY REGULATE confusing, many of the employers in these domains hire a variety of Regulation is about protection of the public. The public has a legitimate individuals from a variety of educational and experiential backgrounds to expectation that those individuals charged with helping them have the carry out the work. So, while a Social Work education might be seen as most education, knowledge, values and skills to assist them to solve their problems. appropriate, it seldom is protected in the way that other professions have This expectation can best be assured by the mandatory registration of qualified protected their disciplines. Many other professions such as nursing, child and practitioners. Registration also provides professionals with the tools to refuse youth care and education see themselves as having similar skills. This is often to carry out unethical activities and with a standard of practice that they are the case but there is generally a lack of a grasp of the implication of the person expected to achieve. The public potentially is protected from inappropriate in the environment. The result is a focus on “fixing the client” rather than actions on the part of government or other employers whose pragmatic considering the client’s relationship with the system. Further, many social decisions may be harmful to the public over the long run. It would enable workers (by whom I mean individuals with a BSW/MSW) are happy to identify social workers to refuse to carry out policies that did not benefit clients and to with the work title. Often, there are benefits such as more approval from the insist on the resources to carry out policies that benefit them. It would ensure employer; a disassociation from the ‘child stealers’ image or the ‘bleeding that the individual practitioner is responsible for their own practice and that heart’, thus garnering more public acceptance; more status in the title marriage they remain current in their knowledge and skill base. counsellor or mental health worker; and support and acknowledgement from The Ministry of Children and Family Development has provided a highly their professors in schools of Social Work who might also identify as a planner structured and monitored environment for Social Program Officers to date. or family specialist. This approach has not resulted in a system that has necessarily or always served children in this province well. The move to regionalization suggests that OUR IDENTITY AS PROFESSIONALS the current accountability will be diluted and regional standards will no doubt Social Work is a highly unionized vocation. There has always been considerable develop. It would seem imperative that mandatory registration is in place prior tension about the relationship between unionization and professional to such a move. Mandatory registration would mean that practitioners are association. In most provinces, teachers, nurses and social workers seem required to be registered if it is their intention to provide professional services to be able to balance both memberships required by their profession and to the public, wish to use the title of social worker and provide mandated their unions. BCGEU, in the past, has been resistant to legislation that services under controlled Acts. P would make registration of social workers mandatory. We can assume that is because the members would move to professional status. A philosophy that grew out of the egalitarian movements of the 1960s Re “The Seven Core Issues in Adoption”, article in Perspectives, March 2008: suggests that both professional education and professional association This author inadvertently omitted reference to Deborah N. Silverstein and separates the social worker from the individuals they work with. It is not Sharon Roszia Kaplan, who originally identified these issues in 1982. uncommon to find very dedicated practitioners who see registration and perspectives june 2008 The Employment Resource Centre for Persons with Disabilities Challenges and opportunities in a multiprofessional service

words Meena hukam, MSW, RSW

A UNIQUE MODEL FOR EMPLOYMENT SERVICES The Employment Resource Centre for Persons with Disabilities (ERCPD) is a program of the BC Centre for ture: Ability which is funded through a contract with Service a Canada. ERCPD is unusual for an employment service

fe in that it engages a full time social worker on its staff team, a position which provides for both challenges and opportunities. The Program is based in the Whalley area of Surrey and provides employment services to people who have 14 self-disclosed disabilities and chronic conditions. These can range from physical impairments and learning disabilities/ difficulties through to mental ill health and recovery from addictions. Many clients who access the service have experienced multiple barriers in seeking appropriate employment, and a substantial number have accessed other employment centres prior to attending ERCPD.

MULTIPLE BARRIERS FACED BY CLIENTS The clients who enter the doors of ERCPD often have a the ‘welfare safety net’ is that they become over-represented at the margins complex range of problems and difficulties that have inhibited their ability of society. The correlations between poverty, ill health, limited life chances, to maintain or find suitable employment, training or education. Many have and social exclusion, etc. are well documented. It is not difficult to foresee the experienced societal prejudice and structural discrimination. A substantial life trajectory for some of those affected. number have had exposure to the often stigmatizing and humiliating welfare For the ‘fortunate’ ones who do manage to secure disability assistance, system, which through its regular procedures, treats those who are unable to the maximum monthly provision for an individual is $906, a subsistence work with the same criteria as those it perceives as capable of working. amount that creates a class of people who live in and at the edge of poverty For example, the application for provincial disability benefit requires and exclusion. Conversely, once disability assistance is established, many individuals to apply first for regular social assistance. The process stipulates individuals encounter ‘system disincentives’ at a later stage, when they are in that they provide evidence of their efforts in seeking employment. For many a position to pursue employment — for example, benefit re-instatement can multi-barriered people, this onerous task is simply overwhelming and, as be problematic for those who find and then subsequently lose employment. they struggle to navigate the demands of the system, many inevitably fall The role of an agency such as ERCPD is therefore crucial in the assistance, through the safety net. support and expertise it can provide individuals to seek and maintain work. One of the ideological concomitants of this ‘one size fits all approach’ Assistance can include pre-employment support, career decision making, is that it serves to individualize what is essentially a systemic failure in social skill enhancement and training, wage subsidy, job search and employment welfare provision, ie by treating everyone the same, it discriminates against maintenance support. those who do not have the opportunity and/or capability to access and The social worker role at ERCPD must be cognizant of the wider social navigate a bureaucratic system – thus individualizing failure. context in which clients live and work, and preferably embrace an anti-  The personal and societal cost of failing to catch the most vulnerable in discriminatory model of practice , which promotes social justice.

 The disjunction and disparity between stated provincial policy and practice provision  For further information on Anti-discriminatory Practice see article in June 07 edition is notable. of Perspectives Volume 29 Number 2 >>> perspectives june 2008 CONCEPTUAL ISSUES ASSOCIATED WITH an exciting interchange of ideas. For example, when an individual client is MULTIPROFESSIONAL WORK presenting in a problematic way, any team member has the opportunity to The ERCPD team consists of several employment specialists, a social discuss the client’s presentation at ‘case review’. This team-based exploration worker, an administrator, and an off-site service manager who is a qualified creates ‘space’ for a resolution-focused discussion that allows for an occupational psychologist by profession. This mix of experience provides exchange of ideas and a consideration of the perspective(s) being utilized fertile ground for diverse and varied opinion. to understand the client’s issues. This process can be highly beneficial in The seminal work of Michael Polanyi (1966) can offer some insight when considering new possibilities and directions of work; however, it can also feel working in a multiprofessional environment. He presents a theory of ‘tacit threatening in its exposure of ‘professional knowing’. knowing’ which can be usefully employed when considering interprofessional The challenges that arise from working as a sole social worker in a exchange. non-traditional setting are many and varied, and by extrapolating from Polanyi’s work can be interpreted to Polanyi’s work it is possible to broadly identify suggest that each professional practice has three thematic categories. its own specifically formulated concerns that Firstly, a number of issues arise from constitute the core basis on which it conducts working within a team where professional its focus. In circumstances where professionals values and ethics are not common to from differing disciplines share the professional training, and where the frameworks focus of their concern, there is the for formulating opinions are distinct and likelihood of interprofessional tension. This different. These can include models/theories tension can be based on the definition of the for understanding human behavior. For ‘client’ as a focus of intervention. For example, example, the perception of a client’s motivation the medical practitioner may see medical and action can vary enormously when symptoms and bodily function as that which viewed through different professional lenses. both describes and defines the client, whereas Professional difference per se does not need 15 the social worker may see psychosocial to be problematic and can offer the possibility influences, as that which describes and defines of dynamic learning. However, in order for the same client. teams to utilize this opportunity, there needs Thus, there is an inherent tension both to be an active culture of accepting and in the recognition of the ‘constitution’ of the considering professional ‘difference’ as the shared interprofessional focus, and in the potential for misunderstandings and competing professionally ascribed approaches, tools, and ideologies is inherent. Failing to explore and techniques employed in considering that shared identify normative team culture can lead to the focus. This tension may manifest itself in issues of conflict and/or enriching negation or devaluation of a particular professional role either overtly, or by interprofessional opportunity. inadvertent omission. This complex practice ‘knowing’ of professionals from disparate Secondly, the professional opportunities for development through backgrounds can be understood theoretically. In the practice of our everyday exploration and discussion with peers is limited, and a sense of isolation knowing, Polanyi describes how we attend from the particulars (of our and ‘fighting for one’s own corner’ can become a regular feature of professional knowledge base) to the specifics of our object of concern professional life. (such as the client). This tacit knowing is by its very nature hard to articulate, Thirdly, the perception of ‘successful intervention’ can also be a point describe and define, and as such, provides fertile ground for confusion and of divergence between different professionals and/or the agency. Typically, potential dialogue. Social Work ethics promote an enabling, self-determining and empowerment Given that professionals of diverse backgrounds attend to different model of intervention, which is process orientated and embraces a varied ‘constitutions’ of a shared focus, a fruitful and pragmatic approach would repertoire of work activities. In agencies/professions where the ‘success’ be one of managing the difference (in attending to a shared concern), rather measurement is concrete and output focused the social workers’ measurement than eliminating difference. of ‘successful process’ may fall short of the criteria as defined by another profession or the funding source. THE CHALLENGES AND OPPORTUNITIES OF If the issues outlined above are managed appropriately, there is MULTIPROFESSIONAL WORKING the opportunity for multiprofessional working in a dynamic and creative The employment specialists and the social worker at ERCPD work very environment that meets the needs of service users in a holistic way. P closely together and a good deal of information exchange, client consultation and deliberation takes place between the different professionals. Reference Polanyi, M. (1966) The Tacit Dimension. Doubleday and Company Inc., New York This opportunity for shared learning is an essential component of successful working within a multidisciplinary team, and can provide for This is an expanded reworking of an article published in BC Connections, Winter 2008.

perspectives june 2008 Thoughts on Interprofessional Practice Team members can learn from each other and allow new perspectives to emerge

words duncan stephen, rSW

You can’t stay in your corner of the forest waiting for others to come to you; you have to go to them sometimes. A.A. Milne in Winnie the Pooh Professional lexicons are replete with terms to describe diverse practitioners working together in meaningful ways. This is particularly true in the health disciplines, where there is significant discussion regarding the use of the prefixes “inter”, “multi”, and “trans” as well

ture: as the terms “disciplinary” and “professional” (D’amour and Oandasan, 2005; Jones and Way, 2004). Working together has also been a conceptualized as “collaborative practice” and “shared care” (D’amour and Oandasan, 2005; Way and Busing, 2000). Language is often

fe imprecise but, for me, the term ‘interprofessional practice’ serves to capture the heightened level of interaction and collaboration between practitioners. “Multi” tends to denote professionals working side by side but not necessarily in tandem, while the term “disciplinary” is generally used to describe a field of study as opposed to a vocation or professional calling (Jones and Way, 2004).

16 nterprofessional approaches are and, ultimately, create enhanced Iincreasingly being incorporated outcomes for our clients. into the academic preparation of new Interprofessional practice is also professionals (Trevillion and Bedford, rife with dilemmas and, sometimes, 2003; Cooper and Spencer-Dawe, even dissonance. When I worked 2006). An excellent example of this is in vocational rehabilitation, my UBC’s Interprofessional Rural Program colleagues and I shared common of BC, which provides students from overarching goals (eg assisting clients health disciplines with opportunities to who had physical disabilities to plan learn and practice in interprofessional for education and/or employment); settings. In addition to fostering however, we drew from very different collaboration among professionals, — and sometimes conflicting — this initiative also promotes the theoretical conceptualizations. My recruitment of health professionals colleagues tended to emphasize to live and work in remote and rural medical and functional approaches communities (Charles, et. al, 2006). to disability, while I endeavored to My first opportunity to engage in apply social models of disability in my interprofessional practice was within the context of vocational rehabilitation practice. From time to time, this led to diverging opinions regarding problems services. I worked with clients who had complex and, in many cases, multiple to be worked, appropriate interventions, and who else should be included on disabilities to develop comprehensive vocational service plans. In the process, the team. I routinely collaborated with a range of professionals from other disciplines, Social workers have a role in ensuring that other voices are heard within including adaptive technology specialists, counselling psychologists, the context of the interprofessional team. Specifically, our clients must be educators, interpreters (American Sign Language and other languages), included as experts in their own experience. In vocational rehabilitation, this occupational therapists, physicians, and psychologists. takes on a particular importance when engaging a client in identifying the Under the best of circumstances, interprofessional practice can foster a accommodations and supports that are necessary for a service plan to be certain synergy among practitioners, reflecting that the maxim that the “whole successful. Unless a disability has been acquired very recently, people who being greater than the sum of its parts” can be realized when team members have disabilities have significant experience navigating through a world that make space for each other to contribute their respective skills and knowledge. is primarily designed from an “ableist” point of view. Insights stemming from Interprofessional practice becomes a reflexive process in which team members this lived experience can be invaluable in the vocational rehabilitation process. learn from each other and, if possible, allow new perspectives to emerge. This Cultural factors must also be considered when it comes to determining level of collaboration can promote innovative approaches to service delivery who should be on the team. I recently read about the First Nations Health >>> perspectives june 2008 Program at Whitehorse General Hospital, and it serves as an excellent example. interdisciplinary collaboration, and new technologies will likely further shape Indigenous and conventional health approaches are brought together in interprofessional practice in the years to come. This trend will be particularly order to address patient and family care in a culturally relevant and holistic important for rural and remote communities that do not always have a full manner. A working group of First Nations elders was involved in creating the range of services available within their geographic vicinities. program, and interaction between elders, traditional healers, and other health Ours is an integrative profession that emphasizes understanding of self practitioners continuously present opportunities to rearticulate and redefine and other, and an appreciation of group processes. We are also in a position to interprofessional practice (National Aboriginal Health Organization, 2005). identify issues relating to power and privilege in order to help our colleagues The concept of working together is nothing new; however, Social develop critical appraisals of presenting problems, thereby linking the personal Work roles and interprofessional practice will both continue to evolve as the and the political. For these reasons, social workers are ideally suited for the systems within which we operate become increasingly complex. “Telehealth” opportunities and challenges associated with interprofessional practice. P and virtual collaboration have opened up new possibilities with respect to Siblings of Special Needs Children They have their own special needs words norah lirag, msw, rsw and barbara borsutzky, msw, rsw

s early intervention social workers at the BC Centre for Ability, we are part Aof an interdisciplinary team which provides a range of services to families 17 who have a child with special needs. There has been a shift over the past two decades from a medical model of care to a family-centered approach in which the contribution of family members is of paramount importance. A child with special needs has a significant impact on his or her siblings and these sibling relationships cannot be isolated from the entire family context. Having a special needs brother or sister adds an additional level of complexity to the role and relationship of siblings within the family. The families we support face additional demands attached to the chronic health and developmental needs of their special needs child. Their emotional, physical and financial resources often become overtaxed, affecting their ability to meet the individual needs of each child within their family. Positive and negative feelings and behaviours constitute the reality of many siblings’ relationships and this remains true for siblings with special needs as well. We have found that commonalities exist amongst ‘typical’ siblings that include a wide range of emotions such as embarrassment, shame, Over the last decade, a few of the tips siblings have shared with us include: pride, fear, grief and loss, resentment and guilt. These siblings also share • Give me opportunities to meet other brothers and sisters of children with distinct experiences such as developing an increased sense of responsibility, special needs so I know I am not alone feeling pressured to achieve, over-parentification and caretaking roles. It • Spend special time with me as often as possible so I don’t feel left out is these emotions and experiences that we have built upon to develop our • Tell me what is happening with my sibling in a way that I can understand; targeted group intervention for siblings of children with special needs. if you don’t give me information I worry that it may be worse than it is The group interventions provide an opportunity for siblings to meet others • Just like other kids I get frustrated, embarrassed, or angry with my sibling; going through similar experiences, to share fears and concerns about their I don’t want to try and be perfect brother or sisters’ special needs/health concerns, to celebrate their siblings’ • Also, just like other kids I am protective and loyal towards my sibling and unique gifts, as well as to acknowledge the reciprocal contributions they want to help if I can make to each others lives. We often find that this experiential opportunity for normalization is a remarkable catalyst to explore their role and relationships Ultimately, the Centre for Ability sibling groups offer outcomes which within their own family system, and to define what it means to them to grow have a profound effect on the overall health and wellness of the entire family. up with a brother or sister with special needs. The sibling groups bring about The opportunities for siblings to have their experiences and feelings normalized the development of specific strategies which assist the ‘typical’ siblings in and validated contribute to the restoration of family balance and positively managing experiences and challenges within the sibling dyad. impact the child with special needs. P perspectives june 2008 Around the Province

Connecting Social Work Research and Practice The longstanding tradition of collaboration

tion: between the UBC School of Social Work and BCASW in celebrating Social Work in British

ac Columbia continues. The Vancouver Sea to Sky and Richmond Delta Burnaby Branches of

in BCASW and members of the School organized a

w presentation of student research in April in the

s Great Hall of the First Nations House of Learning on the Vancouver campus of UBC. Posters describing the work of MSW students as part bca of their research course were displayed. As well, abstracts of BSW students’ Three of the MSW students provided verbal presentations. Jon Breen projects were posted online at http://www.vcn.bc.ca/seatosky/bsw.html. spoke on qualitative research and presented his study of the experiences of Dr. Richard Vedan, Director of the First Nations House of Learning, injured workers who had successfully returned to work. He recounted moving welcomed everyone to Musqueam Territory. Duncan Stephen of BCASW stories of support, loss and transition. Sadia Ramirez outlined her inquiry 18 opened the event by commenting on the importance of Social Work research into how housing policies shape settlement patterns, with a focus on the in linking academic education to social issues and pressing community needs. experiences of immigrants and refugees. Finally, Les Connors discussed his Professor Graham Riches, Director of the School, also welcomed everyone study of care providers’ perceptions regarding issues of self-neglect among and commented on the diversity of the research topics and the high energy older people. that was evident in the event. Barb Keith of BCASW congratulated all of the student researchers, and observed that the work of the students presents a preview of challenges and opportunities for Social Work in the future, and then concluded the evening by inviting everyone to return for the event in future years to see what’s new and exciting in Social Work research.

Letter from Graham Riches Professor and Director, UBC School of Social Work “On behalf of the School of Social Work, students from our research courses and faculty members, I would like to express our thanks for your exceptional work in organizing this year’s presentation of student research. This event has become a major feature of the School’s life, BCASW’s Stephanie Callaghan and Angela Guy with a treat reflecting our belief in the power of establishing partnerships with community and professional sectors. Bringing together students, for the UBC grads professionals, families, community members and faculty, it is a remarkable example of how scholarship, learning and research can Guests then took the opportunity to review posters illustrating the inform and be informed by critical social issues. questions, methods, emerging findings and potential implications of over 40 Through the active participation of Duncan Stephen, Angela Guy MSW student studies. The posters addressed a wide variety of issues, including and other members, the Vancouver Sea to Sky and Richmond Delta child care services, forensic risk assessment of youth, prenatal classes for Burnaby Branches of the BCASW have pioneered the celebration of lesbian couples, mothering in correctional facilities, teen motherhood, living Social Work through this lively event. We are very pleased with the with HIV, anorexia, mental health, addiction, dementia, and interagency success of this year’s event and look forward to continue working with collaboration. There was a lively dialogue between visitors and the student you in this initiative.” researchers.

>>> perspectives june 2008 New UNBC BSW Graduate Receives Bridget Sometimes it is hard to work and live within a system that is so oppressive especially for Moran Award those who are trying to make change, but with all my fellow colleagues and mentors by my side it makes it all the more worthwhile. I can’t thank my community enough for the support they have given me over the last seven years”. The Northern Branch of BCASW announced that Christal Capostinsky was Thompson/Nicola Branch their recipient of the Bridget Moran Advancement of Social Over 50 social workers and social work students gathered in Kamloops to Work in Northern Communities celebrate Social Work Week with a luncheon, where a panel of six local social Award at a lunch attended workers and social work students spoke about the advocacy and social action by more than 80 social they engage in, in the pursuit of social justice. The luncheon was sponsored by workers in April. the Thompson Nicola branch of BCASW as well as the School of Social Work There couldn’t be a more and Human Service at TRU. deserving nominee, noted Dawn Hemingway and Glen Schmidt, associate professors at UNBC Social Work, who submitted the nomination. “Christal has exhibited exceptional qualities in all areas of her life. It may seem unusual to select a student who is just completing her BSW for this award, but Christal’s accomplishments warrant this recognition. She has not only excelled in her academic work, but also in her demonstrated commitment to those who are marginalized and experiencing hardship in our community”. “Her commitment to bettering the community is reflected in her 19 leadership role organizing New Hope — an association of, by, and for sex trade workers. Her substantive work with New Hope includes creating a downtown On May 3rd, Thompson/Nicola branch members and TRU students drop-in centre and completing a high quality research project about sex participated in the Walk for Peace in Kamloops. Many sported the new branch trade workers in northern BC, which is now utilized across the North and T-shirt, with the BCASW logo on the front and “Social Workers Working for beyond. Amazingly, Christal has not only organized but maintained and Change” on the back! developed the work of New Hope while also completing her BSW. This work is further augmented by her many other volunteer contributions throughout our community such as Positive Living North (formerly AIDS Prince George), Committee Against the Sexual Exploitation of Youth (CASEY), the Provincial Women’s Health Network and many others. As a single mother, Christal is a role model, successfully maintaining a rapid and substantive pace of work and life while raising her family. The totality of her academic and community work resulted in Christal being the youngest nominee and finalist for the 2007 Prince George Citizen of the Year. An incredible young woman, Christal has completed her BSW with the capacity and determination that has prepared her well to be an outstanding Social Work practitioner and advocate. In short, Christal exemplifies all the qualities that are part of being a recipient of the Bridget Moran Award. She is already a credit to our profession!” Walk for Peace Christal’s response: “It was such an honor to be given the Bridget Moran Award. I can’t even describe how empowering it was for me in my life to be noticed for the work that I have done in my community. I spent years on the streets in Vancouver homeless and addicted to drugs so to get to where I am today means the world to me. I live everyday grateful for what I have and to do my best to help others reach the same potential. I have worked so hard and given up so many things in my life to do the work that I do. But you know what? I wouldn’t change it for the world. I was at New Hope one day afterwards and some of the women came up to me saying, “I saw you in the paper, wow, that was great! Congratulations!” I felt proud because I was giving them hope. Many of the women I work with at New Hope have been without hope for so long that it felt good to be able to give them something to hold on to. Something that spoke, ‘you can do it too!’ L-R: Jennifer Hancock, Michelle Apps and Christina McLennan perspectives june 2008 CASW Distinguished Service Award

a standing David Turner, recipient of the CASW Distinguished Service OVATION Award (BC) for 2008, was honoured at a dinner organized by Vancouver Island Branch Throughout BC, thousands of social workers provide services that enrich during Social Work Week. He the lives of individuals, families and communities. They work with was presented with the award by commitment, energy and resolve. They make us proud. They haven’t Linda Korbin. asked for one, but let’s give them a standing ovation!

Myrna Tracy, practice leader at the Cancer Agency in Kelowna and BCASW Okanagan Branch president, applauds Debby Hamilton. Hospital social workers celebrate “I have always been inspired by Debby on the many occasions when I have heard her tirelessly speak as an advocate for women. Debby is the Executive Director of Vernon Women’s Transition House Society, an agency that provides a broad range of 20 services for women, children and girls who have experienced violence. Debby started her journey with women-serving organizations twenty years ago as a frontline transition house Debby Hamilton worker in Dawson Creek, BC. Since that time she has worked in an assortment of front line and management roles in a variety of settings, including sexual assault services, specialized victim assistance and emergency mental health programs. Debby has also been a part of many community coordination and development efforts in Dawson Creek, Social workers at Royal Columbian Hospital in New Westminster gathered Kelowna and now Vernon. She is committed to providing feminist, woman together to celebrate Social Work Week. centred services and reducing the impact of institutional revictimization. Debby spent several years on Provincial Boards such as the BC Association of Specialized Victim Assistance and Counselling Programs and the BC/Yukon Congratulations to BCASW Society of Transition Houses. While working full time and mothering three children, Debby earned her Student Prize Recipients BSW through Distance Studies from the University of Victoria, graduating in1999. She has been a long-time BCASW member and is an inspiration to us Each year , BCASW awards a scholarship prize to a all! Good work, Debby!” student member of BCASW at each school of Social Work in BC. The most recent recipients are:

UBC Okanagan Alexandra Tardiff Who inspires YOU? Write us at [email protected] University of Victoria Kelly Mitchell and in 200 words or less tell us about a social worker UCFV Preena Mann who epitomizes the best in Social Work values UNBC Christal Capostinsky UBC Jagjevan Kaur Singh and practice. We will make this a regular feature in Thompson Rivers Jennifer Hagen Perspectives. NVIT Amy Pettis

perspectives june 2008