Social Work Breaks Barriers

March 29, 2023

Information

YCSC Grand Rounds March 28, 2023

Moderated by Tara Davila, LCSW with:

Mackenzie Fay, LPC
Bridget Torres, LCSW
Amy Myers, LCSW
Heather Howell, LCSW
Durrell Snow, MSW Candidate

ID9759

To CiteDCA Citation Guide

00:00Good afternoon everyone and
00:02welcome to Grand Rapids.
00:03Now before we get started today,
00:05I'm just a couple of announcements
00:07and a reminder that next week
00:08we won't have grand rounds,
00:10so grand Rounds is cancelled next week.
00:12Perhaps you could take some time during
00:13that hour to think about speakers
00:15that you would love to invite here and
00:16reach out to the grounds committee
00:18and with any of your suggestions.
00:20So please be on the lookout
00:22from an e-mail from Krista and
00:24we are accepting nominations,
00:25self nominations or nominations
00:27of others and to join our Grand
00:29Rounds Committee for next year.
00:31And so please be on the lookout for
00:33that e-mail and get those suggestions
00:35to the Grand Rounds Committee.
00:37And the last announcement is just
00:39to mention that we'll have Doctor
00:41Stephen Vine from the University
00:42of Illinois at Chicago and coming
00:45to join us on April 12th.
00:48I think it is.
00:50But in two weeks time and who will be talking
00:53about his case study on Allen Ginsberg.
00:55So it's one of these talks where
00:56we'll be embracing the humanities
00:58at the Grand Ryan's the 11th,
01:02April 11th.
01:02Thank you, doctor Cardona.
01:05And so please join us for that.
01:07And if any of you would
01:08like to meet the speaker,
01:09please reach
01:10out to Rose Marie or any
01:11member of the Grand Rounds
01:12Committee and we can set that up.
01:14So that's enough from from me
01:15to for today, I'd like to pass
01:17you over to our host for
01:18the day, my Grandparents
01:19Committee colleague Tara Davila.
01:25Good morning, everyone.
01:26Afternoon. Actually,
01:27I'm still a little behind,
01:28not enough coffee this morning.
01:30I know it's making me sleepy,
01:32but thank you so much for joining us
01:35today and happy social work month.
01:37And so for today, I'm going to use,
01:40I don't know if this is how to pronounce it,
01:42but the sort of Petra Kucha
01:45informed style of presentation.
01:47So it's a style developed in Tokyo
01:49where you do 20 slides with images.
01:52And 20 seconds of commentary.
01:54So this is mostly that where I got a little
01:56shorter in some of the other places,
01:58but this was one of the ideas
02:00when we were moving forward,
02:01so I thought I'd give it a try myself.
02:04So we'll see how it goes.
02:07So as we wrap up social work months
02:10together with the social work Fellowship,
02:12thank you.
02:13One way that we wanted to break barriers,
02:15because the theme is social
02:17work breaks barriers today,
02:18is by shining the light on
02:20contributions of faculty and staff
02:22of different disciplines whose
02:23terminal degree is a masters degree.
02:26This is not to take away from
02:27the work done by others,
02:28but rather to broaden the
02:30perspectives about the contributions
02:31of faculty and staff with masters
02:34degrees across our educational,
02:35clinical and research missions.
02:37And across the various settings
02:40of the Child Study Center.
02:43Our Masters,
02:44faculty and staff create and
02:46disseminate interventions,
02:47develop programs,
02:48engage in research,
02:50teach and train the next generation
02:52of practitioners,
02:53and help youth and families
02:54through complicated clinical
02:56challenges via assessment,
02:57research,
02:58psychopharmacology and psychotherapy.
03:01In 2022,
03:03social workers like professional counselors,
03:07marriage and family therapists
03:10and APRN scheduled 69% of the
03:13appointments for the practice.
03:14So that's like
03:1737,453 appointments. So they are very busy.
03:24And Masters, faculty and staff are
03:27supervisors, preceptors, authors,
03:29directors, associate directors,
03:31and I'm proud to be among the two who
03:33serve the department also as vice chairs.
03:36And so despite these
03:37contributions and opportunities,
03:39we also face challenges.
03:40And the root of many of these challenges are
03:43the systemic barriers within our institution.
03:47Until recently,
03:47faculty and staff with Masters degrees
03:50were underpaid within the institution
03:51and among our peers outside of Yale.
03:54And it took a tremendous amount of
03:57advocacy over many years to correct that.
04:00Additionally,
04:00the school has only provided
04:03continuing medical education credits,
04:04many of which are not recognized by
04:07the licensing boards of some of our
04:09faculty and staff with Masters degrees.
04:11And this caused a burden for us
04:13to go elsewhere and and pay out
04:15of pocket for continuing education
04:16when many of our colleagues could
04:18just get that by coming to work.
04:21This is the first year that we were able to
04:23offer continuing education units arrived,
04:25excuse me,
04:26approved by the National
04:27Association of Social Workers,
04:29which meets the licensing
04:31renewal criteria for all.
04:33Other structural barriers include not having
04:36a defined or valued track within the school.
04:40So you only have to look at the OPD website
04:43to get a sense of how we're regarded.
04:46This is one example of how the institution
04:48communicates that our contributions
04:50are not understood or valued.
04:52It also doesn't recognize
04:53other masters disciplines,
04:55making our colleagues feel
04:56invisible and unsupported.
05:00Until recently, this academic progression
05:02was limited to social work and didn't
05:04acknowledge the contributions of other
05:06faculty and staff with masters degrees.
05:08Thankfully, equity minded faculty
05:10were able to advocate to change this.
05:13However, we are capped at assistant
05:15professor with the bar for what we need to
05:18establish to attract constantly moving.
05:24When the institution as a whole
05:26doesn't recognize our contributions,
05:28there's impact.
05:29Others within the institution have
05:31followed their lead and further
05:33marginalized us as a supervisor.
05:35I've heard countless stories of colleagues
05:38whose terminal degrees are doctorates,
05:40not collaborating and making decisions
05:42for a case in which the treating clinician
05:45has a masters without consultation.
05:48Whether intentional or not,
05:49these actions convey that the clinician
05:51is not as important to the treatment
05:53of the individual and that the person
05:55making the decision knows best.
05:57I, who've always been a member of the
05:59clinic leadership and who came here with
06:01over a decade of clinical experience,
06:02can share countless stories of disrespect
06:05and disregard from fellows and faculty.
06:08And I can also tell the story of
06:10being supported and respected,
06:12which is why I'm able to support our
06:14community in the ways that I do today.
06:16Today you'll hear from a tiny sampling of
06:19our faculty and staff with masters degrees,
06:21and also from one in pursuit
06:24of their Masters degree.
06:28There's no way to tell you about all of
06:30the contributions made across our missions
06:32by faculty and staff whose terminal
06:34degree is a Masters degree in an hour.
06:37So I've shared how busy this group
06:39is with how many appointments
06:41they're scheduling, more than half.
06:43And I'd like to express my gratitude,
06:46my sincere gratitude and admiration
06:48to those on our panel today who were
06:50able to arrange their schedules to
06:52share their experiences with you,
06:53and for those who could not.
06:55We see you and we appreciate you.
06:59Before we hear from our colleagues
07:02about their experiences,
07:03I want to acknowledge that our
07:05community has embraced many different
07:06kinds of grand rounds presentations,
07:08from the very academic to the very
07:11heartfelt and all in between.
07:13When our community members choose
07:15to share their experiences,
07:16there's a level of courage and
07:19vulnerability that presenters embrace.
07:21To support them and to anchor in
07:23the spirit of this presentation,
07:25I ask that you please hold that in mind.
07:27They are experts on their own experiences
07:29and would be happy to answer questions
07:31that are anchored and understanding
07:32more about what they have shared.
07:36So looking ahead, we will hear from
07:38different programs and in home and
07:40outpatient and from clinicians,
07:41learners and model developers about
07:44their experiences as faculty and
07:46staff with master's degrees through
07:48their work at the Child Study Center.
07:50We'll have Mackenzie Fay and Bridget Torres.
07:53Both are clinicians and Bridget is also
07:55a team supervisor and there shall share
07:58about their experiences in the ICAPS program.
08:01We'll also hear from Amy Myers who
08:03is a consultant for family based
08:05recovery model, Excuse Me,
08:07Recovery model development and operations.
08:09Her colleague Karen Hansen, who is
08:12director of of FBR Model and development.
08:15I can never say that right model
08:17development and operations, pardon me.
08:21Had an unexpected situation arise
08:22today and she couldn't join us.
08:24But Amy will present for both.
08:27And then finally we'll hear from
08:29Darrell Snow and Heather Howell
08:31sharing their work in the parent
08:33and Family Development program.
08:35And so Heather is a clinician who's
08:37been with us and does all the
08:39intakes for the program and Darrell
08:41is a clinician and intern.
08:43So thank you for your time and attention.
08:45Thank you for joining us today.
08:47Thank you for supporting everyone
08:49in our community.
08:50And without further ado,
08:52we will start with Bridgette and Mackenzie.
09:05Aye. Please correct me if
09:08I'm using the microphone
09:09incorrectly or you can't hear me.
09:11This is my first time using a
09:12microphone in my adult life,
09:14so we're going to try.
09:17My name is Bridget Torres.
09:18I'm an icaps clinician
09:20and clinical supervisor.
09:22And I have been working within
09:24the ICAPS program and at the Yale
09:27Child Study Center for eight years.
09:29And I'm also going to pass over to Mackenzie.
09:31We're kind of going to do a like back
09:32and forth and share our individual
09:34experiences and then talk a little bit
09:35about the program as a whole. And yes,
09:39I'm Mackenzie Fay. I'm an LPC
09:41licensed professional counselor.
09:42And I've been, I was here for about a
09:46year and a half and then I left for a
09:47little while and came back. So, so yeah.
09:52Yeah, so. I can tell you guys
09:57a little bit more about icaps.
09:59Icaps which stands for intensive in home,
10:01childhood and adolescent
10:04psychiatric services.
10:05Is a program which serves youth
10:08from the age of 4 to 18 that are
10:12experiencing any number of psychiatric
10:15difficulties as well as family stressors.
10:18We see kids that have histories of trauma,
10:21and generally our kids come
10:24to us from outpatient clinics,
10:27they come to us from the hospital,
10:30from IOP, just from many different places,
10:34and we work with the families.
10:35For a total of six months.
10:37We work in teams of two and we
10:40provide individual therapy, parent,
10:43parent sessions as well as family therapy
10:47every week and as well as supporting
10:51the families in multiple domains.
10:54So we work with them in the community.
10:55We also work with
10:56schools. We're kind of everywhere that
10:59the child doesn't, that the family is.
11:02I think it's a very special program
11:04and it has provided a lot of
11:06unique opportunities for learning
11:08over the last couple of years.
11:12I will talk a little bit more now about
11:15what led me to clinical work in general
11:17and then I'll pass over to McKenzie, so.
11:20I when I was. A kid, like many kids.
11:25There were like 3 professions.
11:27You could be. I wanted to be a vet.
11:29That was my calling.
11:31I thought I was going to take care
11:32of animals and realized when I was
11:35fourteen that that involved youthanasia.
11:37And I was like, I don't want to do that.
11:40I can help people.
11:42So I thought about going into therapy
11:45in high school, going into therapy
11:47as a clinician in high school.
11:49I should say.
11:50What kind of spurred my decision
11:52further was that. I had um.
11:55A lot of family experiences
11:59with mental health.
12:00My dad for most of my childhood
12:03had undiagnosed bipolar disorder,
12:04which became diagnosed bipolar disorder.
12:07And when that happened,
12:08we started to interact more
12:10with different therapists.
12:12Psychiatrists did family therapy.
12:16And there was all of the stressors
12:18that come with that and that
12:20being part of your family system.
12:22And then I also have had several
12:24close experiences with people
12:26that have completed suicide.
12:28And so all of these things kind of
12:31happened at a pretty formative time
12:33for me and led me into social work
12:37and therapy as a whole when I was in.
12:41Undergrad I majored in psychology and
12:43child and adolescent mental health,
12:46so I've been in this world for
12:48since I was basically a child.
12:51My brain was definitely not fully developed,
12:54but I had the opportunity to work
12:56with kids with selective mutism,
12:57and I had the opportunity to work in.
13:01School settings.
13:02And I saw the impact that social
13:04workers had with the kids that
13:07were in those settings,
13:08particularly when I was in a
13:09school setting where that was kind
13:11of one of the only mental health
13:12professionals that they had access to.
13:16As I was completing my BA, I thought,
13:18OK, what do I want to do next?
13:19Do I want to try to pursue a PhD in
13:22psychology or do I want to go to social work?
13:25And the combination of kind of seeing
13:27what social workers have been able to do,
13:29as well as knowing that I
13:33didn't really have the money
13:34to be in school for another 5 to 7 years
13:37meant that I pursued social work and
13:40had the opportunity in my graduate
13:42training to work further in a school.
13:44And I also had the chance to work at an.
13:47Intensive outpatient program for youths with.
13:52OCD. And their families.
13:54And I saw the ways that parents
13:58impacted their children.
14:00Kind of from the other side,
14:02as the therapist and when I
14:04applied as I was graduating from
14:07my Masters program moved on to.
14:11Apply for the advanced clinical Social
14:13Work fellowship here and was offered that,
14:15and I was recruited into the icaps track.
14:19So I always say that Icaps chose me,
14:22and then I learned that I loved it.
14:25Umm, and
14:26that is how we got there.
14:27I'm going to pass to my camp.
14:29Thank you. Yeah I kind of similar
14:33I think although when I'm thinking
14:35about how I got here I I do think
14:37the first time I realized I wanted
14:38to be a therapist as an adolescent.
14:40I think I was like counseling a
14:42random peer on their family issues.
14:44So it it it was always going to be
14:46family stuff but I don't think I
14:47realized that until later because
14:49I don't know people know that.
14:50I mean icaps
14:50has from a clinic
14:53a clinician standpoint it's something
14:55it's intensive work you don't
14:57need a licensure to to do it and
14:59so there is kind of a reputation.
15:01By caps as a clinician that you know
15:04you can do it right out of your your
15:07masters and also but it's intense and
15:09it's a lot and so I'd never I can't
15:11say that I had this kind of identified
15:14as something I wanted to do but over
15:16time you know I think I thought I
15:18would go into into private practice
15:20more so but with my experiences
15:24with my own kind of family dynamics
15:28and slowly getting to see over
15:30time that. You know,
15:32issues that people struggle with,
15:34there's always in relation to to somebody
15:37else and often like who's closest to you,
15:40which might be your family.
15:42I started to see that more
15:43significance of that.
15:44And so I I started icaps through
15:48another agency in Bridgeport.
15:51And eventually moved to Yale which
15:54is the the place that the model was
15:56developed in a very different experience.
15:59And then I actually left for a
16:01little while and did some private
16:02practice stuff and came back.
16:03And because there's there's
16:04getting into our experience,
16:05I mean there's there's nothing like
16:07the the way that icaps is and and
16:10the dynamics like we are. You know,
16:13there there's just so many different.
16:14Our, our days are just totally,
16:16you know, in the car driving,
16:18maybe driving a parent somewhere,
16:20maybe helping, you know,
16:21going to school for a PT.
16:22I mean,
16:23it's just very exciting and it is intense.
16:26And we really get to be a part
16:29of the family's lives.
16:31We're in their homes,
16:32we're meeting people in their lives
16:34who are coming through their homes.
16:37It's a really,
16:38it's a really great experience.
16:42I don't know if you want to talk
16:42more about your experience.
16:45So my experience with icaps, like
16:48I said, I started as a fellow
16:50working with. Former fellows and. I was.
16:58It's like so hard to put into words.
17:00I think all of the different ways that
17:02this work is engaging and exciting and.
17:06I remember I always think of this
17:09as like an example of an icaps case
17:11because it was like my first icaps case,
17:13which was a family who had had eye caps.
17:17They had struggled,
17:18they came back and we had the
17:20opportunity to work with them again.
17:22And we engage this family in
17:25every way that you could imagine.
17:29We took this mom to her housing appointments.
17:33We took the kids.
17:34We would pick the kids up from
17:35school and go to sessions.
17:37We had an entire day where
17:39the family had this family.
17:42For part of the period that we were open.
17:45Had insecure housing and they.
17:50Found a new place to live and we
17:52moved their stuff in our cars,
17:54in bags and we spent the whole day
17:57with them and we helped them build
18:00furniture for their new place and we
18:02did all of these things with them
18:04while we were also doing therapy.
18:06We were engaging this parent in a way that.
18:10She could connect with us because
18:13we were literally meeting her,
18:14like where she was at on the floor,
18:17making the furniture, talking about.
18:20Her life and how she got to where she was
18:23and I I think it was in those moments
18:26as a new clinician that I was like,
18:28oh, this is so different.
18:30And this is like really what I want to do.
18:34For a long time. And.
18:38I think even as I've moved,
18:41because I've now been here 8-8 years and
18:43in home world is like 30 years like.
18:48It
18:48feels like a long time and then if
18:50it if it's 30 years, it's like 100,
18:52it's so there's a Max behind it.
18:55But I I think that as someone
18:59say it's true, it feels like it.
19:03I think I've. I've.
19:06Had the experience of being like a clinician,
19:09full-time moving and going,
19:10and it's so exciting.
19:12And then now I'm in this
19:13role where I am supervising,
19:15I've also had the opportunity to
19:17participate in some of the research and
19:19kind of contribute what I've learned
19:21as a clinician to our icaps research.
19:24And present a little bit about it
19:25a couple of years ago with Soyon,
19:27which was really awesome.
19:30And it just has presented all
19:32these really unique opportunities
19:34to continue learning and growing.
19:37And even right now as a supervisor,
19:39I feel like I'm constantly
19:40learning and I'm learning
19:41from the folks that I supervise
19:42who are in this room right now,
19:44and I'm really happy they're here.
19:48And it's just, it's,
19:51I don't know, I I'll keep saying it's
19:53special over and over again, which is
19:55like very repetitive but it's just so.
19:58Unique and has given me so much.
20:02So much as a person,
20:04even like outside of the work,
20:06it's just changed who I am.
20:07So important. Yeah. You want to jump to?
20:13Should I jump to the last piece?
20:15OK. Umm. I guess.
20:19So the the last piece that we were
20:21going to talk about is kind of like
20:23the community within the ICAPS program
20:24and then the community within the
20:26larger Child Study Center and some of
20:28the things that have made it really
20:30great and some of the things that
20:31have been more challenging I think.
20:35Especially when we were
20:36in separate buildings,
20:37it could feel like there was like in home,
20:40dynamic and like.
20:43Outpatient dynamic and they felt
20:44different and it has felt better as
20:46we're like all collaborating more fully.
20:51And I think that that's been.
20:54That's been an interesting thing
20:55to kind of figure out how to deal
20:58in community with everybody here.
21:00Umm. I've also. Joked.
21:05But it's not really a joke,
21:06because it's a fact that,
21:08like Yale is a place that Yale is
21:11a university just started letting
21:14women into their College in the.
21:1716. The 50s.
21:21Too close to like when I was alive.
21:25Like my parents were around.
21:29What year is it, 69? 69. So 69 so yeah.
21:38Yale can sometimes feel like a
21:40place that just started doing open.
21:42So we and because I was born 20 years after
21:46it started letting women in. Umm, so I
21:51I think that can sometimes carry through.
21:54In the ways that people respond,
21:57social work is is a predominantly like.
22:01Female field, but I think that we're
22:05also mostly masters level clinicians
22:08here and that has been. Challenging.
22:13I think sometimes the medical model
22:15is challenging for that reason.
22:16It can feel like we spend the most
22:20time with clients and even. Um.
22:26Come in with a breadth of experience, I feel,
22:30even from like our graduate training,
22:32but it's not always respected
22:34in the same way that an MD.
22:37Z opinion would be even though
22:39we we see a lot and especially
22:40as we like gain experience,
22:42we have a we have a lot of
22:45clinical acumen I think.
22:46And so that has been challenging.
22:48And I think even coming in is like,
22:52I'm a first generation college student.
22:54My parents didn't go to college.
22:55Nobody knew what.
22:57Half my family still doesn't
22:59know what I do for a job.
23:01And so learning the like social intricacies
23:05of navigating has also been tricky.
23:09And I think that I'm.
23:12It's very special because I've
23:13been able to find people to connect
23:15with and talk to about that,
23:16but sometimes it is still really challenging.
23:19Yeah. I don't know.
23:21I know we're probably done with our
23:23time but no, no, no I'll just say
23:26yeah you know and I've been here a
23:28little less than than Bridget but
23:30I appreciate this you know grand
23:32rounds because I will say I've I've,
23:34I've felt like as a masters level
23:36that my opinion is is matters and my
23:39clinical perspective and I feel like our
23:42department has done a really good job.
23:44You as my you know,
23:45supervisor you know in valuing
23:49and really making us feel heard.
23:52And umm, like our clinical judgment,
23:55you know, is matters and it helps
23:56us develop it also.
23:59So I appreciate it because otherwise I don't
24:01know that I would be thinking this way.
24:03And I think it does depend where it is.
24:05You know, coming from another agency to the,
24:08the, the to Yale, Umm,
24:11it's just a, it's a big difference.
24:12I feel like, you know, I can,
24:14I feel like I'm making an impact.
24:15I feel like I'm learning constantly
24:17and it's great. So yeah.
24:21Yeah. So that's our time. I'm going to pass
24:24to Tara, and Amy's going to come up.
24:26Well, thank you both for sharing
24:29your story and your experiences.
24:32We're glad that Icaps chose you,
24:34and we're also glad you found your way back,
24:36so thank you for your.
24:38Dedication and time.
24:39Yeah, I've got to share this screen.
24:42So we're going to hear next actually from
24:44Amy Meyers who's going to talk about.
24:47If I can figure actually is Kyle.
24:48Still, I don't know how to
24:50get this back to Sharon.
24:52Need to share the screen again?
25:00While there. You wanna what do
25:03you want to be able to share? The
25:08people who are talking.
25:12I mean, I'm super impressed. I've got
25:14like 2 1/2 pages almost repeating.
25:213.
25:24Slide I think I'm not quite as skilled.
25:28I would love. I mean. Showing it's
25:33showing the notes. Ohh. Is it?
25:38Oh, that's not showing anything here?
25:43Technical challenges.
25:45Know if you're not here.
25:47A little fear.
25:50Display setting.
25:53I lost the match.
25:58Or something else?
26:04No. OK, here's here. Oh, funny.
26:15Thank you, I think.
26:16No, you got rid of it.
26:23Just, just no spare words. Just like it's on.
26:26We'll try, we'll try.
26:29I think we got it.
26:29Don't don't touch anything.
26:32Thank you. How does this advance? Let's say.
26:38No. Thanks.
26:44Travel.
26:47Mouse. I tried the arrow. Why is it?
26:50I just want to know how to advance and.
27:01Oh. New options for us. Knowing.
27:10Thank you. I won't touch anything else.
27:15Thanks for your help if that works.
27:21Oh yeah, OK.
27:24And and now I think we're
27:25good. OK. Thank you.
27:28Technical assistance. Thank you.
27:31So my name is Amy Myers
27:32and I am a social worker.
27:34And as Tara mentioned earlier,
27:36I was supposed to be presenting
27:38with Karen Hansen today,
27:39who's unable to be with us.
27:41Umm, so umm, as many people know,
27:46but I'll repeat,
27:47master level people at the Child Study
27:50Center include those who do client
27:54or patient facing clinical work.
27:56Often referred to as master level clinicians.
28:01In addition to those who do other things,
28:04I'm here representing a group of
28:06master level faculty and staff who
28:08do some of those other things.
28:10And who represent the professions
28:12of social work and more,
28:15which I'll talk a little bit
28:16more about later.
28:17So I'm speaking today on behalf
28:19of the family based recovery model
28:22development and Operations Group or
28:26FB RMDO.
28:29We are a group who began and have
28:32been staffed mainly by masters
28:35level people for the last 16 years.
28:41So the state of Connecticut
28:43recognized a problem.
28:45That problem was that approximately
28:4850% of children entering out of
28:51home placements in Connecticut
28:53have a parent who has an
28:56identified substance use concern.
28:57For children under the age of 1,
29:00that percent increases to almost 60%.
29:03In these situations,
29:04parents who need treatment for
29:07substance use disorder can be
29:09faced with challenges relating
29:11to stigma and discrimination.
29:13Fear of further systems,
29:15involvement,
29:16lack of transportation to
29:18treatment and lack of childcare
29:20while they attend treatment.
29:27In 2006, the Connecticut Department of
29:30Children and Families approached a master
29:34level researcher at Johns Hopkins University,
29:37as well as master level faculty
29:39at the Child Study Center,
29:40which included Gene Adipose
29:42Master and public Health,
29:44and Karen Hanson, a social worker,
29:47to develop a model to prevent these
29:49out of home placements for infants
29:52and young children due to parental
29:55substance use and to support.
29:57Insurance and creating a stable home.
30:00Thus family based recovery or FBR
30:03was born in 2007 and we started
30:07with six clinical treatment teams.
30:09There are now 13 clinical treatment
30:12teams across the state of Connecticut,
30:14including one here at the CHILD Study Center.
30:17No matter what town a family lives
30:19in in the state of Connecticut,
30:21they can have access to an FBR team.
30:25So a little bit about the FDR model.
30:31FBR brings into the home
30:34substance use treatment,
30:35individual therapy for the parent,
30:38attachment based parent child,
30:40dyadic therapy and support accessing
30:43community services via a treatment
30:46team of three people that is 2
30:49master level clinicians and a
30:51bachelor level support specialist.
30:54The model requires careful and
30:56continued risk assessment,
30:57assessment by the treatment team and
31:01very close collaboration with DCF.
31:04FBR aims to support parents to
31:06recover from the underlying reasons
31:08for substance use and believes
31:11that intervening with parents while
31:12their children are very young.
31:14Underscores what we know about
31:16attachment as a basic basis for
31:19development across all domains.
31:26FBR aims to give parents
31:28the chance to change.
31:30No matter how many treatment
31:32programs they've been in previously,
31:34no matter how long their DCF
31:37involvement, we believe that
31:38there's always hope for change.
31:44We also work very hard to approach
31:46treatment from a stance of humility,
31:48recognizing that parents know themselves,
31:51their needs and their children best.
32:01Additionally, paying careful attention
32:03to engagement as an ongoing process
32:07rather than a phase of treatment,
32:09leaving a focus on engagement
32:10helps to build safe,
32:11respectful relationships that we
32:13hope will be paralleled between
32:16parents and their children.
32:18So it's just a very little bit about
32:20our model in which parents can
32:21stay in treatment for up to a year,
32:23which is pretty extravagant I think
32:26in this world of treatment scarcity.
32:33So our team of model
32:36development and operations.
32:39Which is different from the
32:40clinical treatment team,
32:41consists of seven individuals,
32:43six of us working at the Masters
32:46level and one with a PhD.
32:48As a group, our educational
32:51fields include social work,
32:52professional counseling, health psychology,
32:56art therapy and sociology.
32:59As a group, we manage the statewide
33:02network of all FBR treatment teams,
33:05which includes training all FBR staff
33:07across the state of Connecticut,
33:09weekly clinical constant
33:12consultation with each team.
33:15Data management, model fidelity and
33:18assurance and model enhancement.
33:21Our team also manages the training
33:24and onboarding of adaptation sites.
33:27The FPR model is currently being
33:29adapted in Allegheny County,
33:31Pennsylvania, Ocean County, NJ,
33:34Vancouver, BC, and Hennepin County,
33:39Minnesota.
33:40Our team also provides great training
33:42to the greater community and working
33:44with parents with substance use disorders,
33:46engagement through relationship
33:48based practices and reflective
33:51diadic approaches for family support
33:54and within the Child Study Center.
33:56In addition to working in FBR,
33:57MDL members of our team also
34:00provide clinical supervision to
34:02people in other programs,
34:04participation in the social
34:07work fellowship and.
34:10And in terms of teaching topics in the
34:14social work fellowship and participating
34:16in overall activities of the fellowship.
34:20So pictured on the slide.
34:22It's Karen Hanson,
34:24who is the director of FBRM DOB,
34:26then Heather Simon, research assistant,
34:29Jeanette Radovich, consultant.
34:32Myself consultant,
34:34Michelle Saint Pierre,
34:35consultant and Soyon Kim,
34:37associate research scientist
34:39and Heather bonnets,
34:40more consultant.
34:41And just to call out for a moment,
34:44this is one of our.
34:48Zoom practices that we began during the
34:50pandemic when our staff meetings went online,
34:52that we would take a screenshot
34:53each week at the end of our meeting.
34:56And I think it's been a really
34:58interesting process to see our
35:00pictures over time and to see
35:03our expressions change over time
35:06and who was wearing a mask.
35:07And sometimes we had show and tell,
35:09and so this has been our practice
35:11for just about the last three years.
35:18In 2016, Connecticut's first ever
35:22social impact bond project was launched,
35:25which leveraged $11.2 million in
35:28philanthropic funds to allow a randomized
35:31control trial of the FBR model.
35:34This was a partnership between DCF
35:37social Finance and UConn health in
35:40addition to the Child Study Center.
35:42The project followed FBR families
35:44for 18 months post enrollment and
35:46looked at out of home placement
35:48and Ray referrals to DCF.
35:53FBR families had 21% fewer removals
35:57compared to those in treatment as
36:00usual and 10% with a re referral to
36:03DCF showing the promise of the model.
36:06Program to date. FBR has treated
36:122832 families, which includes
36:15476 fathers and 2636 mothers.
36:2082% of children remain living with
36:24a biological parent at discharge.
36:2747% of parents screened positive
36:30for substances at intake,
36:31which decreases to 13% after
36:34five months of treatment.
36:37Our data show a statistically
36:39significant decrease in pre
36:41post measures on depression and
36:43parental stress as measured by the
36:45parental stress index short form.
36:48FRM DoD aims to combine our data
36:50with what we have learned from
36:52working with families to integrate
36:54evidence based practice and
36:56practice based evidence approaches
36:58to continue informing the model.
37:02There are challenges.
37:08There are challenges and
37:09strengths to doing this work as
37:11masters level faculty and staff.
37:14On the challenge side,
37:16our team straddles clinical
37:17and work and research,
37:19and sometimes it's not
37:20quite sure where we fit.
37:25And we also learned in our process that
37:27we needed to get without PhD or MD.
37:30We needed to get permission to be API's on
37:33the work that we were already executing.
37:36In addition to Dean's approval to submit
37:39an application for an IRB to the IRB.
37:44On the strength side,
37:46we've been afforded opportunities to break
37:48barriers as master level faculty and staff,
37:50spreading our wings by presenting
37:52at conferences, working on model
37:54development and adapting and doing
37:57what we all truly believe in.
37:59And so I'll leave you with
38:01just a few words from, from,
38:02from some families from FBR over the years.
38:22Thanks so much.
38:31No. Thank you for sharing that work and
38:36hearing the numbers was really something.
38:39So I'm so glad that you shared that
38:41data and that this extravagant approach
38:43of having more than, what is it,
38:4628 days of treatment is available to the
38:49families in Connecticut and beyond it seems.
38:52So thank you for that.
38:53And so we will not have any more
38:55technical problems, I hope,
38:56because we have no other presentations
38:58in terms of slides, but we do have now.
39:03Is it? Now let's turn our attention
39:07please to Darrell Snow and Heather Howell.
39:09We'll talk about the.
39:11Parent development program and their
39:13work there. Hello. For having us.
39:19I don't know is it working great.
39:25So my name is Heather Howell and I am the
39:27intake coordinator and a clinician in
39:29the parent family development program.
39:31Tara asked me to talk a little bit
39:32about my Masters level training,
39:34all of which has been at Yale.
39:36In the School of Medicine,
39:37Department of Psychiatry.
39:40Actually, in some early internship
39:41training down at the APT Foundation,
39:44but especially that it was
39:45kind of all the same thing.
39:47I don't know if it is anymore, really.
39:49All of my work at Yale until about
39:51five years ago was all in research.
39:53So I love your data.
39:54I love your P value.
39:56Nicely done.
39:58At facilitated research protocols
40:00ran clinical trials.
40:02All improving,
40:03working to improve mental health for parents.
40:06So a lot of perinatal psych work,
40:07a lot of work based about based
40:09out of primary care settings
40:11and then in community settings.
40:15And I know we don't usually think
40:16of social workers as researchers,
40:17but we're here doing that
40:19work and it's something
40:20that I've been very proud of.
40:22I facilitated a lot of medication
40:24trials, therapy trials.
40:27And one of the things I was really proud
40:30of and probably why Child Study Center
40:32keeps me around is that I could really,
40:34I learned to really carefully
40:36and accurately diagnose.
40:37I think that that is something, you know,
40:40all of social work training is pro social
40:43and you don't put a label on something
40:44if it's not precise and accurate.
40:46I believe on the other hand,
40:47if there is a label that is useful and
40:50informative to somebody's healthcare,
40:51let's talk about it and understand it
40:53so that we can know how to treat it.
40:55So that is my approach. Umm.
40:58I'm really fully committed
40:59to adult mental health.
41:00Again, I feel glad that child Study Center
41:04keeps me around because but I think it
41:06connects so adult recovery and Wellness,
41:08it definitely benefits children and I'm
41:11also just certain that adults deserve it.
41:14So for all those reasons,
41:15that's my commitment,
41:16the parent family development
41:19program was created.
41:20Five years ago, does that sound
41:22right when we got an adult license,
41:23which was a lot of work.
41:25So thank you, Linda.
41:26Mays, I assume you're out there somewhere,
41:29but it was really courageous work
41:31for the Child Study Center to expand
41:33how we think about what we do here.
41:35Our clinic offers exceptional
41:37mental healthcare.
41:38Exceptional.
41:39Our whole team is right here,
41:41an exceptional team.
41:42We see adults who are struggling
41:44to recover from trauma, depression,
41:47anxiety, addiction.
41:50And that is a lot of work.
41:50We see adults with complex mental illness
41:53providing short and long term treatment.
41:56Really speaking to parents own
41:58health and recovery and by extension
42:01all the data tells us that that
42:04strengthens their kids as well.
42:05Makes them better parents.
42:07Really.
42:08When parents are healthy and well,
42:09kids benefit,
42:10so everybody wins.
42:12We experience a ton of collaboration
42:15with other clinics across youth land,
42:19all of the elements of that
42:21it's really very remarkable.
42:22And so I'm going to introduce you to
42:24my colleague and our intern this year,
42:26Darrell Snow.
42:32Good afternoon, everybody.
42:33My name is Darrell Snow and I am a
42:36social work clinical intern from Southern
42:39Connecticut State University working
42:41in the adult outpatient clinic with
42:44Heather and our Prestige colleagues here.
42:47I was born and raised here
42:50in heaven in Connecticut,
42:52in the Hill neighborhood section of town.
42:55I'm matriculated through the New Haven
42:58Public School system and graduated
43:00from Hill House High School in 2010.
43:03And my. Introduction to social
43:06work really was pretty early on.
43:09I remember my 4th grade teacher kind
43:11of surveying the class and asking us
43:13kind of what did we envision ourselves being.
43:17And I didn't have the words for it,
43:19but I just knew that I wanted to work
43:21with people with their feelings and
43:23and and I remember saying that I just
43:26don't want to see people mad anymore, right?
43:28So I grew up in a really hard neighborhood
43:31in New Haven and was exposed to a lot.
43:33And so I felt like.
43:36My my passion came on pretty early.
43:39I remember going to the library
43:40and researching what it meant
43:42to be a social worker.
43:43Once she said that,
43:44that was a possibility for me.
43:47And another reason of my why for
43:50social work is that I've been
43:52very aware since I could remember,
43:54just about the systemic barriers that
43:56people are presented with and how
43:58that impacts their mental health.
44:00When I applied to the CHILD Study
44:02Center as an intern last year,
44:05I was given the option to work either in
44:07the youth clinic or in the adult clinic.
44:09And I had been working with Youth
44:11and home for the last decade or so,
44:14and I wanted to kind of shift
44:15gears a bit and understanding that,
44:18as Heather stated, and which is very true,
44:20was that adult mental health severely
44:23impacts children's mental health.
44:25And so they're all equally important
44:28and they work together.
44:30Another part of my Why is just the lack
44:33of representation in the field for me.
44:36I went into the field knowing
44:40that there was a void and so,
44:42and I understand that although there's been
44:46increases of men in the field of color.
44:49That growth has not been seen for
44:52black men specifically and so,
44:54and my search for therapy some
44:56years ago for myself,
44:58that was something that I considered.
45:00I wanted to have a black note therapist
45:02for my own preferences and so so
45:05understanding that the importance
45:07of representation is another factor
45:10that waited for me to to join the
45:13field as a clinician. Umm.
45:16And it's also important for me to to.
45:19Respond culturally to all the people
45:21that we serve here at the clinic,
45:24but also that stretches beyond
45:26the walls here.
45:28The training that I've received has been
45:31tremendous and I'm just so grateful to
45:34have grown so much clinically under the
45:37supervision of Diane Dodge and all of
45:40the parent team here. I appreciate it.
45:43Receive ongoing support for cases,
45:45feedback, one to one supervision
45:48weekly and group supervision,
45:50as well as a seminar that we have
45:54for all interns across disciplines.
45:56I've gathered a lot of learning
45:59opportunities over the last year,
46:01so I've assisted Heather with some intakes
46:05and also have conducted psychological
46:07evaluations for some of our adult folks.
46:13I find really great passion in the
46:14work that I do here at the clinic,
46:16but I particularly enjoy the work that
46:18I do within our father's program,
46:20founded by Carla Stover.
46:23For many of the men that I work with,
46:26the space that we've created is often
46:28the first time that they are able
46:31to express their feelings in a very
46:33neutral and judgment free space.
46:36They develop an openness to explore
46:38generational patterns of behaviors
46:40and trauma and how that influences
46:42some of their choices and then
46:44in their relationships.
46:46Most of all,
46:47they appreciate discovering new skills
46:49that they can learn and apply in and
46:51outside of the therapeutic space.
46:53And they've also have been able
46:55to access more Community resources
46:57just through my be me being well
47:00versed in the community.
47:02I've grown up here in New Haven.
47:03I know a lot that the city has to offer.
47:06Just want to just say that I really
47:08appreciate the time that I've been
47:10able to learn and grow here and.
47:12Thank you for for listening.
47:25I'm just looking at the time and well,
47:29there's like 10 minutes.
47:31And so I guess one question first
47:33of all is a big thank you to
47:36everyone for sharing for being here.
47:42For choosing to be here,
47:44for sharing your gifts,
47:46for facing the obstacles,
47:48for being part of what brings the
47:50gifts and talents here as well.
47:51And it's really tremendous and it's we're,
47:54we're our community is so lucky
47:57to have all of this available
47:59to us and so thank you.
48:01And I guess also with that I don't
48:03know if there's questions. Yeah.
48:11Thank you so
48:11much for such an inspiring
48:14set of presentations.
48:15I feel like wow, underachieving,
48:19I need to get going with y'all and
48:21I wanted to comment on
48:24the incredible power of the icaps programs.
48:28So over the over the last decade ICAPS
48:31has partnered with the psychology
48:33training program and providing an
48:36invaluable experience for our doctoral
48:39level psychologists who come here.
48:41And they come here and we tell
48:42them about the icaps opportunity.
48:45They say Humana, Humana,
48:46I'm going to someone's home in the community
48:49and is there a treatment manual and how
48:51many are there because they're used to
48:54office based manualized treatments.
48:56And I'm especially grateful to you, Bridget.
48:59For adopting our psychology fellows
49:01for the last couple of years,
49:03where you have modeled and taught and
49:06supervised in a highly compassionate
49:08manner how to be present with families
49:11in the stage of growth that they're in.
49:14And so I'm deeply appreciative of the
49:16teaching and supervision that you've been
49:19providing for our psychology fellows.
49:21And then I have a question for that.
49:23I'm wondering if you might reflect on
49:26what is it like to supervise
49:28across disciplines.
49:30What are the joys? Are there some thorns,
49:33kind of the roses and thorns in a
49:35setting such as this
49:37that hasn't often recognized the talents
49:40of all of our training partners?
49:44So I thought I wondered if
49:45you had a reflection on that.
49:50Which one? OK.
49:56I know I'm quiet. I thank you
49:59so much for saying that and I think a
50:01lot of the credit for the experience
50:03folks have had is also to I know
50:05Doctor Wilson has done a lot of
50:06supervision as well as generally who
50:08is part of gingerly has partnered
50:10with the psych fellows for many years.
50:12This is actually my first year,
50:14so I can share about my experience this year,
50:16which I really enjoyed working with
50:19Kara this year. It was excellent.
50:21I think one of the surprises for
50:23me was in working with somebody who
50:26was in training but who had done.
50:28Therapy before.
50:29So it was, it felt more like kind
50:32of helping her and helping.
50:34To understand the difference in in
50:36homework and also being able to see
50:38what you can kind of learn from the
50:40in home experience which is the like
50:43sitting and being present with a family.
50:45And I think one of one of the things
50:49that I noticed and that we did talk
50:51about was like especially because the
50:53cases we get from that we work with our
50:55psych fellows with our medical icaps cases.
50:58So there's also often a medical component
51:00that contributes to their mental health and.
51:05I think seeing that often the family actually
51:07knew what it was that they needed to do.
51:11They understood the clients medical needs.
51:13It was more of sitting and being like
51:16what what gets in the way or like what,
51:19what is happening with mental
51:20health or how does trauma impact
51:22the way that they respond to this.
51:24And I think having those conversations
51:27was really eye opening for me
51:29in terms of like
51:30oh, you kind of. I'm a newer,
51:32I'm newer to supervising,
51:34and I'm I'm newer to kind of.
51:37Roles where I'm a direct teacher.
51:38I've kind of mentored fellows before,
51:40but I think that was one of
51:41the things where I was like,
51:42oh, I really have something to
51:43share and it was very nice.
51:47And I think it was also progressing in like.
51:53Seeing the differences and also
51:55the similarities in the fields
51:57and kind of that we were all
51:59thinking about kind of like.
52:01Culturally, humble practice,
52:03social justice orientations and
52:05and how we're thinking about the
52:08families and their communities but.
52:10Actually having the opportunity
52:11to kind of guide someone through
52:13seeing that in person for the first
52:14time was really exciting, yeah.
52:16Thank you for your question.
52:19Is it OK if I jump in just briefly?
52:23Sorry for being the voice of God
52:24off screen here. I apologize.
52:25I just wanted to add that that Jinju
52:28also has has remained in touch with
52:32their ex psychology trainees and I
52:34think the model is really powerful
52:36experience for both the clinicians
52:38working together in such challenging
52:40yet yet rewarding circumstances.
52:43Just just to comment there,
52:46just always impressed to see that
52:48connections that form that way and then.
52:51And then the other pieces I think,
52:54yes, like Lori said,
52:55psychology comes in well trained,
52:57manualized experience,
52:58evidence based and you,
53:00you do have to counterintuitively put
53:03that all aside as you as you enter
53:05enter the home I think to start with.
53:09Thank you for offering the MD.
53:13John Ponce and I work a
53:14medical director for Icaps.
53:16And yes, I don't do any of the work.
53:17It's really the social work clinicians
53:19that are in the frontline here.
53:20So full credit is due in a perfect
53:23metaphor for your presentation today.
53:29Were there other questions that folks had?
53:35Yes, doctor Martin.
53:42So can you hear me? Can you hear me?
53:43So First off, thank you to all 5-6 of
53:46you and Tara for putting this together.
53:48This was really wonderful and you know it,
53:51it was painful as you as you relate the
53:54pain of the IRB example was one of the,
53:56you know, that didn't make sense,
53:57right, that you needed all
53:59these special permissions,
54:00kind of a reminder of a different status.
54:03And it it just made me think that there
54:06are social workers throughout the hospital,
54:09throughout the hospital,
54:10but I don't know if any other
54:12department that has shown a light
54:13shined a light shining a light.
54:17And and social work and and I think
54:19I I don't think it's a coincidence
54:21that it's a child study Center
54:22for a number of reasons.
54:23One is that we work with social
54:25workers very closely for years and
54:26I'm I'm sorry that my my friends
54:28from the inpatient unit our social
54:30work colleagues are not here but you
54:32and other masters level folks.
54:36Nursing for example.
54:37I mean we so we have many of these
54:39experiences but but but there's
54:40something about social work that
54:42I think is particularly relevant
54:43which is a mental health component.
54:46And and I guess it my hope would be
54:48that having the child Study Center
54:49being an example and this being an
54:51example of something that could
54:52happen in the broader Medical Center.
54:54You know that we're not going to
54:55see this necessarily nephrology
54:56because they think of kidneys not
54:58of mental health but we think of
55:00mental health and and social order
55:01thinks of mental health throughout.
55:02So I just hope that this continues
55:04but thank you for all the work it was.
55:06And those numbers were very impressive in me.
55:08So thank you for sharing that.
55:09Yeah,
55:10thank you. I will. Yeah. You'll be
55:14our last question looking at the time.
55:17Thank you. So I'm Lilia Benoit.
55:20I'm child and adolescent
55:21psychiatrist from France originally.
55:23And I have worked here at the CHILD
55:25Study Center for two years as an
55:27associate research scientist.
55:29And so as a foreigner,
55:31I'm not yet allowed
55:33to to be a medical
55:34doctor here, but
55:35I'm, I'm starting my residence and very,
55:36very happy about it.
55:38But for the past two years,
55:40I've been allowed to tutor the
55:42Yale medical students at 21 and
55:45and there is always this question.
55:48In this discussion we have in the
55:51inpatient unit because in the end they
55:54they realize that the kids who are
55:57there are there because of society,
55:59because of adversity,
56:01because of of injustice,
56:05because their parents don't
56:06don't receive the help they they
56:09should they deserve to have,
56:11because attachments,
56:12bonds are very insecure and most of the
56:14time we end up having this conversation.
56:16Whenever I say yes,
56:17the inpatient unit helps a little bit.
56:19This medication but what would be
56:22really useful would be to have one
56:25person spending one year with the family
56:28to model what is secure attachment
56:31and and welcome secure bonds and
56:33and create that with the family.
56:35And I didn't have any example until
56:37today to to tell them yes this this
56:40exists but I think from now on I'm
56:42going to say yes this is icaps and and
56:45at least we have some social worker
56:47helping us with this very important.
56:50Work,
56:50so thank you so much for sharing.
56:53Right. And that was also a focus of
56:56the work too with actually all of
56:58the programs that spoke today that
57:00focus on attachment and and taking
57:03care of the the entire system.
57:05So thank you again.
57:08Thanks everyone for joining us today.
57:12For a wonderful panel.
57:17And remember, there's not
57:18a grand rounds next week.
57:20And our faculty meeting,
57:22we're hoping to have a panel
57:24discussion about what it's like
57:25to be a woman in the Academy.
57:27So hope you'll see you there,
57:29and if anybody's interested
57:30in contributing to that,
57:31let me know. Thank you.