The Diversity Social Work Advancement Program

January 4, 2017 / By: Elizabeth Child for Fall 2016 Perspectives newsletter
True Thao and Nelly Torori picture in front of The Family Partnership
True Thao and Nelly Torori MSW '11

BUILDING A CULTURALLY RESPONSIVE WORKFORCE ONE SOCIAL WORKER AT A TIME

While Minnesota is known as a leader in health and mental health services, efforts to develop a diverse workforce have lagged behind. Yet, the state’s increasingly diverse population requires culturally appropriate responses and practitioners with knowledge and understanding of the unique mental health needs of minority, immigrant and refugee communities.

Having uncovered the need, the Minnesota Department of Human Services’ Adult Mental Health Services created funding for programs to increase the participation of minority, immigrant and refugee students on the pathway to Mental Health Professional licensure. Among the first grant recipients was a consortium of MSW programs, including St. Catherine University — University of St. Thomas. In partnership with the lead agency, The Family Partnership, the collaborative designed the Diversity Social Work Advancement Program (DSWAP).

“It started as a pilot and we have had really good results,” said True Thao MSW, LICSW, program director for DSWAP at The Family Partnership, which provides counseling, education and advocacy for children and families in need.

One of Thao’s first students was Nelly Torori MSW ’11. “DSWAP allowed me to be exposed to mental health services in such a direct way that I had not ventured into,” she said. At the time, she was a graduate student in the St. Kate’s — St. Thomas clinical social work program. Today, she works for the Minnesota Department of Human Services as a mental health program consultant in the Children’s Mental Health Division.

To date, more than 50 students from 25 countries have participated in DSWAP, including 16 students from the St. Kate’s — St. Thomas MSW program.

Developing the cultural competence to effectively serve minority populations can give new purpose to professional and personal lives. While today Torori mostly focuses on policy issues rather than direct clinical practice, she takes every opportunity to teach family, friends and members of her community about mental illness and to offer a different perspective on the benefits of early intervention. She serves as children’s ministry director at her church, where she is developing a curriculum for parents of children who exhibit challenging behaviors. And while she has been invited to speak about mental health at church functions, many of her conversations about the once-taboo topic come up in informal settings.

“I like to share what I know,” she said. “That way people are knowledgeable. We used to be very scared of [mental illness].”

THE PRACTICUM

MSW students selected to be DSWAP Scholars complete a clinical field placement at The Family Partnership. Each student is assigned a caseload of clients with mental health issues ranging from anxiety and depression to post-traumatic stress and relationship difficulties. Students have supervisory meetings with Thao each week in addition to weekly case consultation with clinicians from various disciplines, including psychiatry.

DSWAP Scholars learn firsthand that interpretations of mental illness symptoms can vary widely. “Symptoms of mental illness are very universal whether you are Nigerian, Tibetan or Bhutanese,” said Thao. “But how a person defines their issue is very cultural.”

Thao, who is Hmong, explained that members of his community might interpret the symptoms of schizophrenia as possession by an evil force or punishment for a misdeed.

Torori, who emigrated from Kenya, said most people in her culture are ashamed of mental illness so they often won’t seek help. “If I am lonely or crying, why would I need a pill? I am OK,” said Torori, illustrating the attitudes she encounters in her community.

DSWAP prepares MSW students to listen, interpret what they hear and gain clients’ trust. “Students learn to be clinically sound, but also to take their skill and knowledge to create some shared meaning with the patient,” said Thao. “That’s the beauty and the complexity of cross-cultural work.”

The clients Torori counseled through DSWAP were often refugees from war-torn countries who had witnessed atrocities beyond her imagination. “When you think your bad is bad, you think, wow, that’s even worse,” she said. “But being there to listen and be the support that a client needs develops a sense of shared meaning that builds a therapeutic alliance.”

In addition to working directly with clients, DSWAP Scholars receive training in Narrative Exposure Therapy (NET). Torori remembers how eye-opening the training was – and how much it helped her. Clients with PTSD share their stories – both the good and the bad – surrounding trauma they’ve experienced. For Torori, exposure to these traumatic backgrounds laid bare her personal wounds. But it taught her to create professional boundaries too. “I learned how transference and countertransference plays out in a therapeutic relationship,” she said.

Her experiences at The Family Partnership helped her develop skills and confidence as a clinical social worker. Another strong component of DSWAP Torori points to is the intensive, two-day training preparing students for the challenging post-MSW licensure exam. Thao said minority students often struggle to pass the LGSW licensure exam, but DSWAP Scholars pass more than 95 percent of the time.

“DSWAP is an exemplar for how to make real change in the face of a profession,” said Lisa Richardson, director of MSW field education at St. Kate — St. Thomas School of Social Work, and a representative to the original collaboration that designed the program. “It provides a combination of supports and reinforcements, including tuition stipends, individual and group supervision during and post MSW, specialized training, licensure exam preparation, direct and indirect practice opportunities in the practicum, as well as coursework and research focused on serving diverse populations and trauma.” It is the sum of the parts, she noted, that is so effective.

EXPANDING THE REACH

Helping minority, immigrant and refugee students gain experience and pass the licensure exam are steps toward a larger goal Thao believes DSWAP can accomplish. Thao is building on the program’s success by expanding its charter.

In the past two years DSWAP has begun to deepen its roots in communities. It is creating greater awareness about mental health with programs like mental health first aid training and a Hmong radio show broadcast on the internet that answers questions about mental health from far and wide.

The goal of the DSWAP continues to be creating a pathway for students from minority, immigrant and refugee communities to become mental health professionals and ambassadors for mental health. But, Thao also asked, “How can they become managers and leaders where they can influence program design?” To that end, he encourages DSWAP Scholars who have attained the initial post-MSW level licensure (LGSW) to keep working toward the LICSW.

He doesn’t need to look far to see this vision unfolding. Torori is a shining example of what the St. Kate’s — St. Thomas MSW program and The Family Partnership hope to achieve. She not only is a manager in the department that funds DSWAP, but she also brings the mission of educating others about mental health care into every facet of her life, and is a role model inspiring young people in her community to seek careers in the field of mental health.

This article was published in the Fall 2016 School of Social Work Perspectives newsletter