Adelphi University Undocumented Immigrants in Manhattan Discussion Where are the undocumented immigrants in this borough from, and where do they live? Most

Adelphi University Undocumented Immigrants in Manhattan Discussion Where are the undocumented immigrants in this borough from, and where do they live? Mostly of Dominican and Mexican Decent.Where
do they work? Dominicans – cab drivers/bodegas/ home attendants/restaurant workers. Mexicans – Bodegas/restaurant workers/self employed, etc.What kinds of conditions do they live and work in? Make sure to include some sort of tie in to just practice (meaning, history, power, possibility, context) or liberation health model (cultural, personal, and institutional parts of a problem) if possible. Below is a template:The following guide is offered as a suggested approach for preparing the community project papers. Creativity is encouraged! The community project paper is a product of a creative process that flows from the members’ interactions as a group and your group’s learning as a result of engaging remotely with the community of focus. How you write about this process can be a reflection of your group’s unique style and perspective.INTRODUCTION▪ What is the topic of discussion in this paper?▪ What is the connection to social work?▪ What does your paper do?COMMUNITY OF FOCUS▪ Who is the specified community and how does the community identify (who do they say they are)?▪ Why was this community of interest/importance to your group?▪ What were you curious to learn about this community, and why?PRE-ENGAGEMENT▪ What did you learn about the community prior to engagement, and how did you learn what you learned?▪ What power and privilege dynamics as well as biases were you aware that you individually and collectively needed to be mindful of prior to engagement? How did you manage this?ENGAGEMENT▪ What strategies did you employ to engage with the community?▪ What prompted you to choose these strategies?▪ What was it like for your group to use the strategies?COMMUNITY TEACHING/LEARNING AND IMPLICATIONS FOR ACTION▪ What did you learn about the community?▪ How are you understanding this learning in the frame of JP and LH?o For example:▪ How are you making meaning of what you learned? How does context help you to make sense of what you learned? How did you experience power dynamics in your remote engagement with community members (your power and their power)? How has history impacted the community – people, housing, resources, policing, transportation, access to food, health care, clean water, etc.; and, possibilities as seen from the perspectives of the community members?▪ How does the personal, institutional, and cultural provide a frame for all you learned?▪ What from your learning reflects potential intervention and/or advocacy that community members are interested in pursuing?▪ How might social workers support community members in taking action?CONCLUSION▪ What did your group learn about community engagement and teaching/learning from this assignment?o As applicable, how was what you learned influenced/framed within the current Covid-19 crisis?▪ What did your group learn about group work from this experience as a group?▪ How can you use these lessons in your social work practice going forward? Critical and Radical Social Work • vol 3 • no 2 • 309–19 • © Policy Press 2015 • #CRSW
Print ISSN 2049 8608 • Online ISSN 2049 8675 • http://dx.doi.org/10.1332/204986015X14320477877474
voices from the frontline
Towards a socially just social work practice:
the liberation health model
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Jared Douglas Kant,1 jared@liberationhealth.org
Boston Liberation Health Group, USA
This article discusses the ‘liberation health’ model for social work practice and explores how this
model may be used to bring conversations about race and class into the therapy room. It begins with
a review of mental health social work teaching in the United States and moves on to demonstrate
differences between traditional and liberatory practice methodologies. The term ‘liberatory’ is used
in this article to refer to a variety of anti-oppressive theoretical frameworks, with an emphasis on
the work of Paulo Freire and Ignacio Martín-Baró. Additionally, the author demonstrates interviewing
strategies for bringing conversations about intersectionality into the therapy context.
Introduction
Therapy without context
Although many methods exist and are widely taught for understanding the
intersections of race, class and gender in academia, the link between this and direct
practice is under-addressed in social work pedagogy. In the United States (US), the
majority of graduate students looking to pursue a career in social work follow what
is referred to as a ‘clinical track’, which predominately trains new social workers for a
career in individual counselling (Reardon, 2012). Clinical tracks in most social work
schools emphasise modernist and intra-psychically focused theories such as cognitivebehavioural therapy (CBT) and motivational interviewing, alongside relatively newer
methods of family therapy that focus on brief treatment.
Psychodynamically focused practice teaching, which prevailed prior to the elevation
of CBT in US social work pedagogy, made a similar misstep, in so far as it tended to
look to drives, fixations and childhood experiences with family members as the root
cause of the many problems that service users came to therapy to address. Dynamic
theories were heavily focused on the experiences of white clients, particularly upperclass Europeans, which offered little insight into the lives of working poor people and
people of colour in North American cities (Almeida et al, 1998: 415). Moreover,
psychoanalytic practice was largely guilty of perpetuating sexist and mother-blaming
attitudes that are still prevalent in many North American schools of social work. Object
relations and attachment theories, which focus on the important early years of a child,
have paid insufficient attention to the impacts of racism and internalised oppression,
which factor largely into the affective landscape of young parents, particularly those
from lower-income areas and communities of colour.
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Jared Douglas Kant
Critics of mental health education in the US have argued that graduate schools
are designed to train white therapists, whereby both clients and practitioner are
treated as de facto white (Hardy, 2008). Other critics have argued that social work
schools have abandoned the mission of serving underprivileged people altogether,
in an attempt to professionalise (Specht and Courtney, 1994). In the course of this
professionalisation, teaching for social work and other allied mental health professions
has contributed greatly to a literature that seeks to define service users and patients
by a cluster of symptoms, training therapists to participate in the totalisation of their
clients (Madsen, 2007: 31; White and Denborough, 2011: 65-6). Additionally,
the need for reimbursement, particularly in the US where healthcare is a capitalist
enterprise, and the use of diagnostic codes for the purpose of remuneration, have
led to an increase in tangible motivation to use these ways of understanding service
users and the problems in their lives.
One of the early North American movements to challenge these ideas was known
as the rank and file movement – a frontline social worker-led movement heavily
involved in the unionisation of social workers – which was seen as a recommitment
to grassroots organising in American social work (Reisch and Andrews, 2001: 61-87).
It is from this and two other traditions that liberation health is drawn.
The popular education and liberation psychology movements
A pioneer in the field of education, Paulo Freire had been tasked with developing a
literacy programme for poor farmers in rural Brazil. When Freire examined dominant
teaching methods and attempted to make these relevant for his students in Brazil, he
found that then-current pedagogy was not only inadequate for addressing the needs
of his students, but also, in his estimation, oppressive as well. Freire wrote grimly that
educators were practising a ‘banking model’ of education, by which he meant that
teachers were treating students’ heads and minds as empty vessels in which to bestow
knowledge (Freire, 1992: 58-64 [1970], 2001: 30-4). In this banking model, where
the role of teacher and student are absolute, the student experiences themselves as an
‘object’, by which education is a practice that is done to them, rather than with their
collaboration and input (Freire, 2009: 42).
Freire postulated that a critical pedagogy would require a more nuanced, reciprocal
relationship. This reciprocity would help to move students relegated to an object
position to that of a subject, which he referred to as someone who is in a relationship
with the world around them. The role of education, Freire (2001: 76) believed, was
to help students to learn to ‘read the world’, to understand the forces of oppression
around them and to renegotiate these relationships to allow for learning to be both
relevant and transformative. Freire’s literacy programmes experienced unparalleled
success, accounting for his recognition as a thought leader in education around the
world.
In subsequent years, Freire’s critique of education, and the formation of the popular
education movement, were picked up by Salvadoran and Jesuit psychologist Ingacio
Martín-Baró. Martín-Baró recognised a similar oppressive structure in the field of
psychology as reported by Freire in the field of education. Martín-Baró believed
that psychology was playing the role of oppressor, both upholding social norms and
perpetuating the subordination of therapy service users (Martín-Baró et al, 1994).
He documented that then-modern methods of psychological practice treated patients
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as people to whom therapy is done, rather than people to be collaborated with.
Such a practice was inherently colonialist, and reproduced power structures within
the therapy context. Martín-Baró thus adapted Freire’s methodology to counselling
practice, creating a paradigm that sought to deconstruct power relationships and the
messages that reinforce them.
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The liberation health framework for social work practice
The liberation health framework for social work builds on these legacies of antioppressive thought. With the ideas of Freire and Martín-Baró at the core of liberation
health practice, the framework seeks to provide a space for service users and social
workers to think critically about the problems for which they are seeking treatment.
This first requires the discovery of a view of the problem ‘in its totality’. To do this,
workers elicit information relating to the personal, cultural and institutional factors
that influence their lives (Belkin Martinez, 2005; 2014: 23). Given the problemsaturated view promoted by a medical model of clinical practice, many service users
come to social workers with long stories having been written about their lives, which
detail at length diagnoses, developmental milestones, family and addictions histories,
among other things. These constructs, while important, are imposed on service
users by people outside of themselves. These details often make up the traditional
biopsychosocial assessment. However, the traditional biopsychosocial assessment in
and of itself does not capture the entirety of a problem, and classical formulations
leave out what may perhaps be the most important information.
Beginning the triangle: personal factors
To visualise a problem in its totality, liberation health practitioners often utilise a
diagram featuring a triangle, with each point representing the contributing factors
to a problem. The three points are designated as personal, cultural and institutional
factors. Service users are invited to name the problem they are experiencing using
unique language that is meaningful to them. This is put in the centre. The practice
of using family-specific language has a long and important tradition in post-structural
family literature and is essential to centralising the experience of the family. Below
you will find the stories of families who have interfaced with both traditional and
liberation health practitioners. As such, traditional means of understanding problems
will be juxtaposed against liberation health assessments that include issues of race,
class and other avenues of oppression. These will be set in a liberation health triangle.
For example, a family is referred to services following a young child’s ‘behavioural
outbursts’ at school. The child and his mother are subsequently interviewed by
school staff, who observe tension among family members, leading to a referral for
family services. A host of earlier providers have documented that this child meets
the criteria in the Diagnostic and statistical manual of mental disorders (DSM-IV-TR;
APA, 2000) for attention deficit hyperactivity disorder (ADHD), and medication
is suggested by a psychiatrist. An understanding is woven over multiple subsequent
assessments in the years prior to the start of family therapy services that this child is
in need of mental health services and such an understanding becomes intrinsic to
how the family views the problem.
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The factors listed in the referral, as well as other personal factors, make up the first
point of the triangle. These may include demographics such as:







age;
gender (and gender identity);
race and ethnicity;
sexual orientation;
family context;
intergenerational patterns; and
diagnostic and medical information.
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Cultural factors: exploring cultural messages
To allow for a more complete view, a social worker interested in liberation health
practice begins by inviting the family to explore the messages they have received as
a result of this diagnosis. These explorations reveal deeply painful messages about
the stigma of raising a child with mental health needs. The parents reveal feeling
judged and shamed when they take their child to doctor’s appointments. During
an interview, the mother shares how frequently she is asked by nurses whether or
not she used drugs or ingested alcohol while her son was in utero. From here, the
second portion of the triangle begins to list cultural factors that are contributing to
the strain on this family. While these may be listed as concepts (eg, racism, classism
and the celebration of individualism in North American culture), they may also be
recorded as the messages themselves. Some of these painful messages, as have been
relayed by families to this author, are elucidated below:
‘If a child is born with special needs, it must be because the parents did
something wrong.’
‘If parents were able to raise their children properly, they would be able
to pay attention in school.’
‘All children who misbehave do so for attention, and should be treated
as such.’
‘If a child has trouble concentrating or sitting still, they will not be
successful in life.’
‘Children who misbehave in school must come from “broken” homes.’
Consider the following conversation with a mother whose son was suspended from
school after a history of involvement with school disciplinarians:
Mother:
Author:
Mother:
Author:
Mother:
‘I used to get this tightness in my gut when I would go to his
school.’
‘All the time, or at particular times?’
‘Whenever the school would call, and I’d have to go down
there. It would just hurt.’
‘Do you have an idea of what it was that was contributing to
the tightness?’
‘I can hear it in their voices – “your kid is acting up” means
“what the hell are you doing wrong?”’
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Author:
Mother:
‘What message do you hear when that happens?’
‘You’re a bad parent and you have a bad kid.’
Other factors already named in the ‘personal factors’ column contribute to this
parent-blaming. Families of colour often report feeling particularly blamed and
are extra-cognisant of the judgements being rendered upon their families. The
following statement was recorded during an interview with this author and a family
whose young son, a student of colour, was consistently under intense scrutiny at his
mostly white school in a major metropolitan area in the US: “When I hear them
talk about my son like that, when they use the word ‘aggressive’, I know what they
mean by ‘aggressive’. They mean he’s a thug. And they mean a thug … like all the
other black kids.”
Cultural factors may take other forms, such as prejudicial beliefs around sexuality
and gender identity. These are often tied to institutions as well, and can often help
to make the tie between personal, cultural and institutional more explicit. These
messages may be elucidated in various forms and come out in many different ways. A
colleague of this author reports working with a man whose history of suicide attempts
and suicidal thinking are fundamentally tied to messages around homosexuality that
began in early life. A conversation revealed that the service user’s motivation for suicide
centred on being ‘undeserving of life’. Although it would be possible to work to
ameliorate the distress caused by these thoughts, it is equally important to understand
where they come from, as cultural messages are supported by larger social structures.
A liberation health interview revealed explicit statements in support of this belief
coming from the service user’s own faith institution, leading to larger conversations
about the validity and worth of these statements. Introducing new information in
this case included exploring clergy and religious activists who have worked to tear
down the idea that Christianity is incompatible with non-heterosexual identity.
The deconstruction and challenging of these ideas is referred to as ‘deconstructing
dominant discourse’ (Kant, 2014).
Often, conversations around cultural messages offer the opportunity for what
Martín-Baró referred to as ‘introducing new information’ (Martín-Baró et al, 1994).
Martín-Baró believed that structural oppression was upheld principally by the notion
that things have and always will be as they are, or more pointedly: ‘nothing can change’
(Martín-Baró et al, 1994: 30). Practitioners looking to fight oppressive discourses
should therefore look to become students of radical history movements. Working
with the man described above, it would be helpful to explore how the notion that
‘homosexuality is a mental illness’ was driven from psychiatry by dedicated lesbian,
gay, bisexual and transgender rights activists who successfully fought to remove
homosexuality from the DSM, and are now currently working to ban so-called
‘conversion therapies’.
Institutional factors
A complete analysis of the problem requires a third and important category of
information to be recorded – the institutions that families interface with in pursuit
of remedying the problems that affect their lives. As demonstrated above, institutions
themselves can contribute greatly to oppressive conditions by the messages they
perpetuate, but also through structural and institutional racism. It has long been
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documented in sociology literature that black students, particularly black male
students in the US, receive considerably harsher punishments in school than their
white counterparts for the same offences, and consistent reports reveal a much greater
willingness on the part of school personnel to involve law enforcement in school
discipline when young men and boys of colour are involved. In 2013, Kiera Wilmot,
a 16-year-old African-American student, was expelled from school in Bartow, Florida
for doing an experiment she found on YouTube that involved combining cleaning
supplies and aluminum foil to generate smoke (Klein, 2013). Wilmot performed
the experiment in a bottle which unexpectedly burst, and Wilmot was accused of
building an explosive device.
Despite the long tradition of unpunished senior pranks in suburban white
communities, Wilmot was expelled and threatened with charges.
As suggested by Martín-Baró, families should be encouraged to identify who
benefits from the perpetuation of oppression and oppressive ideas. When asked if
there is a benefit to perpetuating the story of the ‘aggressive black male’, a mother
identified:
Mother:
Author:
Mother:
‘The thing is, they don’t know how to handle my son. This is a
way of saying “it’s not our fault”, and not taking responsibility.
This is a way of saying “don’t blame us, we would help him,
but he’s just some thug and that’s beyond our control”.’
‘So, this story is a way of not taking responsibility?’
‘Exactly. Not our fault. Don’t blame us.’
Schools are not alone in perpetuating structural oppression. For example, families
have reported feelings of dread visiting the Department of Transitional Assistance
(DTA) building in Boston, through which Massachusetts’ residents obtain food and
rent subsidies from the Commonwealth. At the entrance, armed guards in black
fatigues stand watch. Parents often report being disallowed to speak until spoken to
and treated with blatant disrespect. Such an environment is disquieting at best, but
should be considered pathogenic in the context of the lives of families. An article
published by the American Orthopsychiatric Association found that families facing
raids from Immigration and Customs Enforcement (ICE) were often subject to
military-style tactics, leading to profoundly increased rates of post-traumatic stress
and hypervigilance (Capps et al, 2007; McLeigh, 2010).
Given the example of the DTA above, let us reconsider the previous family with
the information now documented. Figure 1 illustrates the different factors placed
into triangle diagram.
A student, who has been given a diagnosis of ADHD by previous providers,
is having trouble in school. Communications between the school and the
student’s mother leave her feeling shame associated with dominant messages
about parents of children who present with behavioural challenges. These
feelings of shame are exacerbated by a climate in which students of colour
are disproportionately singled out and leveraged with harsher punishments
at school and in the juvenile justice system. Thinly veiled comments
produce feelings of al…
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