PowerPoint Presentation

Social justice is defined as "... promoting a just society by challenging injustice and valuing diversity." It exists when "all people share a common humanity and therefore have a right to equitable treatment, support for their human rights, and a fair allocation of community resources." In conditions of social justice, people are "not be discriminated against, nor their welfare and well-being constrained or prejudiced on the basis of gender, sexuality, religion, political affiliations, age, race, belief, disability, location, social class, socioeconomic circumstances, or other characteristic of background or group membership" (Toowoomba Catholic Education, 2006).

Pursuing Social Justice in the Treatment of Underserved PopulationsLaura Rothafel, LMFT#32474, LPCC#195www.laurarothafel.com

Sharon Christopher, MFT Intern #91710christopher.sharon.e@gmail.com

Outline of WorkshopIntroductionRoadblocks to Social JusticeUnderserved PopulationsProposed Solutions: Thinking Outside of the BoxConcluding Thoughts

How many of you chose this field because you wanted to help people?

How many of you didnt think about how much time you would spend sitting?

How many of you have been frustrated by the limitations of the services you can provide based on program funding or insurance?

How many of you feel like sometimes there is more paperwork than clinical work in order to justify or prove your clinical decisions?

How many of you answered yes to all of these questions?

Roadblocks to Social JusticeSchedulingLevel of FunctioningLack of Therapeutic SpaceLanguage BarriersLack of ReferralsLack of Resources

Compare therapeutic space with current position in BH

Level of functioning: lower levels of functioning in lower SES populations do to downward drift. Less resources mean that people only pursue treatment when they are very illentrenched poverty, multigenerational cycles of dysfunction.

Compare therapeutic space with current position in BH

Language barriers: vignette of Vietnamese client seeking therapist

Providing services with limitations better than not providing services at all (share vignette of first Spanish speaking client)

Lack of referrals. How are you going to find a psychiatrist that is low-cost? Or that is reasonably easy to access if you:

Dont have resources, May not speak the languageDont even have access to basic services like Medi-cal?

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Roadblocks to Social JusticeLack of clinical freedomTime limitations for treatmentFunds earmarked for specific problems onlyNon-systemic treatment of problems

Funding stream for state and county funded agencies tends to be very specific

i.e. clients may have deeper underlying issue, but funding is only available to address specific issue such as parenting, for example

Crisis counseling at Friendly Center through WYS: only 10-12 sessions. Is this going to help resolve deeply entrenched patterns of dysfunction?

Language barriers: vignette of Vietnamese client seeking therapist

Providing services with limitations better than not providing services at all (share vignette of first Spanish speaking client)

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Therapeutic Whack-a-mole

When funding is only available to treat a specific surface problem

OR, therapy is limited by time, you can treat surface problems without treating the underlying problem. part of the reason generational poverty is so entrenched is that it takes time and a lot of effort to address the underlying problems.

New symptoms and/or crises will keep emerging.

Revolving treatment door of the chronically mentally ill;

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Roadblocks to Social JusticeWhat roadblocks have you encountered?

Funding stream for state and county funded agencies tends to be very specific

i.e. clients may have deeper underlying issue, but funding is only available to address specific issue such as parenting, for example

Crisis counseling at Friendly Center through WYS: only 10-12 sessions. Is this going to help resolve deeply entrenched patterns of dysfunction?

Language barriers: vignette of Vietnamese client seeking therapist

Providing services with limitations better than not providing services at all (share vignette of first Spanish speaking client)

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Underserved PopulationsAdults without ChildrenAdults with Adult ChildrenMen with ChildrenAdults with Learning Disabilities

Share about MR16

Underserved PopulationsIndividuals with Irregular Immigration StatusClients from Cultures with Stigmas surrounding Mental Health CareClients who need long-term mental health care

Share vignette about QL

Share vignette about MR and his need for long-term care.17

Underserved PopulationsThe Partially EmployedThe Employed with Insurance, who cannot afford their deductible

Share vignette about RV18

Underemployment linked to SES

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High Deductible Health Plans (HDHP)

HRA: Health reimbursement arrangement: employer funded medical reimbursement plan20

Underserved PopulationsWhat underserved populations have you noted?Who is falling through the cracks in your clinical sphere?

Friendly Centers Model of Advocacy

Multidisciplinary approach to treatment

FC provides:

Educational resourcesAfter school tutoringESL classesMobile PantryEmergency food Help in signing up for Medi-CalRent and utility assistance

Provides referrals to:

Support groupsMedical resourcesLegal resources

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Making Therapy User-FriendlyOffer flexible hours and locationMake therapy easy to accessProvide Child-careBilingual CliniciansHelp Clients Navigate the SystemPsychoeducation about Therapy

FC has partnered with the community to make itself accessible. Locations in churches and in city and county buildings

One area that FC can improve is to provide child-care to therapy clients. Currently, we have to be creative and non-traditional in allowing clients to bring their children with them to treatment

Bilingual clinicians: FC has staff who speak Spanish and Vietnamese, the greatest non-English speaking populations in our area

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Making Therapy User-FriendlyWhat recommendations do you have in making therapy more user-friendly?

Utilizing VolunteersTrainees and interns need hours for graduation and licensureLicensed clinicians can volunteer as supervisors

Serving the UnderdogWhat are the needs in your particular neighborhood?What are you willing to give?Who are you willing to partner with?

ContactsLaura Rothafellaurarothafel.comFriendly Centerfriendlycenter.org