Code Therapy is a short documentary about how technology is changing the way mental health services are delivered.
Mental illness, such as depression, is one of the leading causes of disability worldwide. 1 in 4 adults in the United States experiences some type of mental illness every year, yet over 100 million people across the nation lack access to sufficient mental health services. In countries with less developed healthcare systems, the situation is even more troubling.
Code Therapy is a documentary short about the application of digital technology in the field of mental health. Behavioral intervention technologies, such as online programs and apps that teach evidence-based therapy skills have the potential to make mental health support more accessible and affordable. Websites and social media platforms provide another way to disseminate mental health information, particular to an increasingly connected generation of millennials around the globe.
Speaking on the barriers to receiving treatment and the benefits and limitations of emerging technologies in this space are entrepreneurs, researchers and mental health providers including:
- Alejandro Foung, Co-Founder of Lantern
- Rob Morris, Co-Founder of Koko
- Steve Schueller, Assistant Professor at Northwestern University’s Feinberg School of Medicine and Faculty Member at the Center for Behavioral Intervention Technology
- Jen Hyatt, CEO of Big White Wall
The film is narrated by Carl O’Reilly, a London-based architect, mental health advocate and author of the new book Defeating Depression, available on Amazon.
Code Therapy was filmed in the US and UK in 2016 and has since screened at festivals in England, Ireland, India and the United States. We were honored to be awarded Best Documentary at the 2016 Dublin International Short Film and Music Festival and has received commendation and nominations at other festivals around the globe.
As it turns out, the behaviour of people around us is contagious. This is truer the closer these relationships are – we are much more influenced by the attitudes of friends and family than we are by those of strangers. We often think of peer pressure as a bad thing we should resist, but it can also be a powerful influencer in terms of shifting social attitudes for the better as well.
I recently read an interesting article in Scientific American about the power of social pressure and how it can influence our behaviour. For example, one 2003 study found:
- If a person gains weight, the likelihood their friend would also gain weight is 171%
- When smokers quit, their friends are 36% more likely to also quit
- Having happy friends increased the likelihood of an individual being happy by 8%
It’s also true that fitting in feels good. We all want to feel a sense of connection and belonging and these things are hugely important to our personal wellbeing. The difficulty is, of course, when fitting in means feeling pressured to change parts of ourselves in ways we are not comfortable with. And feeling under pressure to force yourself to be something you’re not can cause a huge amount of psychological distress.
It’s a no-win situation – we either change (or pretend to change) for the sake of fitting into the group – and feel awful and uncomfortable about not being able to be who we really are – or we stay courageous about our convictions, but experience ostracisation and pay another kind of emotional price for that, too.
So what’s the answer? I’m really not sure, to be honest. I know that personally when I was younger I felt huge amounts of pressure to hide my nerdy and academic interests because they didn’t seem to be shared by the people around me. I didn’t talk about my love for sci-fi, comic books, or video games with anyone. Or show that I loved attending classes and soaking up knowledge anywhere I could. I simply never seemed to have any friends who had the same interests.
But through my 20s I became a lot more comfortable in my own skin and more confident that being different in some way was okay. Just the other day a colleague pointed out a nice, but expensive, piece of jewellery online. She asked, “Wouldn’t you like to own that?” I replied, “Actually, I’d rather have a new Xbox!” We laughed about it. I didn’t feel like an outcast. I felt like I was being genuine and appreciated for that.
And maybe this is the key. Sometimes a lot of the pressure to conform is external, but I wonder how much of it is internal as well. I wonder if my friends in my younger years would have accepted me for who I was if I had given them the chance to.
Or maybe my hard-won comfort with who I am helps other people to feel more comfortable being themselves around me, too. We’ve removed that pressure, together.
But I’m curious – how affected (or unaffected) do you feel by social pressure?
How Should Social Work Respond To The United States Leaving The Paris Agreement?
“Logic clearly dictates the needs of the many outweigh the needs of the few” – Dr. Spock (Star Trek)
This quote is at the heart of a complex political debate; Dr. Spock doesn’t think it’s that complex. Social justice is one of the tenants of social work practice. This often places social work on the wrong side of Dr. Spocks quote.
Frequently, social workers are providing for or advocating for the needs of the few. Dr. Spock had some help in posing this quote. The question originates from the philosophy of Utilitarianism. John Stewart Mill argued that society is a collection of individuals and that what was good for individuals would make society happy.
You can see this gets messy… and quick. This philosophy was recently put to the test with President Donald Trump’s decision to withdraw from the Paris Climate Accords. A 195 country agreement to reduce carbon emissions and offer assistance to developing nations to do so as well. Mr. Trump makes a case for economic justice that our involvement in the Paris Accord forces us to over-regulate businesses. He also argues it places an unfair burden on The United States contribution to developing nations. Trump asserts both factors create undue pressure on some of the most economically vulnerable areas in the country. Taking a strict stance stating he “Does not represent Paris…I represent Pittsburgh”. He believes the needs of local Americans outweigh the need to cost-share climate change with the globe.
Should the United States share in the cost of global warming at the cost of our local economies? The economic impact is up for significant debate. The best analysis of this complex issue is provided by FactCheck.org. I’ll let you read it but the economic rationale for leaving the Paris Accord seems questionable. The report he cited on the economic impact ignores many factors including the growth in the renewable sector.
From the social work perspective, this creates an interesting dilemma. The virtues of Globalism versus the “America First” Populism will remain a challenge. How do the local needs of the “Rust Belt” and “coal country” interact with the global energy economy impacted the Paris Accords?
The issue of Global Warming challenges social work to think about where our “systems thinking” begins and ends. Is our profession concerned for the global good or just the area’s they serve? In a recent speech, the UN Secretary-General argued the poor and vulnerable will be hit by climate change first.
Also, what is not in question is the economic impact in the Rust Belt and Coal Country of the United States. This also depends on where you are placing “The needs of the many”. The loss of manufacturing and energy jobs has had a significant impact on services in these areas. These voters were activated by a hope of a potential change in their economic future. These parts of the country who rely on manufacturing and energy have been economically depressed. There is fear further government regulation and lack of money in these areas will make this worse.
Even if the move out of the Paris Climate Accords does fix local economies, it creates another complex systemic problem. Again thinking about where does our “systems” thinking end? I touched on this in my post about Facebook’s global vision for the world. The debate on globalism is a complex one, but The United States leadership on climate change is not. Have we put ourselves at disadvantage by not being a leader willing to partner in climate change?
Are countries going to want to “make a deal” with us about innovation and technology in the energy sector? How will the impact on the global economy affect our local economy? Seems like this blog post has more questions than answers.
To attempt to answer this, I again consult the National Association of Social Workers Code of Ethics. Section 6.04 in social action says…
(c) Social workers should promote conditions that encourage respect for cultural and social diversity within the United States and globally. Social workers should promote policies and practices that demonstrate respect for difference, support the expansion of cultural knowledge and resources, advocate for programs and institutions that demonstrate cultural competence, and promote policies that safeguard the rights of and confirm equity and social justice for all people.
No easy answers when thinking about dedicating United States funds which may help globally but detract from the local action. This also brings about thoughts of our core value of competence. That whatever we do to help the most vulnerable citizens in the Rust Belt, I hope it based on sound evidence.
Those policies are based on science and evidence-based practices to try to help these local economies. Whatever we do globally it places the people we serve in the healthiest and most prosperous situation. It’s not just social workers who are thinking about the impact but physicians are weighing in as well …
How a Maori Model of Improving Care Experience Has Been Transformative for a Family in Glasgow
Most of us have been there – you look in your diary, see that you have a review case conference for a particular family in a few days and your heart sinks. Two boys who have been on the child protection register for two years. Neglect is the primary risk indicator. Mum came along to each core group and conference for the first year. She would nod her head and promise that things would change. But they didn’t, and the social workers became more worried about the boys.
For a while after that, mum still came to meetings but disagreed with most of what was being said. She would become distressed and angry, and verbally abuse workers before storming out whilst the workers continued to worry. Then mum stopped coming along altogether.
The mood in the conference was flat. Deflated. The core group team had been working really hard to help mum provide better quality care. But the rent arrears continued to accumulate and eviction was imminent. The boys weren’t at school as often as they should be and, when they were there, weren’t ready to learn. The older boy had withdrawn into himself and had taken to seeking refuge in a cupboard. The younger boy had a chronic cough and toothache, which went untreated. They often looked grubby and unkempt.
The discussion amongst the workers was full and frank. They expressed genuine concern and care for the family. Each member was fully committed and driven to affect change, despite the hostility and resistance they were encountering.
The group worked really well together. Simple things like using group e-mail to communicate so that everyone was updated and arranging meetings at the end of the day to enable the boys’ teachers to attend made a difference. This united team supported each other, and their frustration at the lack of progress was understandable.
Family Group Decision Making
It was agreed that, given the harm already caused and the continuing high risk of further harm, it was likely that we would have to seek to remove the boys from their mother’s care. The involvement and protective ability of the extended family was unclear, as mum blocked attempts to engage them. It was therefore agreed that a referral would be made to our Family Group Decision Making service (FGDM).
FGDM was brand new to Glasgow at that time. Evidence from elsewhere had suggested that using this model can really turn things around for family relationships, so we decided to put this into practice. It’s a model that originates from New Zealand, where Maori children were over-represented in the care system with little consultation with or involvement of their extended families. In Scotland, it was pioneered by Children 1st in 1998 and set up in Edinburgh initially. The aim is to enable the family to develop their own support plan which meets the children’s needs and keeps them safe.
The model had been chosen by Glasgow as it fits with the priorities of empowering families and communities, reducing the number of children being removed from their families, and identifying family contacts and placements for children already in local authority care. It was being piloted in North-East Glasgow, with considerable support from the well-established service in Edinburgh, and included an extended family network search function, using the Registrars of birth, marriages, and deaths at the Mitchell Library in Glasgow records to explore fully the family tree.
Each family is assigned a Family Group Co-ordinator, who manages the process and facilitates the family conference. She contacted and prepared the boys, mum and extended family. During this period, mum and the boys were evicted and went to live with the maternal grandmother which forced a closeness that had been missing for some time. The Family Group Co-ordinator organised the family meeting.
The family was given the parameters of what their support plan needed to cover. They were then given private time to produce their plan, which included concrete activities such as the boys getting to school/medical appointments, being available physically and emotionally for the boys, and organising social activities. One of the crucial events here was mum revealing previous trauma to her mother, sisters and workers, which no-one had known, and the subsequent rebuilding of the relationships between mum and her mother and siblings.
No sinking heart and transformative change
Fast forward four months. I looked in my diary and I saw the next review case conference for the family. No sinking heart this time. Instead, a feeling of optimism and hope, tempered with some skepticism about how the reported progress would hold up under the scrutiny of a case conference. The boys chose not to come but had their views represented by their workers. Mum was there, supported by several family members.
Her presentation was transformed – she was smiling and joking, she participated fully in the conference (even the hard bits), was honest, and nearly brought a tear to everyone’s eyes. The family members made valuable contributions and reassured me the situation would never be the same again. I had no hesitation in removing the boys’ names from the register. Five months later, a children’s panel felt able to terminate the supervision orders.
On that day, mum gave the social worker a hug and a plant to say ‘thank you’. I like to contrast that image with the previous one I had, where she chased him out the house and down the street.
Women Have Fundamentally Different Journeys to Financial Wellness, Merrill Lynch Study Reveals
A new Merrill Lynch study conducted in partnership with Age Wave, “Women and Financial Wellness: Beyond the Bottom Line,” celebrates the progress made by women while examining the financial challenges women still face throughout their lives, and offers potential solutions. The study finds that 70 percent of women believe that men and women have a fundamentally different life journey, reinforcing the need to better understand women’s financial concerns and opportunities. The study is based on a nationally representative sample of 3,707 respondents, including 2,638 women and 1,069 men.
“Women’s life journeys are not only different than men’s, they’re different than the life journeys of our mothers and grandmothers.”
“Women have come a long way both personally and professionally, but when it comes to their finances, there is still a trail left to blaze,” said Lorna Sabbia, head of Retirement and Personal Wealth Solutions for Bank of America Merrill Lynch. “As women are at a tipping point to achieve greater financial empowerment and independence, it is even more essential that we support women in helping them pursue financial security for life. This includes encouraging women to invest more of their assets, save earlier for retirement, and pursue financial solutions that closely align to their personal values and life paths.”
Women look beyond the bottom line
While they definitely care about the performance of investments, women view money as a way to finance the lives they want. Seventy-seven percent say they see money in terms of what it can do for themselves and their families. Eighty-four percent say that understanding their finances is key to greater career flexibility. When it comes to investing, about two-thirds of women look to invest in causes that matter to them.1
Longevity needs to be a factor in everyone’s financial strategy, but more so for women, who on average, live five years longer than men. Eighty-one percent of centenarians are women.2 While 64 percent of women say they would like to live to 100, few feel financially prepared, with 44 percent of women stating they worry they will run out of money by age 80.
Confidence in all but investing
The study finds that women are confident in most financial tasks, such as paying bills (90 percent) and budgeting (84 percent). However, when it comes to managing investments, their confidence drops significantly; only 52 percent of women say they are confident in managing investments, versus 68 percent of men. Millennial women were the least confident at 46 percent. Of women who do invest, their financial confidence soars; 77 percent of women who invest feel they will be able to accumulate enough money to support themselves for life.
A trail left to blaze
The study also finds how important understanding the gender wealth gap (as opposed to the wage gap) and wealth escalators are to women’s financial wellness. Women experience a gender wealth gap – the difference between men’s and women’s financial resources across their lifetimes, including earnings, investments, retirement savings and additional assets. This wealth gap can translate to a woman at retirement age having accumulated as much as $1,055,000 less than her male counterparts.3Contributing factors include:
- Temporary interruption, permanent impact: Many women experience lasting effects when they take time away from the workforce to provide care, including for aging parents, their own spouses, and their own children. One in three mothers who returned to the workforce after caring for children says she took on less demanding work, which resulted in lower pay. Twenty-one percent say they were paid less for the same work they did previously.
- Greater lifetime health and care costs: The average woman is likely to have higher health costs than the average man in retirement – paying an additional $195,000 on average4 – due to living longer and having to rely on formal long-term care in later years.
“Women’s life journeys are not only different than men’s, they’re different than the life journeys of our mothers and grandmothers,” said Maddy Dychtwald, co-founder and senior vice president of Age Wave. “We have more opportunities and choices when it comes to family, education and careers, but we’re so busy taking care of other people and other priorities, we often don’t take the time to invest in ourselves and our future financial wellness. If more women can actively take control of their financial future all along the way, it would not only benefit them, but also their families and our society overall.”
Doing more to promote financial wellness
Bank of America’s Global Wealth and Investment Management business serves affluent and wealthy clients through two leading brands in wealth management: Merrill Lynch and U.S. Trust. Advisors specialize in goals-based wealth management, including planning for retirement, education, legacy, and other life goals through investment, cash and credit management.
“In a period of remarkable advances for women in society, a remaining frontier is financial well-being,” said Andy Sieg, head of Merrill Lynch Wealth Management. “It’s a basic component in the quality of life. This report lays out a blueprint for helping to achieve it – and we at Merrill Lynch relish the opportunity to provide women everywhere with advice and support that can make a meaningful difference at every stage of their lives.”
Through its advisors, educational offerings and other resources, Bank of America is positioned to help clients overcome the common challenges presented in the study by:
- Addressing women’s top financial regret: not investing more. Forty-one percent of women say not investing more is their biggest regret. Women cite lack of knowledge (60 percent) and confidence (34 percent) as top barriers.
- Focusing on disparities in wealth, not just income. Women’s financial security is about more than closing today’s pay gap. It’s about accumulating assets or wealth at all income levels, and increasing women’s access to wealth escalators (e.g., employee benefits such as paid time off and pretax savings opportunities).
- Breaking the silence about money. Sixty-one percent of women say they would rather discuss details about their own death than talk about their money. Forty-five percent of women report they don’t have a financial role model.
To learn more about women’s financial wellness, read “Women and Financial Wellness: Beyond the Bottom Line.”
Ending Gender-Based Violence in Conflict
On this International Women’s Day, let’s applaud the advances made in the fight against gender-based violence this year, but also look to the work that still needs to be done.
The #metoo movement saw powerful men held accountable for a range of predatory behavior against women and girls. US states have been finally addressing the issue of child marriage. The Women’s March saw people from around the world gathering once again to advocate for women’s issues. Survivors of Female Genital Mutilation (FGM) also spoke out and said #metoo.
There is no denying the strides that have been made.
Yet, the Council on Foreign Relations estimates that 35% of women will face physical abuse during their lifetime. Furthermore, gender-based violence continues to be a common tool used to terrorize populations during conflict.
A poignant example of this is of the pervasive use of gender-based violence against the Rohingya women fleeing Burma. Rape has been used systematically by the Burmese military against these women, including children and older women. In addition to facing this violence, these women lack basic post-rape medical care after arriving in camps in Bangladesh.
Another recent example of gender-based violence in conflict is that of the Yazidi women who were kidnapped, raped and sold into sexual slavery by ISIS. One brave survivor, Nadia Murad, has spoken throughout the world to raise awareness of the genocide committed against the Yazidi people and to ask for justice.
Even in refugee camps, where women flee to in search of safety, there is exploitation of women. Syrian women have reportedly been forced to trade sex for food aid. The problem has gotten so bad that the women will no longer go to get food. Sadly, sexual exploitation of refugees in conflict zones by aid officials has happened in other crises as well including a vast human trafficking network during the conflict in Bosnia.
Perpetrators of gender-based violence during wartime are not only those in power but often include civilians, as has been documented in the Democratic Republic of Congo—pointing to the pervasiveness of the problem.
With the call for accountability for crimes against women, let this be the “Time’s Up” on gender-based violence committed during war. Ms. Murad and her lawyer Amal Clooney are advocating for evidence to be collected and brought to the International Criminal Court in the case against ISIS–one step toward holding perpetrators accountable.
Murad states, “I want to be the last girl in the world with a story like mine”. Let us channel the fire that brought about these movements to fight back against exploitation of women, especially the women facing the unimaginable difficulties of war.
Turnkey: A Co-Housing Experience in an Italian Public Service for Addiction
Turnkey is a term used in the economic field, but it also fits well in a social rehab project. The idea comes from the need to give some answers to the problem of those patients that experienced a long term therapy in an addiction rehab center for 3 or 4 years.
In the Italian welfare system, the outpatient service team -work (doctor, psychologist, educator, nurse and social worker), operating in the addiction recovery can schedule long term treatment in the residential rehab centers. In some cases, this long time permanence is something obliged, because of the serious addiction and also for the lack of different life perspectives after the recovery.
These kinds of patients need more therapeutic help in order to return to civil society in order to find meaningful social membership. Usually, these clients have no meaningful familiar connections, no job, and no significant friendship.
In the last years, our social services system has become more careful about the use of public money. They noticed social workers more equipped to provide therapeutic interventions using a holistic approach in order to spare economic resources. Social workers are more capable to assist patients in reaching a better life condition by using their abilities toward social integration.
Five years ago, the program’s director asked for the professional team to think about a solution for the rehabilitation of the” long term patients”.
I started wondering about the meaning of poverty which is not only economics but it also the satisfaction of primary needs. It’s the lack of healthy relational bonds which weakness a lot the patients coming out of the drug addiction recovery programs.
I also noticed that this relational deficiency is a modern human condition; in the weakest social situations the loneliness is something that “destroys the mind “.
So I got an idea: I proposed to my director to start thinking about a possible apartment for a temporary co-housing for at least two patients.
He liked the project and submitted the plan to the municipalities which have the competence in the social side of rehabilitation. The municipalities agreed to the project and financed it.
For the patients in long term recovery, the rent was paid through the financing with the municipalities (an average of 6.000 Euro a year for 4 years, renewable), whereas the utilities and the others cost of the house has been in charge to the occupants.
The management of activities like the admission of the patients, the guaranteed respect of the therapeutic contract, the check of daily life and the help in the money administration, are some of my specific competences as a social worker.
In my job role, I had a significant part into find fitting persons for the project who were able to live together. I also contributed to choosing the people eligible to live in that specific therapeutic situation.
I helped the patients to organize their new life and to establish minimum rules of mutual life in the apartment. The project is strictly tied to the learning of the skills required to come back to live a regular life.
– living together is an opportunity for the patients to learn mutual respect
-cleaning the home and paying the utilities is a way to come back to daily responsibility and autonomy.
– having a good neighborhood relationship is a way to learn again to have good relationships without drug addiction to interfered an apartment, next to the main social and sanitary services of the town.
Since 2011, we housed 11 clients in the apartment with an average of one year placement. We should consider that one year in a residential rehab center cost 30.000 euro each person.
Eight of them returned was able to manage a regular social life, their addiction, a job, maintain social relationships which helped them to achieve a dignified lifestyle.
Two persons are still in the co-housing situation, one of them has a regular job, and he is searching for an own house. Only one person abandoned the treatment.
This intervention is a daily challenge for our team; it gave us good results in the recovery outcomes like independence, citizenship, struggle against the stigma and improvement of personal resources.
We also have spared a significant amount of public money while offering to our clients a higher quality of life.
The creativity and the professional skills mixed together with the help of other colleagues in the multidisciplinary teamwork made this project an effective strategy to help patients overcome their circumstances.
So, I can call myself a responsible social worker, because I help to improve the personal resources in my client’s life. I was mostly inspired from the basic professional principle “start from where the client is”.
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