Ego Boost

Today was a rough day to say the least. Due to some shuffling around of interns' and residents' schedules, the caseload of my team nearly doubled. I felt like I was a chicken running around with my head cutoff. Here is a breakdown of exactly what my day looked like today:

8:30 - 9:00      Reviewed patient census sheet
9:00 - 10:30    Attended medical rounds with entire treatment team
10:30 - 11:30  Bio-psychosocial interview, patient note, contacted patient collateral
11:30 - 11:45  Attempted to engage difficult patient; retrieved bible per patient's request
11:45 - 12:30  Bio-psychosocial interview; supervised while patient contacted collateral
12:30 - 1:00   Assisted with patient discharge
1:00 - 1:30     Lunch
1:30 - 2:30     Touch base with supervisor/review caseload
2:30 - 3:00     Wrote patient note for second bio-psychosocial interview
3:00 - 3:30     Prepped for family meeting
3:30 - 4:45     Attended family meeting to discuss patient's discharge

Once I arrived home, I felt exhausted from a busy but productive day. As I was trying to muster up the energy to begin my reading assignments, I decided to procrastinate for a few minutes and check out some of my blog stats. I noticed a lot of new traffic coming from MastersofSocialWork.org, and decided to see if this website posted a link to my blog.

To my surprise, the blog on MastersofSocialWork.org named The Nudge Patrol as one of the Top 50 Social Work Blogs. I'm listed as #4 under the "academic" category.

I am thrilled about this recognition, and it was definitely welcomed after a tough day at placement.

Patrolling the Web this Week

Below are some of my favorite articles and websites I've come across in the past two weeks. I hope readers find them just as insightful and/or entertaining as I do.

A slam dunk for mental health: via Zev Yaroslavsky. As some of you might know, Ron Artest, famous NBA basketball player infamous for his erratic behavior and anger outbursts, has recently sold his 2009 Lakers Championship ring to raise money for The Los Angeles Department of Mental Health. Below is a great in depth interview where Artest explains why he feels so close to this cause.


Ron Artest speaks to Los Angeles County Department of Mental Health from Alysa Solomon on Vimeo.

People Problems Masquerading as Business Problems: By Dan Pallota. Rarely do business and social work collide on the Harvard Business Blog, but the author of the article manages to do so just beautifully. Company founder of Pallotta TeamWorks and president of Springboard, Pallotta talks about the importance of deciphering between work-related problems and life-related problems in employees' lives. He believes that the ability to recognize this difference is the key to increasing worker productivity. His advice? "Make psychological and spiritual well-being as much a priority in your company as all of your other key operating indicators." America could really use more CEOs like Dan Pallota.

Isabelle Caro, Anorexic Model, Dies at 28: By William Grimes. This is truly a tragic story. Isabelle, widely known for her anti-anorexia campaign, lost her life to complications from Anorexia Nervosa in November of last year. It is unforgivable that women die from this completely preventable disorder.

Operation Beautiful: By Caitlyn Boyle. I stumbled across this blogger's website two weeks ago and have loved it ever since. Operation Beautiful is a way for complete strangers to communicate inspiring messages to each other, by means of sticky notes left in public places (bathroom stalls, drug stores, supermarkets, schools, etc.). I really liked today's phrase of the day: “When you get to the end of your rope, tie a knot and hang on.” I have yet to discover an Operation Beautiful sticky note in Los Angeles, but perhaps I will create one this week.

Simple guide to speaking foreign languages: By zenhabits. This article could not have been more timely for me. Zenhabits, a blog I consistently follow, has some really great tips on how to become fluent in a language (in three months!). While my expectations for learning a second language are not quite as bold, I believe his philosophy of speaking the language for at least an hour a day is crucial to the success of mastering another language. Looks like I'll have to find a way to start speaking outside of my Spanish class on Fridays.

Newer antipsychotics overused: By Julie Steenhuysen. According to a recent study, newer antipsychotic medications are being dolled out to patients without hard, scientific evidence to justify the prescription. Originally created to treat psychoses, these medications are now being used by doctors to treat depression, bipolar disorder and even autism. Among the drugs are Risperdal, Zyprexa, Abilify, and Seroquel.

UCLA MSW Program: Pre-Licensure Coursework

Last year, UCLA MSW students felt one consequence of California's budget crisis in a big way; tuition costs nearly doubled, increasing tuition to nearly $18,000 and $30,000 for California residents and non-residents respectfully. As expected, students became outraged and demanded faculty to find ways to mitigate enormous fee hikes.

This past fall, MSW faculty announced a few ways they were going to offset professional fee increases, including the decision to offer pre-licensure courses for students planning to become Licensed Clinical Social Workers (LCSWs). The following is a list of the five required pre-licensure exams (UCLA will provide condensed versions of each class that will still qualify students to sit for licensing exams):

1. Child Abuse Assessment and Reporting (seven hours)
2. Human Sexuality (ten hours)
3. Substance Abuse Dependency (fifteen hours)
4. Spousal/Partner Abuse Assessment, Detection and Intervention (fifteen hours)
5. Aging and Long-Term Care (ten hours)

Although faculty and administration have just started moving in the right direction, I do believe this promise is a great first step in appeasing valid concerns and frustrations over tuition hikes. Pre-licensure courses are extremely practical for micro students, as it will help students save time and money.

Unfortunately, field faculty recently informed one of my classmates that the pre-licensure classes will not be available to 1st year MSW students, the reason being twofold: (1) Faculty wants to ensure that 2nd year MSW students will have a spot in the class. (2) Topics covered in the pre-licensure courses are more advanced than the 1st year curriculum.

To be frank, I feel it is unfortunate that 1st year students are not allowed to participate in the pre-licensure courses. It's inevitable that some students will not be able to complete all five courses (scheduling conflicts always seem to get in the way!). It would be nice to have the opportunity to make up for a missed class. Graduates will then be forced to pay for and find the time to take one of these courses later.

Dare I ask what faculty has in mind to appease macro students?

UCLA MSW Program: Bad Editing

Dear Joan Berzoff, Laura Melano Flanagan, and Patricia Hertz,

You forgot to correct an error on the cover of my Human Behavior text book. Just wanted to bring it to your attention (tipped off by a classmate). Sincerely,

The Nudge Patrol

Confronting the Language Barrier: Spanish for Mental Health Professionals

While I absolutely love my internship experience thus far at Harbor UCLA Medical Center, there is one skill I lack that immensely takes away from my ability to be a competent social worker on the inpatient milieu: I struggle with my ability to communicate with Spanish speakers.

Even though I studied Spanish in both high school and college (for a combined total of 5 years!), I can barely hold a conversation with patients. To say I am embarrassed is an understatement. Lucky for me, a good friend and classmate found a local Spanish class that is designed for psychologists, social workers, and other mental health professionals. The class meets every Friday morning from 8:30 a.m. to 10:00 a.m. at the Family Services of Santa Monica.

Unlike my grammar-focused Spanish classes in high school and college, the class is much more conversational. There are about eight social workers who attend the class, at varying degrees of Spanish competency. We spend a lot of time learning and talking to each other about Latino culture, in addition to practicing words that are helpful in a mental health setting. As a result, I no longer have to rely on the word "triste" to describe my patients' sad moods or affects. I now know words like aguitado (kind of depressed), desatendido (disregarded), depreciado (depreciated) and desilusionado (disappointed). Additionally, the teacher, Eugenio, is very laid back and very patient with all of us novice speakers. We also use the following text book: Spanish for Mental Health Professionals. I highly recommend the class to anyone who is looking to improve their Spanish-speaking skills. See the flyer below for contact information.
Spanish Class for Mental Health Professionals

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UCLA MSW Program: Curriculum Reinvention

Faculty at UCLA conducted a major overhaul of the MSW curriculum. My cohort, the class of 2012, are the guinea pigs to the reinvented curriculum. Since I was not a student in the program last year, I have no basis for comparison, however I did want to give a quick rundown of each class, in addition to the structure of the program in the first quarter.

Weekly Schedule
M: Field Placement (8-5)
T: 240A (9-12), 280A (2-5)
W: Field Placement (8-5)
Th: 230A (9-12), 201A (2-5)
F: Field Modules (8 total)

201A: Human Behavior in the Social Environment
While this is considered a much more "fluffy" part of the curriculum, this discussion-oriented class is difficult because you are forced to process your biases and feelings towards individuals/groups. The point of the class is gain self-awareness (in my opinion you are screwed if you lack this coming into the program), or at least heighten it. The first hour and half of class is devoted to speakers, and the second half to class discussion. A different theme is covered each week, with topics ranging from religion/spirituality, gender/sex/sexual orientation, community responses to oppression, able-ism and ageism. I ended up loving this class, not only because it was a break from the other more theory-based classes we had, but the group dynamic and professor were seriously awesome. If you have the opportunity to take a class from Professor Jorja Leap, do not hesitate.

Average reading/week: 50-60 pgs
Texts: Racism in the United States: Implications for the helping professions; course pack reading 
Major Assignments: Self Assessment Term Paper (12-15 pgs); Ethnographic Term Paper (12-15 pgs)
Caveats: Due to limited discussion time, our class was not able to process all topics covered.
Additionally, readings were not always relevant to class discussions.


230A: Micro Social Work (Individuals, Families and Groups)
I found this class particular useful, both for my internship at Harbor UCLA Medical Center and for the major and career path I intend to take (micro, mental health). The first two phases of the "Helping Process," and its constituent parts are covered, with Phase I including Exploration, Assessment and Planning, and Phase II including Implementation and Goal Attainment. For students who want to become clinicians, this class is particularly helpful in providing a skeleton or a basic structure to one-on-one therapy. We only skimmed over Evidenced-Based Practices, as this will be more of the focus in next quarter's class (230B).

Average reading/week: 40-50 pgs
Texts: Direct Social Work Practice: Theory and Skills; course pack reading
Major Assignments: Midterm and Final Vignette Case Study
Caveats: While we practiced therapy role-plays with each other in class, I wish we were required to submit them on videos each week. I elected to do this as an extra-credit assignment, and found it extremely useful to see myself on camera.

240A: Macro Social Work (Organizations, Communities, and Policy Settings)
This class provides students with an overview of the core concepts related to macro social work, by connecting the dots between policies and the populations we work with. All four sections are required to carry out one macro group project, with my section investigating barriers to receiving mental health care among the elderly population in the San Fernando Valley. The macro project is an overwhelming focus of the class, as students are required to go out into the field and collect data (hold focus groups, distribute surveys, etc.). My group ventured out to Pacoima and Van Nuys to speak with agencies and their older adult clients, in order to understand barriers to receiving care. This project continues through the next quarter, and the final project is presented to the Los Angeles Department of Mental Health.

Average reading/week: 30-50 pgs
Texts: Social Work Macro Practice; course pack reading
Major Assignments: Policy Brief, Macro Project Report and Presentation
Caveats: I felt the macro project took up way too much of our class time. I also felt it lacked structure and direction.

280A: Knowledge Acquisition, Evidence-based Practice and Research in Social Welfare
As someone with extensive research background (I worked in market research for 3 years), I found this class relatively easy. My cohort only attended the class for the first five weeks of the quarter, and will finish the other five classes at the beginning of spring quarter. While it was nice to have a free afternoon the second-half of the quarter, I would have preferred to continue taking the class through the end of the term. The course primarily covers evidence-based practice (EBP), in addition to basic survey and experimental design.

Average reading/week: 30-60 pgs
Texts: Practitioner's Guide to Using Research for Evidence-based Practice
Major Assignments: Evidence-based Practice Term Paper (10-15 pgs)
Caveats: Discontinuity of the 10 week class

Photo Credit: GettyImages

Patrolling the Web this Week

I haven't done this in a while, but here is a weekly roundup of smart, relevant, and entertaining articles and/or videos that caught my eye in the past week or so. Hope you enjoy.

Brene Brown: The power of vulnerability. Ted Talks never fail to deliver. The self proclaimed, "life-hacker" and PhD social worker says that, "What we know is that connection, the ability to feel connected... is why we're here." Her powerful talk uncovers why we, as humans, need to live vulnerably in order to be happy.


The Empowerment Plan: By Veronika Scott. Thanks to my sister who tipped me off to this design student's blog. Scott has created a winter coat, called the Elements Survival Coat, that doubles as a sleeping bag for the homeless population in Detroit. Scott has partnered with the Cass Community Center, which has vowed to pay clients minimum wage to make the coats. She hopes to expand her project across the U.S. and eventually the world.

Thanks For the Tax Cuts! By Larry David: A short but witty op-ed piece by one of my favorite comedians. Larry thanks the Republican party for extending the new tax cuts, which will now allow him to indulge in first class seats on his Hawaiian vacation, replace his aging TV, and buy fresh blueberries at Whole Foods.

A day in the Life of an Oncology Social Worker: By Christine D. For those who are curious what it's like to be a social worker on an oncology unit at a hospital in NYC, blogger Christine D published "a day in the life" post describing the challenges she faces everyday. I especially love the "recipe" for Social Work Oncology that she put together.

UCLA School of Public Affairs News Forum Magazine

Below is the seasonal News Forum Publication, a magazine from the UCLA School of Public Affairs. All previous publications can be found HERE.
News Forum Winter 2010

You Say Mercedes, I say Mental Illness

"God is playing jai alai and you are the ball" 

Dan Neil, a Wall Street Journal reporter recently wrote this catchy description for a review of the new Mercedes CL63 AMG. While I thought this was a cute way to the describe how it feels to accelerate in the coupe, I could not stop thinking about how well these words describe the psychotic symptoms of mental illness, specifically the delusional and hallucinatory symptoms of schizophrenia and other thought disorders.

As an intern for Harbor UCLA Medical Center for the past three months, I have been exposed to a number of patients who are battling severe and persistent forms of schizophrenia. Patient's minds are often transfixed or paralyzed in nightmarish, violent, or persecutory states. Extreme distortions of reality can often have scary and real consequences.

For example, a patient was recently admitted to the inpatient unit after experiencing harrowing ideas of reference. Chorus lyrics from a rap song spoke to the patient in such a way, that he exhibited homicidal ideation towards members in his family. The patient internalized the lyrics and started to believe he was a God-like figure. He reasoned the only way he could preserve his status was to kill members of his family. Fortunately, the patient was admitted before he acted on any of these thoughts.

Another patient, also suffering from schizophrenia, held highly persecutory beliefs concerning her family. The patient was extremely paranoid, and believed her family worked for the FBI and they were plotting to kill her. The patient became distrustful of everyone around her, including her family and the treatment team.

As evidenced by these examples, patients succumb to an outside force that is much larger and stronger than themselves. As one does with a jai alai ball, these patients are figuratively swung around, flung high, and slammed by a disorder that pirates their perception of reality.

Outsiders might stigmatize these experiences as crazy, ridiculous or downright nonsensical. But to victims of mental illness, these experiences are tangible and overpowering. What is even more frustrating, is medicine to treat thought disorders does not suppress or eradicate delusions or hallucinations; patients simply have to learn to live with them.

Photo credit: Jamespot