Dan Wulff

Interprofessional ambulatory primary care practice-based educational program.

Although interprofessional teamwork and collaboration are considered key elements for improving patient outcomes, there are few reports of controlled studies involving interprofessional training of health care learners in the ambulatory primary care setting. We describe an educational program for teams of nurse practitioners, family medicine residents and social work students to work together at clinical sites in the delivery of longitudinal care in primary care ambulatory clinics. Year 1 was a planning year. Program evaluation completed at the end of the second curriculum (Year 3) indicated that the changes the team made at the end of the first curriculum (Year 2) resulted in increased appreciation of the training program, greater perception of value of care delivered by interprofessional teams among team learners as compared to non-team learners, and team learner self assessment of improved team skills including working with other professionals, resolving conflict, and integrating prevention and health promotion into health care. Team learners demonstrated an increased awareness of the limits of their own professions approach to team care. We conclude that interprofessional ambulatory clinical training in primary care where learners work together providing care to patients can contribute to fostering both positive learner attitudes toward interprofessional work and development of team skills.

Current Challenges in Social Work Distance Education: Responses from the Elluminati

One of the first tasks of the Social Work Distance Education Network at the Faculty of Social Work at the University of Calgary was to review the literature and address three research questions to inform policy making and planning relating to distance social work education programming. This paper is intended to disseminate responses to these questions from a small group of dedicated and experienced distance educators who have adopted the moniker Elluminati. (The Elluminati adapted their name from a popular online audio-conferencing program.) These questions include: (1) What is the optimal class size for a distance delivery offering? (2) What supports does an online course require for development and effective delivery? (3) What types of courses are suitable/unsuitable for online learning?

Posttreatment 12-Step Program Affiliation and Dropout: Theoretical Model and Qualitative Exploration

ABSTRACT Treatment outcome research has repeatedly demonstrated that involvement in twelve-step (TS) programs (e.g., Alcoholics Anonymous or Narcotics Anonymous) following treatment is associated with improved substance use outcomes. Treatment providers widely encourage TS program attendance during treatment and for aftercare; yet, evidence suggests that minimal and sporadic attendance or complete dropout is the more common occurrence. Providers would benefit from knowledge that would contribute to a greater understanding of factors that influence posttreatment TS program affiliation or dropout to guide treatment strategies. This article reviews the literature on TS affiliation, advances theory and a model to explain affiliation, and reports findings from a qualitative research study focused on understanding what people in TS facilitative treatment report as good (the pros) and not so good (the cons) about TS program involvement. Results suggest that unresolved ambivalence as well as socio-cultural barriers to support contribute to poor TS program utilization.

Drama in the Academy Bringing Racism to Light

The effort of our School of Social Work’s Diversity Committee to create an engaging presentation/performance focusing on the social issue of racism to our faculty and staff colleagues is described in this article. Our journey to develop two specific performances is outlined, along with descriptions of each and the audience reactions. As we reflected on our experiences with these performances, we recognized the value of using non-traditional forms of presentations in the academic setting to create a meaningful experience that would be most engaging with our academic colleagues. Developing these performances, enacting them, and receiving critical feedback on those performances emboldened us to develop additional performances (rather than traditional formal presentations) in our academic setting.

Searching for Family Therapy in the Rockies: Family Therapists Meet A Paleontologist

Family therapists use concepts germane to other academic disciplines. We recount four notions--context, explanatory metaphors, language conventions, and persistently refining knowledge--that family therapists and paleontologists each utilize. Revisiting family therapys foundational concepts through the lens of another discipline reminds us of our theoretical beginnings, highlights those professional adaptations that we have made over the years, and offers us an opportunity to reinvigorate and expand our central organizing principles.

Researcher as Practitioner: Practitioner as Researcher

We will discuss ways in which clinical practitioners are perfectly positioned and adept at conducting research to examine the patterns across their caseloads and practices to produce immediate change. We use our experience with using Research As Daily Practice to focus on teaching students practices to creatively and integratively research and practice with families who present for therapy. By weaving the actions of research and practice together, practitioners develop broader understandings of, and movement toward, “just” change.

Family Therapy Stories: Stretching Customary Family Therapy Practices

We have created a collection of stories from our authors to provide another glimpse into ways that social injustices manifest themselves in daily interactions and events. The stories each have a different focus on transformation and/or social justice. We offer you stories of trying to explain social justice work in clinical practice, a supervisee’s emotional reaction, a student therapist’s own personal transformation through her professional preparation, the heartbreak of seeing and experiencing injustice inflicted by the helping profession, the complications and unfairnesses that occur when multiple helping systems do not coordinate, what possibilities emerge when there is a softening of the distinction between professionals and clients, and moving from seeing family problems appearing as internal to have external originations. Each story is then followed by a series of questions evoked by the story to help provide a pathway to continue to ponder issues of social justice/injustice in the therapeutic context.

Family Therapy + Social Justice + Daily Practices = Transforming Therapy

We explain our “equation” of adjusting family therapy clinical practices to include explicit talk of social justice issues (“unfairnesses”) experienced by our clients on a daily basis. We concentrate more on the everyday ways that injustices are enacted and experienced than on the macro-discourses of social injustices. This adjustment to see social injustice as behavioral and specific permits us to see injustice in action in everyday lives and affords us the opportunity to act locally and immediately. We advocate for and demonstrate expanding our usual activities of research and supervision to attend to social justice in order to help with transforming our therapeutic processes. These efforts can grow and be applied outside the therapy room, both by clients and their therapists. This chapter concludes with an articulation of our common purpose as authors in coming together to write this series and a brief introduction of each of the contributors/teams and their innovations.

Community-Minded Family Therapy

Therapy often focuses on the family in the room as the locus of change. While this can mobilize change efforts on the local level, this may inadvertently encourage people to solve their troubles by adjusting themselves to their life conditions, thereby propping up situations and contexts in their world that are hurtful and should not be supported. Noticing those societal discourses/influences that families enact, in both helpful and non-helpful ways, is our way of bringing the idea of community into therapy. Additionally, discussing the societal discourses as part of how to best live our lives can lead to initiatives on the part of our client families and ourselves to challenge those ideas not only in the therapy conversation, but also in our overall lives (at work, school, etc.). We offer suggestions about ways in which we can look at the extra-familial social levels and societal discourses in our therapeutic practices.

A Postmodern Critique of Societal Discourses of Male Violence in Interpersonal Family Relationships: A Balancing Act for Social Work

In recent years, treatments of family violence have tended to be built around conventional discourses suggesting that men are major initiators in instances of interpersonal violence. Utilizing a postmodernist analysis, we assess societal discourses that continue to give life to this narrow conceptualization of interpersonal violence. We also examine literature suggesting that both men and women resort to violence to resolve relationship difficulties and suggest that a more holistic and inclusive approach to understanding interpersonal violence is critical for social workers committed to social justice and a balanced understanding of the contextual nature of human problems.