Boston College Social Work Magazine 2011

seventy- fifth anniversary issue 2011

bc social work bos t on c o l l e g e

graduate school of social work

Global Health • Relief + Development Immigrants + Refugees • Health Equity Mental Health • Jesuit education • Aging children + families • Empowerment • Entrepreneurship • social Innovation • Global Health • Relief + Development • Immigrants + Refugees • Health Equity • Mental Health Jesuit education • Aging • children + families

Transformation Empowerment • Entrepreneurship • social Innovation • Global Health • Relief + Development • Immigrants + Refugees • Health Equity • Mental Health • Jesuit education Ag i n g • c h i l dr e n + f a m i l i e s • E m p o w e r ment • Entrepreneurship • social Innovation • Global Health • Relief + Development I mm i gran ts + Refu gees • H ealth Equ it y

The New Social Frontier What 22 innovators say is critical to effect change

contents 2

contributors

4

global health

8

relief + development

12

immigrants + refugees

16

health equity

20

mental health

24

jesuit education

28

aging

32

children + families

36

empowerment

40

entrepreneurship

44

social innovation

editor Vicki Sanders Spence & Sanders Communications writers Vicki Sanders Jane Whitehead Jeri Zeder art director Susan Callaghan GSSW Marketing Director photography Gary Coronado/ZUMAPress.com, p. 4; Erik Jacobs pp. 7,8,20, 23,31,43,44,47; Chris Soldt MTS BC p 11; Boston Globe via Getty Images p. 12; Diane Cook and Len Jenshel/Photonica/Getty Images p. 15; Kerry Burke MTS BC pp. 19,39; Gamma-Rapho via Getty Images p. 24; Getty Images p. 25; BC OMC p. 27; Tim Laman/National Geographic/Getty Images p. 29; Rose Lincoln p. 35; Jerry Gay/Stone/Getty Images p. 37; Tanit Sakini p. 40; IStock pp. 17,33.

Please send your comments and letters to: Boston College Graduate School of Social Work Office of Communications McGuinn Hall Chestnut Hill, MA 02467 E-mail us at: gssw@bc.edu Visit us on the web at: www.bc.edu/socialwork

education that transforms lives by dean alberto godenzi At a recent meeting of friends of the Graduate School of Social Work, I was asked what kind of jobs our students assume after graduation.

I mentioned a number of fields such as mental health, child and family services, the veterans administration, and the criminal justice system.

Contemplating my response, one participant said it seems they work where things are messy.

To which I answered, you are right, social workers do not shy away from challenging tasks. On the contrary, they have always been in the midst of things that matter, regardless of how difficult the situation.

I recalled this conversation when I met with the editorial team of the Boston College Social Work magazine. We were bouncing around ideas on how our annual publication could best contribute to the 75th anniversary festivities.

It was clear that we wanted to emphasize the fact that social workers are at the forefront of addressing key societal issues such as aging or health equity. At the same time, we wanted to highlight that core social work approaches such as community engagement and empowerment have successfully been applied to tackle these entrenched challenges.

Furthermore, social work has always been most effective when learning from and collaborating with people from other fields or professions. It was therefore only natural to pair GSSW faculty, students, and alumni with visionary leaders outside our School and to interview both groups about some of the most pressing challenges of our time. We wanted to know what innovations our interviewees identify as essential to solving complex problems.

It was exciting that the external and internal experts equally stressed the importance of listening to people in their environments and jointly developing innovative and sustainable solutions respectful of and applicable to where they live and work. It was felt that community-based and participant-directed approaches carry great potential to empower individuals and families.

Underpinning this undertaking was the fact that our School would not be what we are today without the inspiration and guidance of a great number of Jesuit leaders, beginning with our founding dean, Father McGuinn. Jesuit education (pp. 24-27) is a crucial part of our mission and identity. It invites us all to “a depth of engagement with reality� that has the potential to transform our lives and the lives of people and communities about which we care.

“THE MOST IMPORTANT SOCIAL RESPONSIBILITY OF A UNIVERSITY IS TO BE A PROMOTER OF JUSTICE AT ALL LEVELS: IN INDIVIDUAL RELATIONS, IN ORGANIZATIONS, AND ALSO IN SOCIETIES WHERE IT OPERATES, WITH A VISION THAT IS BOTH LOCAL AND GLOBAL.” Adolfo Nicolás, SJ superior general of the society of jesus

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CONTRIBUTORS

The articles in this magazine are condensed and edited versions of oral and written interviews conducted with the contributors by GSSW reporters. The article by Adolfo Nicolás, SJ, was excerpted from a speech he gave in 2010, “Depth, Universality, and Learned Ministry: Challenges to Jesuit Higher Education Today.”

stephanie berzin, PhD, Assistant Professor and Chair, Children, Youth, and Families concentration. Co-director, GSSW Social Innovation and Leadership Program and Collaborative. She specializes in vulnerable youth, child welfare, emerging childhood, child and adolescent mental health, and is the recipient of the 2009 Frank R. Breul Memorial Prize.

jack connors, Founding Partner, Boston advertising firm Hill Holliday. Chair, Partners Health Systems, Inc., and Board of Fellows, Harvard Medical School. He has twice been chairman of the Boston College Board of Trustees. Philanthropist and entrepreneur, his recent ventures include restructuring the Archdiocese of Boston school system, cofounding Camp Harbor View in Boston, and backing the Edward M. Kennedy Institute initiative. He received an honorary doctor of business administration degree from Boston College in 2010.

tiziana dearing, MPP, CEO, Boston Rising. Former President, Catholic Charities Boston, and former Executive Director, Hauser Center for Nonprofit Organizations, Harvard University. Recipient of the Greater Boston Chamber of Commerce’s 2010 Pinnacle Award as Emerging Executive. She serves on the Harvard Cooperative Society Board of Directors, the Rappaport Institute for Greater Boston Advisory Board, the Quadir Prize selection committee, and the Marion and Jasper Whiting Foundation Board of Trustees.

paul farmer, MD, PhD, Co-founder and Executive Vice President, Partners in Health.

Kolokotrones University Professor, Harvard University. Chair, Department of Global Health and Social Medicine, Harvard Medical School. Chief, Division of Global Health Equity, Brigham and Women’s Hospital. He received a MacArthur Award in 1993. The United Nations Deputy Special Envoy to Haiti, he published Haiti After the Earthquake this summer. He received an honorary doctor of science degree from Boston College in 2005.

garth graham, MD, MPH, Deputy Assistant Secretary for Minority Health, Office of Minority Health, US Department of Health and Human Services. Previously appointed a White House Fellow and special assistant to the Secretary of the Department of Health and Human Services. He founded the Bos-

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ton Men’s Cardiovascular Health Project and served on the Public Health Executive Council of the Massachusetts Medical Society and the Board of Directors of Physicians for Human Rights. He is on the Harvard Medical School faculty.

ken hackett, President, Catholic Relief Services, 1993-2011. Served in Africa and at national headquarters since 1972. The former North America President of Caritas Internationalis, he was recently named to Maryland Governor Martin O’Malley’s International Advisory Council. From 2004–2009 he served on the Board of Directors of the Millennium Challenge Corporation, a federal effort to link foreign aid with good governance.

He is Knight Commander of the Papal Order of Saint Gregory the Great and received an honorary doctor of humane letters degree from Boston College in 2006.

joy-anne headley, 2012 MSW Candidate, Global Practice concentration. She has volunteered with children and women affected by prostitution in Thailand and India, served as a research assistant on gender-equity issues in East Timor, and worked with children from resettled refugee families in Vermont. She recently interned with a domestic violence prevention program in Dorchester, Massachusetts.

t. frank kennedy, SJ, Peter Canisius Professor and Director, BC Jesuit Institute.

Rector, BC Jesuit Community. Member, BC Graduate School of Social Work Board of Advisors. Chair, Music Department. He co-authored Sexuality and the US Catholic Church: Crisis and Renewal, which won the Catholic Press Award First Prize in gender studies in 2007, and he received the BC Outstanding Alumni Achievement Award in 2002.

paul kline, PhD, Associate Professor for Clinical Practice. Chair, Diversity Committee, BC Graduate School of Social Work. He specializes in clinical social work with children and families, the impact of trauma on development for children and adults, and the impact of clergy abuse on spirituality. Among the courses he teaches are Human Behavior & the Social Environment, and Psychosocial Pathology.

risa lavizzo-mourey, MD, MBA, President and CEO, the Robert Wood Johnson Foundation. She was co-director of an Institute of Medicine study requested by Congress on racial disparities in health care, resulting in the publication of Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. A member of the Institute of Medicine of the National Academy of Sciences, LavizzoMourey is the recipient of numerous honorary doctorates and other awards.

maryanne loughry, RSM (Religious Order of the Sisters of Mercy), PhD, Associate Director, Jesuit Refugee Service Australia.

Research Professor, BC Graduate School of Social Work and Center for Human Rights and International Justice. A member of Campion Hall, Oxford, she serves on the Governing Committee of the International Catholic Migration Committee. In the Queen’s 2010 Birthday Honors list, she was awarded the honor of AM (General member of the Order of Australia) for her advocacy for displaced persons and refugees.

james lubben, DSW, MPH, Louise McMahon Ahearn Professor, BC Graduate School of Social Work. Director, BC Institute on Aging. Professor Emeritus, UCLA. Founding Director, Hartford Doctoral Fellows Program in Geriatric Social Work. He is also on the National Program Advisory Board for the Hartford Faculty Scholars’ Program and has served four terms on the National Advisory Committee on Gerontology and Geriatrics for the US Department of Veterans’ Affairs.

kevin mahoney, PhD, Professor, BC Graduate School of Social Work. Director, National Resource Center for Participant-Directed Services. From 1996 to 2008, Mahoney was the national program director for Cash & Counseling Demonstration and Evaluation.

Recent honors include the Gerontological Society of America’s Maxwell A. Pollock Award in 2005 and the Flynn Prize for Social Work Research from the University of Southern California in 2007. He also served as Secretary of the Gerontological Society of America from 2005 to 2008.

lisa manganiello, MSW ’09, Clinical Social Worker, Boston Medical Center. After graduating from Loyola Marymount University in Los Angeles, she worked one year with the Jesuit Volunteer Corps. During her social work training, as an intern at Shriners Hos-

pital for Children in Boston, she coordinated care and provided psychosocial support for an international population of children with severe burn injuries and their families.

ruth mcroy, PhD, Donahue and DiFelice Professor, BC Graduate School of Social Work. Professor Emerita, UT Austin. Recent honors include the 2004 Flynn Prize for Social Work Research from the University of Southern California, the 2005 George Silcott Lifetime Achievement Award from the Black Administrators in Child Welfare, and the 2006 Distinguished Achievement Award from the Society for Social Work and Research. She is a Senior Research Fellow of the Evan B. Donaldson Adoption Institute Board and serves on the Board of Trustees of Catholic Charities of Boston.

adolfo nicolás, SJ, Superior General, Society of Jesus, since 2008. He earned a doctorate in theology from the Pontifical Gregorian University in Rome and was Professor of systematic theology at Sophia University in Tokyo, Japan, for 30 years. He directed the East Asian Pastoral Institute in the Philippines, was Provincial of the Japanese Province for six years, and worked for several years with poor immigrants in Tokyo.

In 2004, Fr. Nicolás returned to the Philippines to become Moderator of the Jesuit Conference for Eastern Asia and Oceania. As Superior General, he presides over more than 19,000 Jesuits worldwide.

deval patrick, JD, Governor of Massachusetts since 2006. Graduate Harvard College and Harvard Law School. President of the Harvard Legal Aid Bureau. Practiced law with the NAACP Legal Defense and Educational Fund. In 1994, President Clinton appointed him Assistant United States Attorney General for the Civil Rights Division of the Department of Justice, the nation’s top civil rights post. After his service in the Clinton Administration, he worked in the private sector as an attorney and business executive at Texaco and Coca-Cola.

elaine b. pinderhughes, MSW, Professor Emerita, BC Graduate School of Social Work. Her work is focused on diverse practice, diversity training, and genealogy as a therapeutic tool. Among notable works is the 1989 Understanding Race, Ethnicity, and Power: The Key to Efficacy in Clinical Practice. She received the American Family Therapy Academy Lifetime Achievement Award in 2001

and was honored by the establishment of the annual Elaine Pinderhughes Lecture at BC.

marcie pitt-catsouphes, PhD, Associate Professor, BC Graduate School of Social Work. Director, BC Sloan Center on Aging and Work. Co-director, Social Innovation and Leadership Program and Collaborative.

She was an issues expert at the 2005 White House Conference on Aging, won the WorkLife Legacy Award from the Family and Work Institute in 2007, and has served on the National Advisory Committee for Workplace 2010 at Georgetown University and at the Purdue Center for Families.

corinne h. rieder, EdD, Executive Director and Treasurer, the John A. Hartford Foundation. Former Corporate Secretary, Columbia University, and former Executive Vice President and Dean, Bank Street College of Education. Previously, she was associate director of the National Institute of Education, study director at the Office of Management and Budget, and advisor in education at the former Department of Health, Education, and Welfare. She also served as a Peace Corps volunteer in the Dominican Republic. She is a board member of the American Federation for Aging Research.

daniel j. schoeps, Director, Purchased Long-Term Care Group, Office of Geriatrics and Extended Care, US Department of Veterans Affairs. National Program Officer for all long-term care services purchased by VA. He was senior staffer and principal writer of “VA Long-Term Care at the Crossroads,” a blueprint for VA’s expansion of home and community-based care services. Schoeps was awarded the Hubert H. Humphrey Award for Service to America by the Secretary for Health and Human Services, and the Federal Public Service Award by the National PACE Association.

marylou sudders, MSW, President and CEO, Massachusetts Society for the Prevention of Cruelty to Children. Faculty, BC Graduate School of Social Work. Former Commissioner of Mental Health for the Commonwealth of Massachusetts. Key legislative successes during her tenure included the passage of mental health parity insurance; five fundamental rights for mental health consumers; civil commitment reform; the children’s mental health commission; and the hospital interpreter law.

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“A lot of the people we work with, in Haiti, in Latin America, in Africa, feel that their poverty is a reflection of historical forces, not of some accident, and they would like to see those redressed.”

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GLOBAL HEALTH Paul Farmer Co-founder and Executive Vice President, Partners in Health if you want to address global problems —and I know this is true for global health, but I can’t imagine

it’s not true for environmental change, climate change, and the other big problems facing the world—I would put social inequalities at the top of that list, the rich getting richer. It is the ranking problem of all, that there can be such grotesque disparities on the same planet.

Partners in Health is a living link between the rich world and the poor world, and I don’t only mean between nations, I mean between Roxbury, Massachusetts, and Brigham and Women’s Hospital in Boston.

Being a living link between those worlds implies figuring out the financing for building health systems in the poorest places and that will require significant transfers from the wealthy world to places like Haiti.

The thing I’d shout out to the world is, you can’t do global health work without significant investment in training both in the rich world and the poor world. And for the training programs to be ethical, they have to be linked to training programs for young Haitians and Rwandans. They have to be linked to building health systems, because how can you expect people to do global health without building infrastructure—hospitals, clinics? Finally, we need this feedback loop called research or monitoring and evaluation.

The great thing is, it’s really not rocket science: You have to build infrastructure, you have to train local people, and you have to deliver services. To do that, you have to raise capital. In Haiti, for example, we’ve built a local organization. It’s not called Partners in Health, it’s called Zanmi Lasante, which means the same thing in the local language, but it’s got Haitian leadership and it’s probably the biggest outfit in the country, health delivery-wise.

Wherever we have been rigorous about linking our services to training and a feedback loop, that’s where we’ve had the most success. If you think about some of the projects we launched that are well known, like the HIV/AIDS Equity Initiative, we documented what we were doing, we trained others to do it, and we linked patient care with documentation and monitoring.

No doctor sits in one of these clinics and thinks medicine is going to cure poverty. The social workers, nurses, and doctors know that the problems of the people we see come from forces beyond our control: poverty, gender inequality, racism. That doesn’t mean that we can’t complement what we do clinically with other projects. So in every place we work, we go ahead with other interventions to break the cycle of poverty. That can involve helping local farmers get access to credit or better fertilizer, or setting up businesses with local women. However modest the intervention, we try to have a poverty-reduction component.

We also have these huge new internet-based communication platforms that have radically changed things. Partners in Health developed open source electronic health records before most American hospitals did, a development that would not have been possible even 15 years ago. Now you can get an ultrasound read remotely in 45 minutes at the Brigham, from a hospital in Rwanda. The penetration of cell phones over the last 10 years is staggering. I’ve met paupers in rags who don’t have enough to eat, but they have a cell phone. When we start drawing on that proliferation as a connection not just to patients but also to community health workers, I think we’re really going to see some improvements.

We have little idea how much cholera is going on in Haiti. If everybody in our network were to report in a case or suspected case immediately from the village, I can imagine a lot of lives being saved. We have problems with treating complex illnesses, like drug-resistant TB, a lot of issues with the medications, so we started using handheld devices to connect the community health workers to the central database. It’s crucial, because a big part of this work is moving health care out to where people live.

In a kind of reverse innovation, we started using community health workers in the 1980s in Haiti, then brought that model home to Roxbury and Dorchester and Mattapan in Massachusetts. These are lay people from neighborhoods who are trained to be health care workers with a focus on a limited number of drugs and side effects. Their strength is that they belong in the community and they know the community. If you’re facing a tsunami of chronic illness, as you are in this country, as are most countries in the world, you need to move care out of the hospitals and into homes and neighborhoods. , ,

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GLOBAL HEALTH Lisa Manganiello ’09 Clinical Social Worker, Boston Medical Center

poverty, inequality, and racism affect health out-

comes for people in rich countries as well as in the developing world. I see that every day in my job as a social worker at an American city hospital.

I often think what a lonely place it must be for our patients whose closest friend may be the person who gives them crack at night. That is just heartbreaking.

I’m sure other people would say housing should come first, or financial stability, but I think having a good network of people who encourage you on a daily basis to wake up and do well would be a good starting point to improve outcomes.

The first questions we ask people are: Do you have a partner, do you have kids, do you have family, do you have people whom you can identify as positive supports in your life? Many of them cannot identify anybody.

I’ve been dealing primarily with domestic violence, elder abuse, substance abuse, and chronic illness.

Housing is another huge challenge; I get a lot of consults for homelessness. People don’t realize that housing lists have a three- to five-year wait in this area. It’s not as simple as discharging a patient and having him be given a place to live. A lot of times we discharge to the local shelter, and that makes everyone uncomfortable, but it’s the only option.

Lack of education is a big challenge; I have patients who aren’t taking their medication because of that. Lack of finances is obviously a huge issue. Technically, Boston Medical Center no longer has a “free care” pool, so it can be challenging to arrange adequate services for patients once they’re discharged if they don’t have insurance, housing, or financial support.

The hardest thing is empowering patients to advocate for themselves. I spend a lot of time encouraging them to be persistent and trying to give them hope that however many roadblocks they hit on the way, they’ll obtain a better living environment eventually if they keep working for it.

In the clinical setting, not everyone has time to dive into the history of a patient. As social workers, our role is to do just that, to learn a lot about them and pick

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out their strengths. You might say, oh, so you only had 8 drinks last week instead of 15, how did you cut down?

I feel like our patients are constantly getting pushed down, so I encourage them that things can get better if they really want them to be.

Technology isn’t always a friend to patients. Most have cell phones but a lot of them use Pine Street Inn, Barbara McInnis House, Woods Mullen Shelter, or Rosie’s Place as their address, and they don’t have access to the internet at a lot of those places. So I can’t very well say, you can apply for food stamps online. They’d look at me like I had five heads.

Without the world of Google, I don’t know what I would do. Sometimes patients will know that their counseling service is at a specific address but can’t remember who their counselor is or what the agency is called. So I put in the information they have and find it from that. Or for next of kin searches, when a patient can’t tell you how to contact family members, I go into the White Pages and try to track them down online. It’s great to have all the Alcoholics Anonymous and Narcotics Anonymous meetings updated online, so you don’t give a patient a listing of an AA meeting that no longer exists, which sets someone up for immediate failure.

So many patients come in time and time again. People use the emergency room as their primary care physician. I’m on an emergency room committee that collaborates with numerous shelters, the police, and other community agencies to find high utilizers more stable housing or get them into substance rehab programs. ,

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“I often think what a lonely place it must be for our patients whose closest friend may be the person who gives them crack at night. ...We’re really trying to identify the underlying issues the patient has, instead of just being a Band-Aid.”

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“As we think about responses to the needs of the poor, the needs of the hungry, we can’t look at those responses in a compartmentalized way, we’ve got to look at it holistically.”

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RELIEF + DEVELOPMENT Ken Hackett President, Catholic Relief Services

one of the most important questions policy makers and practitioners are asking today is how do we

support a stable, equitable economic opportunity for the majority of people? How do we take a balanced approach, an integral approach, to efforts not just to assist poor people, but also to engage poor people in defining what their situation should be like over the long term?

As economically poor countries move further in the decades ahead, they’re coming out of a tradition of oligarchies and political situations where a small number of people call all the shots. That’s unsustainable.

With the large growth in the numbers of young people, with the large growth of urban populations, with increases in large numbers of poor people in richer countries, governments have to find ways to engage their populace in a meaningful way. If they don’t, we’re going to have Arab Spring squared. People are frustrated, and they’re young, and they’re energetic, and they know how to use all the social media tools.

So the challenge for Catholic Relief Services and many others is to find ways to touch this dynamic cohort of young people who can bring about change in a positive as well as a negative way.

I absolutely view our young people as without boundaries. They are not stymied by problems but are ready to find innovative solutions to any and all challenges. And that offers great promise for the future— the hope that young people in economically struggling countries will find a way to make things improve for themselves and for others. We’re already seeing change happen at a faster rate. What I’ve noticed, particularly in sub-Saharan Africa and in parts of south Asia, is a very rapid change, and an improvement.

We have a tendency to focus on the so-called fragile states, the broken states, but a much larger number of countries are doing much better than they were 10 years ago, and that’s better in terms of both economic growth and in the improvement of the lives of the people. So I’m hopeful.

We don’t see ourselves as the world’s service provider; that era is gone. We see ourselves as matching resources that we’re able to mobilize, with capacities that we’re able to assist with through local institutions.

So it’s not going to be so much about us.

The future will see CRS focusing on improving the capability of local institutions, starting with the local church and expanding from there to citizens’ groups, to women’s groups, and empowering their abilities to accomplish whatever objectives and visions they have.

To prepare for these changes, the social workers of the future, particularly in the international arena, are going to have to be multidisciplinary. You can’t intervene in all ways for all people, but to think more integrally about whatever intervention you’re going to make, you’ve got to think in the broadest sense. It’s not just about improving water supplies or just offering HIV/AIDS treatment. It’s about the person in their family, in their community, in their nation, and as you intervene, you affect so many things. It all fits together, and that’s the challenge for how we educate people who will be intervening in the future.

Technology is going to play a major role in all this. The technology of the future will be available for the majority of people in the world, not a minority of rich people. One innovation that’s spreading very, very fast is texting. Texting can empower poor people because it’s information. If you are a farmer, and you want to take your beans to market 20 miles away, and you can text to find out the price of beans in this market, you decide when to hold and when to deliver. If you’re a pregnant woman, you can have messages sent to you about what you should be doing during your pregnancy, or if you’re an AIDS patient, you can link up with some medical establishment.

That kind of technology is already giving people connections, information, and opportunities that they never had before. In East Africa, the whole concept of sending money by phone, so that people in the city can send money back to their families in the country, is very widespread. The same is true in India and the Indian subcontinent. I don’t see it happening yet in places like Afghanistan, but it’s going to come. It’s happening in Pakistan, it’s happening in the Philippines and Indonesia. I think it’s going to be phenomenal how people will be linked. ,

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RELIEF + DEVELOPMENT Joy-Anne Headley 2012 MSW Candidate, Global Practice Concentration

i’ve had experience with vulnerable groups in differ-

ent parts of the world, from women and children affected by prostitution in Thailand and India, to refugees in Vermont, and families dealing with domestic violence in Dorchester, Massachusetts. Among the key elements of effective programs is recognizing that it’s so important to approach the people you consider vulnerable as having strengths and the capacity to be agents for change themselves.

One of the main questions you have to ask is, how is a program sustainable in the long run? You can have programs meeting immediate needs, like hunger or protection from human rights violations, but what would be the long-lasting impact on the people in the community if for some reason the organization had to close down and leave? Have you given people the opportunity to become leaders in the issue? Have they been exposed to social action campaigning or how to advocate? You have to make sure you engage people in the community in the process of helping them and then they can become advocates long after agencies move on.

Because organizations can only be there for a time, it’s important to help the people you’re working with reclaim some of their power, to help them realize that they know the issue best, they know the culture best, and they know what needs to be changed and how it needs to be changed.

My first year field placement at Boston College was with an organization in Dorchester called Close to Home, which focuses on community-based prevention for domestic violence. The approach is that in order to change the culture of domestic violence it needs to start within the community, so the work was focused on creating social action and getting community members to talk about the issue at hand, and getting both men and women involved.

That emphasis was significant to me because with problems like domestic violence, or any form of violence against women, the only way to effect change in the long term is by educating men and women at the same time about why it’s wrong and what it does to society and why it needs to change.

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One of my responsibilities as an intern was conducting an impact assessment on how people in the community perceived the work. A lot of them acknowledged that domestic violence was evident in their community, wasn’t really talked about, and was very much behind doors. But they said that being involved in the organization helped them recognize the importance of addressing it from a community point of view and that having a network of people in the community who are vocal about it had been very useful.

My classroom work helped prepare me to deal with the issues I’ve encountered in the field. Being exposed to the “strengths-based” perspective, which emphasizes that the people you’re working with come with strengths—and you don’t just assume you have to go in there and fight for their rights—has given me a theory to capture all my scattered thoughts.

The Basic Macro Social Work class confirmed my commitment to working with issues on a broad scale, on more of a community level. In that class we also learned that it’s possible to bridge advocating on a community level with being connected to the grassroots movement.

Learning the social work approaches to creating social change and bringing in my cultural anthropology background have reinforced the idea that when developing, implementing, or assessing programs, it’s important to look at cultural factors, especially gender, which can often be overlooked and can make or break how successful a program is. ,

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“Because organizations can only be there for a time, it’s important to help the people you’re working with reclaim some of their power. …They know the issue best, they know the culture best, and they know what needs to be changed and how it needs to be changed.”

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“The notion that we should turn away from people in need because of how they came to this country seems to me to violate something about our values. How we sort that out is a big practical challenge, but it has to be consistent with our values.”

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IMMIGRANTS + REFUGEES Deval Patrick Governor of Massachusetts the

“massachusetts

new americans agenda” published in 2009 provides a state strategy of inclusion.

My impression of our approach to immigration, even before I was a candidate for governor, was a combination of collective hostility or denial, meaning either people were pretending we didn’t have newcomers or they were using hate mongering around immigration as a political tool. Neither one of those things seems to be right. We conflate illegal immigration, or undocumented people, with all immigration today. As a result, it doesn’t seem we have a very constructive public discourse about immigration.

Having listened to many people talk about their experience being new to Massachusetts, about whether they felt welcomed and integrated into mainstream life and the mainstream economy, it was important to me to sort out what, if any, role state government has in finding solutions to the problems they encounter.

More than anything, I wanted to create a space for more constructive public discourse about immigration.

There are a number of innovative recommendations in the New Americans Agenda, but some of the most important are also the most basic. For example, we heard over and over again from immigrants how important it is to have English as a Second Language opportunity. It puts the lie to one of the suppositions about immigration groups: that they don’t want to integrate into the larger mainstream. Actually, they are hungry for integration. English language proficiency is an expression of that.

The report recommended a “climate shift” in the commitment to foreign born residents. What is meant by that is a shift in attitude and a shift in heart. Policy will follow that. With the exception of a relatively small proportion of the American population, all of us are from someplace else.

I hear over and over from legal immigrants that they are worried that efforts to enforce immigration laws on a local level will mean they will get swept up in a kind of wholesale profiling. That’s something that some people get and some people just don’t. And I can tell you as an African American man, I get that. I’ve been emphatic that as long as I have anything to say about it, we are not going to have an immigration law like the Arizona Act of 2010 in the Commonwealth. It’s just not who we are.

As for the difficulty of changing attitudes—it was hard to change the idea of Jim Crow too, but we did that. It’s one of the more remarkable things about this country, as distinct from almost any other country in human history: We aren’t organized around a common language or religion or even culture. We’re organized around a handful of civic ideals—equality and opportunity and fair play—and we keep testing our reality against those ideals through history. It’s one of the reasons I think we’re the envy of the world.

Sound immigration policy is important for other reasons. There’s an awful lot of talent in the broad population of immigrants. It matters to the business community, the academic community, it matters to our economy generally. And just as a matter of common decency, you want to make the sense of welcome genuine and successful.

I was new here once too. It was people reaching out, paying attention to me, showing me what the unwritten as well as the written rules were, that helped me become part of this community.

Area colleges and universities also play a role in meeting our immigration integration goals. We signed the Achievement Gap Bill in 2010, which is meant to reach kids stuck in an achievement gap that has persisted for 18 years now. It’s an education and economic issue to have an achievement gap at all, but to let it go on for this long—that’s a moral issue.

So-called “innovation tools” are central to the new law. The idea is to bring into underperforming schools whatever it takes to meet those kids where they are. That may mean a longer school day, ELS classes, a different level of parental engagement, social services, and the flexibility not to have the same solution in every school. Partnerships with colleges and universities can be part of that. There are really exciting things that they can do in particular schools today that will make a difference right now. ,

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IMMIGRANTS + REFUGEES Maryanne Loughry Associate Director, Jesuit Refugee Service Australia, BC Research Professor

Having worked with displaced people in diverse settings, including Palestinians in the occupied territories and Aboriginals in Australia, it’s clear that displacement has an impact on people’s coping mechanisms, regardless of who and where they are, because the very nature of displacement means that people are without their normal social supports. The ways we’d conceptualize the needs of the people at the basic level are very similar, but on top of that there are great cultural differences and social differences, depending on why people are displaced, how long they’ve been displaced, and their capacity to respond to their displacement.

We’ve discovered that we need to engage the communities themselves. That’s a very different model from the past, where we would come in as experts with a program. Now, it’s a question of understanding that communities themselves bring a lot of resources to the displacement setting.

These are principles familiar to social workers; they come out of a model of looking at people’s resilience, and at what happens when their resilience is overwhelmed. The model can be used here in Massachusetts, as far away as the Pacific, or in conflict settings.

We also put a lot of emphasis on being culturally sensitive and gender sensitive, so that we’re engaging people appropriately, within their culture, and also working with members of the population.

One of the big concerns is to do no harm by making sure we’ve got an ethical framework and we bring best practice to what we’re doing. We’re concerned about the capacity of humanitarian workers, that they are also im-

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bued with the principles that we think are important.

That’s where a place like Boston College can help.

A number of our Global Practice students do placements in refugee settings, and we’re very careful to find places where they will get adequate supervision and mentoring in best practice. It’s also crucial that they have support so that when they’re out learning these skills, they’ve got people back here who understand what challenges they’re facing.

One of the roles my colleagues and I play is constantly bringing real world issues to students—I’m in and out of refugee settings at least 50 per cent of the time. Our research and fieldwork comes into our classes and into our advice to students when they’re doing their own research, so our teaching is always informed by our practice.

We’re aware of what resources we’d want students to take with them—practical resources, manuals, training materials, UN and international guidelines on practice—so that should they come across something unknown to them, they can rely on these as examples of good practice. We’re also continually making connections for them between what they know from their work in other settings and how they can maximize that knowledge in settings that are more unusual.

The key thing for social workers in any displacement setting is to be highly attuned to people’s need for protection. Whether it’s for women, who are very much at risk of gender-based violence, or for children, who are at risk of many abuses, the social worker’s brief is to develop a protective environment. They should be thinking ecologically and holistically, so that protection happens in existing systems and we don’t have to set up separate programs. ,

“Displacement has an impact on people’s coping mechanisms, regardless of who and where they are, because the very nature of displacement means that people are without their normal social supports.”

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HEALTH EQUITY Garth Graham Deputy Assistant Secretary for Minority Health, US Department of Health and Human Services we have to confront the social, economic, and environmental fac-

tors that contribute to health disparities if we are to fulfill President Obama’s goal of “winning the future”.

In the past we have issued several reports detailing health disparities. The idea behind the recent US Department of Health and Human Services Action Plan to Reduce Racial and Ethnic Health Disparities and the National Stakeholder Strategy for Achieving Health Equity was to identify key actions that we could take immediately.

The first federal report documenting minority health disparities came out in 1985, and certainly we’ve seen the persistence of health disparities since then. But the Affordable Care Act 2010 offers some key opportunities. One is the expansion of health insurance. The majority of the uninsured in the US are people of minority populations. So we believe policies that expand health insurance will be key to reducing health disparities. There will also be expenditure on improving access to care, through community health centers and similar kinds of infrastructure, and an emphasis on improving quality of care, with a focus on prevention.

Where people live, learn, work, and play affects their health as much as their access to health care. So we’ll work with colleagues across the federal government on issues that impact health. For example, we’re going to be working with the US Environmental Protection Agency on environmental justice issues. These problems are multifactorial in nature, so we need to take a multifactorial approach.

There are fundamental challenges to the sustainability of our health care system. If you put the costs of our system together with the changing population dynamics, you see the challenges coming together in a way that’s never happened before, so it pushes us to find solutions. The stakes are extremely high.

This is not just a problem for minority communities—it’s not an African-American problem, a Hispanic problem, an Asian-American problem, or a Native American problem—it’s an American problem.

We have reason to be optimistic, because our country as a whole is implementing forward-thinking health care interventions on a grand scale, so we’re moving into a time when we have an opportunity for great change on a macro level. We’re trying to collect better data on minority populations, disabled populations, non-English-speaking populations, so we can quantify the problem better as we move forward.

We’re seeing a large growth in minority populations across our country, and this is pushing the health disparities conversation into the mainstream. In places like South Florida, Los Angeles, Texas, New York City, and other major cities, we’re seeing our minority populations becoming a major, if not already a majority, part of the population.

Social workers are at the crux of the health care system because they provide a bridge between the patient’s life outside the clinical care setting and their experience within the clinical care setting, and bring an overall understanding of who the patient is as a person. Social workers need to be fully engaged in the discussion of strategies and approaches to reducing health disparities, and bring to bear their own experiences, their own energies, their understanding of patients’ complicated lives, so that the social determinants of health are fully taken into account. From our perspective social workers are a key part of the solution to these challenges. ,

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Racial and ethnic minorities are among the fastest growing of all communities in the country, and today comprise more than a third of the US population. The US Census Bureau projects that by the year 2042, more than half of America’s population will be made up of minority groups. Among kids, the white majority will disappear by 2023.

boston college | graduate school of social work 17 

HEALTH EQUITY Elaine B. Pinderhughes BC Professor Emerita

disparities in health have been on the federal agen-

da since 1985, yet data suggest that some populations, particularly minorities, continue to suffer poor health, and that the health gap has widened since the 1980s.

To correct this situation would require massive social programs and citizen action to combat poverty, racism, crime, drug usage, and disease. Those are the five main issues that reinforce health disparities.

Addressing economic equity is a major underlying issue when it comes to correcting these disparities.

Drastic changes are needed in educational systems and programs that teach people how to live healthily, how to parent well, and provide information about rights advocacy. People need to know how they can do something to bring about a change in their entrapping conditions.

Prevention programs, which would be one solution, have been central to social work forever. They never get much funding, because the money goes to where the problems are, instead of to whatever programs would prevent the problem. Prevention is always shortchanged because of the crises that we continually live in. There have always been meaningful and worthwhile programs that achieve some kind of success, but as soon as there is a crisis, a war, or an economic emergency, those programs get cut out and then we have to start all over again. And that’s apparently where we are now.

For example, health disparities were reduced by President Lyndon B. Johnson’s Great Society initiative that lifted many people from poverty in the 1960s.

These were very successful programs, but they have been constantly eroding since the Reagan years, so that today we have the current disastrous numbers of disparities. This is a values as well as an economic issue in terms of what this country sees as a priority. So these disparities are getting worse, despite a lot of attention and funding to address them from the Minority Health and Health Disparities Research and Education Act in 2000.

In terms of what social work can do, there’s been enormous progress in training social workers to work with populations suffering from disparities not only in

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relation to health care but also to education, employment, divorce and family instability, children in care, and much more. Social work and Boston College, particularly, have made much significant progress in training for work with multicultural populations.

You see the effects in terms of social workers being able to view minority populations as they are, instead of as stereotypes, in the readiness to empower them, to find ways to change their situation, not only their individual situation, but to work with others to change the system. That’s what our students are now learning that they must help their clients to do. It’s a mindset change that has led to a different perception of people, a different way of working with people.

On an individual level, it’s a comfort with difference.

That’s number one. That means knowledge of the self, in terms of the blind spots and prejudices you have to manage, it means respecting your clients’ culture and their strengths, because your work will build on their strengths, and helping the client use his or her cultural strengths in the pursuit of an effective and healthier life. Respect for the culture is critical. In the past, we aimed to turn everybody into a middle-class American.

Now we know that that is not the goal. But despite such progress we still we have these disparities, so there is much work to be done.

,

,

“Prevention is always shortchanged because of the crises that we continually live in. There have always been meaningful programs, but as soon as there is a crisis, a war, or an economic emergency, those programs get cut out and then we have to start all over again.”

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,

“The good news about the world of mental health is that because we’ve been so undervalued, underappreciated, and underfunded, there’s opportunity to be innovative.”

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MENTAL HEALTH Marylou Sudders President & CEO, Massachusetts Society for the Prevention of Cruelty to Children it’s staggering, given some of the advances we’ve had, that mental health remains the stepchild

of the health care system in terms of research dollars, funding for services, and the acceptability of the illness as a legitimate illness.

Stigma is so pervasive when it comes to mental health. Because mental illness has become more politically correct, we don’t overtly engage in words that are stigmatizing, but that only taps the surface.

When you realize that mental illness affects 1 in 10 children and 1 in 15 adults, you’d think we would have acknowledged the epidemic and have channeled our national and state resources toward mitigating it. Yet we continue to blame family members for a child’s or adult family member’s illness.

The good news about the world of mental health is that because we’ve been so undervalued, underappreciated, and underfunded, there’s opportunity to be innovative. There aren’t a lot of structures in place that need to be taken down or funders to say they won’t fund us anymore. We are free to chart the new course for the treatment of mental illnesses.

Our great challenge and opportunity is to use some of the federal platforms, such as the federal parity insurance law [Wellstone-Domenici Mental Health Parity and Addiction Equity Act of 2008] and the health care insurance law [Health Care and Education Reconciliation Act of 2010], to make sure that mental health is at the table in discussions about access and the availability of services for children and others who need those services.

We always think our work is done once legislation is passed, but the reality is that the hard work starts once the legislation becomes law. The new laws provide a great vehicle for those of us who care deeply about mental health services to engage in different kinds of public policies and different structures for funding mental health services than have previously existed.

Social workers have a legitimate role in policy planning and strategy at the macro and micro level.

Being clinically trained is a great foundation for public policy and legislative work. It gives us the skills to negotiate and to understand the perspective of other individuals and the issues in the context of the community and environment. Social work at the table brings a broader experience than many other professions and provides the social justice aspect of advocacy. Our challenge is to have the confidence to be at that table.

Fundamentally, we understand that our work is based upon the individuals whom we care about in the context of their community and environment. The family voice—the individual voice—is a powerful one for us to channel to ensure that mental health funding and services are where they need to be.

There’s no question that the voices of those who are primary consumers and their family members are also paramount to social workers’ ability to ensure that the services they provide are the most effective and the most acceptable to families.

A great advantage in the mental health community that did not exist in the past is the fact that social workers, in particular, acknowledge the incredible importance of the family voice. That is so in terms of children’s services and the experience of individuals who are consumers and clients in the mental health system. We take their perspectives, their histories, and their struggles and incorporate those into the treatment that we provide for individuals.

Among the most significant scientific breakthroughs in recent years are studies on treatments. An example is “wraparound services,” a way of providing clinical services and concrete supports for a child with emotional disturbance and that also supports the family. It’s a treatment modality that acknowledges the child in the context of the family. It provides a range of community-based interventions that help the child manage illness and make sure the environments around them are supportive. It’s highly effective. ,

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MENTAL HEALTH Paul Kline Associate Professor for Clinical Practice

a major challenge for us as a profession and as a

faculty is staying current with the explosion of new knowledge about the complexity of human development and the ways that people respond to adversity. How do we integrate that knowledge into our current ways of understanding people and their problems and how do we do that while staying true to the fundamental values that are the foundation of all social work practice? How do we integrate new knowledge while remaining deeply rooted in our humanistic orientation to people and our appreciation for the uniqueness of each individual?

The clients and communities we serve are making it very clear that even though we sometimes become deaf to their ethnic, cultural, and religious ways of knowing, they will do their best to fit our professional knowledge within those powerful frameworks. So, we’re listening.

Finding a team paradigm that enables us to embrace people in this holistic way is most effective, deeply respectful, and profoundly hopeful.

What’s most exciting to me is the movement toward transdisciplinary practice. This model requires more than working side by side in a respectful and collaborative way with clients, their families and communities, and with other professionals. It can transform our individual professional approach to people and their problems by integrating our ways of understanding and helping with the approaches taken by other professions and with the therapeutic resources already present in the client and the environment. If a team of professionals creates a way of working together that makes that possible, then every person’s practice is transformed and elevated to a different level of effectiveness and a different power of team functioning is reached.

The impetus for this new way of practicing is coming from different directions, most importantly from our empathic listening to people who are suffering and from their families. When we listen carefully and ask questions respectfully, they tell us quite clearly where our current ways of working are failing to produce optimal results or even harming their progress by creating barriers to the resolution of their problems. It is crucial that, as a faculty, we take that feedback into our class-

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rooms, research, and practice to address the limitations in our current practice models that are preventing the outcomes everyone desires to achieve.

The most exciting interventions are those that bring the voices of clients and their families to the center of the conversation, that seek to integrate all of the different dimensions of people’s experiences into the therapeutic process.

So, for example, to what extent do our current interventions attend to the spiritual questions, strengths, and longings of people who suffer from a mental illness? Are we empowering clients to be the authors of their own recovery, in partnership with professionals?

Are we seeing parents, siblings, and friends as experts who carry great wisdom and insight, not only concerning their loved one’s suffering but also their loved one’s potentialities?

Our greatest challenge is rising above the dehumanizing aspects of the systems of care where we practice.

These systems often encourage us to focus narrowly on a particular slice of a person’s reality and experience.

When we collude with this approach, we unintentionally deliver a message of indifference to everything else that is true and precious about that person and, as a result, they feel diminished and insignificant. How can any treatment hope to overcome that injury?

As a result of the recent Diversity Initiative at the Graduate School of Social Work, we continuously seek to grow our appreciation for the uniqueness of people as members of a particular ethnic, cultural, or spiritual and/or religious group and the power of those traditions to strengthen our own professional interventions.

It involves marrying what we have to offer as empathic professionals to those cherished and enduring ways of knowing and healing that are the “natural” therapeutic resources rooted in the wisdom of ethnicity, culture, spirituality, and specific faith traditions. ,

,

“The most exciting interventions are those that bring the voices of clients and their families to the center of the conversation, that seek to integrate all of the different dimensions of people’s experiences into the therapeutic process.”

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“The globalization of superficiality challenges Jesuit higher education to promote in creative new ways the depth of thought and imagination that are distinguishing marks of the Ignatian tradition.”

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JESUIT EDUCATION Adolfo Nicolás, SJ Superior General of the Society of Jesus

[…] jesuit education should change us and our students. We educators are in a process of change. There is no real, deep encounter that doesn’t alter us. What kind of encounter do we have with our students if we are not changed? And the meaning of change for our institutions is “who our students become,” what they value, and what they do later in life and work. To put it another way, in Jesuit education, the depth of learning and imagination encompasses and integrates intellectual rigor with reflection on the experience of reality together with the creative imagination to work toward constructing a more humane, just, sustainable, and faith-filled world.

The experience of reality includes the broken world, especially the world of the poor, waiting for healing. With this depth, we are also able to recognize God as already at work in our world.

Picture in your mind the thousands of graduates we send forth from our Jesuit universities every year.

How many of those who leave our institutions do so with both professional competence and the experience of having, in some way during their time with us, a depth of engagement with reality that transforms them at their deepest core? What more do we need to do to ensure that we are not simply populating the world with bright and skilled superficialities? […]

For a world of globalized superficiality of thought means the unchallenged reign of fundamentalism, fanaticism, ideology, and all those escapes from thinking that cause suffering for so many. Shallow, self-absorbed perceptions of reality make it almost impossible to feel compassion for the suffering of others; and a contentment with the satisfaction of immediate desires or the laziness to engage competing claims on one’s deepest loyalty results in the inability to commit one’s life to what is truly worthwhile. I’m convinced that these kinds of processes bring the sort of dehumanization that we are already beginning to experience.

People lose the ability to engage with reality; that is a process of dehumanization that may be gradual and silent, but very real. People are losing their mental home, their culture, their points of reference.

The globalization of superficiality challenges Jesuit higher education to promote in creative new ways the depth of thought and imagination that are distinguishing marks of the Ignatian tradition. […]

Globalization has created new inequalities between those who enjoy the power given to them by knowledge, and those who are excluded from its benefits because they have no access to that knowledge. Thus, we need to ask: Who benefits from the knowledge produced in our institutions and who does not? Who needs the knowledge we can share, and how can we share it more effectively with those for whom that knowledge can truly make a difference, especially the poor and excluded? We also need to ask some specific questions of faculty and students: How have they become voices for the voiceless, sources of human rights for those denied such rights, resources for protection of the environment, persons of solidarity for the poor?

Excerpts from the speech, “Depth, Universality, and Learned Ministry: Challenges to Jesuit Higher Education Today,” by Father Adolfo Nicolás, SJ, Superior General of the Society of Jesus, held at the April 23, 2010, conference in Mexico City on “Networking Jesuit Higher Education: Shaping the Future for a Humane, Just, Sustainable Globe.” ,

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JESUIT EDUCATION T. Frank Kennedy, SJ Peter Canisius Professor and Director of the BC Jesuit Institute

Jesuit, Catholic schools have at their core a mission to educate men and women for others. If you do that, then the faith and justice component becomes very obvious as one t u r n s t o w a rd that challenge. How do you become unselfish, how do you become a person who has a vision that’s really common in the old-fashioned sense of the common good?

That is the basic vision of a Jesuit education. It’s a kind of spirit: to look at people not just as a job, to take care of them, to see them as our brothers and sisters. We are called to look at that side of life. We can’t not look at it.

In the early years, the School of Social Work trained many of the social workers in Boston and Massachusetts. We sent out generations of people into the cities and towns to work for poor and disadvantaged people.

In more recent years, in addition to training people who are going into the field, we’re also beginning to realize the kind of effect that serious scholarship has around some of these projects. We can shape our future more if we have top-notch faculty who are doing that research, who are moving the theory forward as well as the practices. This kind of leadership is what we want to show to other universities, to the academic world in general: That the Jesuit vision is not myopic, that it is not pious, that this is a vision that is really tremendous. It’s not just spiritual; it’s transcendent.

The school awakens in us a dimension of care and concern. It is an invitation to love. I know from just watching what goes on at the School of Social Work and coming to know some of the people on the faculty, that a sense of connectedness comes out of this as well. This is really God’s work here.

When you are invited to love, you don’t exclude any-

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body. It’s always an invitation to people to look deeper, to come along, to come as you can come, and that’s a wonderful thing about Boston College and Jesuit, Catholic institutions. If you’re a Christian or you’re not a Christian, you are welcome. It is not meant to be some kind of indoctrination.

This is the spirituality behind the School of Social Work. A Catholic will become more deeply involved in his or her faith, I think, if one comes to a Jesuit school and participates fully. A non-Catholic will become more deeply involved in his or her own journey, even if it’s not Catholic, if they come to a place like BC, because they will experience people on that journey, a journey that moves outwards toward the other. I think some of the inspiration that we give our students, through the kind of research we do, the kind of faculty we are, as well as the kind of students we prepare, has a definite stamp, and it says, BC. And if you look more deeply, it says Jesuit and Catholic.

All of Jesuit life is characterized by a little book, The Spiritual Exercises of St. Ignatius. Ignatius formulated these exercises as a way of being, of seeking God in all things. The final meditation is called The Contemplation to Obtain Love. When you go through those exercises, that experience of learning to find love not only in other people, but also in a sunset, in a rock, in the sea, in your life as it is happening around you, you say, well, God is moving here. And as we pay attention to God moving among us, we’ve come to see that Boston College is also imbued with that spirit of discernment.

You can see it in the way that we plan. There are elements of discernment as we think and do strategic plans. Jesuits call it “our way of proceeding.” But it has come to characterize our works as well. Schools can have that spirit in them. Finding God in all things is the way to sum it up. I think it’s very characteristic of our works, certainly in the School of Social Work and of the whole university.

We belong to one another. If we could all agree on that, and agree to act that way, we’d be better off. That’s what the Jesuit, Catholic tradition says.

,

“Finding God in all things doesn’t involve telling someone else what to do. It’s a way of discovering. Looking inside yourself and sizing up a situation and really beginning to understand the connectedness of human beings. The School of Social Work—that’s the front line of that process.”

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AGING Corinne H. Rieder Executive Director and Treasurer, the John A. Hartford Foundation

one of the biggest challenges to healthy aging is that, as a

society, we’re not very planful. We won’t be until the aging issue hits us. But the matter of aging in this country is, in fact, upon us. I’ve identified eight of the biggest problems.

Number one is fundamental demographic changes. The growth of older people is dramatic. Today in the US, we have about 40 million people 65 and older; by 2050, we’re going to have 89 million.

Two, as we age, we lose physiological reserve. What that means is that we collect chronic diseases. Three is a result of the second. The use and cost of health services dramatically increases as people age and that’s primarily due to chronic diseases. Right now, adults 65 and older represent about 13 percent of the population but account for 50 percent of ambulatory care visits, 50 percent of hospital days, 70 percent of home health services, and 90 percent of nursing home residents. Also, Medicare beneficiaries 65 and older with 5 or more chronic diseases see 3 times as many physicians, visit physicians 4 times as often, and receive 5 times the number of prescriptions.

Four: Are the health care system and health professionals ready to provide quality care to this group of older Americans? The answer is no. We have an inadequate and poorly prepared work force and a health care system that still focuses on acute, not chronic, disease. If you look at the shortage of geriatric social workers alone, it’s striking. According to the National Institute on Aging, by 2030 we will need 60,000 to 70,000 geriatric social workers. In 2000, there were only 13,500 and their median age was 50 years.

Five, workforce shortages are exacerbated by an inadequate health care system, which is truly broken for older people. Among the reasons for this are a focus on acute rather than chronic care; favoring specialist care over primary care, particularly in reimbursement; lack of communication among multiple health care providers; and payment policies to doctors that encourage volume not quality. We need capitated and bundled care.

Six, age discrimination and ageism are widespread. Seven, our country has and is facing financial, ideological, and ethical challenges, and there are real differences with respect to the role of government.

Our interest is, of course, on what that role is and its effects on the aging population. Eight, older adults are not prepared to care for themselves.

How do we address these issues? Every practicing social worker, indeed, all health professionals, should be prepared to provide quality care to older adults. Work sites need to provide quality clinical training so students can see what good quality care is. Social workers need to be advocates for their patients, and patients and families need to advocate for themselves. This is critically important. Our health care systems are really difficult to navigate; you can get lost in them.

More faculty members need to be experts in geriatrics. Only through faculty specialists in geriatrics can you teach the next generation. Furthermore, because we’re never going to have enough geriatric social workers, geriatrics needs to be infused across all health curricula so every social worker, physician, and nurse can take care of older patients. Students across all health professions need more and a greater variety of clinical experiences with older people and the institutions that serve them.

Older people benefit from having team care, so we need to remove the barriers to interprofessional training and teamwork. Clinicians must be allowed to work at the top of their training and the edge of

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“Every practicing social worker, indeed, all health professionals, should be prepared to provide quality care to older adults, through the education they receive, innovative partnerships with academic institutions, and on-the-job training.”

their license. States have different regulations about who can perform certain functions, such as writing prescriptions, so each profession needs to be prepared to do these tasks. Health education programs don’t need to reinvent the wheel. In education and service delivery there are an abundance of ideas, materials, and models waiting to be adopted. Schools that train health professionals, including social workers, need to explore the funding opportunities available in the Affordable Care Act. For instance, what more can social workers do to alleviate the problem of hospital readmission? Currently, 20 percent of people who leave the hospital return within 30 days.

Social workers need to better define who they are and what they can do, to make a business case for themselves with evidence of their cost-effectiveness. Social workers are the only ones who see the whole person and their families. The public and other health professionals are not fully aware of social work’s real and potential contributions to improving the health care of older people. Social workers are hurt by fragmentation. There are so many associations, it’s unclear who speaks for social workers nationally.

Finally, despite the fact that academic institutions take great pride in their research, are they asking critical questions? I would challenge every one of them to look hard at their own institutions and ask if they are meeting the challenges of the aging population. , boston college | graduate school of social work 29

AGING James Lubben Louise McMahon Ahearn Professor and Director, BC Institute on Aging

aging is life itself. We first approached aging as if it

were a medical problem, seeking treatments. In fact, even now, we have this anti-aging theme that seems to pervade a lot of the literature, and even some branches of medical science, as opposed to embracing aging as a natural phenomenon.

One of the remarkable phenomena that we’ve had the joy of experiencing is the aging of our populations.

For centuries, cultures throughout the world have savored the prospect of a long life, the ability to see one’s offspring grow up and enjoy their success, and we’re living in that time.

The aging of our populations is a matter of social justice. So many more people are reaching the age of 65 or older, that the masses now can reasonably expect to live a long life, whereas in the old days it was only the privileged class who could think about living that long.

Already the fastest growing demographic, people 60 years and older, will make up 22 per cent of the world’s population by 2050.

What we now need to do is add vitality to those extra years. Most of us don’t want to be put in a warehouse in our older years. Quite the contrary. We want to be integrated within society. If we live long enough, all of us will eventually have physical and mental needs. So we need to develop the infrastructure that will provide that care in as humane a way as possible so people can maintain their dignity even in the face of infirmities.

The Institute on Aging at Boston College was created to address the phenomenon of aging populations from a multifaceted perspective, to look at the physical, mental, social, spiritual, and economic aspects of living long lives, and to make sure that there’s meaning and purpose in those extra years to which we’ve been entitled.

We’re developing the infrastructure to train the next generation of nurses, social workers, and, hopefully, educators and lawyers, even helping to identify the future artist who will be able to capture this aging phenomenon and communicate it to a wider audience. In other words, helping awareness of these issues permeate the

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whole campus. And we’re starting to see that.

I see social workers as resource mobilizers, whether they’re mobilizing the resources within an individual, within a family setting, within organizations or communities, or within policy settings—that’s the role.

So what we need are social workers who are adept not only at identifying deficiencies, but also at identifying strengths, and being adept at leveraging those strengths.

I’m the founding national director of the Hartford Doctoral Fellows Program, which is part of the Geriatric Social Work Initiative (GSWI) supported by the John A. Hartford Foundation. The GSWI addresses the three core professions of medicine, nursing, and social work, to help these professions develop a cadre of well-trained professionals who can deliver the needed services to this rapidly expanding population of older people in our societies.

The Doctoral Fellows Program is one of two approaches to cultivating the next generation of academic leaders, by identifying and supporting the most promising doctoral candidates interested in geriatric social work. It runs in parallel with the Hartford Foundation Faculty Scholars Program for junior faculty, for which my colleague Barbara Berkman is the national director, so our doctoral students have the benefit of two national leaders of this major initiative to help social work respond to the aging population.

The Hartford initiatives use the term “aging-savvy” social workers. We really need highly creative, highly innovative individuals because we’re building a whole new infrastructure of services and supports for the aging population. We need those social entrepreneurs, who are going to be on the cutting edge of developing what those programs and services will be, and who will figure out ways to maximize their productivity.

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“I see social workers as resource mobilizers, whether they’re mobilizing the resources within an individual, within a family setting, within organizations or communities, or within policy settings.”

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CHILDREN + FAMILIES Risa Lavizzo-Mourey President and Chief Executive Officer, the Robert Wood Johnson Foundation

the core question that should be driving efforts to improve the

lives and futures of vulnerable families is how can we best meet vulnerable families where they live, learn, work, and play so that we can make a significant and positive difference in their lives? Where are the opportunities for intervention in their neighborhoods, homes, schools, and workplaces?

Research tells us that we can’t make significant progress in reducing poverty without also improving education; nor can we eliminate health disparities without taking poverty, housing, education, and other factors into account. These issues must be addressed together. And for that to happen, we need more collaboration across sectors and across issues—fewer silos, more inclusiveness, more interconnectedness. Although this is not common practice yet, we are starting to see this kind of collaboration happen more frequently which I found very encouraging.

A few examples: One, the Healthy Food Financing Initiative started by the US Departments of Treasury, Agriculture, and Health and Human Services is a $400 million program that seeks to eliminate “food deserts”—places typically in urban and rural communities where parents and kids can’t find nutritious foods—within the next seven years. Two, the Departments of Housing and Urban Development and Transportation, and the Environmental Protection Agency have created a partnership that will coordinate federal transportation, environmental protection, and housing investments to make neighborhoods safer, healthier, and more vibrant. Three, the Robert Wood Johnson Foundation and the Pew Charitable Trusts have launched a project to promote health impact assessments as a decision-making tool for policymakers. The assessments use a flexible, data-driven approach that identifies the health consequences of new policies. Policymakers can then develop practical strategies to enhance the benefits of new policies and minimize their adverse effects.

To support a broader perspective for addressing social change, philanthropies and other organizations in the vanguard of social change need to think big themselves. They need to look for ideas that have the potential to achieve fundamental breakthroughs in the circumstances that affect vulnerable people—what Clayton Christensen at Harvard Business School calls “disruptive innovations.”

We know that medicine alone won’t solve health problems, especially for patients who are poor, have no food at home, or are living in a car. Without dealing with these non-health problems up front, many of these patients will just get sicker. But doctors don’t have the time or knowledge to address patients’ basic resource needs. Under a promising project called Health Leads, doctors “prescribe” food, housing, or other critical resources for patients. Patients take their prescriptions to help desks in the clinic waiting room, where volunteers connect them to the resources they need. The goal of Health Leads is for all doctors to be able to prescribe solutions that improve health, not just manage disease.

We’re also deeply interested in exploring how social networks that negatively affect the health of populations can instead help promote health. In the New York Times article, “Are Your Friends Making You Fat?” two years ago, Harvard physician Nicholas Christakis documented how a preventable condition like obesity can spread in a community’s social networks among friends, family, and acquaintances. We’re now looking closely at whether and, if so, breakthroughs in the health of large populations can be facilitated through social networks.

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“The national recession has affected the lives of millions of Americans. As a result, we are also seeing a heightened demand for solutions to alleviate this suffering. This new urgency is what gives me cause for cautious optimism.”

Such breakthroughs in technology and communications also create opportunities for huge paradigm shifts. For example, Project ECHO in New Mexico uses Web-based teleconferencing technology and bestpractice medicine to eliminate barriers to specialty care in underserved communities, and even eliminates racial and ethnic disparities in treatment outcomes. It successfully addresses lack of access, increasing costs, poor and uneven quality of care, and severe workforce shortages, not only to improve health but also to transform lives. This is a paradigm shift—a holistic disruptive innovation—that could change fundamentally the practice of medicine, the training of health professionals, and the way they collaborate.

Future generations of social innovators and change-makers need to be well-grounded in social determinants research across the spectrum of social issues, must understand how social factors interact to affect people’s lives and their communities, and must not view social problems as intractable but as solvable.

Their challenge will be to find those creative approaches that will make a difference at the local community level. For that, they need to be trained to work in teams across sectors, issues, and disciplines.

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CHILDREN + FAMILIES Ruth McRoy Donahue and DiFelice Professor

the graduate school of Social Work is working hard

to improve outcomes for children and families within their communities. We conduct research across cultures, across nations, to build knowledge on policies and practices that affect vulnerable populations. There’s great benefit to global research because, through understanding context and the various circumstances in which policies are developed or practices evolve in a particular country, we can better understand and propose more relevant solutions appropriate to the country.

Also, this knowledge of comparative cultures helps enlighten and strengthen our work in the US. My specific research focus is on adoption practices and policies, and I am most interested in the opportunity for cross-cultural comparisons. Who are the children available for adoption and why, what are their ages, what is being done to find them families? Through cross-cultural comparisons, it is possible to review and analyze the data, the historical and contemporary policies, the practices, and to acquire a deeper and broader understanding of factors that influence experiences and outcomes of children and families in various settings.

In the US, I’m currently involved in the evaluation of AdoptUSKids, which is supported through a cooperative agreement with the Children’s Bureau. It is designed to raise public awareness about the need for foster and adoptive families for children in the child welfare system and to assist states, territories, and tribes to recruit and retain adoptive families. AdoptUSKids has also developed targeted recruitment campaigns to increase the likelihood of adoption of children of color, who are disproportionately represented in the nation’s foster care system. The strategies and processes they have developed, in turn, can be informative as other countries address the issue of finding permanency for children in care.

People all over the world are looking at these issues and comparing what’s being done in different countries. Everybody benefits from the opportunity for sharing and exposure, and they can go back to their country of origin with new information to bring to the table.

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The most important qualities for a social worker who is working across cultures are a willingness to be open, to listen, to take the time to understand the history of a country, the context of the policies and practices that have evolved in other cultures and countries, to not go into a new environment making judgments based upon one’s own culture or background or policies or experiences. It is essential to be able to analyze without judging.

I’ll never forget a family whose home several of my colleagues and I visited in 2010 in South Africa. We were in a very poor neighborhood. The home had a dirt floor. The mother sat, prepared a meal, and served us.

She talked about her situation, her family, and we could see her love and her caring for her children. It would be easy to go in and make a judgment. But no. Our openness and acceptance of her and her family helped her to feel safe enough to share her experiences with us. I think respect is critical in all of this.

I’ve always done mixed-methods research, both qualitative and quantitative. We can frame a problem by looking at the numbers; we can frame it through an analysis of key indicators of well-being. But I am enriched by hearing directly from the people in a particular country, whether they be professional social workers or researchers or the families themselves.

It takes that immersion experience to begin the process of appreciating the experience of others. Social work has typically, historically, looked at the person in the environment, but now, more than ever, we’re expanding that to include an examination of environments both here and outside the United States. ,

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“The most important qualities for a social worker working across cultures are a willingness to be open, to listen, to take the time to understand the history of a country and the context of the policies and practices that have evolved in other cultures and countries.�

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EMPOWERMENT Daniel Schoeps Director of Long Term Care Purchasing, US Department of Veterans Affairs

i’m looking at care not from the viewpoint of what a healthy

23-year-old veteran coming out of the Army needs to improve his or her life, which would be housing, jobs, and education. My frame of reference is, what about the 23-year-old who did not come back whole, or what about that 23-year-old’s grandfather who is a veteran with dementia? That’s my world.

Much of the future depends on listening to clients, in this case, veterans, and allowing them to select to the maximum extent possible what services they want to meet their needs, instead of us telling them what and how much of it they need.

Participant direction in long-term care is key, and not only at Veterans Affairs; participant direction is embedded in the Affordable Care Act. The idea is that when you go to a person-centered, veteran-centered approach, it costs less money, which is also what we’re trying to accomplish with health care: do more, but cost less.

We are committed to a participant-directed approach for veterans needing long-term care. We’re introducing it in Veterans Affairs nursing homes, which are called community living centers.

On the home care side, we’ve introduced veteran-directed home and community-based services at 30 medical centers. We’re planning to go to 45 by the end of the year, and to have coverage in all states by 2014.

Sometimes it takes a professional or corporate epiphany to inspire this kind of change. That’s what happened here. What opened us up to think that we might want to try something different was the Washington Post series of articles about neglect at Walter Reed Hospital. Even though Walter Reed was part of the Army, not part of Veterans Affairs, it shook us to the core.

We were very fortunate in that we got to talking with the US Department of Health and Human Services’ Administration on Aging. They had a relationship with the National Resource Center for ParticipantDirected Services at the Boston College Graduate School of Social Work and introduced us to the center’s director, Professor Kevin Mahoney.

That relationship has breathed so much life into our program and our approach. You need university, think-tank kind of input in your conversation. We talk about all sorts of things and have some clever ideas still to come.

For example, there are technologies in home tele-health that can help monitor medical conditions so people don’t have to come to a clinic, or that can be made more accessible and easier to use. I see a lot of potential for veterans making their issues and concerns known directly through these networks, through social networking, and that will affect what we do.

When we offer veterans home care services, or adult-day health care, or home hospice care, or respite care, there’s very much a sense that this is the right thing to do, the right service at the right time.

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“Much of the future depends on listening to clients, in this case, veterans, and allowing them to select to the maximum extent possible what services they want to meet their needs.”

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EMPOWERMENT Kevin J. Mahoney Professor and Director of the National Resource Center for Participant-Directed Services

people with disabilities, elderly or not, need help get-

ting dressed, getting out of bed, going to the bathroom, and so on. Traditionally in the US, they would get their supports and services from agencies. They would have no say in who helps them with such personal tasks.

They would be at the mercy of the agency’s schedule and the rules that bind the agency.

Early forms of participant direction gave people with disabilities authority over hiring those who served them. The “Cash and Counseling” approach that we pioneered here at the GSSW goes much further. It puts people in charge of the budget equal to what an agency would have spent on their behalf. They can hire close family members, modify their homes and cars, buy assistive devices, and purchase a range of goods and services to be more independent. They develop a spending plan with a counselor, and the only litmus test for the plan is that it has to tie back to how you want to meet your personal assistance needs and stay independent in the community.

We first experimented with this approach on 6,700 people in Arkansas, Florida, and New Jersey. Half the participants were randomly assigned to traditional agencies, half to Cash and Counseling. The results were amazing. Those in Cash and Counseling had better access to care, were more satisfied with their care, and often had better health outcomes. They had fewer unmet needs, and the costs were similar to the traditional agency model. With these results, we continued expanding our projects and studying the outcomes.

Meanwhile, a great need was arising at the Veterans Administration in terms of arranging supports and services for returning Iraq and Afghanistan war veterans who had long-term care needs and were living in rural areas. The VA read the research results of Cash and Counseling. By the time they heard of it, we had replicated the demonstration in 12 states through the Medicaid program. The VA came to us and designed the Veteran-Directed Home and Community Based Services Program, which was patterned after the original Cash and Counseling demonstration projects.

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From the beginning, the program was intended for all veterans needing long-term care, not only veterans of current wars.

We help the VA to design the program and the processes and rules and policies, and to train their staff.

Then, we assess program readiness. The goal is to go from 40,000 to 109,362 veterans in home and community based services and in every VA medical center in three years.

We know from our pilots and research that the Cash and Counseling model, as an option, not a mandate, works very well for the kind of assistance and services that family members would provide for each other, that address long-term care in the community.

Now we are working with the Robert Wood Johnson Foundation on the feasibility of testing this on a large scale for people with serious mental health service and support needs and even for those with addiction problems.

Building off the success of the Cash and Counseling project and with major funding from the Robert Wood Johnson Foundation and the Atlantic Philanthropies, we established the National Resource Center for Participant-Directed Services at the GSSW in 2009. The center gives states and other organizations the tools they need to implement a wide variety of consumer-directed programs. Over the years, we also worked with federal agencies such as the Assistant Secretary for Planning and Evaluation. In July 2011, we received a major grant from the Administration on Aging to enhance homeand community-based service delivery.

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“It is a big change to go from professional decision-making to empowering the participants, which is truly at the heart of social work.”

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“There’s inspiration everywhere. The best way to teach social entrepreneurship is to help people see, to give them an example of what’s possible.”

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ENTREPRENEURSHIP Jack Connors Business Executive and Social Entrepreneur

to be effective, a social entrepreneur needs to ask, what is the scope of my work, how big a world do I

want to play in, and what is the nature of the social justice I am going to address?

Social entrepreneurship is an effective approach for addressing social inequalities because there’s nothing more powerful than an idea. Entrepreneurs can answer the question, how am I ever going to do this?

We live in a period where we’re reminded almost daily that everything is possible. But the mountain always looks a lot higher when you’re at the base of it. If someone says, I know a trail that might be a little easier than going straight up, it’s helpful to people. Nothing is overwhelming if you just take it a step at a time.

When I was a young man, I wanted to change the entire world. Now, as an older man, I’m just happy if I can make a couple of improvements in my community. And so, I think scope is important. If everyone were able to bring peace to one person’s life, then the world would be at peace. So, you don’t need volume.

You need quality.

The true artists, the truly creative people, are the ones who simplify things.

I played the role of a social entrepreneur when I got a call from the mayor of the City of Boston. He said, you’ve got to come down to my office. Kids are getting killed and I have to figure out what to do about it. So I went to his office, and he told me the story. Parents sometimes keep their kids in the house in the summer months because they’re afraid of stray bullets, etc. Their world is six blocks. I said, okay, give me 10 days.

I did some research, and decided to take Mayor Menino out to Long Island in Boston Harbor. We’re in the middle of nowhere, and the sea’s raging in November, and I said, you own this. If you lease it to me for 25 years for a dollar a year, I’ll build you a summer camp for boys and girls in the inner city. And I’ll raise $10 million. (By the way, instead of $10 million, we’ve raised $29 million so far.)

Last June, we opened the camp for the fifth season. There are 900 kids who go there. They get breakfast, lunch, and dinner. There’s no such thing as a bad kid. There’s been not one letter of graffiti, there’s never been a shooting, there’s never been a stabbing. They go and they have fun. And they’re all poor.

Our first kids are going to college and we’re giving every one of them a $10,000 scholarship towards their college.

We had a wonderful woman say to us, you know, you wrap your arms around these kids for a month and then you send them home. You have to do more. So now we have four social workers and two full-time interns who work with the families. We have a parent support group, we have holiday parties, we have tutoring sessions. There was a gala this summer to raise at least three and a half to four million dollars. All I’m doing with my life is reintroducing the haves to the have-nots. It’s a thrill. That’s social entrepreneurship.

What that takes is imagination. The real market is for imagination. There’s inspiration everywhere. The best way to teach social entrepreneurship is to help people see, to give them an example of what’s possible.

Take the example of water. There are water bubblers, there are jugs, there are little mini-bottles, there’s vitamin water, there’s water with pomegranate in it that is going to make everybody better. There’s all kinds of water, and someone’s out there trying to invent the next flavor of water.

But there’s a social entrepreneur who’s saying, well, for one thing, it costs twice as much water to make the bottle as what’s in it, and beyond that, what if instead of bringing bottled water, we drilled a well? I’m on the board of Partners in Health with Paul Farmer. You can drill a well for a few hundred bucks. If you want to sponsor a well, if you want to sponsor 10 wells, you can probably do it for $5,000 and bring fresh water to 20 villages.

What distinguishes Boston College is its ethic to make a difference in the world and to have you be a part of the solution. The great teaching of Ignatius was, let’s get out of these monasteries and abbeys and go to where the people are. There is true passion among the Jesuits to teach people to make a difference.

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ENTREPRENEURSHIP Marcie Pitt-Catsouphes Co-Director of the Social Innovation and Leadership Program and Collaborative Director, Sloan Center on Aging & Work the definitions of social innovation and social en-

trepreneurship continue to evolve. Here at the Graduate School of Social Work, we think of social innovation as transformative ideas that have a social impact at the micro or macro level. Social innovation seeks to address sticky problems, like homelessness, poverty, or food shortages, which may not have immediate solutions, as well as new and emerging social issues brought on by changing economic systems, globalization, population shifts, and so on. That is what social innovation, broadly speaking, does. The question then becomes, what are the approaches?

Social entrepreneurship is one approach that has grown out of strong business and management models on entrepreneurship and innovation. Social entrepreneurship takes that body of both academic and practice knowledge and applies it to social problems so that excellent practices can now have positive social impact.

We need to nurture, foster, and support individuals who have created innovative ideas, whether those ideas are focused on products or technology or services. Depending on the idea, there may need to be an entrepreneurship structure, that is, a new organization that must be created.

Social entrepreneurship can bring innovation, but social innovation is much broader than that.

In addition to entrepreneurship, there are other approaches that the School of Social Work feels it needs to promote. One is how we build the capacity in existing social service agencies to discover and implement innovative solutions. There tends to be a high failure rate with the entrepreneurial, experimental approach.

We want to support that approach, but for purposes of sustainability, we also want to support the capacity of existing organizations to be innovative.

While supporting innovation through entrepreneurial models and existing organizations, we also focus on what might be called intrapreneurship. Intra-

 

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preneurship is about being innovative with the inner workings of an organization: harnessing and unleashing the potential of people who come to work every day, creating jobs within organizations that engage people so they can feel dedicated and meaningful. What you have then is a synergy that gets sparked.

Through the GSSW’s Social Innovation and Leadership Program and Collaborative, students and faculty have engaged not only with social service agencies, but also with for-profit businesses to bring improvement and innovation to their organizations. As a range of social issues cross into workplaces, it is important that organizations, no matter what sector they are in, look to schools of social work to help them function and perform better and in a way that takes into consideration the well-being of their employees.

For organizations that want to be innovative, that want to be able to sustain their innovations and are focused on social justice issues, the place to go is the Boston College Graduate School of Social Work.

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“Social entrepreneurship takes the body of both academic and practice knowledge from business and management and applies it to social problems so that excellent practices can now have positive social impact.�

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“Leaner and meaner, more innovative, whether we like it or not, is the direction we have to head because it’s just the new normal now.”

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SOCIAL INNOVATION Tiziana Dearing Chief Executive Officer, Boston Rising

the most important question social innovators are asking today is, if what we’ve been doing for the past

50 years isn’t working, then where are the innovations coming from to break that cycle? What do we do instead? We’ve been working on generational poverty for 50 years and generational poverty is no better than it was. You have no better prospects of not being poor once you’re born poor than you did 50 years ago.

The two big innovations on the poverty question have to do with making place matter and valuing the individuals in their place. Placed-based initiatives—rather than taking approaches that lift families or children out of their place or support an escape strategy—say, no, the place and the context matter and the solutions need to happen with that place valued and as a piece of that context. We are changing our approach both in direct social work and across the poverty work spectrum towards valuing individual choice and control of the individuals and communities experiencing poverty. We are putting choice and control back in their hands.

When we finish executing this strategy, it will be radically different and a truly disruptive approach to how we think about doing the poverty fight from a funder’s perspective.

In social innovation, there’s also a set of questions around management and how you operate an organization. Can we use dashboards and scorecards, can we improve our metrics for impact as opposed to input metrics, can we think about how we’re spending our dollar, can we combine back office operations to lower the cost of traditional overhead? Social work-based organizations have been heavily state, city, and federal funded, and that money is gone and it’s not coming back in the scale that it used to be available. And so leaner and meaner, more innovative, whether we like it or not, is the direction we have to head because it’s just the new normal now.

Part of our problem is that traditional philanthropies have essentially been direct-service organizations that have been operating by subcontract. That does not devolve choice and control to the families and communities experiencing poverty. To change that requires a dramatic mind shift, where you are willing to take control out of your own hands and put it into the hands of those who want to chart their own paths and who are more than capable of doing so if we can just get out of their way.

We talk about having two value propositions when we discuss the work we are doing at Boston Rising.

1) Co-investing effectively. You take the corpus of money you have available to invest in grants and you co-design and co-administer that money with the families in the communities you’re seeking to serve. You also have to simultaneously care about and invest in people’s capacity for human agency, their access to capital, and their social connections.

2) Unleashing philanthropy. We are trying to add another zero to poverty giving. If there are a thousand dollars of poverty giving, we want ten thousand; if there are a million, we want ten million. We are going at that by integrating social networking platforms, online giving technologies, and peoples’ desire to express their values and who they are through their social networks. These approaches have democratized small scale philanthropy and have allowed people to evolve their own social networks to solve a particular problem or help a particular cause, as opposed to making a particular investment in a particular organization.

If you can build a marketplace where you can bring forward the causes and pair that with peoples’ desire to leverage their own interests and social networks, you can have real impact on a small, fast scale. The capability of building that marketplace exists now. It didn’t five years ago. So if you can catch the fire at the right time, you actually can unleash something that is possible today that wasn’t yesterday and for which there might be less interest tomorrow.

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SOCIAL INNOVATION Stephanie Berzin Co-Director of the Social Innovation and Leadership Program and Collaborative Chair, Children, Youth and Families Concentration in society today, where resources are so scarce and

problems are so complex, the solution to intractable social problems can’t be solely creating new programs and new structures but rather rethinking current processes and pushing ourselves to approach problems differently. Through our new Social Innovation and Leadership Program and Collaborative, we are defining social innovation broadly as a set of thoughts, structures, processes, and programs, all of which lead to an innovative and transformational response.

In developing our program, we asked, What are the top 10 issues facing our country and the world going forward? How do we think about social work at a time when globalization means our clients are not just from 10 different countries but are from 50 different countries and speak hundreds of languages? How do we integrate all of that diversity into new social work practice and models?

When society previously thought of juvenile justice as having to do with a criminal act or something punitive, for example, we had a certain set of solutions.

When we reframed it as a public health issue, all of a sudden that led to a very different set of solutions and dramatically shifted our way of responding.

Similarly, a lot of the issues these youths face, such as poverty, housing, and mentoring, have been dealt with separately. One comprehensive way to combine support for these youths is to partner with a college.

Such a program simultaneously tackles the issues of housing, educational attainment, and the likelihood of getting out of poverty with higher paying jobs. If you can put a supportive structure in place in the college setting, you can transform the lives of those youth without creating a new structure.

Social workers are dealing with deep intergenerational poverty problems in a range of populations that go far beyond social work of the past in the areas of mental health, child welfare, aging, and the like. So, we

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are filtering into all of our programs content related to poverty, diversity, and diverse client populations.

We’re introducing students to new skills they’ll need to be transformational leaders in the future. We’re teaching them to ask: How do I stimulate innovation and new ideas and how would I lead an organization designed to address complex problems?

We’ve devised a new training model that takes a fresh approach to courses and the integration of practice, field work, and research.

The model integrates field practice and classroom work, involves students in our social innovation lab, which partners with nonprofits and social service leaders, and places students in the field where innovation is taking place.

We describe what we’re doing as a social innovation triangle. At the top of the triangle are thoughts, ideas for action. If we rethink a problem, does that lead to a new set of solutions? The second part of the triangle is about process and structure. If we do our business through a different set of processes, can we create transformational change? The third part is about programs. This is the side people traditionally think of as innovative, where you come up with a new solution by creating a new program or service. But, if you get stuck there, you wind up continually creating new programs and services and not also asking how you can transform existing programs and services.

Our goal with this triangle is to create something that has social impact, works for social justice, and is scaleable and sustainable. Unless we can do all of that, we haven’t met our goal of social innovation.

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“This is not just about transforming organizations and our response to social problems but also about how to produce leaders who can both effect change and sustain it.”

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“AS PARTNERS OF LOCAL AND GLOBAL COMMUNITIES WE HAVE AN OBLIGATION TO DO NO HARM AND AN OPPORTUNITY TO STRENGTHEN THE CAPACITY OF PEOPLE AND SYSTEMS TO BECOME AGENTS OF CHANGE.” Joy-Anne Headley 2012 msw candidate, global practice concentration

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