Work of Service

A Conversation with Lana MacLean

INTERVIEW BY SHALYSE SANGSTER, MSW, RSW

Ed. note: this interview has been edited for length and readability.

SHALYSE SANGSTER: How did you get started as a social worker? What influenced this career path?

LANA MACLEAN: I grew up in a faith practice. Social justice and equity have always been a part of my faith journey. Since I was a kid, I’ve been raised to do “God’s work,” in terms of volunteering in marginalized communities.

I pursued a BA in community studies at CBU to understand community resiliencies, building community capacity and supporting marginalized communities. Afrocentricity became popular and people began looking at issues from an antioppressive and anti-Black racism perspective. Being a Black woman, I was passionate to work in African Nova Scotian communities and with women’s issues in employment and intimate partner violence.

I then went to Dal for my BSW. I learned from white women who were allies and feminists about advocacy and social justice work.

When doing my MSW, I gained experience working with Black youth in a community setting and white youth in a healthcare setting. I noticed the impacts of racialized trauma and questioned how those social cultural influences impacted decisions. I didn’t see Black youth accessing the healthcare supports, even though I saw them struggle in the community.

I questioned: why aren’t they accessing the traditional mental health and addictions programs? I wondered: how can we, from an Afrocentric perspective, care for Black youth around substance use?

This gave me an opportunity to compare and contrast difficulties between access points and clinical treatment modalities. What I was being taught didn’t work for both groups of youth. I had to identify a cultural lens; some treatments were helpful for white youth but not transferrable to Black youth. This challenged me clinically to derive different ways of knowledge translation that was culturally relevant.

S: What motivated your transition into private practice?

L: I decided to open a private practice because there were not many Black clinicians at the time. I had great mentors and allies who provided supervision and support. My experiences drove my interest in continuing to work with racialized youth, women and families. I realized that you cannot work with youth unless you have the capacity and desire to work with families. I also realized how people define families can be very specific to their lived experiences. Within the African Nova Scotian communities, family doesn’t always mean biologically related.

S: Has your work in private practice exposed you to any new awareness of the gaps in services delivered to African Nova Scotian communities?

L: Not just access to services, but timely access to quality clinicians who have a practice of cultural humility and cultural competency.

There aren’t many Black private practice social workers. Most of us are working two or more jobs, and do private practice part time. This is largely due to the legacy of racism in employment and poverty; we have to maintain a full time job and provide clinical service to our communities part time. Thus, access to us in private practice is limited.

Clients should have the ability to say: I want to see someone who looks like me, walks like me, understands me, and I don’t have to attend to their ambivalence to issues of race, or have to help the clinician navigate if they aren’t comfortable asking, “how does being Black impact your life,” or “how does racism impact your life.” Our current assessment and intake tools don’t ask those important questions. Therefore, they don’t present as a safe place for African communities to enter when, from the minute you walk in the door, no one asks the questions or even acknowledges in the room that race matters. It’s important for clinicians to be able to speak to that. Another issue is that most practitioners work in the health authority. When you work within a system, you can’t always vest interest in the African Nova Scotian community in the way that is using the best practice model for those particular needs. The best practice models, or the best practice, doesn’t always reflect the best interest of the African Nova Scotian community. The healthcare system can actually marginalize racialized people because they haven’t yet developed a strong cultural competency clinically to meet the best interest of racialized communities. Although we have a free healthcare system, we have access and cultural competency issues.

S: In your opinion, how do we close the gaps?

L: In order to be responsive to the needs of community, there has to be some capacity-building within the social work school that allows for academic learning to address how we work with marginalized communities. Without offering professional development, they are not being responsive to filling in a gap of service delivery, and communities will suffer. We all have an accountability to acknowledge how and what we’re doing to support access to care for the African Nova Scotian community.

White social workers have the responsibility of learning the skillset and being equipped to work with diverse communities. Articulating what’s been happening, giving it language and context in the community to talk about racialized trauma, impacts of systemic racism, mental health and wellness. The conventional models, even the DSM, have asked us to ensure we are taking a cultural formulation, and take culture into consideration when doing the work that we do. Otherwise we are being negligent as a clinician.

Lana MacLean accepting an award at a past NSCSW conference

S: How else could we respond to the needs of African Nova Scotian communities more effectively?

L: I encourage other Black social workers to give some consideration to open a private practice, enhance clinical skills, and participate in professional development. I take on learners through preceptor roles, mentor other Black clinicians, and hire associates at my practice. I often question the legacy I’m leaving in the community through the work that I’m doing. This includes my own personal accountability of: what seed did I plant so someone else can have a stepping point. We need to share the knowledge.

Having a critical race analysis around issues of mental health and addictions, and being willing to ask tough questions of yourself and others. Having difficult conversations with clinicians both Black and white; just because you’re Black doesn’t mean you have a good critical race analysis on those issues. It’s also about understanding complexities of racism, and its interplay on race and class.

As a member of the African Nova Scotian community, I’m not even sure how many Black private practitioners are out there. I would think less than 10. It would be helpful to have a resource list of Black practicing clinicians who can help bridge access, so when people ask “who are the Black therapists in the city who work with BIPOC people?” we can say, “oh, I know this person!” We in private practice and of African descent should pull together with the College to create a committee in which we do our own clinical supervision, to discuss our specific needs. I would encourage all mentors to get together to discuss what is important, and ensure core competencies are addressed.

Organizations aren’t always safe places for Black people to work. There’s the balance that you want to do the work but you are the only Black clinician in the building. There’s racial aggressions, anti-Black racism and macroaggressions that you’re exposed to even within the organization that we work in.

Black clinicians are able to help give mental health literacy in a way that makes sense to the African Nova Scotian community, to validate what’s really happening in their lives. The way we ask questions, through cultural literacy or cultural framing, can give people culturally responsive ways to understanding how mental health impacts their lives. To say from a CBT perspective to avoid your thoughts? Well, Black people can’t avoid racism, and when it happens to us it can be enraging. So, normalizing some of the behavioural responses instead of mitigating or ignoring it. Doing psychoeducation in the community is one thing that is really valuable: workshops with youth and seniors; dementia and elder care; shame/blame in the community, what it looks like and operationalizes; how to work with people who have been emotionally/sexually traumatized by immediate family members, considering that family is such a high core value in our community; how do you “take the business out of the home” when that is actually doing more harm than good; how to break silences, etc. The clinical work is liberating work.

S: How do we become more accessible and inclusive?

L: Something I’ve always done in private practice is offering pro bono support. Volunteerism in my community is my ethical responsibility. Supporting and writing grants, and advocating for culturally specific service delivery. This alone might not fill the gap, but it helps our community to learn to navigate the different pathways to our care and how to trust those pathways – which is a new way forward.

I also complete cultural assessments and reports which are used as a tool for building better advocacy and insight for the criminal court and child welfare systems. These reports are used to adequately reflect the social, cultural and gendered identity of the client. This provides a great amount of cultural insight and also helps the client understand their own behaviours and the impacts of racism and culture on their lives.

S: What supports have you had throughout your journey in private practice? As a Black social worker, do you feel well supported?

L: Being able to find the clinical support that I need – if you want to be a good clinician, be with people who are smarter than you. Find a clinical supervision group. We meet monthly, since 1997. They’re smarter than me. People I can learn from, can share knowledge with from a clinical social work lens, have clinical critical discourse, discuss case reviews, larger systemic issues, system opportunities and impacts that disrupt good client care. Discuss how we support people and ourselves through vicarious trauma. We are a psychosocial support to each other. This mentorship, along with ABSW and HAAC, has been instrumental in my career.

S: Any final points?

L: Black clinicians can be creative in figuring out the journeys we need to take to do the work we want to do, that is enriching and best supports the African Nova Scotian community. My initial upbringing in the faith practice is: the work we do is work of service. And that trickles into the work I do in my everyday practice as a healthcare social worker working within the healthcare system.

The piece of humility in social work practice is that we actually are doing work of service. When you recognize that you are a vessel or an instrument for change, for potential. Just to be present with someone during difficult times, to be able to hear a narrative without judgment. That in itself is service, humility, empathy.

SHALYSE SANGSTER is a social worker based in Halifax, Nova Scotia. She graduated from the Masters of Social Work program at the University of Toronto in 2017. She is a member of the Association of Black Social Workers, and has a keen interest in promoting social justice and advocating against Anti-Black Racism.

LANA MACLEAN is a Halifax-based social work clinician who works with individuals, youth and families, and within/ for African Nova Scotian communities. She received the Ron Stratford Memorial Award from NSCSW in 2018, recognizing her commitment, creativity, and leadership in her practice, advocacy and social action.

CONSIDERING PRIVATE PRACTICE?

There are 17 Private Practitioners registered with our College who have self identified as African Nova Scotian. Only three of these social workers are based outside the capital region.

If you are a Black social worker interested in exploring private practice, please visit our website for more information about the registration process, or get in touch with the College.

nscsw.org/private-practice/become-private-practitioner