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In The Trenches Of Social Work

March is Social Work Month. Today on the blog, a social worker explains why her work is so crucial to primary care. 
By Tiffany Brennaman, LCSW

“You’re a social worker? How noble and sweet!” I've been a social worker for nine years now and if I’ve learned anything, it’s that this field is about so much more than being noble, and it sure ain’t sweet. I started out working for a therapeutic foster care agency while completing my graduate degree. My first two years in the field, I wasn't thrown to the wolves; I was chopped up into pieces and placed in their food bowls. I responded to crises at 3 a.m. on multiple occasions. I sat in on session after session as therapists explained to children why they would never be able to return to their parents again. I spent a week at the bedside of a comatose teenage girl who'd attempted suicide. I spent six hours de-escalating a teenager in the woods. The evening of my 29th birthday, I slept on the floor beside a child who was on suicide watch. After those first two years, I was ready to quit. Not just foster care, but social work.
But I didn't quit. I went into homeless services and I am currently a social worker for the homeless services program at the Atlanta Veteran’s Administration.
Social workers are becoming increasingly essential to interprofessional teams. While doctors, nurses, psychiatrists, and other health professionals might not always be able to focus a substantial amount of time on building relationships, social workers can be seen as the relationship experts who can communicate most frequently and effectively with clients and their families. During a crisis, a social worker is often called upon to intervene. Most importantly, social workers serve as tremendous advocates for clients. We believe that everyone deserves fair, just treatment, and that social justice does not discriminate.
Prior to my current position, I spent several years working for an organization called Back on My Feet (BoMF). BoMF uses running (yes, running) to help individuals change the way they see themselves so that they can make real change in their lives. This job gave me the opportunity to seek out the good in people, help them see the good in themselves, and use it to propel their lives in a positive direction that could not only benefit them but others as well. 
What made me so beneficial to BoMF? Social workers are acutely aware of the many circumstances that often surround an individual's life choices. We use a biopsychosocial model to look at the person in their environment and examine all the potential contributing factors that led to their lot in life. Using this model, it is easier to decipher not only root causes but also external circumstances that can lead a person to make destructive decisions habitually.
The reduction of recidivism is oftentimes a social worker's primary goal, especially in the field of homeless services. Recidivism can be associated with criminal offenses, but it can also refer to repeated relapses into substance use, hospitalizations, and episodes of homelessness. Reduction of recidivism is of course tremendously beneficial to the client, but the impact on society and the economy is where the long-term change can be felt. Multiple hospitalizations for repeated relapses cost a lot more than keeping someone housed and providing intensive case management. Social workers are typically working the front lines, implementing all possible resources and interventions to reduce the frequency of self-destructive behaviors in a client.
Often, it is these barriers that must be overcome before individuals can even begin to benefit from good primary care, regardless of how much they may need that care. Falling in and out of homelessness, substance abuse, and crime are certainly barriers to medication adherence, self-care, preventive care, and management of chronic disease.. That’s the benefit of having a social worker on a primary care team.
Social work puts clients first. By clients, I don't always mean those who pay for services. I mean those who need help. Our code of ethics will not allow us to discriminate against anyone. We help our clients learn how to take a different road and avoid falling into the same hole over and over. And by ensuring their continued stability, the rest of the primary care team’s work is that much more effective.

Tiffany Brennaman, LCSW, is a social worker for the HUD-VASH program at the Atlanta Veterans Administration. She is also a self-help junkie who enjoys running, hiking, yoga, and trying foods from all over the world.

Posted by Sonya Collins on Mar 23, 2017 3:04 PM America/New_York
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