Letter from the ChairSURVIVING OR THRIVING IN TODAY’S COMPETITIVE PRACTICE ENVIRONMENT: ETHICS, INNOVATION, AND PERSONAL CHOICES

Whether you are a newly minted licensed clinical social worker or a seasonedsocial work psychotherapist with decades of wisdom to impart, you may findyourself considering alterations to your practice approach in order to garnermore interest from prospective clients. Should you sign up as a managed carepanel provider? Identify yourself as an expert in working with a specialty population, such as addictions oreating disorders? Advertise in Social Work Today, Psychology Today or some other periodical intended forthe general public? Create a professional website? Consider joining a group practice or professional network?Take advanced training in an area of specialization, such as coaching, which is described in this issue?

Answering these questions may seem simple and straightforward, yet each is potentially fraught with ethicalconcerns and decisions around the level of comfort in describing one’s professional identity. For example,consider the decision to identify yourself as an expert in a particular area. If you’ve treated several clientswith addiction problems but do not have certification as an alcohol and substance abuse counselor, is itappropriate to list it as an area of specialization on your website or provider profile, and/or to actively seek these referrals from colleagues? The choice may be governed by high ethical principles, a qualifiedprofessional description, and practical concerns, such as the size of one’s practice or, more likely, acombination of these and other factors.

Personal financial pressures coupled with the need to hone one’s professional identity in today’s competitiveprivate practice environment can potentially compromise one’s judgment in making such decisions. Eachsocial work clinician gauges his or her multiple needs, aspirations, and self-perceptions, and makes a choiceconsistent with his or her level of comfort, ethical standards, and primary practice approach. Maintainingtheoretical and practice approach purity may give way to pragmatic concerns and the need to be perceivedas flexible and knowledgeable about current therapeutic trends. It is essential to consider each newapproach. There are many innovative methods, especially for trauma— such as mindfulness, somatic-basedtherapies, and cognitive processing, among others. It is essential to consider each new approach, and takeinto account whether these approaches are consistent with or contradictory to your method of practice. Thedecisions you make about these approaches are both personal and professional

Carol Tosone, PhD, LCSWAssociate Professor, New York University Silver School of Social WorkChair, NASW Private Practice Section Committee

SPRING/SUMMER � 2016

SECTIONCONNECTION

NASW Practice & ProfessionalDevelopment BlogWhere can you find the latestinformation posting about socialwork practice? Visit the NASWPractice and ProfessionalDevelopment Blog. Designed forNASW Section members and socialworkers in practice, it offers trendingtopics, valuable resources, andprofessional developmentopportunities. Learn more atwww.socialworkblog.org/practice-and-professional-development/.

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PPP R I V A T E P R A C T I C E

Coaching isnow the “in”buzzword—everyonewants to be

“coached. But family historyare not always presented, andthere is less time invested thanthere is in actual counseling orpsychotherapy. Clients oftendon’t see a coach with thesame regularity, nor does thecoach usually go into familydynamics or look into systemicthinking. Nevertheless, I believecoaching does have a placeand can be very valuable to the

client; however, it must not beconfused with in-depthpsychotherapy. So, how dosocial workers use coaching intheir practices—or do they?Does it make sense to add it toour repertoire of skills? Let’s firstlook at how coaching is defined.

According to the CoachingReally Works website, coachingis the practice of supporting anindividual, referred to as acoachee or client, through theprocess of achieving a specificpersonal or professional result.Furthermore, we are told that

the structure and methodologiesof coaching are numerous butare predominantly facilitative instyle; that is, the coach mainlyasks questions and challengesthe coachee. (www.coachingreallyworks.com/tellafriend/what-is-coaching/)

There are a variety ofapproaches within the coachingmethodology. Coaching isperformed with individuals andgroups, in person, over thephone, and online. Some of themany different types of coachinginclude: life, Attention Deficit

Hyperactivity Disorder, (ADHD),business, executive, expat andglobal executive, career,financial, personal, health,sports, dating, and conflict. Itshould be noted that each ofthese works on one singleproblem or issue that thecoachee or client has self-identified. The coach isexpected to stay on topic andwork with the individual only onthe issue that has been discussed.

Coaching has definitely burston the scene as an innovativeway for persons to find

IT’S A FACT: In infancy, a child’s beliefs about self his or her primary caregivers.

Carol Tosone, PhD, ChairMaria Baratta, PhD, LCSW Patricia Gleason-Wynn, PhD, LCSW, CSWGSonyia Richardson, MSW, LCSWAlice Stremel, LCSW, ACSW

Private PracticeCommitteeMembers

NASW PRESIDENTDarrell Wheeler, PhD, MPH, ACSW

CHIEF EXECUTIVE OFFICERAngelo McClain, PhD, LICSW

NASW STAFFDirector, Professional andWorkforce DevelopmentRaffaele Vitelli, CAE

Specialty Practice Section ManagerYvette Mulkey, MS

Project CoordinatorRochelle Wilder

COACHING – A NEW PARADIGMFOR SOCIAL WORK or JustAnother Word for Counseling?HOWARD LEIFMAN, PHD, MSW

and others are taking form through the attachment process with

personal or professionaldevelopment. Coach andpsychotherapist, Dr. EdwardDreyfus, lets us know that aspeople seek to achieve greaterfulfillment from their work, theirmarriages, and their life ingeneral, the need for coacheswill continue to increase. Hefurther explains on his website(www.docdreyfus.com/coachingandpsycho.htm) that previously,many people soughtpsychotherapy for personalgrowth, not just for treatment ofemotional problems or mentalillness. However, now peoplewant other forms of assistancewithout the association tomental illness carried bypsychotherapy. As a resultsome people turn to personalcoaches whose focus is onenriching all areas of one’s life,rather than on internal stressand emotional conflict.

It is helpful to understand thatboth coaching and therapyhave the same roots. Modern

psychotherapy is the result ofover a hundred years of researchand contributions by some ofthe greatest minds in history.For example, Alfred Adler andCarl Jung saw individuals asthe creators and artists of theirlives, and frequently involvedtheir clients in goal setting, lifeplanning, and inventing theirfutures—all tenets in today’scoaching practices.

In the mid-20th century, CarlRogers wrote his monumentalbook, Client Centered Therapy,which shifted counseling andtherapy to a relationship inwhich the client was assumedto have the ability to changeand grow. This shift inperspective was a significantprecursor to the field ofcoaching. Coaching was birthedas a result of great advances inpsychotherapy and counseling,and then blended with consultingpractices, and organizationaland personal developmenttraining trends (such as Erhard

Seminars Training, (EST), LifeSpring, Landmark Forum, andTony Robbins). Coaching takesthe best each of these areas hasto offer and provides a nowstandardized, proven methodfor partnering with people for success.

While therapy and coachingmay share a commonbackground, their differencesare vast. Therapy is vital forthose presenting psychologicalproblems—what we call“pathology.” Coaching is forthose who are healthy andtypically self-motivated. Bothfields have their place andshould not be confused. Foradvanced therapy patients,coaching can be an additionalbenefit, but coaching assumesthe healing and well-being of itsclients as a given. A therapistmay add coaching skills to hisor her practice, but a coachnever engages in therapy. Acoach is trained to detect anyneed for therapy and there areguidelines for when to refer acoaching client to a therapist.

This list of differences could beextended indefinitely, but thepoints above provide a basicsummation. Essentially, atherapist is the professional withthe answers to pain andbrokenness; a coach is apartner to assist in discoveryand establishes a design forgrowth. The shift from seeingclients as “ill” or havingpathology, toward viewingthem as “well and whole” andseeking a richer life isparamount to understandingthe evolution of coaching.

Though coaching is NOTpsychotherapy or counselingand must not be confused assuch. With more and more,corporations and not- for- profits

hiring coaches to coach fortheir employees, the time is nowfor social workers to considercoaching. Organizations arelooking for coaches to transformtheir people to be betterperformers, better leaders, andbetter team players. These areall things social workers aretrained to do but might not havethought about in this context. Soyes, coaching could be a newparadigm for social workersjust as long as it is not thought ofas another word for counseling.

Howard Leifman, PhD, MSW, is aninternationally recognized expert inthe area of human development. He works with corporate clients,consulting firms, not-for-profits, andindividuals. His areas of specialtyinclude: psychodynamic psychotherapy,career development, executivecoaching, change management,counseling, human resources, out-placement, training, recruiting, andstaffing and time management. He isalso an adjunct professor at New YorkUniversity and LIM College. Dr. Leifmanhas a bachelor’s degree and a master’sdegree in communications management,both from Syracuse University, and an MSW and PhD from New YorkUniversity.

RESOURCESMaslow, A. (1962). Toward a

psychology of being.

Rogers, C. (1951). Clientcentered therapy.

The following table lists some fundamental differences betweencoaching and therapy.

THERAPY COACHING

Deals with identifiable dysfunctions Deals with a healthy client desiring a better

in a person situation

Deals mostly with a person’s past Deals mostly with a person’s present and seeks to

and trauma, and seeks healing help him or her design a more desirable future

Helps patients resolve old pain Helps clients learn new skills and tools to build a

more satisfying and successful future

Doctor-patient relationship Co-creative equal partnership

(Therapist has the answers) (Coach helps the client discover own answers)

Assumes emotions are a symptom Assumes emotions are natural and normalizes them

of something wrong

Therapist diagnoses, and then Coach stands with the client and helps him or her

providesprofessional expertise identify the challenges, then partners to turn

and guidelines to provide a path challenges into victories, holding the client

to healing accountable to reach desired goals

Progress is often slow and painful Growth and progress are rapid and usually enjoyable

Terrorism is perpetuallyin the news; its constantpresence seems to be thenew normal. When the

November 13, 2015, terroristattacks in Paris happened itseemed to have conjured thememory of September 11 andreawakened residual symptomsof posttraumatic stress disorder(PTSD—or at least that’s what Ihave noticed among mypatients. It is of concern to meas a clinician, and I wonder ifthis reawakened PTSD issomething that will emergemore frequently going forward.

Following the September 11,2001, terrorist attacks, I treatedthe PTSD that accompanied theevent and that continued foryears afterward. I included inmy intake with new patients thequestion of whether September11 had affected them—not somuch if but, more often thannot, how severely. Coupledwith the events of recentmonths, September 11memories and residual PTSDhave been the focus of anincreasing number of sessions.

I was in my office onSeptember 11, 2001, afterhaving driven right past theWorld Trade Center on mymorning commute fromManhattan to my Brooklynoffice. Within minutes of myhaving passed the towers onthe West Side Highway, the firstplane hit. I had been listeningto music on that perfect blue-skymorning, oblivious to what hadjust occurred. I learned about itwhen I went into a store andoverheard someone talkingabout a plane crashing into thetower. I had just passed there,I remember thinking. But thatwas the calm before the stormof what transpired in my office.When I got in, my phone wasringing and did not stop ringingfor the longest time. Several ofmy patients worked in theFinancial District and called meas their first contact after thehorrifying events. All access toManhattan was closed—allbridges and tunnels andtrains—so I was forced toremain in my office. Mypatients who had contacted meknew that they were welcomein my office and several of them

utilized it as a safe haven asthey found their way back totheir home borough ofBrooklyn. Covered in thatinfamous black soot from thecollapse of the first tower, theyarrived in shock and unable tocomprehend the impact of whathad occurred.

In years following, as I treatedthe PTSD that accompanied theevent, I found that there was aconsistent pattern of avoidantbehavior, such as avoidingbridges and tunnels and findingalternate routes to work,avoiding elevators, andavoiding Manhattan altogether.I remember attending aChristmas tree lighting eventlater that year and when anairplane passed overhead onthat beautiful December night,all heads turned upward,hyperaware of the airplane—something that would havebeen ordinary and certainly notnoteworthy in otherwise usualtimes. This awareness occurredfor a few years followingSeptember 11 but seemed tohave lessened as years passed.

Fast-forward to the November13, 2015, terrorist attacks inParis: Several patients voicedtheir concerns aboutexperiencing the symptoms

associated with the originalterrorist event of September 11.The reemergence of PTSDsymptoms included theinvoluntary recurrent andintrusive memories of the event and the psychologicaldistress that included avoidantbehavior and alterations inmood (American PsychiatricAssociation, 2013).Unfortunately, it appears thatterrorism is on the radar onceagain with the Belgium attack.

In a New York Times article,“10 Years and a DiagnosisLater, 9/11 Demons HauntThousands,” it was noted that10,000 firefighters reportedlysuffered from PTSD as a resultof the terrorist event and manyof them had still not recovered.In that same article, CharlesFigley, professor of disastermental health at TulaneUniversity’s School of SocialWork and an expert in PTSD,explained that September 11trauma was “so hard to shake”because it occurred not faraway, but at home withconstant visual reminders(Harocoli, 2011).

In response to the September11 attacks, I participated inseveral trainings specificallyaimed at treating the PTSD

TERRORISMin the ConsultationRoomMARIA BARATTA, PHD, LCSW,ACSW, BCD

associated with that event.There was not a “one-size-fits-all” treatment approach, andwe were cautioned thatrevisiting the event might re-traumatize the patient. And that’s what we facetoday—the fact that for manyPTSD sufferers the eveningnews broadcast or dailynewspaper headlines are allthey need to reawaken theterror of having survivedSeptember 11 more than adecade and a half ago. I wouldimagine that this is true forpatients as well as for clinicians.

PTSD might be described as aswitch that is turned on,triggering a hyperawarenessto things that might remindsufferers of the originaltraumatic event. We, asclinicians, need to be mindful of that possibility, because our patients need us tounderstand them.

Maria Baratta, PhD, LCSW, ACSW,BCD, is a licensed clinical socialworker in private practice in NewYork City. She is the author of SkinnyRevisited: Rethinking AnorexiaNervosa and Its Treatment, publishedby NASW Press. In addition, she

is one of Psychology Today’s“experts” and a regular contributorand blogger forPsychologyToday.com.

REFERENCESAmerican PsychiatricAssociation. (2013).Diagnostic and statisticalmanual of mental disorders(5th ed.). Arlington, VA:American PsychiatricPublishing.

Harocolis, A. (2011, August 9).10 years and a diagnosislater, 9/11 demons hauntthousands. New York Times.[Online]. Retrieved fromwww.nytimes.com/2011/08/10/nyregion/post-traumatic-stress-disorder-from-911still-haunts.html

2016 INTERSECTIONS IN PRACTICE Call for Articles Intersections in Practice, the annual bulletin of the National Association of Social Workers (NASW) Specialty Practice Sections(SPS) will be accepting submissions for the 2016 publication, The Role of Social Work in Promoting Social Change until August 1,2016. Submissions should focus on how social work and social work practice can be used for social change.

Article submissions should follow the author guidelines set forth for the Specialty Practice Sections. Articles should contain timely,practice related content applicable to one of the following Sections: Administration/Supervision; Aging; Alcohol, Tobacco and OtherDrugs (ATOD); Children, Adolescents, and Young Adults (CAYA); Child Welfare; Health; Mental Health; Private Practice; SchoolSocial Work; Social and Economic Justice and Peace (SEJP); Social Work and the Courts.

Visit www.socialworkers.org/sections for Author Guideline details.

Topics may include, but are not limitedto:

• Criminal justice and classism

• Racial disproportionality in childwelfare

• Healthcare and access to healthservices

• Immigration and discrimination

• Islamophobia and religious freedoms

• Racial and ethnic disparities

• School- to-prison pipeline

• School Shootings and PTSD

• Environmental justice

• Aging Workforce Challenges

• Healthcare and Baby Boomers

• Marijuana legalization

• Child abuse and neglect fatalities

• Intimate partner violence interventionand prevention

FREE PRIVATE PRACTICE CONSULTATION

Have questions about your private practice? Take advantage of a free 15 minute private practice consultationduring NASW’s National Conference, June 22 – 25, 2016 at the Marriott-Wardman Hotel in Washington, DC. Thisparticular program is only available to NASW 2016 National Conference attendees. It is first come and first servefor registrants. Spots will fill up quickly you may email your name to naswconference@naswdc.org (please putprivate practice consultation in the subject line) or register for consultation at the conference registration desk.

For more details on the 2016 NASW National Conference Leading Change | Transforming Lives visitNASWConference.org.

750 FIRST STREET NE, SUITE 800WASHINGTON, DC 20002-4241

For more information, visitSocialWorkers.org/Sections

Did You Know?Over 20 percent of children and

adolescents in the United States

have experienced a severe

mental illness.

Call for Social Work Practitioner Submissions

NASW invites current social work practitioners to submit brief articles for our specialty practice publications. Topics must be relevant to one or more of the following specialized areas:

For submission details and author guidelines, go toSocialWorkers.org/Sections. If you need more information, email sections@naswdc.org.

• Administration/Supervision• Aging• Alcohol, Tobacco, and

Other Drugs• Child Welfare• Children, Adolescents,

and Young Adults

• Health• Mental Health• Private Practice• School Social Work• Social and Economic

Justice & Peace• Social Work and the Courts