Three Silos and a Skyway: The Interprofessional Center for Counseling and Legal Services at the University of St. Thomas

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1 Three Silos and a Skyway: The Interprofessional Center for Counseling and Legal Services at the University of St. Thomas George Baboila, MSW, LICSW Patricia Stankovitch, Psy.D, LP Virgil Wiebe, JD, LLM

3 Disclosure Information 3 Silos and a Skyway Disclosure of Relevant Financial Relationships We have no financial relationships to disclose. Disclosure of Off-Label and/or investigative Uses We did not discuss off label use and/or investigational use in our presentation

4 How did the Interprofessional Center come to be?

5 In the beginning... Conversations between School of Professional Psychology and School of Social Work The School of Law (re)opens The Interprofessional Center is born!

6 Original Goals Practical skills Interdisciplinary study Serving the underserved Seeking social justice

7 Our Mission The IPC advances social justice through service and advocacy with underserved individuals and communities through transformative educational experiences for our students.

8 Grounded in their own professional standards Directors rejected the conclusion that one discipline s professional requirements could be subsumed under another s Social workers on a legal case are governed by social work professional obligations, not legal professional obligations, e.g.

subsumed under another s Social workers on a legal case are governed by

9 Grounded in their own professional standards (cont.) Had to address issues of confidentiality, mandated reporting, duty to warn, in collaborative service Mindfulness, disclosure and consent, communication

mandated reporting, duty to warn, in collaborative

10 Independent and collaborative Need to provide full professional experience for all students from all disciplines Experience in both interdisciplinary and non-interdisciplinary work Protect and respect equal status of each discipline within the Center

Experience in both interdisciplinary and non-interdisciplinary

11 Social Work Case Management Independent & Collaborative Client Service Practice Groups Bankruptcy Elder Immigration Professional Testimony Consultations Therapeutic Services Testing Psychology Law

12 Different kinds of cases Independent: law only, psychology only, social work only Consultation with another discipline Refer for unrelated services Refer for integrated services to support work of home discipline Full collaboration

another discipline Refer for unrelated services Refer for

13 Benefits of Interprofessional Collaboration Enhanced student learning Enhanced client service Professional growth for all

14 Starts with Orientation: Integration of Mission and personal identity Clients in crisis Unpacking our professional assumptions

15 Unpacking Our Professional Assumptions: or Boy, Those Lawyers/ Social Workers/ Psychologists Can Be Jerks!

16 Laura the Lawyer Says: Well, Mrs. Jones has a lot of non-legal issues that you can help her with Stan. For instance she needs Stan the SW hears: I expect you to fix this client s whole life, so that I don t have to be bothered. I ll just do the interesting, important legal stuff. I m in charge and you work for me.

For instance she needs Stan the SW hears: I expect you to fix this client s

17 Laura the Lawyer hears: I don t want to work that hard. I ll just pick the easiest problem for me, and forget the rest. Stan the SW says: I have a lot of experience with housing issues but I don t think I can budget for her.

18 Laura the Lawyer hears: I m not a very good psychologist, and you re just going to have to live with my limited skills. Paula the Psychologist says: The Rorschach is a specialized tool that I m not trained to administer or interpret.

19 Goals at Orientation, and beyond: Role clarification Team Functioning Collaboration Communication Conflict Resolution Develop a set of principles for working together that respects the ethical values of members

Conflict Resolution Develop a set of principles for

20 Counseling and Law have different disclosure rules Psych or Social Work Law Office Mandated reporting Permissive reporting

21 L SW P Cones of Silence

22 L SW P Overlapping Cones?

23 Classes that Help us Work Effectively Interprofessionally Interprofessional Ethics Clicker Exercise Small Group Case Study Exercise

24 When does a lawyer first begin to owe duties of confidentiality to a person seeking legal services? (choose one) 1. As soon as the lawyer receives any information from a person who needs legal help 2. Once the person seeking legal services reasonably assumes that the lawyer represents him/her 3. Once the person seeking legal services gives the lawyer information in order to possibly become a client 4. Once the retainer reflecting the agreement to provide legal representation has been signed by the lawyer and the client

25 When does a social worker/psychologist first begin to owe duties of confidentiality to a person seeking mental health services? (Choose One) 1. At the second therapy session 2. When the individual calls to make the appointment 3. Once informed consent has been obtained 4. Never

26 When must a lawyer give a third party confidential information about a client without a client s consent? (mark all that apply) 1. When the lawyer reasonably believes that the client has committed a crime involving serious bodily harm or death 2. When the lawyer reasonably believes that the client will commit a crime unless the lawyer discloses 3. When the lawyer reasonably believes the client has lied to a court 4. When the lawyer reasonably believes that the client is not capable of making his/her own decisions and that disclosure is necessary to protect the client 5. When the lawyer reasonably believes that the client is sure to kill or seriously injure someone unless the lawyer discloses

27 When must a psychologist/social worker give a third party confidential information about a client without a client s consent? (mark all that apply) 1. If there is a clear and imminent danger that the client may harm him/herself or others 2. If there is suspected or confirmed abuse or neglect of a child or a vulnerable adult 3. If the provider is concerned that the client may hurt someone 4. If the client reports or describes sexual exploitation by a previous therapist 5. If the client is pregnant and abusing marijuana. 6. If the client is a sexual offender whom the provider reasonably believes will likely abuse others in the future

28 Classes that Help us Work Effectively Interprofessionally Secondary Trauma Didactic Small Group Discussion Psychological Assessment Didactic Large/Small Group Discussion

29 Classes that Help us Work Effectively Interprofessionally Professional & Expert Witness Role Plays Therapeutic Jurisprudence Working with Differently-abled

30 Classes that Help us Work Effectively Interprofessionally Dialectical Behavior Therapy DBT Skills Individual Therapy Weekly Consultation Team Meetings Couples & Family Therapy Consultation - Weekly treatment team meeting SW & Psych

31 Classes that Help us Work Effectively Interprofessionally Grand Rounds 4 per semester Psychology Social Work Law Interprofessional

32 Consultations Across Professions Examples: Ambiguous Loss Trial Preparation Referral Questions for Psychological Testing

33 Evaluating Interprofessional Collaboration Consideration of Multidisciplinary Options Did the student look for opportunities to meet the clients needs holistically by involving other disciplines in the representation or by referring clients for other services? Role Definition and Maintenance Was the student aware of the professional roles played by different service providers? Did the student maintain and re-clarify his or her own professional role when necessary? Was the student sensitive to ethical issues arising for other professionals or due to the interprofessional nature of the representation? Interprofessional Respect Did the student work effectively with colleagues from other disciplines? Did the student give appropriate deference to the expertise and responsibilities of other professionals?

34 Under each skill area, please select the number that you think best reflects your performance on each skill, using the scale provided... 1 = routinely exceeded the standard expected (exceptional performance - can perform the skill, task or transaction in an outstanding manner) 2 = always met and often exceeded the expected standard (better than average performance - can perform the skill, task or transaction adequately without further training) 3 = generally met, sometimes exceeded, and occasionally failed to meet the expected standard (average performance - can perform the skill, task or transaction adequately with moderate supervision) 4 = often failed to meet the expected standard (unacceptable performance - may be familiar with the skill, task or transaction, but may not able to perform it without close supervision)

35 Law student response I have worked with Meg [doctoral psychology intern] on Luann s referral question, and have provided Psych with legal standards for VAWA and U-visa. It was helpful to take on this task because it forced me to really narrow the question of, what are we trying to accomplish for Luann? The requirement of presenting our legal analysis in a brief and comprehensible manner to Psych helped me understand the case better myself. Working with these professionals helped me understand just how important their roles are.

36 Quick guide: Making interdisciplinary collaboration work Articulate your role: Ethics and Values Understand the roles of other disciplines: Their Ethics and Values Identify and seek common ground Acknowledge differences: Celebrate breadth that comes with diversity Address conflict, don t let resentment accumulate Proactive in establishing and maintaining collegial relationships NASW 2013

37 Silos With Skyways

COLLABORATIVE ENGAGEMENT AGREEMENT NEUTRAL DIVORCE COACH

COLLABORATIVE ENGAGEMENT AGREEMENT NEUTRAL DIVORCE COACH KAREN P. FREED, LCSW-C, LICSW, BCD 12007 Whippoorwill Lane North Bethesda, MD 20852 Ph: 301-816-0978 Email: kpfreed@hotmail.com This document constitutes