Anita Adams, LMFT, CHW CHW Conference May 20, 2016

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1 Anita Adams, LMFT, CHW CHW Conference May 20, 2016

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3 Depression & Oppression 1.1. A state of feeling sad; feelings of severe despondency and dejection. "self-doubt creeps in and that swiftly turns to depression 1.3 : a serious medical condition in which a person feels very sad, hopeless, and unimportant and often is unable to live in a normal way: a period of time Depression 1a : unjust or cruel exercise of authority or powerb : something that oppresses especially in being an unjust or excessive exercise of power 2: a sense of being weighed down in body or mind

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5 Psychological problems do not exist on their own, nor do they come out of thin air; they are connected to people s social support, employment status, housing conditions, history of discrimination, and overall personal and political power. [Therefore,] promoting complete health means promoting social justice for there cannot be health in the absence of justice (Prilletensky, 1999, p. 99)

6 Virginia Satir is considered to be the mother of therapy The presenting issue or surface problem itself was seldom the real problem; rather how people coped with the issue is what created the problem. Satir also offered insights into the particular problems that low self esteem cause in relationships The ability to feel loved and connected with others is the core component of developing a healthy sense of self and the personal agency needed to feel she has the power to create or co-create a healthy relationship dynamic.

7 Social justice clinicians locate the source of individual suffering in these social conditions and then work to change them Empowerment framework of treatment externalizes the problems to be outside of the person, rather than an organic condition within the person. CHW can help client directly address ways to fight oppressive conditions

8 Mary Field Belenky, et al. (1986) Traditional Classic Psychological Cognitive Theory excluded the experience of women Women are relational beings Connected ways of knowing; Knowledge as co-created Addressing the silence of women and internalized self doubt that comes with oppression

9 Belief they are dependent on the authority of others and unable to speak up for themselves Connecting women in community to promote their own sense of power to be change agents Feminist therapists explore ways to promote women s voice, rather then to allow silence to dominate

10 CHW are sometimes the only support for clients Support our clients in expanding their supportive communities and networks Depression is not successfully treated in isolation Positive connection with others increases sense of self agency & self efficacy All human beings need positive social connections with others CHW can bridge the gaps!!!

11 B Team- Others who you would draw upon in a time of need (Extended family, close friends, co workers, leaders in faith community) A Team- The first people you will call C Team- Members of a religious/ social organization; Childhood friendships or friend of friend distant family or college friends; recovery community ; professional network

12 Provides health education, resources and referrals to pregnant and parenting women to reduce infant mortality and eliminate health disparities, primarily amongst minority groups. Serve 800 clients within a 10 zip-code catchment area in Marion County identified as highest risk for infant mortality Clients are all screened for depression and referred to mental health services and/or Stress Reduction Group.

13 Builds a sense of community and connection Helps depressed mothers know they are not alone Creates safe environment to express strong emotions and normalizes these emotions Combats the feelings of isolation, loneliness and disconnectedness. Promotes the concept of being a good enough mother none of us our perfect Safe place to risk new behaviors to promote change; learn from others

14 Partnership between Indianapolis Healthy Start and CDC to pilot Legacy for Children Evidenced Based Positive Parenting curriculum through the CDC Builds a supportive community for low income women to overcome the barriers of stress, poverty, oppression Mother only and mother-baby sessions 10 block sessions over 3 year period

15 Legacy teaches us all parents can overcome the challenges of poverty to have positive relationships with their children Strengths based approach assumes all clients want to be successful and healthy; Assist clients in transcending barriers; survival skills under oppressive conditions are often mistaken as pathology Go in teams. Don t work alone! Keep talking

16 On going self examination Sharing power Giving voice Facilitating consciousness raising Building on Strengths Leaving clients with tools for social change Goodman, L.A., Liang, B., Helms, J.E., Sparks, E., Weintraub, S.R. (2004). Training Counseling Psychologist as Social Justice Agents: Feminist and Multicultural Principals in Action. The Counseling Psychologist, 32, 6,

17 Awareness of your own social location and biases Be mindful of language Assist clients in seeing new possibilities Acknowledge how social oppression contributes to the mental health problems that client s present Use future story as a way to embrace the power of change and new possibilities. Practice what we preach! We must take care of our own mental health needs to be effective with others