Wildfires on Hawaii’s Maui Island in August killed at least 114 people, forced tens of thousands of residents and tourists to evacuate, and devastated the historic resort city of Lahaina. Major news outlets on August 21 called it the “deadliest U.S. wildfire in more than 100 years.”

Amid the chaos, social workers stepped up when the American Red Cross asked them to help, said NASW Hawaii Executive Director Sonja Bigalke-Bannan, MSW, LCSW. When someone from the Red Cross asked her the range of problems and challenges social workers usually help with, Bigalke-Bannan said she replied: “Everything.” So, the Red Cross asked the chapter to take on a management-type role, including community engagement, staffing and shelters.

“Because the public has cultural conditions,” they asked for assistance from NASW, said Bigalke-Bannan, who then emailed the NASW Foundation, because “this clearly was not in our budget. They said, ‘Absolutely, yes. We’re there for you.’ We were so grateful for this help.”

Displaced survivors were staying in hotels and Airbnbs. Many others could not get around because they lost their cars and bikes. People sought various shelters, including gyms and community centers, Bigalke-Bannan said. Many homes burned, and the chapter tried to assess things, like if folks knew of friends or family members who needed medication, or if housing was needed.

Read more in the NASW Social Work Advocates magazine.

Social workers play an important role in health care, even more so as health care services become increasingly integrated. The impact that social workers have on their patients, the patients’ families and the health care team as a whole varies depending on the setting and the specialty. However, the one constant is social workers’ ability to connect their patients with the resources and additional services they need. Such is the case with palliative care.

For example, the Veterans Health Administration published a study in January of this year that analyzed the records of 43,200 veterans receiving care through a Veterans Affairs health care site. The veterans, whose average age was about 65 and all of whom had been recently hospitalized, were found to be 95% more likely to access palliative and hospice care if they were connected to a social worker through their primary care physician.

In this case, all of the health care providers were connected to the Social Work Patient Aligned Care Team (PACT), a health care model that works with veterans and their health care professionals to focus on whole-person, lifelong health and wellness.

These findings come as no surprise to social workers, particularly those in palliative care or another medical field. Nonetheless, they serve as a reminder that while palliative care is invaluable to patients dealing with long-term and life-limiting illnesses, it is a service that is often underused and misunderstood.

According to the World Health Organization, while there are an estimated 56.8 million people globally in need of palliative care each year, only about 14% of individuals receive it. Social workers play a key part in changing that. Through education, relationship-building and a commitment to palliative care, social workers can help ensure more patients and their families are fully informed of the discipline and take advantage of the access that already exists.

Read the full story in NASW Social Work Advocates magazine .

Consequently, SCD is frequently contested as a disability—opportunities to support people with SCD in everyday challenges escape many healthcare providers. These trends speak to the legacy of anti-Black racism in the Global North, which deeply entwines disability with racialized boundaries of citizenship and broader debates about “deservingness” of welfare.

To address these gaps, an article in a recent issue of the journal Health & Social Work delineates the medical and social models of disability as well as anti-Black racism to explore how social workers can embed human rights for people with SCD in everyday practice.

This article is contextualized in Ontario, Canada, a province that recently launched a quality standard, Sickle Cell Disease: Care for People of All Ages.

The author writes:

Social workers are one of the few healthcare workers with an explicit social justice mandate…. Along with our person-in-environment perspective, our commitment to social justice can rally human rights for people with SCD to facilitate accommodations and entitlements—essential tools that people with SCD can use to shape their lives while living with a serious and what is often an unpredictable condition…. Until structural change is made, social workers can work in alliance with people with SCD to strategically advance human rights amid disability contestation…. By championing our foundation in human rights, social workers can bring progressive policy documents, such as Ontario Health’s (2023) SCD Quality Standard, to life.

Study Author:

Sinthu Srikanthan, BA, BSW, MSW, RSW, social worker with Red Blood Cell Disorders Clinic, University Health Network, Toronto, ON, and research assistant, Youth Research and Evaluation eXchange, School of Social Work, York University.

NASW journals are co-published by NASW Press and Oxford University Press. The journal Social Work is a benefit of NASW membership. It is available online or, at a member’s request, in print. Children & Schools, Health & Social WorkSocial Work Research are available by subscription at a discounted rate for NASW members, online or in print.

Learn about NASW journals and subscriptions.

Hospitalizations and deaths from COVID-19 are trending down according to the Centers for Disease Control (CDC) data. Still, only 17% of eligible people nationwide have received an updated booster dose. Trends noted from CDC data collected in 2021 showed the general population being fully vaccinated at 59.8% while only 25% of people experiencing homelessness (PEH) were vaccinated. These statistics indicate that vaccination rates among PEH have also dropped.

The Federal Drug Administration (FDA) began approving vaccines in late 2020. The FDA has now approved a 4th vaccine, Novavax, that is approved for a 1st and 2nd dose to children and adults age 12 and up. More information on the different vaccinations is available on the CDC’s website. Still, COVID-19 remains an active concern. Recent CDC information shows that more than 1 million people have died of COVID-19 in the US as of November 2022. The virus continues to mutate and currently we are learning about long COVID’s disease process and presentation.

The National Health Care for the Homeless Council (NHCHC) noted in a 2020 brief that PEH are at risk for experiencing chronic medical conditions as well as behavioral health concerns. NHCHC notes that demographics collected in 2018 showed 40% of the 1 million clients served were age 50 or older. These health risks alone open PEH to higher risk of infections. Additionally PEH often have limited access to hygiene facilities making it difficult to follow public health advice.

Continuing Challenges Reaching the PEH Population

Even as availability to vaccines becomes more widespread, challenges remain in reaching the PEH population. Mistrust of healthcare institutions is one factor to consider. If previous experiences with clinics where vaccines are being offered were negative, a person might not be motivated to return. Further concerns come with the need for a secondary dose and potential side effects from the initial vaccine. Adherence to masking and social-distancing guidelines remain difficult to guarantee.

The National Association of Social Workers (NASW) provides information on how to reach people with limited access to COVID-19 vaccines in the Connect to End COVID resources.

While challenges remain in the delivery of healthcare to PEH, this pandemic experience has been an opportunity to expand all health care to PEH. Some states participated in the National Health Care for the Homeless Council’s Vaccine Ambassador Project to engage people experiencing homelessness and provide education around the vaccines while also developing strategies to assist with distancing. The NHCHC recognizes some of the lessons learned from the Ambassador Project in a brief from November 2022, COVID-19 and the HCH Community: Lessons Learned from the Pandemic.

Social Workers as Trusted Messengers

Social Workers are present in many systems that PEH access, providing us an opportunity to utilize these lessons for the benefit of our clients. One important lesson learned is including people with lived experience into the decision making process when seeking new ways to connect PEH with vaccines or education in changes with the COVID19 virus. Hiring a Vaccine Ambassador into organizations working with PEH is a great way to include someone with lived experience. The expansion of virtual healthcare is another opportunity to engage PEH with healthcare professionals.

Some suggestions from the brief are to invest in portable technology that might be taken to encampments, or arrange for a private room in a shelter or resource center to allow clients to have virtual medical visits. Creating partnerships with other providers and services has been a key part of some success in distributing vaccines. One example was partnering with local food banks to provide snacks during a vaccine drive. Additionally, sharing information with local providers can assist in offering more opportunities for PEH to access a vaccine drive and potentially encounter a provider they trust. The CDC has information on arranging a mobile vaccine on its the CDC website.

As social workers, we are seen as trusted messengers by our clients, including those who may be experiencing homelessness. We meet people where they are and give them the information they need in a non-judgmental way so they can make an informed decision about vaccines and self-care. Educating ourselves about the virus and the latest developments about vaccines is the first step toward helping our clients and communities.

For more information about NASW’s Connect to End COVID-19 initiative, visit the NASW website.

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This project and blog post are supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $3.3 million with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS, or the U.S. Government.

It is easy to forget how terrified we were in the early days and months of the pandemic—and the relief we felt when mRNA vaccines were developed, approved, and rolled out across the country in seemingly record time.

In January of 2020, as COVID-19 began its global spread, the Secretary of the U.S. Department of Health and Human Services (HHS) declared a 90-day public health emergency (PHE), which was renewed every 90 days from 2020 to early 2023. The World Health Organization (WHO) declared a public health emergency of international concern (PHEIC) January 31, 2020 and a worldwide pandemic on March 11, 2020. The president declared a national emergency in the United States March 13, 2020.

The numbers, since then, are staggering: nearly 105 million total cases have been recorded in the United States alone, with more than 1.1 million total deaths, according to the Centers for Disease Control and Prevention (CDC) COVID Data Tracker, as of May 11, 2023.

The WHO COVID-19 Dashboard: 765,903,278 confirmed cases of COVID-19, including 6,927,378 deaths, reported to WHO, as of May 10, 2023, with a total of 13,349,320,292 vaccine doses administered globally.

In the United States, 81.4% of the U.S. population has received at least one COVID-19 dose, while 69.5% completed the primary series, and 17.0% received the updated (Bivalent) booster dose, as of May 10, 2023, according to CDC COVID Data Tracker.

COVID-19: A Changing Landscape

It is worth remembering what transpired during the pandemic, especially as coordinated response efforts undergo anticipated transitions. The World Health Organization (WHO) declared on May 5, 2023 that the public health emergency of international concern should end. The White House officially allowed the COVID-19 public health emergency to expire in the United States May 11, 2023. The national emergency ended April 11.

According to the CDC website, it is “. . . shifting from an emergency response to incorporating COVID-19 activities into routine public health practice.” The website provides an array of ‘What You Need To Know’ information and tools.

While the pandemic landscape is changing, and many of us, as individuals, may feel done with COVID-19, experts say COVID-19 is not done with us. As it continues to infect, kill, and potentially evolve—vigilance should be our watchword.

The WHO International Health Regulations (2005) (IHR) Emergency Committee regarding the coronavirus 2019 disease (COVID-19) pandemic statement transmitted by WHO Director-General Tedros Adhanom Ghebreyesus on May 5, 2023 said:

“During the deliberative session, the Committee members highlighted the decreasing trend in COVID-19 deaths, the decline in COVID-19 related hospitalizations and intensive care unit admissions, and the high levels of population immunity to SARS-CoV-2. The Committee’s position has been evolving over the last several months. While acknowledging the remaining uncertainties posted by potential evolution of SARS-CoV-2, they advised that it is time to transition to long-term management of the COVID-19 pandemic.

The WHO Director-General concurs with the advice offered by the Committee regarding the ongoing COVID-19 pandemic. He determines that COVID-19 is now an established and ongoing health issue which no longer constitutes a public health emergency of international concern (PHEIC).”

Connect to End COVID-19 Campaign

In 2021, NASW and the NASW Foundation partnered with the Health Behavior Research and Training Institute (HBRT) at The University of Texas at Austin Steve Hicks School of Social Work on a national $3.3 million CDC-funded initiative to support social workers and their clients in informed vaccine decision-making, Connect to End COVID-19.

Social workers, as professionals who provide services in a wide range of community settings—and are seen trusted messengers—are thus in a unique position to continue to promote COVID-19 vaccine confidence, access, and uptake, particularly among populations with low vaccination rates and higher vulnerability to severe forms of infection.

During this two-year initiative a majority of NASW’s Chapters participated by providing valuable communications to state audiences and/or by collaborating with NASW, the NASW Foundation, and HBRT, in offering 25 six-hour Motivational Interviewing (MI) and Screening, Brief Intervention, and Referral to Treatment (SBIRT) trainings to social workers across the country. MI-SBIRT are evidence-based models for supporting clients in making informed decisions about their health. These evidence-based modalities can be effectively deployed to help guide collaborative conversations with clients about COVID-19 vaccine decision-making.

Connect to End COVID-19 also engages with approximately 40 social work Ambassadors and Social Work Sister Organizations that assist in promoting COVID-19 vaccine confidence.

Thoughts from NASW Chapter Executive Directors

Gwen Bouie-Haynes, PhD, LMSW is the Executive Director of the NASW Mississippi Chapter, and serves as the Connect to End COVID-19 Project Coordinator for Special Populations. She admits that initially she felt doubtful about the efficacy of the vaccine. Like many Americans, she felt it happened so fast and she wasn’t sure it would make a difference. Then, she said, her daughter, a physician, “showed me data from my own community, and my age group. I saw how many people were dying. She said, ‘Do you want to die or do you want to live?’ I want to see my daughter and her twin brother, an attorney, make a difference in their professions. That is when I decided to err on the side of caution, and view the vaccine as preventative.” She added, “If I’m going to be an advocate, I have to set an example.”

Brenda Rosen, MSW, CSW, ACHP-SW, Executive Director of the NASW Kentucky Chapter, is participating in Connect to End COVID-19 by communicating about the initiative and promotes vaccine confidence to her state audience. She has seen the impact of the campaign on both a statewide and local community level. “The work NASW has done to connect social workers and community agencies, citizens, and network partners to help keep everybody updated throughout the course of the pandemic has really aligned with the work we’re doing with Team Kentucky.”

She also emphasized the importance of getting churches, community centers, and health departments on board. “It really makes your heart happy when you see some of the shifts in attitudes. People are suddenly saying: ‘this is something we need to do as a community. We need to pull together.’” Brenda supports NASW’s Connect to End COVID-19 campaign outreach as well, calling the website’s content “necessary, vital, and needed information” and describing the training as “invaluable, engaging, and empowering.”

While the goal of this initiative is to promote vaccine confidence and make informed choices, success will ultimately be measured not in vaccine uptake, but “keeping people healthy and saving lives.”

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Social Workers can stay up to date on COVID-19 vaccine information by visiting the CDC website. Safe and effective, COVID-19 vaccines have been shown to prevent severe illness, hospitalization, and death.

Learn more about Connect to End COVID-19 by visiting NASW’s website. Register for four complimentary self-study national webinars and stay tuned for new webinars in 2023. A limited number of complimentary CEUs are also available, so secure yours by signing up today.

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Resources

The White House

• COVID-19 U.S. national emergency and public health emergency (PHE) set to expire May 11, 2023

World Health Organization (WHO)

• World Health Organization says COVID-19 no longer a public health Emergency of International Concern (PHEIC) on May 5

Centers for Disease Control and Prevention (CDC)

• CDC COVID-19
• CDC COVID Data Tracker
• Stay Up to Date with COVID-19 Vaccines
• Building Confidence in COVID-19 Vaccines
• How to Tailor COVID-19 Vaccine Information to Your Specific Audience
• End of the Federal COVID-19 Public Health Emergency (PHE) Declaration | CDC

U.S. Department of Health and Human Services (HHS)

• Telehealth policy changes after the COVID-19 public health emergency
• May 9, 2023, Fact Sheet: End of the COVID-19 Public Health Emergency
• April 26, 2023, CMS Fact Sheet: What Do I Need to Know? CMS Waivers, Flexibilities, and the Transition Forward from the COVID-19 Public Health Emergency – PDF
• April 26, 2023, CMS Frequently Asked Questions on CMS Waivers, Flexibilities, and the End of the COVID-19 PHE – PDF
• April 18, 2023, Fact Sheet: HHS Announces ‘HHS Bridge Access Program For COVID-19 Vaccines and Treatments’ to Maintain Access to COVID-19 Care for the Uninsured
• April 14, 2023, Fact Sheet: HHS Announces Intent to Amend the Declaration Under the PREP Act for Medical Countermeasures Against COVID-19
• April 14, 2023, HHS Secretary Xavier Becerra’s Letter to US Governors on Intent to Amend the Public Readiness and Emergency Preparedness Act (PREP Act)
• March 7, 2023, Letter to US governors from HHS Secretary Xavier Becerra thanking governors for your efforts over the last three years during the coronavirus disease 2019 (covid-19) pandemic
• February 27, 2023, CMS Fact Sheet: CMS Waivers, Flexibilities, and the Transition Forward from the COVID-19 Public Health Emergency
• February 9, 2023, Fact Sheet: COVID-19 Public Health Emergency Transition Roadmap
• February 9, 2023, HHS Secretary Xavier Becerra’s Letter to US Governors on the End of the COVID PHE

National Association of Social Workers (NASW)

• NASW COVID-19 Resources
• Planning for Medicaid Unwinding in 2023
• Tips and Tools for Social Workers: Key Health Care Policy Dates in Spring 2023
• Crisis Impact: Social Workers Confront Pandemic While Caring for Others
• Vaccine Education: CDC Grant Will Help Train Social Workers to Inform Clients, Communities (NASW Social Work Advocates)
• COVID-19 Year 3: Social Workers and Their Clients Continue to Navigate the Pandemic and its Impact, Even as Society Shifts Back Toward ‘Normal’ (NASW Social Work Advocates)
• NASW Social Work Talks Podcast Episode EP80: Vaccine Education with “Connect to End COVID-19”
• NASW Social Work Talks Podcast Episode EP85: How To Reach Special Populations with Motivational Interviewing

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This project and blog post are supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $3.3 million with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS, or the U.S. Government.

Search online for “Planned Parenthood and abortion rights” and a page opens with large white letters standing out against a dark background. The message: “The U.S. Supreme Court has ended the federal constitutional right to abortion — handing our power to control our own bodies to politicians.”

After Roe was overturned on June 24, 2022, and lacking a federal policy, many states scrambled to either protect access to abortion or ban it. Several months later, the Kaiser Family Foundation published information on the status of access to abortion, including: Abortion banned in 13 states; abortion ban temporarily blocked making abortion legal in five states; abortions available in 24 states and Washington, D.C.

“Access to safe legal abortions,” Kaiser states, “now depends on where you live, and the national divide in access to abortion care has been intensified.”

Laws and regulations have been altered or new ones passed as states craft and implement legislation that protects or criminalizes women’s health care — and in some cases its providers — if abortion services are given. Also at risk as some state legislatures flex their muscles are gender identity services. Social workers in some parts of the nation are navigating ethical dilemmas and many worry they could face civil or criminal situations just for doing their jobs.

Ethics Guide

“Regrettably, social workers in a number of jurisdictions throughout the United States are facing daunting ethical challenges in light of recent court rulings, state statutes, and governors’ executive orders,” said Frederic G. Reamer, PhD, a professor in the graduate program at the Rhode Island College School of Social Work in Providence.

“Some laws — especially those related to reproductive health and gender identity and sexual orientation — have placed social workers firmly on the horns of an ethical dilemma. Social workers who are deeply committed to serving their clients’ needs now find themselves facing onerous repercussions if their actions violate the law,” Reamer said.

Reamer, chairman of the task force that wrote the current NASW Code of Ethics and who serves on the Code of Ethics Revisions Task Force, said for example, “Social workers who assist a pregnant person who is making a difficult decision about the pregnancy could be at risk of prosecution or other sanctions if their actions violate state law. The same is true of social workers who provide good-faith services to minor clients who seek help managing challenges related to gender identity or sexual orientation.”

Read the full story at NASW Social Work Advocates magazine.

Although social workers have an elevated risk of infection with COVID-19, no previous studies have investigated the virus’s impact on practitioners.

An article in the February 2023 issue of the journal Health & Social Work addresses this gap in research. In the article, authors publish the results of a study that identified associations between stress, depression, and COVID-related factors and explored the role of social connectedness as a moderator for mental health among Ohio social workers. The results of the study showed that among social workers with a positive COVID-19 diagnosis, 70 percent experienced moderate/high levels of stress, and 37 percent met the criteria for clinical depressive symptoms.

Results from the multiple regression analyses showed that perceived stress was positively associated with a positive COVID-19 diagnosis for social workers, and depression was positively associated with working with a client with a positive COVID-19 diagnosis. An interaction effect was also identified between social connectedness and social workers’ mental health.

These findings suggest that the provision of individual or organizational interventions that emphasize social connectedness can help to protect social workers’ mental health.

The authors conclude:

Among the many challenges brought on by the COVID-19 pandemic, social workers have been tasked with rapidly transitioning to an entirely new service delivery format while providing clinical services in the midst of an unprecedented medical, behavioral, and mental health crisis. In regard to this environmental adversity, this study indicates that social workers have been experiencing high levels of stress and depression during theCOVID-19 era, and the results also showed that social connectedness can mitigate some negative mental health effects associated with COVID-19. These findings suggest that social connectedness improves social workers’ mental health in the pandemic environment, and it is therefore important that social workers are screened with accurate assessments for social connectedness, and that they are provided with appropriate levels of individual and organizational support to strengthen their social connectedness when a need is identified. It is also suggested that a longitudinal study be conducted to generalize the relationships between mental health and social connectedness among social workers. Finally, this study was conducted in the prevaccine era, and future work should explore the effects of vaccination and a reduction in mandatory quarantines on the mental health status of practicing social workers.

Authors of the study:

• Daejun Park, PhD, assistant professor, Department of Social Work, College of Health Sciences and Professions, Ohio University, Athens, OH
• Mingun Lee, PhD, associate professor, Department of Social Work, College of Health Sciences and Professions, Ohio University, Athens, OH
• Kara Osborne, MSW, social worker, Athens, OH
• Dane Minnick, PhD, assistant professor, Department of Social Work, Ball State University, Muncie, IN

Social worker Jennifer Kljajic, LCSW, works to help others better manage their pain. The issue is paramount as the opioid epidemic continues to be a serious public health issue in the U.S. People are more likely to lose someone close to them due to opioids than from a car crash, Kljajic explains.

She leads the NASW Specialty Practice Sections webinar, Pain Assessment and Management: The Critical Role of Social Work, available at the Social Work Online CE Institute. Kljajic is director of coaching and therapy at Lucid Lane, a company that specializes in medication taper management and support. She emphasizes that social workers play a critical role in helping people manage their chronic pain, including those who may have developed an opioid misuse disorder.

Building trust and therapeutic rapport is essential when working with any client referred to mental health services, Kljajic says. It’s important to take a mindful approach to treatment since such people may offer resistance from the stigma they face having an “invisible” illness or being mislabeled an addict, she says.

Interventions, such as motivational interviewing, and techniques, like going with resistance and offering empathy, validation and reflection, are important. Always start where the client is, she suggests, and validate their feelings.

The DSM-V notes that pain disorders relate to psychological factors. “This is where a person presents symptoms of depression, anxiety or insomnia, but their primary problem is chronic pain,” Kljajic says.

Chronic pain can linger even when the initial illness has vanished.

“The pain signals remain active in the nervous system for weeks, months or years,” Kljajic says.

NASW members, sign in to read the full NASW Social Work Advocates story and more.

As the world nears the end of the third year of the COVID-19 pandemic, the United States is both transitioning back toward pre-pandemic life and settling into a new normal. It’s a delicate balance that continues to evolve, as does the virus. 

Cases of the coronavirus have not disappeared. In mid-September, two and a half years after the pandemic began in the U.S., there were 471,611 reported weekly cases in the country and 3,230 deaths. 

However, vaccines and proven treatments have allowed for a somewhat more relaxed, though still cautious, relationship with the virus. For example, the Centers for Disease Control and Prevention no longer advises fully vaccinated and boosted individuals to quarantine after exposure, and the World Health Organization stated in September that the end of the pandemic was in sight. 

For social workers and their clients, the pandemic may not be as front of mind as it once was, but it remains a factor and adds another layer to already challenging situations. 

“It’s stressful personally,” says Danielle Wagner, MSSW, LCSW, staff therapist at a Pennsylvania college who also sees patients in private practice. “In the sense that it’s just one more thing to check in about, and then systemically, it’s stressful in that it’s a strain on our very strained resources.” 

General Policies 

For social workers and their clients, the changes in how COVID-19 is managed may be most visible now in an organization’s or facility’s policies. This is, after all, where many individuals first encountered COVID-19 restrictions. 

“During the height of the pandemic, we were limited to how many people could be present in a room at one time, we had to wear masks and wipe every surface down that we touched, and we were required to work remotely or quarantine if we felt sick or came in contact with COVID-19 in any way,” describes Megan Macareno, MSW, Housing and Street Outreach program supervisor at Valley Youth House in Pennsylvania. Macareno works primarily with young adults aged 18 to 24, many of whom are experiencing homelessness. 

These restrictions were not uncommon for social workers on the front line, and some remain in place today. For example, both Jeffery Jin, DSW, an oncology social worker in New Jersey, and Jordan Levy, LCSW, a social worker for an inpatient psychiatric unit in Philadelphia, note that masks are still worn by employees and likely will be for the foreseeable future in medical facilities. “I personally do not ever plan to work in the hospital without wearing a mask/PPE (personal protective equipment),” says Levy. 

Read the full article at the NASW Social Work Advocates magazine here.