At a substance abuse treatment center, a Master of Social Work student working as an intern speaks with an alcoholic, who is feeling torn between wanting to quit drinking and not knowing how else to numb his pain.
Using interviewing techniques designed to build trust, the intern asks her client about the benefits of drinking, giving that person permission to talk about something that people normally don’t discuss. The man, appreciating that his counselor is attempting to understand where he is coming from, replies that drinking alcohol makes him feel better. When the student asks about the downside to drinking, the client tells her that he has spent all his money on alcohol and has alienated his family. When the intern then asks her client how he would like his life to look a year from now, she is giving that person the tools to make his own argument for changing his behavior.
These are just some of the practical clinical skills the USC School of Social Work is teaching its MSW students, a result of one of the first partnerships between research and field education at a school of social work. By providing students with training in evidence-based interventions, the school is better preparing them to interact with clients at their internships.
The program, now in its second year, instructs MSW students in motivational interviewing, which teaches basic skills in relationship building through role play, and problem solving therapy, which builds on the previous course with practical ways to tackle specific issues. Each class is an intensive 8-hour meeting that results in the ability to conduct a 20-minute counseling session – something that students will need to be able to do in their field placements and as working professionals. Students also receive a certificate of completion, which they can then use to increase their employment prospects after graduation.
“In traditional social work programs, evidence-based interventions are spoken about in general,” said Marleen Wong, associate dean of field education. “What we’re doing that’s so unique is we’re showing the need to teach practical applications that really help people. It’s not just an abstract idea but a real-time translation of recent science.”
The evidence-based interventions training program stemmed from a research grant John Brekke, professor and associate dean of research at the School of Social Work, received from the National Institute of Mental Health to speed the use of evidence-based practices into community-based treatment for individuals with serious mental illness. As part of the project, Brekke and Clinical Associate Professor Betsy Phillips trained 10 MSW students interning with Pacific Clinics in Arcadia, Calif., in motivational interviewing.
The training was such a success that Marilyn Flynn, dean of the School of Social Work, requested similar instruction at the school for all MSW students. Working with the field education department, Brekke and Phillips designed the training to still allow for small-group interaction, which was part of the original program’s success, through the participation of field faculty, who work with each group of students to teach them how to implement the interventions practically.
“The students have told us that they’re so grateful to have these skills,” Phillips said. “It’s not just in their heads anymore – they’ve actually practiced it.”
So far, students have been instructed in motivational interviewing, with problem solving therapy training starting this year.
“The school places a high level of emphasis on translational science – research whose findings can be used practically to enhance health and well-being,” Flynn said. “By giving our students hands-on training in the skills they’ll need as professionals, we’re educating social workers who will be better prepared to serve the needs of a variety of client populations.”
MSW student Veronica Diez said she and other classmates were apprehensive about the motivational interviewing training at first, but that feeling quickly went away.
“We were a little scared, but by the end, the skills we had learned seemed to come automatically,” she said. “Now at my internship, where I perform one-on-one grief counseling, I feel more confident being an active and reflective listener. I’m able to validate what clients are saying in their own words.”
As an intern with the Richard J. Donovan Correctional Facility in San Diego, student Jack Gorham taught inmates in the Showing How Insight Never Ends re-entry program how to use motivational interviewing in mentoring first-time offenders.
“Those guys are hard nuts to crack,” Gorham said. “They want to tell the young guys what to do and what not to do based on their own missteps and current incarcerations.”
Gorham cited learning how to engage in reflective listening as one of the most useful skills he learned in the motivational interviewing course and how he used that in counseling his inmate clients.
“Motivational interviewing provided me with the tools required to build a relationship with clients through empathy, as well as help them in mapping out their recovery processes,” he said. “It encompasses everything social work is based on: meet the client where they are, use reflective listening to demonstrate empathy and mirroring, which is key in building attachment, and collaborate with the client to formulate a therapeutic plan.”
Student Emma Simmons also has had good experiences using the skills she learned. At Mark Twain Middle School in Los Angeles, Simmons worked with students who were at risk of dropping out or had behavioral problems.
“Motivational interviewing worked well with this adolescent population, especially the use of open-ended questions and reflective listening,” she said. “These two skills helped to build a rapport with the students and guide their thought process throughout our sessions.”
Simmons noted the value of the trainings for all social work students, even those who may not deal with counseling clients directly, because the evidence-based interventions have proven effective for a variety of populations in different situations.
“Even though our classes teach us the theories behind clinical practice, these interventions are actually hands-on lessons that we can take with us for our internships and beyond in our careers as MSWs,” she said.
These evidence-based interventions are so innovative that even the field instructors at the school’s placement agencies have requested training in them, something Gorham said he has heard from his own internship experience.
“In many cases, field placements lack the time and resources to teach these essential evidence-based interventions,” he said. “The benefits of having such an aggressive training program at the School of Social Work would place the skills and clinical expertise of USC interns above those learned in any other social work program.”