"Truth, Lies, and Social Work Practice":
Keynoter Woodrow addresses new era in service delivery

By Deborah K. Shepherd, CSW, Assistant Director
(May 1997)

Dr. Richard Woodrow, Director of Organizational Development at Mount Sinai Medical Center, was originally going to call his keynote address at the Chapter's April 14 Annual Meeting "Climbing through Chaos." He decided he liked the Chapter's title, "Truth, Lies and Social Work Practice," however, because "...it captures where I as a practitioner and educator struggle and try to stay professional and whole in these times."

Dr. Woodrow captured the feelings expressed by many social workers when he addressed his audience: "Some of us may feel that we do not recognize our own health care and social service settings as they evolve and change in an era of economic crisis, an era in which we are wrestling with the advent of managed care and the nostalgia of health care reform, with the breakdown of the welfare system as we know it and the claim of welfare reform. And we may worry that we will change so much that no one will recognize us as social workers in these systems...if we have jobs."

The questions he has been struggling with, he said are: "How can we make sense out of our service organizations in such crazy, topsy-turvy times? As we experience the changes so personally, is there any way to understand rather than personalize the changes that are occurring? Beyond understanding, are there any strategies for holding onto our identity as professionals in an environment that seems to be so anti-professional and so antithetical to social work values?"

A PROFOUND MORAL CRISIS

Warning that "...society is in the midst of a profound moral crisis...as we desperately focus on bottom lines and become enamored with technology, human beings are...in peripheral vision, sometimes off the radar screen...we are in jeopardy of losing the mission," Dr. Woodrow read a litany of "...metaphors that shape and reflect our organization of life: Downsizing, rightsizing, upsizing, capsizing, rebalancing, cascade bumping; merging, acquiring; reengineering, redesign, reorganization, reinvention. Not a thing of beauty. For the metaphors are themselves distanced, technocratic, devoid of human beings--and sometimes humanity."

In order to survive, he said, "...those of us whose very essence is about helping and serving others, must live in the shadows and in the margins...as loyal oppositionists so that we can bear witness and tell the truth in a way that it can be heard, so that we preserve the values that will be needed to get through the inevitable moral crisis.

ACHIEVING BALANCE

"But to survive, we face a precarious challenge: We will not be effective unless we are heard. And we will not be heard if we seem out of synch with the central preoccupations of organizational survival. ...Therefore, we need to balance our professional requirements and values and organizational demands and values...In our practice and our education, we need to build organizational content into the center of clinical work, so that our colleagues understand rather than withdraw from us as central players in organizations and the delivery of care. And we need to find some way to link our values to behaviors that contribute to the organization, even when our values clash with dominant societal values that permeate organizations...We can no longer afford to retreat from organizations as intrusions into practice."

To achieve this balance, he said, social workers need to ask themselves these questions:

"What are we doing to our organizations? How does and can social work contribute to and influence these organizations? What can we do to lead the profession to a vital, viable role in an emerging, new era of [service] delivery?"

"What are we doing to our organization? How does and can social work contribute to and influence these organizations? What can we do to lead the profession to a vital, viable role in an emerging, ne era of [service] delivery?"

Dr. Woodrow asked his audience to think about the things they do to "get through the days...To help you feel even a modicum of pride and success in your work? To stay focused on the work? And to uphold the values of social work in a bottom-line and chaotic organization/world?"

He then provided some of his own strategies, using metaphors:

  1. White Water Rafting: "Be flexible and anchored at the same time. What happens if you are too rigid? Over you go. What happens if you are too loose, go flailing all over the place? Over you go. Taking the metaphor to practice...we are anchored and bounded by our function and our values, and we must stay authentic. But we need to become more flexible around our structures, our models, our methods, our interventions in order to thrive in a changing world."

  2. Begin at the End: "Create and develop a vision for yourself, your department, your organization, your profession. Start with the future, not the present...Imagine you are working in the kind of organization that makes you proud, feel successful, glad to come to work each time...Then, move back to the present and analyze the gap between where you are and where you want to be."

  3. Be a Mover and Shaker: "Who else if not social workers will document the impact, intervene around the impact, and influence decision makers about the impacts on our clients and our organizations?...We need to exercise the C.O. muscle of our profession though political action outside the organization where most fundamental change is occurring, and through influence inside the organization where incremental change can happen and make a difference."

  4. Create Community: "[This] is a time to build on common ground and create communities for learning and for political action..When structured departments of social work are changed or eliminated in institutions...it means practitioners need leadership for program planning, staff development, and supervision of students.That requires creative work together, as a professional community, about how to maintain lifelong education and staff development."

  5. Look Inside: Look at why organizations "...need what is special about social work: our ability to work closely with people, especially in crisis, our understanding of social systems and processes, our ability to take in multiple levels of perceptions and realities and bring them together out of and through conflict...We need to achieve the balance of profession-client-and-organization...The question is how to medicate the organization goals with our professional goals and values and client needs. For example, to be a patient advocate who cares about he bottom line, who demonstrates how development of a solid professional relationship with patients, the community and with populations in need will enhance our ability to attract these people to our service, to enhance their compliance, to decrease medically unnecessary and costly use of services...So that we connect our work, our process, to outcome variables and business strategies that are so hot in the organizational field today."

In order for social work to thrive in organizational settings, Dr, Woodrow stated, the profession must "...take leadership in developing a humane work environment...[holding] our function, while flexibly finding links to the organization as a political ally and to the organization as a 'client'--and therefore caring about its goals without taking them on as our only goal."

Dr Woodrow concluded his remark with the hope that social workers can become "...clear about the struggles that define who we are and where we are going, so that our truth can be told and heard, and we can be the makers, rather than the victims of change...because, the truth is, we are the profession of change."

Several hundred NASW members and guests attended the meeting, which was held at the NYU Medical Center and presided over by Chapter President Dr. Carmen Ortiz Hendricks and Executive Director Dr. Robert Schachter. The meeting was dedicated to the late Dr. Carol H. Meyer, a social work pioneer and Chapter leader. Dr. Meyer was the unanimous choice for winner of the 1997 Chapter Service Award, which was accepted by her sister, Dr. Maxine Greene, on behalf of the Meyer family.

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