Eric Stone, a licensed clinical social worker for 15 years, who works out of Harlem, Brooklyn and the Bronx, is no stranger to helping people navigate traumatic experiences. But when the pandemic hit, forcing him to move to an online platform, he worried that he’d lose the essence of his job. How could he help people if he couldn’t even be in the same room with them?
This is a question that social workers across New York City have struggled with as the pandemic has forced them to switch to remote practice, conducting most of their work through online services commonly known as telehealth. The elimination of in-person interactions and hands-on training has presented innumerable challenges for social workers, including addressing cases of abuse through a laptop or phone screen. Yet, some social workers have found unexpected benefits in the efficiency of remote work, and hope to use the telehealth infrastructure to make improvements in the industry.
“The main issue is how to deliver services to community members,” said Ovita Williams, a professor of social work and the executive director of the Action Lab for Social Justice at the Columbia School of Social Work.
According to the New York Social Work Guide, there are currently 60,000 social workers in New York State, with the largest subset—just under 25,000—working as family, child and school social workers. Their job has become more difficult, said Williams, particularly in cases of child welfare and domestic violence.
Since the pandemic, domestic violence has risen worldwide, and New York is no exception, with calls to local domestic violence hotlines doubling or even tripling in the past few months, according to figures reported by Politico. But families don’t always have access to the kind of technology required for telehealth, said Williams, and even then, it’s difficult for individuals facing abusive situations to speak to their ill-treatment if their abusers are at home with them.
“We’ve really seen the impact of not being able to stay connected with families and children who may be at risk of abuse in the home,” said Williams. “It’s hard to be able to know everything that’s going on in the family if you’re not in the room. You just don’t have the same tangible access that you did before.”
Stone agreed. “In some cases, telehealth has definitely made social work a lot more difficult,” he said. “You can’t get a good sense of body language through the screen to see what’s really going on, or—in cases of domestic violence— they can’t always say everything that they want to say because they’re not alone.”
Williams is especially concerned about the generation of social workers getting their degrees under the pandemic. Usually, said Williams, social work students get placed in intensive internships for at least a year or two to get hands-on training helping people in the community. “But now, that’s not going to be the experience of MSW students across the country,” said Williams, referring to students pursuing master’s degrees in the field, who will now have their social work internships moved online. “We’re missing that core part of social work education.”
As a consequence, said Williams, most social work schools across the country have had to reach out to the National Organization for Social Workers, the largest membership organization of professional social workers in the world, to reduce the number of fieldwork hours required for a social work degree. “In that way,” added Williams, “the social work education field has taken a huge hit during the pandemic.”
Susan Bloch Leach, a licensed clinical social worker who works out of Suffolk Country has faced her own share of difficulties. “Some people that I work with don’t have WiFi or smartphones or computers,” said Leach. “And so for them, I’m just doing telephone calls, and they’re feeling extremely isolated.”
Yet, there have unanticipated benefits as well. One of them is financial relief for the people she helps. With the exception of home-welfare checks, many social workers never visit individual’s homes. Rather, clients commute to the social worker’s offices for meetings.
“It’s been good for people who are really broke,” said Leach. “Sometimes my clients are deciding between food and gas money. So this way, they don’t have to spend time or money on transportation. It’s more accessible.”
The other bonus to remote work, said Leach, is the added flexibility and immediacy. She’s been able to see more people than she usually can because there’s no travel time, allowing her to help people in new ways.
“There was one woman who had a very traumatic experience in her home,” said Leach. “And she just took me into her room on her laptop, when before, I wouldn’t ever have gone into her house.” Leach said she was able to work with the woman using breath work and relaxation techniques, to help her deal with the triggers of being in that particular room. That wouldn’t have been possible before the pandemic, said Leach.
Stone, too, encountered similar benefits. “I do a lot of work with frontline healthcare workers, who were very traumatized by the pandemic,” said Stone. “And through telehealth, they could just call me, and I could have coaching sessions with nurses and doctors who were literally just on their breaks in the hospitals. In some ways it made the social work that I do much more immediate and much more available.”
Stone noted how the pandemic has affected sleep patterns, including his own, he said. “I was sometimes doing meetings with people in the middle of the night. That was something you would never have been able to do before the pandemic.”
Alexandria Theodore, a 31-year-old social worker in Middlesex County, New Jersey, also sees the benefits of being online. “I work with a lot of people who have chronic illnesses and sometimes have trouble getting to me, so the accessibility of telehealth has been wonderful,” said Theodore, adding that she too has consistently been able to see more people during the pandemic. “Attendance is up in general,” she said. “And as New York transitions into the colder winter months, I’m expecting to see a lot less people canceling their appointments.”
Theodore said her clients are also more comfortable interacting with her from their homes. “Every case is different, but in a majority of the cases that I see people are getting results quicker, because there’s something about being in your house where the emotions are happening versus the sterile environment of a social worker’s office,” she said. “Obviously, I’m hoping that things will get better. But I’m also hoping that telehealth will remain an option for people who have really benefited from it.”
Stone also hopes that telehealth will become a permanent fixture of social work. “It’s helped to make the profession overall less rigid,” he said. “We’re encountering a new era of social work, and it’s teaching us a lot about how the work that we do now isn’t always accessible, and—more importantly— how we might be able to change that to make the field better in the future.”
(Photo by Edward Jenner for Pexels)