Originally published November 14, 2014
By Laura L. Acosta
UTEP News Service
A program at The University of Texas at El Paso that trains social work graduate students to become culturally competent bilingual mental health practitioners has become a model for schools of social work throughout Texas.
In May, the Hogg Foundation for Mental Health awarded the UTEP Department of Social Work in the College of Health Sciences $172,142 to provide technical assistance to schools of social work in Texas, in order to improve bilingual mental health education in the state. Texas is home to 54 accredited social work schools.
Over the next two years, Mark Lusk, Ed.D., professor of social work, and Sam Terrazas, Ph.D., assistant professor of social work, will develop curriculum modules and materials for Texas schools of social work to enhance the linguistic and cultural competence of Master of Social Work (MSW) students. Funds also will be used to provide scholarships to MSW students at UTEP.
“There is an acute shortage of bilingual, Spanish-speaking mental health practitioners in Texas and in the United States,” said Lusk, who formally announced the project at the 38th Annual National Association of Social Workers, Texas Conference, Oct. 18-20 in San Marcos. “Yet, language alone will not suffice in fully meeting the needs of Hispanic patients and clients. Clinicians must also be trained in the subcultures and health beliefs of Latino clients in order to be culturally competent and effective caregivers.”
Lusk and Terrazas will collaborate with Sergio Aguilar-Gaxiola, M.D., Ph.D., an internationally renowned expert on mental health in ethnic populations, to develop the curriculum modules that will be used to train bilingual social work students in graduate programs across Texas.
The modules will be available online in 2015. Lusk and Terrazas also plan to provide assistance to Texas social work schools through teleconferencing and Elluminate Live!, an online virtual classroom and conference room available at UTEP.
“UTEP is well positioned to serve as a national model for training the next generation of culturally and linguistically competent social workers,” said Rick Ybarra of the Hogg Foundation program office. “But most importantly, to serve as a programmatic model for other social work programs to emulate.”
The technical assistance program stems from the University’s innovative Bilingual Mental Health Program.
Started in 2010 with a grant from the Hogg Foundation, the training program has prepared 25 MSW students at UTEP to become bilingual mental health practitioners who have high levels of cultural competency for working with the Hispanic population.
Among those students is Daniel Fierro, a graduate from the MSW program in 2013. Fierro is a social worker in La Clinica Familia, which provides medical care, including mental health services to residents in the medically underserved city of Sunland Park, New Mexico.
“I deal with patients from all walks of life,” said Fierro, who estimated that 90 percent of his job is done speaking in Spanish. “The medical terminology I learned has helped me a lot with the doctors because I’ve been able to communicate our patients’ needs and advocate for them. I also know that especially with Hispanics, there’s a lot of stigma with mental health, so how you treat them is very different.”
At the center of the program is the “Assessment and Intervention in Spanish” course where students who are proficient in Spanish learn how to engage in clinical social work with Spanish-speaking patients in a culturally competent manner.
The class, which is taught entirely in Spanish, is the first of its kind to be offered by a university social work department in the United States.
Students learn technical vocabulary in mental health and review literature on mental health treatment for Latino populations.
“There’s also a way of speaking to an older person in Spanish,” explained Silvia Chavez Baray, Ph.D., a lecturer in the social work department who teaches the course. Spanish speakers use tú and usted, which both mean “you,” to convey the formality of a relationship. Tú is less formal than usted. “If you refer to them as tú, they are going to see it as a lack of respect and that can hinder your communication to continue with the interview. So at the same time that we are teaching technical terms, we are teaching cultural behaviors, which can sometimes be a barrier to communication.”
Students also engage with standardized patients, or actors trained to perform as patients, making it possible for them to practice their clinical skills.
Standardized patient exercises take place in a state-of-the-art laboratory in the Health Sciences and Nursing Building that features a two-way mirror and video equipment. Students can review their performance and get feedback from their professors and classmates.
Lusk, who recently was awarded the Albert Armendariz Sr. Lifetime Achievement in Human Rights Award from the Paso del Norte Civil Rights Project, and Baray demonstrated the technique to Texas social workers and educators at the recent National Association of Social Workers conference.
Lusk said a growing demand from employers for Spanish-speaking social workers in medically underserved areas across Texas has led schools of social work to train bilingual and culturally responsive social workers.
“All of West Texas is in an underserved area,” Lusk said. “You travel 100 miles west of Austin and you enter a mental health medically underserved area. It goes all the way down to Presidio, up to Hudspeth, Culbertson, up to Abilene and down. All of those counties, including El Paso, are underserved in mental health.”
Eighty-five percent of clients at Family Services of El Paso, which offers counseling services to people of all ages, are Hispanic and 40 percent require their therapy be conducted in Spanish.
“To be able to adequately serve this population, Family Service must be culturally competent,” said Richard Salcido, executive director of Family Service of El Paso. Three students from the MSW program at UTEP are interning at Family Service of El Paso this fall semester. “To be culturally competent we need to have a diverse staff. Among the diverse staff we need competent practitioners who can speak the language of the clients that we serve. Among our current staff we have therapists whose case load is 100 percent Spanish-speaking.”
The Hogg Foundation was created in 1940 by the children of former Texas Governor James S. Hogg. The foundation advances recovery and wellness in Texas by funding mental health services, policy analysis, research and public education.