“The change seemed to happen overnight,” said Emily Rubin (BSW, ’16). “One day we were out testing people, having meetings about partnerships with other agencies, and preparing to recruit people for two of our initiatives. Then the next day we were told to work from home for the foreseeable future.”
The COVID-19 pandemic crisis has upended work and life worldwide. For three Colorado State University social work alumni who specialize in HIV/AIDS interventions, there has been a clear need to carry on offering support to clients, as well as to prioritize professional self-care.
Safeguarding vulnerable and at-risk populations in urban areas
Every day in her job with the nonprofit Association House of Chicago, Rubin addresses the impact HIV/AIDS has on disadvantaged and disproportionately-impacted communities of the West Side and South Side neighborhoods.
“I am a community health specialist specifically concentrated on HIV interventions, such as 60-second HIV testing, counseling, referrals, linkage to care, mass-condom distribution, street outreach, and sexual health education,” said Rubin.
As a BSW student, Rubin received early training for her role through a field placement at Colorado Health Network, formerly known as Northern Colorado Aids Project (NCAP).
“Due to my experience at NCAP,” Rubin said, “I was introduced to sex-positive, client-centered harm reduction and non-judgmental frameworks, equitably meeting the needs of people who inject drugs, men who have sex with men, the LGBTQ+ community, and people experiencing housing instability or homelessness.”
After graduation, more valuable career experience came via Peace Corps service in Botswana. “I refined my knowledge surrounding HIV/AIDS and sexual and reproductive health, experienced the stark impact HIV/AIDS has on community and country, and [learned] how to balance progressive thoughts and attitudes, and work with cultural humility and respect.”
In the early days of the pandemic, Rubin learned that due to funding issues, employees of her organization were required to follow state government orders to stay at home. “We were aware of the virus, yet like much of the nation we lacked information and preventative measures,” said Rubin.
“One of our biggest concerns was regarding the health, well-being and safety of our most vulnerable and at-risk populations, people experiencing homelessness and communities of color, and also, how people living with HIV can protect their health against COVID-19.”
The stay at home order also affected Rubin’s work due to HIPPA regulations. “In order to be HIPAA-compliant, we are unable to bring files home, which restricts much of our job responsibility and ability to communicate with our clients.”
To continue making an impact, Rubin and her colleagues have been collaborating with local clinics and healthcare centers while working from home, “to reach our high-risk HIV-negative people, people living with HIV, and those who are on treatment and need access to emergency medication.”
“I am also completing various professional development certifications online, and developing various projects in preparation for implementation when we can return,” Rubin said. “It has been an interesting yet necessary transition, and we are doing the best we can with our limited resources and movement.”
Rubin believes self-care is vital and also rooted in the desire to do social work. “Burn-out is real, and in order to continue doing what we love to do it is because we learned about self-care from the get-go,” said Rubin, “like how to manage our stress, how to be adaptable, flexible, and lean into things that make us uncomfortable and maybe even scared.”
“This pandemic showed me that a lot of people have that chutzpah or ‘umph’ to do social work,” Rubin said. “I’ve seen individuals, organizations, and businesses use strengths-based approaches in order to take control of their COVID-19 response…providing love, care and support that our communities desperately need at this point in time.”
Telehealth platform offers promise for helping rural populations
Aliza Menashe (MSW, ’18) also completed a year-long internship at Colorado Health Network during her time as a student in the MSW program. After graduation, she was hired as a behavioral health clinician for their Fort Collins location, which also serves rural populations.
During the pandemic, Colorado Health Network implemented a rotating schedule of open days for clinics, in combination with telehealth services from employees working from home, which is how Menashe has continued to provide individual counseling for people living with HIV.
“I’m getting emails from DORA [Colorado Department of Regulatory Agencies] weekly,” said Menashe. “They’ve expanded our ability to use verbal consents. That’s huge. To be able to say someone can verbally consent to my services over video, for the first time.”
“We’re seeing major disparities in who is being affected by covid-19,” Menashe said. “DORA is basically saying if you can offer people mental health support right now, please do. I mean we’re meeting as often as they want. Usually weekly through these HIPAA-compliant [telehealth] platforms.”
“There’s a big learning curve in terms of accessing those platforms,” added Menashe, “but I think this just gives us more resources. Because in rural social work, asking someone to travel anywhere from 40 minutes to two hours to meet for an individual counseling is generally not available to most people.”
As much as she values the new accessibility of telehealth, Menashe is aware of the need to incorporate self-care into the process of adopting new technology systems.
“I’m going to have to really be intentional with monitoring a very different form of burnout symptoms,” said Menashe. “I’ve been to the telehealth trainings but I’m not ready to claim that I am competent as I would like to be as a telehealth provider yet.”
“There’s a difference in terms of the service that I can provide when I’m not in the room with someone,” Menashe said. “I worry, what else could I be implementing to make sure that I’m providing the best care and taking care of myself at the same time? It’s different and we’re all learning together.”
Changing environment requires flexibility and patience
As a behavioral health clinician in Colorado Health Network’s Greely location, Victoria Cervi (BSW, ’15, MSW, ’17) noted both the challenges and opportunities currently faced by social workers administering behavioral health services remotely.
“Our clients are often hesitant to engage in programing even without the limitations presented by the COVID-19 pandemic,” said Cervi. “This has imposed even more barriers to accessing services, which has been difficult to navigate for us as service providers.”
“My biggest concerns were regarding the safety of our clients. Not only are our clients immunocompromised, the majority live at or below the poverty line and often fear losing housing or having access to food,” Cervi said. “I was worried our clients would have to prioritize accessing resources over their physical health.”
Fortunately there are also signs of adaptation to changing environments. “Our case management team is great and has been able to be flexible and to effectively offer resources remotely and do food box delivery” Cervi said. “I have found that the clients are taking the risks seriously and have been very flexible with us as well.”
“We have had to pay close attention to changing state statutes…such as for verbal consent and signatures, as most of our clients do not have access to printing and scanning equipment,” Cervi said. “Currently we are creating procedure for conducting intakes remotely, as we want to be able to continue offering services to clients who are looking for support.”
Cervi believes flexibility must guide implementation of supportive services and that policy, both at the organizational and state levels, can be adjusted to meet the needs of clinicians and the people they serve.
“I hope that once we are able to resume in person services we are also able to maintain the flexibility to offer services to those who may not have had access before, especially for those in more remote locations, or with disabilities that prevent them from accessing services in person.” said Cervi.
Flexibility, as well as patience, are also essential for social workers themselves, now more than ever. These key concepts are helping CSU alumni generate the strength and resilience needed to survive the 2020 pandemic.
“It has taken me a full month of working from home to get to the point of offering myself self-compassion,” Cervi said. “I was incredibly stressed at the beginning of this pandemic, as many of my clients were not responding well to the concept of telehealth, but we are all adjusting. Providing services in whatever way I can is enough.”