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Social work supervisor: What cases do you want to discuss at this conference?

Social worker #1 (Julie): I have two: the McDonalds and the Sanchez family.

Social worker #2: I want to see if anyone has ideas for additional housing resources for Juanita Robinson, but we can talk through that after we staff Julie’s cases.

Supervisor: Okay, sure. (turning to social worker #2) Remind me to talk with you about the new supportive housing program at New Light Mental Health, by the way. It’s not the right fit for Ms. Robinson, but I want to make sure you understand the eligibility criteria so you can assess if any of your clients are a good fit. (turning to Julie) Julie, where do you want to start?

Julie: Let’s start with the Sanchez family. I met with Celia yesterday, and the financial strains are really getting to her. Having Roberto (as an aside to social worker #2)—“that’s Mrs. Sanchez’s nephew—stay with them has increased the pressure on Hector as the family’s primary earner, and Celia is worried that his income just won’t stretch far enough to meet their needs. We talked about the family applying for SNAP, but she said that Hector will never agree to use Food Stamps. It’s frustrating, really, because, while I understand that he is proud and hard-working, the SNAP program was designed to support good nutrition for those in need, and there is no reason why this family shouldn’t get that help. I’m not sure what else to try.

Social worker #2: Are you sure that the family would qualify for SNAP? Hector and Celia aren’t citizens yet, are they?

Supervisor: Noncitizens are eligible for SNAP if they are qualified immigrants and since (checking file in front of her) the Sanchezes are Lawful Permanent Residents with more than 5 years in the United States, their immigration status wouldn’t be a barrier. Of course, Roberto won’t count as a member of their household, since he is undocumented, right? That will make it a little more difficult for them to qualify, but I’m assuming you have run the calculation, Julie, of their income against the USDA guidelines?

Julie: Yes, and they are income and asset-eligible. It’s just that I think that our cultural differences are getting in the way, too. I don’t think that Celia believes that I can understand Hector’s reluctance to apply for assistance, and I guess I can’t really imagine what it must be like to leave your home country, make so many sacrifices for your family, and then not be able to provide for them the way that you really want to. I think that Celia trusts me, though, at least enough to confide that she is so desperate that she wishes there was a way to apply for SNAP without her husband even finding out. I’m just not sure at all how to get through to him.

Social worker #2: What about other options for food assistance? Have you tried the church pantry? What about the mobile food bank?

Julie: Yes, absolutely. Celia gets some food from her church pantry, but, of course, Hector has diabetes, and most of the donated food that’s available is pretty high-fat and high-sodium, which isn’t good for his heart or his weight management. It’s such a paradox; so many of my clients who lack enough food are overweight at the same time. It almost seems like obesity and hunger are two sides of the same coin. Anyway, what she needs most are additional resources to help her afford good food at the grocery store. She is a great cook and has learned so much about how to help Hector with his diet and health, but she doesn’t have enough money to put those skills into practice. What can I do to connect the family to this critical support?

Supervisor: It seems that you already know the answer, Julie; you have to work on building a trusting relationship with Hector so that you and he can partner, together, towards his goal of providing for his family. SNAP could be a tool that Hector uses to meet his family’s needs, especially during this difficult time, as they support Roberto, as well. But to get there, you’ll have to begin with Hector’s strengths and reflect for him what you said earlier, about how many sacrifices he has made for his family’s well-being, and how hard that must have been for him.

Julie: I know. That has been hard, though, since he works so much that he is rarely at home when I visit with the other family members, and since language is sometimes a barrier; even though he speaks English, I can tell that he doesn’t always feel comfortable speaking English with me, maybe because he is self-conscious, or maybe because Celia doesn’t understand it well. When she comes here, I can use our interpreter, and it has made building a relationship with her so much easier. I have also talked with Alejandro, their younger son, because he has quite a bit of anxiety and some depression, much of it stemming from the stresses he sees on his parents and his feelings of frustration that he can’t provide them with more help. He talked with his mom and tried to explain the system to her, and how benefits could help them, but he just doesn’t feel comfortable challenging his dad’s position.

Social worker #2: Sometimes people accuse immigrants of not adopting U.S. values and customs but, you know, it occurs to me that Hector’s hesitation to use Food Stamps is quite (makes air quotes) “American.” Maybe he’s responding exactly the way that people want him to.

Julie: What do you mean?

Social worker #2: I read in the paper yesterday that the state is getting a new vendor for the SNAP cards—you know, the ones that you use at the grocery store, instead of the coupons that people used to get? Anyway, they claim that that’s the reason for the new design of the card, but I think that sounds fishy. Get this: it’s going to be bright red and labeled Food Assistance!

Julie: Seriously? Can they do that?

Social worker #2: They say that they can. The card SNAP recipients get now just looks like a credit card, and people swipe it just like a credit card, too. Sometimes when I’m at the grocery store in line next to people using those WIC coupons, other customers roll their eyes, but that doesn’t happen much with SNAP, since people can’t usually even tell that someone is receiving assistance. A bright red card would certainly change that. I can’t help but wonder if part of the rationale isn’t to try to shame people into not applying for the help, so that then they don’t have to pay for it. I know that sounds cynical, but there’s no reason for them to make such a blatant move, in my opinion, otherwise.

Supervisor: I haven’t seen anything about this yet. Is it just a proposed change, or has it already happened?

Social worker #2: As far as I remember, the contract for the new card vendor has already been signed. The state privatized that function quite a while ago, of course. The article said that some legislators were upset about it, though, and that there would be a legislative hearing to investigate the details of the new contract and explore alternatives to the design.

Julie: That would be such a horrible move. I have had a hard enough time convincing the Sanchez family that they deserve this help, and that there’s no shame in asking for assistance when your family is in need, without such an overt stigma attached to getting food aid. If the state moved to a scarlet letter for people in poverty, I would probably have other clients go hungry in order to avoid being embarrassed, too. It makes me so angry, too, especially because Hector works so hard at his job and is trying so hard to improve his diet and his health. How can the state consider something like this?

Supervisor: It is maddening, and it often seems like policy changes like this are proposed by people who have very little understanding about what our clients’ lives are really like. I doubt that any of the policymakers who negotiated the new contract and the revised design have any idea how reluctant people like Mr. Sanchez are to ask for help, even when they need it, or how hard he works to try to provide for his family. I wish that all of our legislators had to live for a month on a food stamp budget, to see how hard it is to provide for your family’s nutrition on so little money.

Social worker #2: Julie, why don’t you testify at the hearing that the legislature is going to hold about the new SNAP cards? It would be great if Mrs. Sanchez would go, too, to tell her story about how much her husband resists asking for help even when they need it, but I would imagine that she would be very reluctant to do that. Couldn’t you talk about the obstacles that your clients face in getting help from government programs, though, about how stigma keeps people from applying for the help that they are entitled to, and about how important good nutrition is to good health? I would help you practice your testimony; I testified once in college when there was a bill to reduce funding for our School of Social Welfare because some legislators objected to the fact that we had a human sexuality course. It was scary, but I got a lot of positive feedback from legislators, and it was a good experience overall.

Julie: Do you think I could do a good job? What would I say? And I would have to take vacation time, right, because I can’t go to the legislature on work time.

Supervisor: Actually, Julie, we could ask for permission from the CEO for you to represent the organization at the hearing. We do lobby on some issues that matter to our programs, through our state association, and this issue certainly falls within our broad concerns about policies that affect low-income families. If you are willing to go, I would be happy to make the request for paid leave on your behalf. I think it’s a great idea, and it might make you feel better about having hit a bit of a brick wall with Mr. Sanchez, too—at least you’d be doing something! I wonder if Alejandro might be interested in going with you; maybe he could even share something about how there is so much stigma in his community, already, about using public assistance, and how this move would just make it worse.

Julie: He might; I think, at the least, that he would be interested in going with me. He has gotten involved with some political action at the community college where he’s taking classes, and he and I have had some good discussions about how policy in the U.S. is quite different from how it’s portrayed in other countries. How long would I need to speak? Where would I even go? What if they ask me really hard questions? It’s sort of overwhelming, but it does make me feel a little less hopeless…and the idea of those bright red cards just makes me so mad.

Social worker #2: I had coffee the other day with a social worker at Stand Up for Kids, the organization that puts on that early childhood lobby day every year. I could call her and I bet she would have a lot of information about how the hearings work and how to prepare. She might even be able to meet you at the capitol that day, to help you get to where you need to go. I’ll look for the article so that you have the information about the new card design—I think it even had a picture of the proposed layout. There might be some information online about other states that have done something similar, or about how social workers can oppose efforts to stigmatize receiving public assistance. We can check it out. And, seriously, I will listen to you practice your testimony at lunch every day this week, if you want!

Julie: OK, I’ll do it. You’re right, Susan—these policymakers have no idea how difficult my clients’ lives are, or how much it would pain someone like Ms. Sanchez to experience the stigma associated with being branded a ‘charity case’. I may not be able to convince the legislature to change the contract or go back to the old cards, but it will feel good to stand up for Mrs. Sanchez and her family. I think about her every time I’m at the grocery store, and about how hard it must be for her not to be able to afford the food that she knows her husband and children need. I’m going to keep trying to get her connected with good sources of food assistance, but I need to try to do something about this policy, too.

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Initial Social Work Interview with Emilia Sanchez

SOCIALWORKER: Hi! How are you today?

EMILIA: Fine.

SOCIALWORKER: Good, good. Thanks for coming in today. What we’re going to do is I’m going to ask you some nosy questions, and whatever you’re not comfortable with answering, just let me know and we can move on. But before we get started, I just wanted to let you know that there are a couple of rules of confidentiality. The first one is that if you are a danger to yourself or to anybody else and if there’s any—if you report to me any child abuse, I will have to do something about that. So I just want to let you know those things upfront so you can decide how you want to proceed with your answers. Okay?

EMILIA: Okay.

SOCIALWORKER: Do you feel comfortable?

EMILIA: Yes.

SOCIALWORKER: Okay. Great. Why don’t we start with telling me why you’re here today?

EMILIA: Well, my parents want to adopt my son who’s been staying with them and I don’t want that to happen.

SOCIALWORKER: Okay. How long has your son been staying with your parents?

EMILIA: Since he was born.

SOCIALWORKER: Okay. And how—?

EMILIA: And he was in foster care.

SOCIALWORKER: And how old is he?

EMILIA: He’s four.

SOCIALWORKER: He’s four. Okay. So, your parents have had custody of him pretty much from the beginning?

EMILIA: Yeah.

SOCIALWORKER: Okay. How did they come to have custody of your son?

EMILIA: When he was born, he was tested positive for drugs and so they took him away.

SOCIALWORKER: Okay. When you say they took him away, was that DFS that took him or your parents?

EMILIA: DFS.

SOCIALWORKER: Okay. And so that’s why you’re here is to look at how you can get your son back?

EMILIA: Yes.

SOCIALWORKER: Okay. Great. Tell me about your relationship with your parents right now?

EMILIA: They are not very happy with me.

SOCIALWORKER: Okay.

EMILIA: They are angry because I got an abortion a few years ago and they don’t believe in that.

SOCIALWORKER: Okay. That sounds like that was a really difficult situation that you were in.

EMILIA: Yeah.

SOCIALWORKER: Okay. Do you feel comfortable talking about the circumstances that led up to you making the decision to have the abortion?

EMILIA: Sure.

SOCIALWORKER: Okay. Tell me what was happening with you and your parents at that time.

EMILIA: Well, I was pregnant and they wanted me to keep the child because they don’t believe in abortions and I refused to do that.

SOCIALWORKER: Okay. What was your support like outside of your parents during that period?

EMILIA: Well, I mean, I have friends that I’m staying with right now.

SOCIALWORKER: Were they supportive of you keeping the baby or were they wanting you to have an abortion, too?

EMILIA: They told me it was my decision.

SOCIALWORKER: Okay. And how did you feel having that type of support?

EMILIA: I thought it was good because they’re letting me do what I think is best for me…

SOCIALWORKER: Okay.

EMILIA: …and not trying to influence me.

SOCIALWORKER: So it sounds like even though your parents weren’t very supportive of you having an abortion that you were able to find other people in your life who accepted you and made you feel like what you were doing was what was best for you.

EMILIA: Yes.

SOCIALWORKER: Good, okay. You had mentioned earlier that your son had been removed from your custody due to substance use on your part. Tell me about your substance abuse history.

EMILIA: Well, I started in high school and I got addicted, and so I’ve been trying to stop.

SOCIALWORKER: Okay, good. How have you tried to stop?

EMILIA: Well, right after Joey was born, they put me in rehab but I wasn’t able to finish, and so now I’ve just been trying to stay sober.

SOCIALWORKER: On your own?

EMILIA: Yes.

SOCIALWORKER: Okay. What are some of the skills that you learned when you were in rehab that you’ve been able to use to stay sober?

EMILIA: Things like going to meetings, trying to spend time with the people who aren’t using.

SOCIALWORKER: Okay. You mentioned that you learned that you need to change your social situation. Are these the same folks that you kind of depend on to support you when your family is not around?

EMILIA: The people I’m staying with right now don’t use drugs.

SOCIALWORKER: That’s great. That’s really a helpful tool that you—make sure you keep yourself in a safe environment. The people that you’re living with now, it sounds like they’re supportive of you as a person and I’m wondering how supportive they are of you with getting your son back.

EMILIA: Then they told me that I probably won’t be able to live with them with my son.

SOCIALWORKER: Okay.

EMILIA: So they said if I’m going to be living with him, I’m going to have to find somewhere else to stay.

SOCIALWORKER: Okay. How do you feel about that?

EMILIA: I think it’s a good thing because if I’m going to get him back, I’m going to need to get my life together and hopefully have my own place I anyways.

SOCIALWORKER: Okay. So it sounds like what you’re saying is that even if these folks have been really supportive of you and your sobriety, they know their limits and that they can’t have you and a baby living in their home. Okay. So that could be kind of scary.

EMILIA: Uh-huh.

SOCIALWORKER: To have to go out on your own with you and your son without the support that you’ve been counting on. Who else do you find to be supportive of you in your life?

EMILIA: Some of my siblings support me. Some of them are on my parents’ side but there are a couple who still talk to me.

SOCIALWORKER: Oh, good. Okay. Okay. Let’s talk a little bit more about what was happening in your early high school years when it sounded like things were starting to get out of control with starting to use drugs and having problems in school. Tell me about your relationship with your parents back then.

EMILIA: Well, right, I had always been like the nice quiet one and I got tired of being that person, so I started changing and my parents didn’t really know what was happening so it was kind of hard for them, I guess.

SOCIALWORKER: And how did they respond when you started maybe hanging out with different people or doing things that they weren’t used to you doing?

EMILIA: Well, they didn’t really notice at first because they were—they have all the other stuff like to take care of and I never had done any trouble before. And then after they noticed, they tried to punish me, things like that, so that I ran away from home.

SOCIALWORKER: Okay. Let me just make sure that I’m understanding what you’re saying is that up until early high school, you’d been a really good kid in your parents’ eye, didn’t cause any trouble, did everything that you were supposed to do. And then something happened during that period and you started to rebel. And at first they didn’t really notice and then they didn’t know what to do with you, and so they tried to punish you, and instead of kind of working things out, you decided that it was better just to get away. Is that correct?

EMILIA: Yeah.

SOCIALWORKER: Okay. Okay. It sounds like that was a really difficulty period for your whole family.

EMILIA: Uh-huh.

SOCIALWORKER: Would you say that you feel like maybe you got lost in the mix there with all the kids at home?

EMILIA: Yeah. I mean, nobody ever really paid that much attention to me, so.

SOCIALWORKER: Okay. But it sounds like once you started using drugs and alcohol and hanging out with the different group of people, they really started to pay attention to you.

EMILIA: Yeah.

SOCIALWORKER: Okay. Yeah. So tell me more about what led up to you having Joey?

EMILIA: Well, I mean, his father and I were never—I didn’t even know him. And then he got me pregnant and then I had Joey.

SOCIALWORKER: Okay. How did your parents respond when you told them that you were pregnant?

EMILIA: Oh, they were disappointed in me but they knew they wanted me to keep the baby, so they were pretty supportive.

SOCIALWORKER: Okay. So it sounds like they were supportive of you until you actually had the baby and then they took him from you.

EMILIA: Well, he—I mean, the government took him and my parents decided that it would be better for him to stay with them than just another foster family.

SOCIALWORKER: Okay. So they stepped in to help out?

EMILIA: Yes.

SOCIALWORKER: Okay. But they’ve been reluctant to return him to you?

EMILIA: Yes.

SOCIALWORKER: Okay. And so that’s what being here today is about is figuring out ways to get him back. Is that correct?

EMILIA: Yeah.

SOCIALWORKER: Okay, good. So what are some things that you feel like you want to accomplish in order to get Joey back?

EMILIA: Well, I don’t want my parents to adopt him because I feel like once they do that, I’ll never be able to get him back.

SOCIALWORKER: Okay. Why do you want your son back?

EMILIA: Because he’s my son and I want to be able to support him.

SOCIALWORKER: Okay.

EMILIA: And I don’t want him to feel like I’ve abandoned him.

SOCIALWORKER: Okay. So it sounds like being a parent and being responsible is really important to you. The next part of the assessment is that I need to do what’s called a Risk Assessment and basically what that means is I just need to make sure that you are safe and that your environment is safe at this point, okay? Do you have any questions about that?

EMILIA: No.

SOCIALWORKER: Okay. So I’m going to ask you just some real direct questions. The first thing is in the past 24 hours have you had any thoughts of wanting to hurt yourself or anybody else?

EMILIA: No.

SOCIALWORKER: Okay. Is there any danger of you returning home at this point?

EMILIA: Danger?

SOCIALWORKER: Is there anything going on at home that might be a safety issue for you at this point?

EMILIA: Oh. No.

SOCIALWORKER: Okay. Have you ever been accused of or perpetrated any type of child abuse?

[END VIDEO at 0:12:51] No.

SOCIALWORKER: Okay. Thank you. Have you been hospitalized in the past year for any type of psychiatric issues?

EMILIA:No.

SOCIALWORKER: Okay, good. Finally, let’s just kind of look at where we’re going to go from here, and you had said before that you want to get your son back and I think at this point we just kind of need to figure out what our plan is going to be. So tell me a little bit about what you think you need to do in order to get Joey back.

EMILIA: I think I need to get sober and get a job, maybe go back to school. So can you help me with that?

[END VIDEO at 0:12:51]