Current



Analysis of COVID – 19Caitlin BauerBriar Cliff UniversityIntroduction During the current pandemic of COVID – 19, there is no doubt of the great impact it has on society. But, further analysis with a social work lens is required to understand exactly how great the impact is across systems at the micro, mezzo, and macro level. In order to achieve this, a variety of resources will be used. They include: current knowledge on COVID – 19 from credible sources, the Council on Social Work Education’s (CSWE) nine competencies (2015), and findings and recommendations from my internship agency and my community. Current InformationIn order to fully understand the impact COVID – 19 has, it is necessary to be aware of the current state of the pandemic as well as current information on it. Nationwide, as of April 9th, 2020, the reported number of COVID – 19 cases is 427,460 out of the total United States population of 329, 497, 250; in other words, about 0.13% of the U.S population has contracted the virus (CDC, 2020a). As of April 9th, 2020, Colorado has 5655 confirmed, reported cases (CDC, 2020a). A population estimate from the United States Census Bureau approximates the Colorado population, as of July 1st, 2019, at 5,758,736 people (USCB, 2020a). In other words, about 0.1% of the Colorado population have contracted the virus as of April 9th, 2020. On an even smaller scale, in Weld County, my county of residence in Colorado, there are 614 confirmed cases (CO, 2020). A population estimate from the United States Census Bureau approximates the Weld County population, as of July 1st, 2019, at 324,492 people (USCB, 2020b). In other words, 0.19% of the Weld County population contracted the virus as of April 9th, 2020. While these numbers represent current confirmed cases, they do not, represent the full impact of COVID – 19 across systems. In Colorado, institutes of education, workplaces, places of worship, and recreational sites have been closed, because of the stay-at-home order, to slow the curve of the pandemic. Due to this, people have adapted in great ways to working, learning, worshiping, and living at home. While these adjustments show the resilience of Coloradans, the shadow side of the stay-at-home order warrants concerns for mental health as many people are isolated from friends, family, and coworkers. A complete analysis of COVID – 19, through a social work lens, will include a look at what changes have been made in my community on a micro, mezzo, and macro level due to the pandemic; it will also include what my internship agency, as a leader in behavioral and mental health care in northern Colorado, is doing to respond. Competency 1: Demonstrate Ethical and Professional BehaviorSocial workers often face ethical dilemmas when working in the professional environment. When such situations occur, an ethical decision-making model can be applied to reach a decision ensuring all ethical guidelines have been followed. One ethical model comes from the National Association of Social Workers, Massachusetts Chapter (NASW-MA) and can be applied to the current pandemic in Colorado on all three levels of practice (see Appendix A). First on the macro level, the steps for ethical decision making were followed which indicates the state government adhering to ethical codes. The first step in the model is to determine whether there is an ethical dilemma present and the second step is to determine what values are then attached to the dilemma (NASW – MA, 2017). For example, Colorado governor Jared Polis explained that “this decision was made to help save lives” at a press conference on March 25th that first announced the stay-at-home order going into effect (Polis, 2020). This indicates that after weighing the great economic costs of the order with the potential costs of human lives, the value of life was prioritized. The state of Colorado then moved to steps four and five which is determining and then implementing an action plan (NASW – MA, 2017). Part of the ethical guidelines for implementation is making use of core social work skills (NASW – MA, 2017). For example, the state partnered with major hospitals as well as Colorado University (CU) and Colorado State University (CSU) to set up new labs to test personal protective equipment for redistribution (Polis, 2020); this exemplifies standard 2.03 Interdisciplinary Collaboration in the Code of Ethics (NASW, 2017). Second, this same ethical decision-making model can be applied to analyze the steps my internship agency took to address the pandemic on a mezzo level. Prior to the stay-at-home order being issued, North Range Behavioral Health (NRBH) made the decision to temporarily close all locations for two days; this decision was not taken lightly (B. Shover, Personal Communication, April 20, 2020). NRBH followed step three in the ethical decision-making model and determined that the long-term safety and health of the community overall was a higher priority than the immediate, short-term needs of clients. However, the clients of NRBH were still kept a top priority as the agency immediately implemented their developed action plan: telehealth and remote work. By following the model through step five, the agency not only adhered to ethical practice, but also kept the whole community surrounding NRBH safe by minimizing potential exposure to the virus. Also, by immediately implementing the action plan of telehealth and remote work, NRBH adhered to their agency value “customer first” which means helping customers achieve recovery every day (NRBH, 2018). This is similar to ethical standard 1.01 in the NASW Code of Ethics that explains “social workers’ primary responsibility is to promote the well-being of clients” (NASW, 2017, par. 3). Finally, on a micro level, I also applied the ethical decision-making model in my personal life which has helped me to demonstrate ethical and professional behavior during recent changes. I am especially following step six of the model which is to reflect on the outcomes of the process (NASW – MA, 2017). I realize that when I adhere to the instructions of my internship agency, who is also following the direction from the state government, I too am following the ethical model. For example, according to the Center for Disease Control and Prevention (CDC) older adults are one of the populations most at risk to the virus (CDC, 2020b). I know that the disappointment of no longer engaging in the public ranks below the benefit of keeping my family safe from exposure, especially since I live with my grandparents whom are in their late seventies. In addition, I am demonstrating ethical and professional behavior not only by following the ethical decision-making model, but also by using technology ethically and appropriately to facilitate practice outcomes and by using supervision and consultation to guide my professional behavior (CSWE, 2015). For example, I am participating in several regular weekly meetings through Zoom, one of which is supervision; I am responding to emails and other forms of electronic communication in a timely manner. I also recently led a grounding/meditation exercise through Zoom for a reflective group meeting; these help professionals to develop self-awareness in order to better serve their clients. By understanding ethical decision making on all levels of practice, and by engaging in ethical practice myself during this pandemic, I am becoming a more competent professional. Competency 2: Engage Diversity and Difference in PracticeThe Colorado stay-at-home order went into effect on March 26th, 2020, and due to this, countless businesses deemed as non-essential temporarily closed. This has a large negative effect on the economy because people are not working to earn money, therefore, they are not spending money. The cycle of monetary exchange has slowed, and even stopped in some ways. Analyzing this through a systems perspective, provides an awareness to the intersectionality of diversity in terms of class and race which results in greater competence in practice for professionals during this pandemic. In addition, NRBH professionals exemplify competence in diversity. On a macro scale, since the outbreak of COVID – 19, Americans are adjusting to a new lifestyle, but adjustment is harder for marginalized populations. Due to the unequal distribution of wealth in America, there is an unequal distribution of the security wealth provides in times of crisis. With little no to wealth security and bleak job prospects, African American and Latinx families are more likely to face insecurity during crisis than their white counterparts (Solomon & Hamilton, 2020). Insecurity may present itself in housing, food, and health, meaning the basic necessities for life are in jeopardy during the current pandemic.Looking at a smaller scale in Weld County, the intersectionality of diversity can be understood better. A population estimate from July 1st, 2019, approximates 65.4% of the population is White, 29.6% of the population is Hispanic or Latino, and 1.5% of the population is Black or African American; also 19.3% of people speak a language other than English at home (USCB, 2020b). These numbers show that while White peoples make up a majority of the population, there is no doubt of the great diversity in Weld County and therefore, a great need for services that understand this diversity. Similarly, the same estimate approximates that 10.5% of people are living in poverty in Weld County; this number however, is reflective of a stable economy not experiencing crisis (USCB, 2020b). Thinking of minority populations, the percentage of those in poverty is expected to rise now because “those families who are more likely to experience the fallout from this crisis are disproportionately nonwhite families with low levels of wealth” (Solomon & Hamilton, 2020). This shows the relationship between wealth and race and the effect it will have on Weld County residents. On an even smaller scale, the clients that NRBH serves in Weld County are extremely diverse in terms of class, race, and needs; understanding this diversity allows professionals at NRBH to respond in an appropriate way to help their clients. Once the agency made the transition to telehealth and remote work, in order to respond to the state-wide stay-at-home order, they were able to continue serving their diverse clientele. NRBH serves clients in several different languages, and by using technology, is able to continue helping those in need. For example, therapists and home visitors are able to meet with clients through the HIPAA compliant platform Zoom for face to face interaction (B. Shover, Personal Communication, April 20, 2020). Phone calls are another way of reaching clients. This allows for continued services aimed at reaching clients through a mode of delivery that is accessible to them. NRBH exemplifies the Code of Ethics value of service by adapting to new means of providing care to their clients because they are helping those in need and addressing different social problems (NASW, 2017). In addition, services that were provided in English and Spanish continue. For example, the program called Dina School, a therapeutic classroom environment for childcare while parents are in group/therapy, is now called Dina Club. It is a fifteen-minute session held over Zoom that children can engage in activities at home similar to the ones in the classroom (B. Shover, Personal Communication, April 20, 2020). At home, children are still developing the social and emotional skills of Dina School because the professionals are purposeful in the lessons each day. Another example is the parenting group that occurs twice a week, one in Spanish, one in English. This group has also been able to resume via Zoom (B. Shover, Personal Communication, April 20, 2020). By continuing to provide services to diverse clientele, NRBH is aware of the different needs in the community and they are adhering to ethical standard 1.05 Cultural Awareness and Social Diversity (NASW, 2017). Personally, I am developing this competency by engaging difference in practice. Although I no longer engage in direct service with clients, through the virtual meetings, I present myself as a learner to other professionals. Life during the pandemic is unique for everyone, yet the same because it is difficult. By listening to the different experiences of professionals at NRBH and participating in conversation, I am engaging others as experts in their own experiences. Similarly, by reflecting on the different experiences everyone is having during this time, I am applying self-awareness and self-regulation to manage my own biases I may hold during this crisis. I have developed competence in diversity and difference especially through conversation engagement and personal reflection. Competency 3: Advance Human Rights and Social, Economic, and Environmental JusticeAs the world works to slow the curve of COVID – 19, human rights and social, economic, and environmental justice are at risk. Human rights and social justice refer to access to protective equipment as well as medical testing and treatment of the virus. Economic justice refers to the amount of wealth available to an individual or family during the pandemic which is directly related to aspects like health insurance and job security. Environmental justice refers to accessibility to non-medical resources such as food, living situation, the ability to social distance, and the ability to self-quarantine. All of these factors impact the spread of COVID – 19. Thinking of these definitions, the global interconnections that impact human rights and social, economic, and environmental justice during this time include location and development status of countries. Globally, nations across the world are struggling with the spread of the virus and with access to medical care due to the space/region of their location, and their economic status. For example, Africa is the world’s second largest continent by population and land area (World Atlas, 2020). This continent has been deemed especially vulnerable to COVID – 19 due, in part, to “the layout and infrastructure of some of the biggest cities on the continent, where the majority of the urban population lives in overcrowded neighborhoods without reliable access to hand-washing facilities” (Dwyer, 2020, par. 4). Once it is noted that 34 of Africa’s 54 countries (about 63%) are on the United Nation’s list of least developed countries as of 2013, the interconnections of space/region and economic status of countries globally becomes clear (UN, 2014). In other words, the varying location of a people globally greatly impacts their risk or protective factors to COVID-19. The easy contraction of the virus in addition to the fact that developing nations already face daily challenges such as “fraying health-care systems, fragile governments, and impoverished populations in which social distancing can be practically impossible” brings awareness to human rights and social, economic, and environmental justice issues on a macro level during the pandemic (Faiolo et al., 2020).Looking at the same interconnections of how the location in which people live and their economic status impacts human rights and social, economic, and environmental justice, systemic inequality can also be understood on a local level. Weld County is mostly a rural community, aside from the city of Greeley which makes up about a third of the population. Living in a rural setting provides some protective factors such as making it easier to social distance and self-quarantine. However, rural living also provides risk factors when it comes to accessibility and economic status. In Weld County, 10.5% of the population, or about 34, 072 people are living in poverty (USCB, 2020b). Considering this number with high level of rural communities raises concerns for local leaders on strategies to safely provide social, economic, and environmental justice and promote human rights. Despite the structural barriers presented by systemic inequality on both local and global levels, there are a few strategies to be taken in order to ensure equity. First, partnering and sharing resources on a global and local level can help to create equity. In other words, this means that those who have more, or have access to more, share with those who have less, or have access to less; this will promote human rights and social, economic, and environmental justice by creating equity in resources. For example, NRBH Family Connects program is creating “survival kits” to send to the families they currently serve; these contain resources for parents, resources for children, as well as tangible items such as markers and bubbles (B. Shover, Personal Communication, April 20, 2020). Another example is that NRBH has partnered with United Way of Weld County (UWWC) to supply resources for families in need with young children. The resources include items such as diapers, wipes, and baby formula (B. Shover, Personal Communication, April 20, 2020). This is made possible through coordinated efforts of FEMA and the Colorado State COVID Emergency Fund. Second, identifying those global populations or local communities that are most in need will promote environmental justice by creating safer, healthier spaces for people everywhere. Third, creating and advocating for policies to address inequality in crisis will ensure equity by fighting policies that create structural barriers. Policies that provide relief funding for families locally and globally are needed to avoid non-viral causalities during the pandemic. For example, in the US, the CARES Act was passed in late March; this legislation provides economic support for individuals and businesses in addition to changes in tax policy (Watson, et al., 2020). This financial aid provides some relief for families in poverty who may not have an income during the pandemic, as the legislation provides more relief for those with lower incomes. Following strategies such as these will help slow the negative impact that COVID-19 has on human rights and social, economic, and environmental justice. Competency 4: Engage in Practice-informed Research and Research-informed Practice Understanding the full impact of COVID-19 through research will inform best practice in a variety of situations. On a macro level, the negative impact of the virus quickly became evident due to the rapid growth of transmission and infection rates worldwide. A study located in Germany and completed in late January, gave an insight early on to how the virus was spreading so quickly (Rothe et al., 2020).One reason the virus spread so rapidly, the study points out, is that “asymptomatic persons are potential sources of 2019-nCoV infection” (Rothe et al., 2020). What this means, is that persons who have contracted the virus, may not even be aware of it due to an absence or delay of symptoms. This fact is a major concern for leaders across the globe and resulted in a “reassessment of transmission dynamics of the current outbreak” in order to slow down the spread (Rothe et al., 2020, par. 7). Furthermore, the study also raises the point of concern of possible transmission of the virus even after recovery (Rothe et al., 2020). As a result, leaders in the medical field wondered what measures could be taken to prohibit rapid spread of accidental infections.This reassessment of COVID-19 dynamics currently guides professional and personal practice on the micro, mezzo, and macro level even three months later. One evidence-based approach that resulted from information revealed in the study is social distancing. The World Health Organization (WHO) recommends social distancing of at least one meter (WHO, 2020a). However, most public places are taking extra precautions and doubling the length to six feet of social distancing. This is because when a person coughs or sneezes, they spray small liquid droplets from their nose or mouth which may contain virus; if another person is too close, they can breathe in these droplets that may contain the virus (WHO, 2020a). Social distancing is recommended on a global level, and can especially be seen practiced in local communities as markers have been placed on the floor in grocery stores for people to maintain the six-foot distancing when waiting in line to check out. On a micro level, NRBH, although currently engaged in telehealth and remote work, has implemented policy adhering to social distancing. If employees need materials from the office, they must schedule in advance and notify supervisors for monitoring purposes (B. Shover, Personal Communication, April 20, 2020). The intention is to keep the number of people and their time spent in the building to a minimum. The second evidence-based approach that resulted is wearing face masks. On a macro level, the WHO urges people to wear masks if they are coughing or sneezing, or if they are caring for someone with COVID-19 (WHO, 2020b). On a mezzo level, the governor of Colorado declared that if people are out of their homes, they should use a mask at all times (Hill, 2020). While not a requirement, the governor urged all Coloradans to wear any sort of cloth face covering out in public that can be washed frequently in order to protect those most vulnerable to the virus (Hill, 2020). On a micro level, NRBH has put policy in place that if anyone enters one of the eleven locations, they must be wearing a face mask. In addition, as childcare resumes at Family Connects, providers would most definitely wear face masks to protect young children and infants from the virus (B. Shover, Personal Communication, April 20, 2020). Competency 5: Engage in Policy PracticeThe importance of engaging in research-informed practice is similar to the importance of engagement in policy practice. In the social services and medical fields, one of the most essential public health policies to be aware of is the Health Insurance Portability and Accountability Act (HIPAA). HIPAA was passed in 1996 and plays a critical role during the COVID-19 crisis as many healthcare providers switch to telehealth (HHS, 2020). Since telehealth requires a new use of existing technologies, following public health policy such as HIPAA is necessary for continuing to meet the needs of clients and adhering to professional ethics. Agencies that engage in practices with HIPAA compliant technologies are also adhering to the NASW Code of Ethics (2017) standard 1.07 privacy and confidentiality of clients. Local agencies such as NRBH are adhering to both HIPAA and the NASW Code of Ethics (2017) in their telehealth services. When discussing possible methods of video communication with clients, NRBH noted that platforms such as Skype, Google Hangouts, and FaceTime are not HIPAA compliant; other platforms such as Zoom are, as long as it is through a professional subscription (B. Shover, Personal Communication, April 20, 2020). The US Department of Health and Human Services (HHS) also supports the use of platforms such as Zoom because they provide HIPAA compliant video communication services and because they will enter into a HIPAA business associate agreement (BAA) (HHS, 2020). In evaluation of the HIPAA technology policy’s impact on service delivery, a couple points are brought to light. First, the shadow side of telehealth is that by not using platforms already installed on smartphone devices, such as FaceTime, it may be difficult for clients to gain access to other platforms. This impacts service delivery because either extra time is needed or valuable time is taken away from scheduled appointments to help the client gain access to and become familiar with a new technology. However, this obstacle is minute in comparison to the alternative of not providing behavioral health services at all due to lack of technology access. Second, socioeconomic factors have to be taken into consideration as some clients may not have access to reliable internet services or own technology capable of video. In this case, then telehealth can be conducted through phone calls; however, in order to adhere to ethical policy, the phone calls must be made by the employees on NRBH issued phones (B. Shover, Personal Communication, April 20, 2020). A second policy to consider is a federal policy that allocates funding for state-wide initiatives to combat hunger during COVID-19. Under H.R 6201, the Families First Coronavirus Response Act (FFCRA), a variety of measures were taken to ensure the continued health of families during the pandemic; they include, but are not limited to, nutrition waivers, tax credits, health provisions, and emergency paid sick leave (FFCRA, 2020). Title II in this legislation is the COVID-19 Child Nutrition Response Act and mainly provides waivers for certain requirements of school lunch programs so they are able to serve families during this crisis. These programs include, but are not limited to, the school lunch program, the child and adult care food program, and the summer food service program all under the Richard B. Russell National School Lunch Act, as well as the school breakfast program under the Child Nutrition Act of 1966 (FFCRA, 2020). The waivers are for “providing meals and meal supplements under a qualified program”; however, it is important to note that this must be done taking the proper safety measures regarding COVID-19 as determined by the Secretary of Agriculture (FFCRA, 2020). As a result of this legislation, communities across Colorado are able to provide free meal services for families who might be facing food insecurity during the current pandemic. Families of all income levels may be facing food insecurity during the crisis due to unforeseen expenses or loss of employment. In other words, anyone is able to receive the meals. This service also benefits families in both urban and rural communities because schools in both types of areas are providing free meals (see Appendix B). Furthermore, the program is decreasing the risk of exposure to COVID-19 because students are able to take meals away from distribution sites to be consumed elsewhere; this allows for social distancing (CDE, 2020). On the mezzo level, it is clear that this federal legislation benefits many families in a variety of circumstances by creating equal access to critical food resources. Competency 6: Engage with Individuals, Families, Groups, Organizations, and Communities Understanding human behavior and the social environment is central to the field of social work; applying related theories will help professionals better engage with individuals, families, groups, organizations, and communities during the COVID-19 crisis. The Person-in-Environment perspective (PIE) looks at people as constantly interacting with various systems around them; for example, family, friends, workplace, educational places, religion, politics and social services (Zastrow & Kirst-Ashman, 2016). With this perspective, it is clear how people’s environments have drastically changed due to measures taken to slow the spread of COVID-19. A professional recognizes that constituencies must keep the current changing environment of individuals in mind when engaging in social service approaches. My engagement approaches across systems occurs regularly during the week through technology. For example, I am able to meet with my practicum task supervisor weekly as well as participate in reflective groups; I still stay in touch with my family during the stay-at-home order. In addition, the strengths of constituencies such as NRBH include resiliency and teamwork; this agency is using technology to continuously provide services to clients during uncertain times.In addition to PIE, Erik Erikson’s Theory of Psychosocial Development can also be applied to describe engagement approaches across systems. Erikson’s theory outlines eight stages of development; stage six is intimacy versus isolation and occurs between the ages of about eighteen to forty (McLeod, 2018). This stage especially refers to the exploration and development of long-term relationships other than family members. Intimacy is achieved in forming a variety of relationships while isolation is the result of the crisis of young adulthood in which people put barriers between themselves and others (Zastrow & Kirst-Ashman, 2016). In relation to the COVID-19 crisis, people who once enjoyed intimate relationships may now be experiencing isolation in relationships due to requirements for stay-at-home orders. Constituencies in the social services field must recognize the need people have for connection and intimacy in order to properly continue services. Isolation on top of pre-existing mental health challenges creates a unique challenge for providers in that clients may have new needs that arise. Strengths of constituencies such as NRBH include creative ways to maintain relationships with clients and colleagues. For example, the idea of starting a new grief group held over Zoom for clients was proposed. This would be a group for people who have lost loved ones to the virus or people who are simply grieving for the loss of what life used to be before the pandemic. in addition, NRBH recognizes the need of its employees to maintain intimate relationships and addresses this need by scheduling supervision, virtual lunch hours, and group meetings over Zoom. Competency 7: Assess Individuals, Families, Groups, Organizations, and Communities Continuing with the identification of theory in relation to COVID-19, theory can also help in assessing the needs and strengths of my community. Family Systems Theory looks at families as a system and subsystems within a family (Zastrow & Kirst-Ashman, 2016). For example, a family with two parents and three children is a system, while the three children are a separate subsystem from the parental subsystem. Family Systems Theory also looks at the relationships that exist in a family and how they influence the individuals in the system (PAT, 2016). Using this theory, I would assess my communities needs in the system of families. Children are now finishing the school year at home with online learning and many parents have switched to remote work. Understanding the unique functioning of each family is especially important during times of crisis to address new needs that may arise. For example, if I was meeting with a family via Zoom that I used to see for in-person services, I would inquire about their daily routine and what additional stressors are present. Depending on the needs identified, I would assess those through a family systems perspective and assess what services would best support the family system. For example, I could recommend services such as Dina Club, hosted by NRBH, for the children; this gives the parental subsystem respite for a few minutes every day. Giving the parental subsystem time to reflect and refresh might be beneficial for the family because the parents may then be more responsive to the children with the absence of stress. Another theory that helps in assessing the needs and strengths of my community is Ecosystems Theory. This theory is used to “describe and analyze people and other living systems and their transactions” (Zastrow & Kirst-Ashman, 2016, pg. 23). My community of Weld County has shown the strength of resiliency to address to new needs of its members. Using ecosystems theory, a closer look can be taken at how community services are helping individuals during the crisis. For example, families that are experiencing food insecurities can pickup meals at various schools serving as distribution sites; organizations like the Weld Food Bank are partnering with school districts to help with this need. The strength identified here is collaboration among constituencies.Reflecting on my personal experiences and reactions during the current pandemic, I understand that not everyone has the same experiences as me and that others reactions may be different than my own. Being able to self-reflect and hold my viewpoints will allow me to properly assess and make decisions with the clients best interests in mind. Competency 8: Intervene with Individuals, Families, Groups, Organizations, and Communities During the time of the stay-at-home order, new challenges arise in meeting new needs of clients and families. There is a need for people to stay connected now more than ever and to meet this goal, social service agencies can communicate information on ways to sustain close relationships with friends, family, and coworkers to combat feelings of isolation. For example, if I was meeting with a client who was experiencing increased anxiety due to feelings of isolation, I would inquire about their connection habits. I would prompt a discussion about who they have connected with lately and how they have connected with others. I would communicate free technology resources for them to use to visually connect with others in their system in addition to phone calls. I would also collaborate with the agency I am employed for and suggest possible virtual groups my client could attend in order to feel more connected and know they are not alone in feeling isolation. A second need identified during the time of the pandemic is the need for resources. Individuals and families may be experiencing a lack of resources due to unexpected changes in employment or income, which can result in greater stress/anxiety in the family system. To meet the goal of providing resources to individuals in my community, I would collaborate with other professionals to connect clients to resources available. For example, if a family is experiencing food insecurity, I would connect them to a meal site pickup location that is closest to their home. If a family is experiencing a lack of financial resources, I can connect them with federal resources online to gain access to filing for unemployment, checking eligibility for the economic impact payment, or local resources online in search of employment opportunities. Collaboration with other organizations is critical to gaining shareable knowledge of resources in the community for individuals and families. Competency 9: Evaluate Practice with Individuals, Families, Groups, Organizations, and Communities It is important to evaluate practice efforts in order to understand if client goals are being met, or if new efforts need to be taken to meet those goals. The use of tools such as an ecomap and the GAD-7 assessment will be helpful in evaluating the effectiveness of the strategies identified above to meet the goals of individuals and families. An ecomap is used by social work professionals that shows the client or family in their social environment; it helps both the professional and client to gain a holistic view of the client’s life and the nature of their relationships (Zastrow & Kirst-Ashman, 2016). Using this as a professional would allow me to evaluate if a client is connecting with the right people to combat feelings of isolation. By visually seeing all of the relationships in the client’s life, they will be able to better identify those who they wish to connect with. It would also allow me help the client to examine if the means of connecting with those in their ecosystem are successful or not. For example, using the ecomap will help see which methods of connection are successful with some people, and which are unsuccessful with others. This then leads to developing better strategies of connecting to people identified in the client’s ecosystem. In addition, the GAD-7 (generalized Anxiety Disorder-7) assessment can be used to evaluate the effectiveness of connection to resources in reducing the stress of clients during the pandemic. This assessment tool is self-reporting and is mainly used to diagnose anxiety disorder (Jordan et al., 2017). During the pandemic, clients may be experiencing increased anxiety due to stress from change. As a professional, my main goal in using this assessment tool would be to measure the level of anxiety of a client prior to gaining access to resources in the community and after utilizing identified community resources for two weeks. This allows me as the professional to determine the effectiveness of the resources. If the anxiety levels have decreased after using the community resources for two weeks, then the client goals have been achieved. But if anxiety levels have not changed or have increased, then the client goals are not being achieved. It would then be necessary to talk with the client to affirm goals and explore alternative ways to achieve those goals. Conclusion To conclude, the analysis of the COVID-19 pandemic through a social work lens has resulted in a greater and more holistic understanding of the impact it has on society. I have been able to examine the crisis on the macro, mezzo, and micro levels of practice to better understand the connection across systems. By using a variety of evaluation tools through a social work lens, I have a greater awareness of how to conduct myself as a professional during times of crisis to best serve those in need. Appendix A Essential Steps for Ethical Problem-Solving1. DETERMINE whether there is an ethical issue or/and dilemma. Is there a conflict of values, or rights, or professional responsibilities? (For example, there may be an issue of self-determination of an adolescent versus the well-being of the family.)2. IDENTIFY the key values and principles involved. What meanings and limitations are typically attached to these competing values? (For example, rarely is confidential information held in absolute secrecy; however, typically decisions about access by third parties to sensitive content should be contracted with clients.)3. RANK the values or ethical principles which - in your professional judgment - are most relevant to the issue or dilemma. What reasons can you provide for prioritizing one competing value/principle over another? (For example, your client’s right to choose a beneficial course of action could bring hardship or harm to others who would be affected.)4. DEVELOP an action plan that is consistent with the ethical priorities that have been determined as central to the dilemma. Have you conferred with clients and colleagues, as appropriate, about the potential risks and consequences of alternative courses of action? Can you support or justify your action plan with the values/principles on which the plan is based? (For example, have you conferred with all the necessary persons regarding the ethical dimensions of planning for a battered wife’s quest to secure secret shelter and the implications for her teen-aged children?)5. IMPLEMENT your plan, utilizing the most appropriate practice skills and competencies. How will you make use of core social work skills such as sensitive communication, skillful negotiation, and cultural competence? (For example, skillful colleague or supervisory communication and negotiation may enable an impaired colleague to see her/his impact on clients and to take appropriate action.)6. REFLECT on the outcome of this ethical decision-making process. How would you evaluate the consequences of this process for those involved: Client(s), professional(s), and agency (ies)? (Increasingly, professionals have begun to seek support, further professional training, and consultation through the development of Ethics review Committees or Ethics Consultation processes.)National Association of Social Workers – Massachusetts Chapter (NASW – MA). (2017). Essential steps for ethical problem-solving. Retrieved from BInteractive Map of the Locations of School Feeding Sites in Colorado center21907500Feeding Sites for Students COVID19. (2020). Colorado. Retrieved from for Disease Control and Prevention (CDC). (2020a). Coronavirus Disease 2019 (COVID – 19): Cases in U.S. Retrieved from for Disease Control and Prevention (CDC). (2020b). Coronavirus Disease 2019 (COVID – 19): People who are at higher risk for severe illness. Retrieved from Department of Education (CDE). (2020). Emergency feeding: For students and families. Retrieved from Governor Jared Polis (Polis). (2020). Gov. Polis announces statewide stay-at-home order, provides update on Colorado response to COVID-19. Retrieved from on Social Work Education (CSWE). (2015). Educational policy and accreditation standards. Alexandria, VA: CSWE. Retrieved from , C. (2020). U.N. agency fears ‘vulnerable’ Africa may suffer at least 300,000 COVID-19 deaths. National Public Radio. Retrieved from , A., Raghavan, S., Bearak, M., and McCoy, T. (Faiola et al.) (2020). Public health experts: Coronavirus could overwhelm the developing world. The Washington Post. Retrieved from First Coronavirus Response Act (FFCRA). (2020). Retrieved from , J. (2020). Gov. Polis calls on Colorado to adopt a ‘strong mask culture’ to fight Coronavirus. Colorado Public Radio News. Retrieved from , P., Shedden-Mora, M., Lowe, B. (Jordan et al.). (2017). Psychometric analysis of the Generalized Anxiety Disorder scale (GAD-7) in primary care using modern item response theory. PLoS ONE 12(8): e0182162. , S. (2018). Erik Erikson’s stages of psychosocial development. Simple Psychology. Retrieved from Association of Social Workers – Massachusetts Chapter (NASW – MA). (2017). Essential steps for ethical problem-solving. Retrieved from Range Behavioral Health (NRBH). (2018). Employee handbook. Retrieved from Parents as Teachers (PAT). (2011 rev. 2016). Foundational Training Guide. Parents as Teachers National Center, St Louis: MI.Rothe, C., Schunk, M., Sothmann, P., Bretzel, G., Froeschl, G., Wallrauch, C., Zimmer, T., Thiel, V., and Janke, C. (Rothe, et al.). (2020). Transmission of 2019-nCoV infection from an ansymptomatic contact in Germany. New England Journal of Medicine, 382, 970-971. DOI: 10.1056/NEJMc2001468 Solomon, D. and Hamilton, D. (19 March 2020). The Coronavirus pandemic and the racial wealth gap. Center for American Progress. Retrieved from of Colorado (CO). (2020). Colorado COVID – 19 updates: Case data. Colorado Department of Public Health and Environment, Colorado State Emergency Operations Center. Retrieved from Nations (UN). (2014). World economic situation and prospects: Country classification. Retrieved from States Census Bureau (USCB). (2020a). QuickFacts Colorado. Retrieved from States Census Bureau (USCB). (2020b). QuickFacts Weld County, Colorado. Retrieved from States Department of Health and Human Services (HHS). (2020). Notification of enforcement discretion for telehealth remote communications during the COVID-19 nationwide public health emergency. Retrieved from , G., LaJoie, T., Li, H., and Bunn, D. (Watson et al.). (2020). Congress approves economic relief plan for individuals and businesses. Retrieved from Atlas. (2020). Map and details of all 7 continents. Retrieved from Health Organization (WHO). (2020a). Coronavirus disease (COVID-19) advice for the public. Retrieved from Health Organization (WHO). (2020b). Coronavirus disease (COVID-19) advice for the public: When and how to use masks. Retrieved from , C., and Kirst-Ashman, K. (2016). Understanding human behavior and the social environment. Cengage Learning, Boston: MA. ................
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