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A podcast about international social work. Made by SocNet98, an European network of 18 universities that graduates students in social work. In this podcast you can listen to a broad specter of topics that is all connected to social work in an international perspective.
[Automatic captions by Autotekst using OpenAI Whisper V3. May contain recognition errors.]
[Steinar Vikholt]
Welcome to The Social Pod, a podcast brought to you by SockNet98, a network of universities sharing the common interest for social work in an international perspective.
[Hannah Nguyen]
Hello, my name is Hannah Nguyen.
I'm a professor in the Department of Human Services at Cal State University, Dominguez Hills.
And today I'm going to discuss the discovery model.
I'm sorry, the recovery model.
[Steinar Vikholt]
The recovery model.
[Hannah Nguyen]
The recovery model.
It's early morning.
So I'm currently teaching a class on mental health recovery, and the entire emphasis is on the recovery model, helping clients living with mental illness find themselves, empower themselves, and recover, lead a meaningful life.
And so
I think my visit to Norway has really sparked my thinking on what that could look like.
I came from the United States context, so we have some examples of that.
But we're also seeing some examples of how things are done here, and we'll go into that.
And I'm here with my two colleagues.
Would you like to introduce yourselves?
[Phu Phan]
My name is Phu Phan.
I'm the chair of the Human Services Department at Cal State Dominguez Hills.
And we've been in Norway.
Hannah and I have been in Norway for a week now for this collaboration.
And we've been exploring different topics.
So today, I'm happy to do this.
Thank you for having me.
[Steinar Vikholt]
Yeah, my name is Steinar Vikholt, and I work at the University of Southeastern Norway.
I'm the project leader of this international collaboration called SoWGloWthat this is a part of, and I'm very happy to have my colleagues here coming from the United States.
We have this exchange each year, having faculty from the Mingus Hills coming to the University of Southeastern Norway, and this time we have been out in nature, isn't that right?
[Hannah Nguyen]
Yes, so let's go...
to this idea of mental health recovery and what it means.
In the United States, there's a huge movement in the past few decades about focusing on individual strengths and strengths within their environment, in their neighborhoods, where they live, in the community, and focusing not on the client's deficits, not on their diagnosis and the labels, what they can't do,
how limited their communities are, but rather what the individuals can offer, the strengths they bring with them, and also finding pockets of strengths, natural support systems within the community.
So I think on one hand that's the theoretical piece, but we're still seeing a lot of our clients living with mental illness going into treatment centers, inpatient, outpatient.
And this weekend when Phu and I and Steinar were doing our hike to experience the free air living in Norway, I think it really struck me because I believe we came across an example of what it means to empower clients toward success.
And you can correct me if I'm wrong, but I saw someone accompany, maybe a social worker, I'm guessing, or a family member, I don't know, right?
Accompanying a young man on the hike.
And it really took me by surprise because I don't know if that's something that I have ever seen in the United States.
And Fu, maybe you can chime in, but that was my first time
[Steinar Vikholt]
I can give you a little bit of the Norwegian backdrop of this.
In Norwegian social work, there's always been a tradition to use the nature as a part of social work.
I think it's because using nature, being outdoors.
You talked about outdoor living.
In Norwegian, we call it friluftsliv, and it's starting to get as an international coined term also, about being out in nature, just enjoying being with nature.
because that is a part of the Norwegian culture.
We also brought that, of course, then into the way we give or try to give social services when we can.
So taking people, that patience, if you call them that, out in nature, if it's possible, we try to do that, yeah.
[Phu Phan]
Yeah, and in the United States, you know, especially in Los Angeles, it's kind of hard to do that.
But
you can kind of see aspects of it where there are many places that has a modest garden for clients to go out and just sit and you know to experience just different flowers and plants and stuff
So there's the spirit, but of course the environment is hard and it creates roadblocks to that.
But I think whenever we can, we've talked a lot about taking people out into hikes and to do that also in the US.
But it's nice to see here because this is part of Norwegian living, naturally.
The Norwegians go out a lot, so I think it's easier for Norwegians to do that with their clients because it's just part of who they are.
[Steinar Vikholt]
Yeah, and you mentioned the environment here, and that also when we're working internationally, we use different terms for different positions of what you do as a professional.
In Norway, you talk about the direct translation of a social worker and the position that he's working with.
is environmental therapist, that you work with the client in the environment they are in.
Often that is in their homes, where they live, and that as a concept, not the clients coming into your office, then you're a therapist, but an environmental or milieu therapist, we call it in Norway, then you work in the environment of the person.
And that also can be supporting that person in what is a big part of Norwegian culture, being outdoors, going sailing, going camping, this kind of stuff.
[Hannah Nguyen]
And, you know, I thought a lot about this idea of community integration that also comes up in the recovery model.
And what you just said about an environmental therapist or social worker helper going into the homes and helping this client integrate.
I mean, we see aspects of that, right?
We have...
programs where social workers would visit the client in their home to check in on them, to make sure they're taking their medication and maybe getting to their job or just managing their activities of daily living.
But to the extent of community integration, I would like to raise another example.
We visited Lisande, did I say that correctly?
[Steinar Vikholt]
Lisand.
[Hannah Nguyen]
Lisand, and the focus is on employment.
[Steinar Vikholt]
Yeah, so this is a company that we listed, yeah.
[Hannah Nguyen]
For the consumers or clients.
And I think one thing I saw when I walked in was that it's built on this idea of community and everyone was active participants.
So when we walked into the workspace, the production space, we saw stations where clients sat at
doing things that they were good at and meaningful for them.
And I think that was something that also, you know, I appreciate a lot.
And it made me think about the recovery model that says, you need to give people meaningful things to do, not at your agency, not in an inpatient treatment center, but in the community where they feel a part of.
And so I, then that was something that I really connected with.
Yeah.
[Steinar Vikholt]
You can see it's pretty simple sometimes.
When we went there, we saw the people working there.
It was people maybe with intellectual disability, Down syndrome, a lot of different reasons for them to be there.
But you can see there, also, of course, when we came as visitors, they were standing up truly proud about the work that they're doing.
It's meaningful.
They are proud that they're doing this job and that they are able, that the people working around them is enabling them to work because they want to work.
They want to participate.
And that is meaningful.
It's meaningful work.
The stuff that they're producing, they're proud of it because it's actually something true, something valuable that is going to be sold in a store.
Yeah.
[Hannah Nguyen]
And you saw that in the smiles as you walked around.
And I also really love that we were able to sit and have lunch all together.
Yeah.
Because sometimes I find that there can be, not all the time, but a separation in treatment centers, right?
Client comes in, they sit in an office, they see you for therapy, you check on their medication, make sure they're okay.
And then maybe they'll join a support group or an activities group.
And then that's that.
And you just go on from there.
But I think this idea of cultivating a sense of belonging beyond that and meaningful work.
[Steinar Vikholt]
Yeah, you're pointing out something there.
I'm just sitting here.
It doesn't show on a podcast, but I'm sitting here just smiling because the points that you're making is the differences in how this is situated.
Where do the people eat, for example?
I would guess that at this place and a lot of places where Norwegian social workers work, they eat their food with people.
in the same place they're doing it with the clients because you're you're equals you're not supposed to send them off to a support group or getting into an office this is maybe the things that we're talking about when you come to environmental therapy or milieu therapy to be a part of the environment you're sitting there talking about maybe what you did this weekend on the same levels that the clients are talking about what they did this weekend yeah
[Hannah Nguyen]
I think I need to go back and research a little more on this environmental therapy idea.
[Phu Phan]
Yeah, you know, excuse me, I was happy to see that, but at the same time I was a little bit taken aback because it points out the difference between Norway and the US in that when we asked them a question about how many people they had working there, they said they had around 20.
and asked them about how many clients they had, they said 24.
That's just everybody.
For me, it just blew my mind about how resources are allocated and how much it takes
to really integrate people back into the community, into their meaning, into their recovery.
And in the US, sad knowing the US that probably we will never have that kind of resources to put to
recovery of clients because it takes a lot to do so.
It's very nice to see where the important things are and where resources are located and it's really good.
It's a good example of what the recovery model
can do when you do have enough resources.
[Steinar Vikholt]
Yeah, but I asked the CEO about this because it was all about the ratio.
How can we as a nation use so much money?
You could easily run that company more effective, I would think.
Having even more people sitting there.
The quality of the services would be lower.
I'm probably sure about that.
But he actually told me that his background was in economics.
And he, of course, wasn't working there because of the economics, but he can always understand and defend how they can allocate these much resources to this.
Because as a society in Norway, you will in the long run save money.
So it's well spent money to have people being able to go back into work, trying to get them back into work, getting us confidence, working with them in their individual recovery processes, the processes that they own.
And as a community, you will save money.
So there's an economical aspect of this that also makes sense in the Norwegian context, with the Norwegian welfare system, where someone pointed out that if one of these people goes to work, that person, and we have research that supports this, that person will have less medical expenses.
And medical expenses in Norway is paid by the state, of course.
Meaning that the state saves money on having people go to work, not being sick, not going to the hospital so much.
So this makes sense in this whole economical aspect also.
[Hannah Nguyen]
And I think in the United States, we have also had that discussion about the economical costs of mental illness.
Yeah.
Hospitalizations, rehospitalizations, being unhoused, homeless, not working.
But to Fu's point about resources, I was also really surprised because I looked at the number.
I think we asked about, oh, how many people do we serve?
And I had a chance to speak one-on-one with the nurse.
Yeah.
I think her caseload was about six or so.
One to six or so.
I mean, that's amazing.
You can do a lot with that number.
I don't think that's the case for many contacts or offices in the United States.
And I think that's a huge constraint.
But I think just to the spirit or to the point of how can we promote recovery, it's easier done when you have a smaller ratio.
Because we talk about human connectedness.
How can you connect when your client's just a number?
[Steinar Vikholt]
Oh, yeah.
[Hannah Nguyen]
And I thought really hard about that.
And I saw how the workers were going around and interacting, engaging with clients.
I think you see that humanity comes out, right?
Oh, yeah.
I can't imagine being someone...
[Steinar Vikholt]
a client and how empowering that is for me to feel like oh someone recognizes me as a human being we have seen that when it comes to public services in Norway by trying to make it more effective we always want to try to save money as a society on bureaucracy for example so we can see that in the national welfare office or services in Norwegian called NAV that is like the social services the
Pretty much all the public services that the public can access is through one office, the office of NAV.
So everything is collected in one place.
And that company or public company is trying always to work more and more effective, moving their services to online, to self-service.
And a big part of that has helped a lot.
But at the same time, they started shutting down the local NAV offices where you can go to the public office and talk to someone.
And suddenly people in Norway started truly reacting on that.
And like, but my case handler, he doesn't know me.
I'm just a number.
Again, then the Norwegian public in big sorts
in a big way started reacting to that.
This is not right.
We're not supposed to only be online sending in forms.
So they're trying to right now make it both effective, but if you need someone, then it should be a person there.
And if you're kind of going through the first gates trying to figure out where to go, if they see you truly need a one-on-one help, it's possible.
to do that so when we're talking about this company they stated also yeah but we got a like a one to six ratio or something like that but it's not there the people coming to us they have been referred by the public office first and the public office they have huge caseloads so yeah this is kind of a second what is called the second tier of services yeah
[Phu Phan]
I think one of the lessons we can take from our experience here, connecting it to the recovery model that I think in the US for social workers and professional helpers, especially for our department,
human services professionals is that when you do work with people using the recovery model, just to remember the person in the environment that Steiner was talking about regarding environmental social workers.
In the US, we have that concept of the pie, the person in the environment.
Remember to use nature when you can and when you can't, then you use the environment using its strengths.
Sometimes it could be just a walk in the park or other times it could just be taking the client around the neighborhood and talking.
and try to incorporate whatever it is that you're talking to the client about, but in their environment, making sure that they're connected to the environment.
Sometimes it may be just a car ride.
Sometimes that's even more effective than sitting in the office face-to-face talking to the client.
I found a lot of times when I was practicing that
Car rides were one of the best ways to do counseling or get students to talk about their day.
We don't have all the resources, but you do what you can to try and help the clients.
[Steinar Vikholt]
Yeah, it's so nice that now you're suddenly mentioning the social work car ride.
And Norwegian social workers also say the exact same thing about that car ride.
Being able to just sit, drive somewhere and talk, and you get truly nice talks from that.
Getting out of that office, I think that's a lot what it's about.
and doing something together.
It can be going to buy an ice cream together or just play some basketball together.
Doing something together and having activities as the basis of talking.
Not having that feeling that, hey, you're coming to my office, sitting down in my chair, following my social rules or norms inside my office.
And yeah, being with the person.
[Hannah Nguyen]
One of the things that we do know about the recovery model is this.
There was an author who did a study, a review of all the different studies that have been done with the recovery model, the strengths model, strengths perspective.
And a lot of the success in clients' outcomes was dependent on the focus on client strengths.
And I hear both of you are talking about that, right?
And how does that translate into like a practice setting for our students or just practitioners?
And some of the things that I love what Fu shared, focusing on what you can do and what clients love and what drives them and motivate them.
And I hope our students or listeners take that away.
So sometimes we're so constrained by the service system or in the US we have to bill.
We have to have enough billing for hours to get paid.
We need to see this many clients in a day.
We only have this much time and we only have this much space as well.
But the little things like do clients like to draw, to just read, to walk, that's important.
And I forget the gentleman's name that we met in Lisan.
He was part of the video production team.
[Steinar Vikholt]
Oh, yeah, Tore.
[Hannah Nguyen]
Tore?
Yeah.
I think he really illustrated it.
the spirit of what it means to focus on client strengths.
Because he said he's been in the media or journalism or media production for many years.
He doesn't have a degree in this field.
But the way he talked about some of the concepts that we're trying to practice, to me, that was beautiful.
He talked about including clients in production.
If they can handle a camera, let them handle the camera.
Or if they can just sit back and help with wiring or in the backdrop with the production or something.
And then they come out and they're like, look, I did it.
I did it, right?
And I think that was like a really powerful illustration of what it means to draw on client strengths.
So I wanted to kind of go back to that as well.
[Steinar Vikholt]
Yeah, and I also think that one of the points that he made was that what they are delivering as a small media production team was something real.
Their speciality is streaming from, what do we call it...
Help me.
When the municipality has their meetings, they're streaming those meetings.
So it's true stuff that they're doing.
They're doing something for the leaders, the municipality, and they take a big pride in what they're doing.
So he tries to give them a little course in how can you use a camera, can you just hold it.
But the product that they're producing is real because it's a service for the whole municipality to be able to watch their politicians discuss online.
and also the thing that he pointed out in when after maybe a couple of weeks the the the the clients could get a diploma that it made that is a true diploma that states that this person now know basic video production maybe and something like that and and talking about the clients how how proud they were for forgetting that that might be the first diploma they got they got
because they've been maybe living a life where they always heard about the stuff that they cannot do, that they're not achieving.
And this is so important to point out what the person actually do achieve.
Hey, you're struggling with this and that, but hey, you're good at this, you're good at that.
Yeah, I've also seen you can do this.
And hey, let's have a short meeting or something, and then we can work on your skills on this.
So we can start documenting all the stuff that you do know to do.
Because a lot of times in the system we write down and report on all the stuff that the clients cannot do.
[Hannah Nguyen]
Do you find that to happen here in Norway as well?
[Steinar Vikholt]
Oh yeah, absolutely.
It's kind of the journeying, a journal system that we have.
It's writing down the sicknesses of people, what they're struggling with.
So when we're working with people, of course, we would like to know what they're struggling with, but we're also always talking about what they're struggling with, not what are their powers, what would they like to do, what are their strengths, and then building upon them.
So what you're talking about, this empowerment model, yeah, we need always to do that.
Recovery process and recovery model is going hand in hand, finding out what the clients can do.
And I think a lot of people that we give services to, they've been living a life hearing about what they cannot do, what they are struggling with.
And you also, whenever coming to a social worker or public services, you need to state that openly, about you need to put in words what you're struggling with.
And that does something with your mental health also.
[Hannah Nguyen]
You start believing in that.
[Steinar Vikholt]
Oh, yeah.
I'm not good at this.
I cannot do that.
Yeah.
[Hannah Nguyen]
Yeah.
So I think just to recap what we're talking about here, this idea of the strengths perspective in the recovery model.
In theory, it sounds like a great thing, but I think in practice and considering the constraints within our service system, the way we're trained to apply sameness to every client.
Yeah.
and diagnose them.
But I think the little efforts that we can make, that examples from all of us here today, focusing on the strengths of things clients can do and finding systems in the environment, opportunities that will allow them to thrive, I think are really good outlets for living that recovery and strengths perspective model and practicing that.
So thank you so much for your time.
Thank you.
[Steinar Vikholt]
You're so welcome.