Perspective of a social justice mental health microbusiness

The intersection of CARF standards, NASW code of ethics, and our core values and practices

By Valeria Benabdallah, CEO/Psychotherapist, VEMB Psychotherapy Services

Vincent Van Gogh Starry Night
Starry Night, by Vincent Van Gogh hangs in VEMB’s office

In 2000, I relocated from Berkeley to Oklahoma City to share my clinical skills with a less busy part of the nation. After being an independent-contracting social worker for a year and a half, I planned to open my own mental health practice. In 2002, I did just that.

Valeria E. Milstead-Benabdallah, LCSW, PC (dba VEMB Psychotherapy Services) was born with the motto develop the courage to do something different. It takes courage to do something different from what is familiar.

Van Gogh’s painting, Starry Night, is displayed in the office as a constant reminder and visual depiction of the courage it takes for the bright stars to emerge from the darkest nights. Therapeutic sessions begin with that acknowledgment of the individual, familial, cultural, societal, racial, gender, religious, and socioeconomic positionality of persons served.

VEMB the microbusiness

(Microbusiness: A small business with five or fewer employees)

VEMB is a private, nonprofit, client-centered organization. It is financed with service fees paid by persons served and insurance companies and fees I receive for organizational consulting. Its mission is to provide competent, compassionate, evidence-based, and innovative client-centered psychotherapy in assisting individuals, couples, families, and groups in becoming unstuck.

VEMB prides itself on being a tiny organization that makes a significant impact in the lives and community of persons served. It has two employees, including myself, who wear multiple hats:

CEO/director/psychotherapist/treasurer (me)
Office manager/behavioral specialist/behavioral health aide/biller

Being a microbusiness means that stakeholders, persons served, and the two staff members work closely together. My work as a social justice mental health clinician is to collaborate with appropriate systems while providing psychotherapeutic interventions to clients and their families. As a CEO, my job is to provide sound leadership and oversight to all business, clinical, and financial functions of the organization.

CEO and fairy princess. In her microbusiness, Valeria Benabdallah wears many hats

Covering a broad range of client-based services can be taxing for a microbusiness, yet all our professional practices remain comprehensive, thorough, ethical, and compassionate. It can be extremely draining, exhilarating, hectic, and rewarding. Failure is not an option. It is a requirement for us to be highly skilled in multiple areas of the mental health profession with ongoing trainings. All experiences are learning opportunities.

VEMB has been a CARF-accredited microbusiness for 12 consecutive years. Allowing CARF to survey VEMB is one of the best decisions the organization has made to ensure that it stays close to and compliant with its mission, vision, and core ethical values. Our clients, particularly the most vulnerable ones, benefit from the highly client-centered CARF standards.

VEMB is among approximately 10 percent to 15 percent of CARF-accredited organizations with behavioral health programs that employ 5 or fewer full-time employees (FTEs). One-third employ 15 or fewer.

Psychosociocultural context of a sample population of the people we serve

VEMB firmly believes that no entity or person is without context or community. This work requires trust, patience, and action toward a common goal—improving the quality of life for persons served.

For example, one population that VEMB serves is children whose families are from lower economic statuses. This segment of population faces specific and unique challenges. According to the Children’s Defense Fund, children who are poor trail behind their middle-class peers in many ways beyond their economic status.

Low-income children:

Tend to be less physically and mentally healthy.
Have more issues with emotional and intellectual development.
Demonstrate lower school performance.

Furthermore, while 22.5 percent of children overall in Oklahoma are considered low income, that percentage rises to 37.4 for African-American children. According to the U.S. Department of Education's Office for Civil Rights, compared with their peers, African-American students across America:

Face harsher discipline.
Have less access to rigorous high school curricula.
Are more often taught by lower-paid and less-experienced teachers.
Are far more likely to be suspended or expelled from school (males in particular).

When added to a situation where a child has no permanent family connections or connection with a caring adult, these contextual factors create numerous barriers as the child struggles to become a self-sufficient adult. A significant portion of the children we serve have experienced microaggressions in the school system, community violence, and inconsistent family support while also displaying problematic behaviors.

How CARF practices support our core values

To meet the needs of this unique population and others, it is vital that VEMB exercise core values and ethical principles that are respectful of persons served and illuminate their innate dignity. Its professional stance is rooted in the National Association of Social Workers (NASW) Code of Ethics, which has proven to be beneficial to persons served for over a decade.

Similarly, CARF standards require the entire organization to ethically accommodate the needs of persons served, staff, and other stakeholders. The CARF standards are highly client-centered, which benefits our clients. They help us achieve our professional goals:

Appreciation of person-in-context
Empowerment and self-determination of persons served
Using trust as therapeutic tool
Emphasizing human relationships
Professional competence of all VEMB staff.

The collaborative triangulation among CARF standards, NASW code of ethics, and our own core values and practices provides our microbusiness with the right documentation and feedback to stay zeroed in on the persons, families, and other stakeholders we serve.

The table below displays examples of how VEMB’s ethical codes, mission, principles, and values align with CARF standards and the NASW code of ethics.

CARF, NASW, and VEMB Crosswalk

CARF Standards 2017

NASW Code of Ethics

VEMB Values & Practices

Section 1.A. - Leadership

Standard 1.A.2. Intent Statements:
The organization’s person-centered philosophy should be evident in the development and delivery of services, systems, approaches, and interventions. Implementation of this philosophy from the unique perspectives of the leadership, personnel, and persons served is addressed during the survey process.

Value: Service

Ethical Principle: Social workers’ primary goal is to help people in need and to address social problems.

Core Values and Ethical Principles: VEMB promotes and exercises core values and ethical principles that are respectful of persons served and illuminate their innate dignity. VEMB professional stance is rooted in the appreciation of person-in-context, empowerment of persons served, the inherent dignity and worth of a person, trust as therapeutic tool, the importance of human relationships, self-determination of persons served, and professional competence of all VEMB’s leadership and staff.

Section 1.A. – Leadership

Standard 1.A.5. Intent Statements:
The organization demonstrates an awareness of, respect for, and attention to the diversity of the people with whom it interacts (persons served, personnel, families/caregivers, and other stakeholders) that are reflected in attitudes, organizational structures, policies, and services.
The organization’s cultural competency and diversity plan addresses how it will respond to the diversity of its stakeholders as well as how the knowledge, skills, and behaviors will enable personnel to work effectively cross culturally by understanding, appreciating, and respecting differences and similarities in beliefs, values, and practices within and between cultures.

Value: Social Justice

Ethical Principle: Social workers challenge social injustice.

Vision: VEMB firmly believes that no entity or person is without context or community. Through contextual cultural responsiveness, the organization values and serves a vast array of clients within its professional scope and will continue to strive to improve the quality of life of persons served.

Section 1.K. – Rights of Persons Served

Standard 1.K.1. Intent Statements: To demonstrate relevant service delivery and appropriate ongoing communication with the persons served, the organization implements a system of rights that nurtures and protects the dignity and respect of the persons served. All information is transmitted in a manner that is clear and understandable.

Value: Dignity and Worth of the Person

Ethical Principle: Social workers respect the inherent dignity and worth of the person.

Written Cultural Competency and Diversity Plan based on consideration of sexual orientation with annual review. Demonstrated annual review of rights of persons served.

Code of Ethics: VEMB develops program options that preserve the dignity of those persons served and their families, and actively works to reduce the stigma of seeking services.

Section 3.O. – Outpatient Treatment

Standard 3.O.6. Examples:
The program demonstrates its understanding of the need for persons served to develop and maintain a healthy support system. There is evidence that the program assists the person served to create long-term natural supports to reduce reliance on providers in their transition post-discharge.

Value: Importance of Human Relationships

Ethical Principle: Social workers recognize the central importance of human relationships.

Code of Ethics: VEMB values families as the societal unit best able to meet the needs of its members.

Section 1.A. – Leadership

Standard 1.A.4. and 1.A.5. Intent Statements
The organization demonstrates an awareness of, respect for, and attention to the diversity of the people with whom it interacts (persons served, personnel, families/caregivers, and other stakeholders) that are reflected in attitudes, organizational structures, policies, and services.

The organization’s cultural competency and diversity plan addresses how it will respond to the diversity of its stakeholders as well as how the knowledge, skills, and behaviors will enable personnel to work effectively cross culturally by understanding, appreciating, and respecting differences and similarities in beliefs, values, and practices within and between cultures.

Value: Integrity

Ethical Principle: Social workers behave in a trustworthy manner.

Code of Ethics: Value Every Man’s Being (VEMB).

Section 1.A. – Leadership

Standard 1.A.6.
Intent Statements: Corporate responsibility demonstrates what an organization stands for including its ethical, social, and environmental values.

Value: Competence

Ethical Principle: Social workers practice within their areas of competence and develop and enhance their professional expertise.

Mission: To provide competent, compassionate, evidence-based, and innovative client-centered psychotherapy in assisting individuals, couples, families, and groups in becoming unstuck. VEMB’s main thrustis to aid clients to develop the courage to do something different.

Intersection of critical values, practices, and standards: CARF, NASW, and VEMB

References and further reading

Children's Defense Fund. Cradle to Prison Pipeline® Fact Sheet Oklahoma (2009)
Children’s Defense Fund. The State of America’s Children
Benabdallah, V. (2017). “Psychosocial Biases and Diversionary Strategies Affecting the School to Prison Pipeline.” Diversity Challenge Conference: Race, Culture, and Criminal Justice throughout the Lifespan. October 13-14, 2017, Boston College, The Institute for the Study and Promotion of Race and Culture, Chestnut Hill, MA. Conference Presentation.

Valeria Benabdallah is the CEO/Director/Leading Psychotherapist of VEMB Psychotherapy Services. She has a Bachelor of Arts degree in Sociology (with a special emphasis in Social Welfare) and a Master of Social Welfare degree from the University of California, Berkeley. She is completing her Ph.D. at the University of Oklahoma and is a Diplomate in Clinical Social Work (DCSW). Ms. Benabdallah served as a policy statement panelist for NASW’s Civil Liberties and Poverty & Economic Justice panels. Her chapter, “Hip Hop in the Time of Trauma,” will be featured in the forthcoming book Hip Hop Dismantling the School to Prison Pipeline (2018; Peter Lang Publishing). In addition to her clinical work, she is a researcher, educator, and advocate. For more details about VEMB Psychotherapy Services and the founder, visit www.vbtherapist.com.

5/10/2018
(Behavioral Health,Child and Youth Services)