Call it a perfect marriage of need. As the COVID-19 health emergency upended people’s lives this spring and summer, faculty at the USC Suzanne Dworak-Peck School of Social Work found a way to help Master of Social Work (MSW) students, and the greater Los Angeles community, with an innovative initiative aimed at promoting well-being to underserved populations through pro bono telehealth counseling services.

The USC Telehealth SAFE-T Program was created in April 2020, offering free, private and confidential online counseling via secure internet portal or phone. An expansion of mental telehealth services offered via USC Telehealth since 2012, the SAFE-T program was born out of a new set of challenges arising from the coronavirus pandemic.

As social service and mental health agencies and organizations around the country limited in-person service provisions due to the pandemic, some MSW students found their opportunities for field placements shrinking. At the same time, job losses and health impacts from coronavirus combined with weeks of social unrest across the country related to police brutality created a lot of stress for many of the area’s most vulnerable populations.

“We asked ourselves, what can we do to expand our capacity to serve the community and to take in these MSW students who need to finish their field placement requirement to graduate?” said Sarah Caliboso-Soto, clinical assistant professor for field education and interim clinical director of USC Telehealth.

A creative and mutually beneficial solution

The field education faculty and the USC Telehealth team found an elegant solution. Why not expand the services provided by USC Telehealth, creating supervised mental health counseling internships for MSW students displaced by COVID-19 workplace restrictions while offering pro bono services to community organizations in desperate need of resources? It sounded like a win-win to everyone involved.

The community’s need for additional support was clear. As the SAFE-T program ramped up, Caliboso-Soto spoke with a broad cross-section of organizations such as local school districts, law enforcement agencies, housing service providers, health care providers and many more who were interested in partnering with USC Telehealth.

With just five weeks to plan before the summer semester started, work had to begin quickly. Field Education Director Ruth Supranovich supports a culture of inclusivity and empowers her faculty to take leadership on various initiatives. In this particular case, Supranovich tapped Clinical Associate Professor of Field Education Maria Hydon to lead a workgroup of seven faculty members with the mission of  adapting the summer semester’s field placements to the new demands of COVID-19 life. In addition to Hydon, the faculty workgroup was fellow Clinical Associate Professors of Field Education Rosemary Alamo, Umeka Franklin, Suh Chen Hisao, Rick Ornelas, Holly Sotelo, Vivien Villaverde, Lisa Wobbe-Veit and Clinical Professor Stephen Hydon.

In all, 41 MSW Virtual Academic Center (VAC) students were without field placements for the summer semester. Of that group, 80% would not be eligible to graduate in August 2020  without the ability to complete the required field hours. Placing each student within an expanded USC Telehealth program was the first step. The second step was to get them trained and prepared for the work.

“We knew we had to find a way to be creative,” Maria Hydon said. “Just like how we teach our MSW students to meet their clients where they are, COVID-19 has created a new paradigm shift that has forever changed our ways of thinking and behaving which has resulted in different approach to delivery of services”

The power of teamwork

As the workgroup began to prepare for the delivery of the intervention model and train students and field instructors how to use it, each of the 41 MSW students were assigned to USC Telehealth for their summer field placement. The workgroup collaborated closely with Caliboso-Soto to coordinate trainings for the students and their supervisors.

The planning of the training took place as faculty dealt with the disruptions of COVID-19. “Each field education faculty member graciously rolled up their sleeves and placed all hands on deck to support our future social workers and field instructors,” Maria Hydon said.

Home-based interruptions became a normal part of planning calls and contributed to team members’ sense of cohesion and support. “I remember one session on Zoom where my daughter Téa was in the background shouting for chicken nuggets,” Maria Hydon said. It was all part of the new work-at-home order and everyone was adjusting and making the best of it.

The SAFE-T program was designed to provide up to six weekly counseling or case management sessions to vulnerable individuals referred to USC Telehealth by community or governmental organizations. Because of the relatively short duration, the workgroup decided to use an intervention known as Psychological First Aid/Listen, Protect, Connect (PFA: LPC-Model and Teach), well-known for its effectiveness in providing immediate support to people in crisis and connecting them to additional services.

The workgroup labored diligently to ensure the training was facilitated and delivered in an efficient manner. Each faculty member delivered the Psychological First Aid, Listen-Protect-Connect-Model and Teach (PFA: LPC-Model and Teach) training to students placed within the USC Telehealth Program.

Psychological First Aid

PFA: LPC-Model and Teach was co-developed by Marleen Wong, the David Lawrence Stein/Violet Goldberg Sachs Professor of Mental Health and senior vice dean of field education.  It was first created for educators and school staff members to use in supporting students after disasters or traumatic events and has been implemented in schools across the country.

“The health pandemic can be considered as much of a disaster for some as an earthquake, flood or fire,” said Umeka Franklin, clinical associate professor. “Everyone in the world has experienced the impact of coronavirus, but not everyone is affected by it in the same way.”

Stress brought on by shelter-in-place orders, job losses, family health issues and more can be overwhelming and leave many struggling to cope. These factors made the PFA: LPC-Model and Teach intervention well suited for helping people from first responders on the frontlines to people who lost their jobs to those facing health or housing issues.

The PFA: LPC-Model and Teach intervention has five phases: Listen, Protect, Connect, Model, and Teach. Building on research that people in trauma want to talk and get help, the intervention begins with a series of targeted questions and careful listening, followed by validation of their feelings. From there, people learn how to connect to resources reinforced by behavior modeling and teaching.  The three goals of this specific intervention are to develop and sustain a sense of physical and emotional safety, emotional and behavioral stabilization, and assist with reengagement of their daily functioning.

After weeks of tailoring the intervention to COVID 19, faculty provided interactive PFA: LPC-Model and Teach trainings to the students and their field supervisors. Special care was taken to adapt the intervention and the trainings to meet the needs of people struggling to cope with anxiety, isolation and depression. The workgroup took the initiative in embedding COVID-19 PFA: LPC questions that were developed by Wong from the North American Center for Threat Assessment and Trauma Response.  These types of questions aim at supporting an individual who is impacted by COVID 19. Overall, the PFA: LPC training mission was to teach students how to listen, convey a sense of compassion,  empathy and understand how to connect survivors to community resources.

The end result made an impact on two levels. The first was that MSW student interns helped 150 underserved clients who might not have had access to mental health services any other way, said Caliboso-Soto. “Many didn’t have anywhere else to go,” she said.

Second, the innovative model initiated by quick-thinking faculty at the social work school ensured that dozens of MSW students graduated on time. More than that, the feedback from the MSW students has been very positive. A few reported learning more than they would have in a traditional, in-person internship.

But the biggest proof of success for Caliboso-Soto is that all seven of the first-year MSW students that participated in the USC Telehealth field placement model for the summer semester asked if they could stay on at USC Telehealth for their field placement in the fall.

Stephen Hydon said that the team overcame the coronavirus-imposed obstacles thanks to the field education faculty’s willingness to pitch in and do good work under tight time pressures.

“We’ve always worked together like a family,” Stephen Hydon said. “The challenges arising from COVID-19 and the senseless loss of Black lives have drawn us closer to do the important work of social work education.”