Summer in the Field: Evaluating the Liberation Health Model Amongst Greek Social Workers
There is a wealth of information on the mental health challenges across the globe. Whether global prevalence rates, specific population variations, differing access to mental health services, or the impacts of global or local events are being examined, there is great, documented need for mental health support.
Depending upon the situation, a person’s life experiences, and their self-identified suffering or symptoms, it could make sense to employ a vast array of different clinical treatment modalities – for instance, cognitive behavioral therapies, psychodynamic practices or protocols specifically intended to address trauma responses.
The Liberation Health Model is a clinical framework that acknowledges the sociopolitical factors that contribute to a person’s mental health challenges. The model posits that the problems of individuals and families can only be understood with a rooting in the political, economic and social conditions of the person’s context. For example, the model would encourage practitioners and service users to acknowledge and challenge how racism, classism, gender norms and expectations, and xenophobia contribute to their problems as well as the contributions of the healthcare system, education system and criminal legal system.
This specific theoretical clinical model has been successfully applied in the United States for more than 20 years in various social service settings. While there are now practitioners across the world who have studied the Liberation Health Model and employ it in their work with clients, there has not yet been comprehensive training, implementation and evaluation abroad.
This year marks a monumental step in evaluating this model outside of the US. In partnership with Dr. Dawn Belkin Martinez, Associate Dean for Equity & Inclusion and Clinical Professor at the Boston University School of Social Work, Dr. Dimitra-Dora Teloni, Assistant Professor in the Social Work Department at the University of West Attica, Greece, and Panteion University in Greece. As part of my 2024 Summer in the Field Fellowship, I supported training sessions, conducted focus groups and site visits and engaged in mixed methods analysis in order to help enable this clinical framework to be further used globally.
Greece was chosen due to the willingness of Greek academic partners as well as similar sentiments of limitations and challenges encountered in the social service setting. A group of 10 Greek social workers were recruited from a variety of social service settings, ranging from child welfare to substance use programs, to engage in a series of eight training sessions. These trainings included both didactic instruction on the Liberation Health Model theory and methodological steps as well as case presentations and discussions. In between sessions, the participating social workers read articles, used the model to conceptualize cases from their own practice, and kept track of their learnings and ongoing questions.
While the mixed methods analysis is still underway, several important themes have already emerged.
First, front-line social work practitioners demonstrated a level of desire to learn about and practice this model. Participation in the training has been strong and the social workers come with stories for each session of how they have been thinking about the model in their ongoing work. There is hunger for this theoretical approach, and no similar model exists in the Greek context. The Liberation Health interventions focus on 1) identifying dominant worldview messages, 2) deconstructing dominant worldview messages, 3) introducing new information, 4) rescuing the historical memory of change and 5) activism as a therapeutic intervention. The participating social workers reported that these intervention suggestions were welcome and extremely useful. The group reports having additional skills and resources to draw upon in their work.
Second, and related to the first point, this pilot has strongly underscored the value of this model to the social workers themselves. In addition to further equipping the social worker with skills and strategies so that they are more effective in the work with community members, the social workers have also therapeutically gained themselves. One of many moments that crystallizes this point was when a participant used the case presentation opportunity to present herself and her struggles as the client. This social worker’s presenting problem was “frequently feeling stressed and tired” about her work. She described her current work within child welfare, including the large number of children on her caseload, how understaffed the agency is, and the extreme pressure to, seemingly magically and immediately, make problems disappear. Her cell phone could ring at any hour of the night or day, which affects her sleep, relationships and ability to rejuvenate and do enjoyable things.
The Liberation Health Model helps uncover the dominant worldview messages and systems that contribute to her stress: for instance, sexism and gender role messaging that women are expected to care-give and self-sacrifice at all hours of the night and day, or the classist message that the overcrowded and understaffed conditions in the child group home is acceptable for poor children. By calling attention to the sociopolitical factors that bring about stress and tiredness, the social worker feels less that she as an individual is the problem or defective. “Burnout” and “provider fatigue” are common terms associated with the routine accompaniment of someone in suffering; models that also help sustain practitioners are essential.
Certainly, additional learnings and recommendations will emerge as the mixed methods research concludes. It is already apparent though that the Liberation Health Model’s first official implementation and evaluation abroad has produced a wealth of interest, information and effectiveness.
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Learn more about the Summer in the Field Fellowship Program.