The Behavioral Corner 

Hi, and welcome. I'm Steve Martorano. And this is the Behavioral Corner; you're invited to hang with us, as we've discussed the ways we live today, the choices we make, the things we do, and how they affect our health and wellbeing. So you're on the corner, the Behavioral Corner, please hang around a while. 

Steve Martorano 

Hey, everybody, how are you welcome once again to the Behavioral Corner, my name is Steve Martorano. This is my corner. I own this corner. I have here. And you know why we gather on the corner because it's very informal. And you never know who's going to come by. Folks come out of you know, the newsstand over there or the bodega and they've, they're in a hurry. And very often they stop and they're always fascinating. And that's certainly the case on the Corner today, with our guests R.A. Sexton, Ron by name. We'll get Ron here in a second but Ron's a social worker. And I don't know about you guys, but my idea of a social worker comes to me like everything else, by way of, you know, law and order, or one of those television shows, and social workers always are the same depicted the same way on television and in movies, they're frazzled, they're overworked. And they're always carrying around a gigantic stack of folders, which represent their workload and their clients who have every problem under the sun. That's what I think with social work, we're gonna find out how much more it is from Ron Sexton today. Ron, thank you for joining us. Ron, is a clinical supervisor, with our underwriters on this program, Retreat Behavioral Health. We welcome him to the Corner. Hi, Ron how are you?

R.A. Sexton 

Hi, Steve. I'm fine. Thank you for having me.

Steve Martorano 

Did I get that sort of popular notion of a social worker, right?

R.A. Sexton 

So there are social workers walking around with stacks of paper and who is frazzled, but social workers do so much more. For example, I'm a licensed clinical social worker, which means I went through extra training to work in a clinical setting.

Steve Martorano 

And let me see if I understand that, does that mean that it's just not the job of solving the immediate problem of the client, which is, you know, maybe filling out an application or getting their rent paid? But the underlying clinical reasons for why their lives aren't working?

R.A. Sexton 

Yes. How can I put that into simplicity? So social workers, we look beyond what is the immediate problem, right? What's right in front of you, that might be more of a counselor who does that? a social worker is looking beyond the beyond, we're always asking questions. We're, we're always connecting. We take a system approach, holistic, we're looking at everything, not just why you're depressed, we're looking at your environment, we're looking at what's going on, medically, we're bringing it all together.

Steve Martorano 

Because of the immediate problems that most people have more to them than just the surface immediate problem. And that's why later on in the program when we talk about the impact race has on your work, it becomes more apparent about the size of the problem that social workers work so very hard to try to solve. Tell us about yourself. What brought you to this career?

R.A. Sexton 

To be honest with you, Steve, I'm a little new to this career. I came to this career later in life, a little background information. I have a Master's social work degree from Temple University. I'm a person who's also in long term recovery. I got laid off from a job back in I think, 2008, during that crisis, and I decided to take a college course and I took a course and I liked it. I took another course I liked. And here I am. I originally planned on going into social science until I discovered I needed to have a Ph.D. and a bunch of other things. And I had an advisor who steered me in the way of social work. And once I got bit by the social work, bug, I stuck with it. I like to think of myself as a true social worker. I live and breathe our code of ethics.

Steve Martorano 

Social workers are like foot soldiers. They're the infantry. In the battle, we're fighting Is that right? I mean, you're in the trade.

R.A. Sexton 

We don't shy away from crises where most people would be like, No, I'm a social worker is drawn to it is never a social issue. too big or small for us. We're like magnets to it.

Steve Martorano 

And that says You remind me of firefighters. It's impossible to be cynical about a firefighter. The first time you see a firefighter running into a burning building, you understand something new about dedication. Because that's just the instinct to run away from danger. And in your case, the instinct to go up to many problems over there. I can't do that.

R.A. Sexton 

It's a passion I have people on, I've had a friend asked me why in the world of all the things that I could have done, why would you choose to do that? You know, and I tell him, I'm glad everybody doesn't think that way. We are needed. Social workers are probably the largest provider of mental health services in the country. I knew that was true seven or eight years ago, I don't know that it's true today. But we are probably the largest provider of mental health services

Steve Martorano 

Nevermore important right now. And again, it's going to touch upon the issue of the race we talked about earlier, police are too often given the responsibility of handling social services or psychology, in situations they're not trained for closer cooperation between people like you, in the police department would go a long way towards solving a lot of problems. We know that we have in that regard, you know, and I will let me rise to a point of personal privilege here to point out how I know for personal reasons, how silly it is to say to somebody in social work, my goodness, why would you have done that? Because I did the same thing. When my daughter told me, that's what she wanted to do. She, she's been out for a while now back in working with children in schools. And I remember when she told me she can do social work, I remember thinking, really, really? Okay, what are you kidding? And it's a stupid idea. Anybody says they're in social work, you should congratulate say Way to go. Anyway, let's talk about the nitty-gritty of what you do. clinical social work is fascinating. And it dovetails very, directly into my question about, tell us about the relationship between what you do as a social worker, and the idea of behavioral health. How does that manifest itself in your work?

R.A. Sexton 

Our whole skill set that. That is our training, we assess, we diagnose, we work in the areas of prevention. I'm here in Pennsylvania, for example. I believe a bill just passed HB I can't remember that -- I don't want to get it wrong. All right, allows social workers to diagnose and bill insurance, we work independently. We encompass sociology, psychology, psychiatry, we bring them all together into one service.

Steve Martorano 

Is that a new bill in Pennsylvania? Does that include you guys being able to prescribe?

R.A. Sexton 

No, we don't prescribe.

Steve Martorano 

But you can diagnose?

R.A. Sexton 

Yes, we do make recommendations depending on the setting that you're working?

Steve Martorano 

Yeah. In that context, Ron, we're talking to Ron Sexton, he's a clinical supervisor at Retreat, behavioral health, his specialty is social work. The in the context of that holistic picture here. What percentage of the people you deal with are suffering from the trauma of some sort.

R.A. Sexton 

99.9% of the people are suffering from trauma.

Steve Martorano 

We throw that word around a lot these days, people think they understand what trauma means. But it's a little more subtle than that. When you say someone has been traumatized. What are we talking about?

R.A. Sexton 

A person who's still impacted by an event that occurred in the past on what we know about, for example, PTSD is it's one of the pathologies that can be traced to a singular event, we can actually tell you what happened when a sexual assault happened. When a car crash happened.

Steve Martorano 

Right. You, though, are in the position of dealing with people every day, whose trauma is an ongoing occurrence? Correct? Doesn't have to be traced back to any specific event that happened in the past. It's going on all the time, right? 

R.A. Sexton 

Yep. Yep, we certainly do. I do. I encounter people who are in traumatic situations and what we get as a social worker, what we would try to do is help a person navigate that. Offer them healthier choices, educate them, help them to see, I never want to tell a person what to do. I want to teach a person how to make healthy choices.

Steve Martorano 

The people you're dealing with, are traumatized, like you said, quite beyond a specific event that may have happened in the past. They're traumatized, literally traumatized by things like poverty, crime, and violence. And it doesn't even have to be violence that's occurred to them personally is just violence in their lives.

R.A. Sexton 

So I'll give you a perfect example. I don't I know we have a limited amount of time there is a study. And I believe it's out of the University of Maryland and Baltimore, it's called the Long Shadow. (Doris) Entwistle is one of the authors.  It's a longitudinal study and it goes on to explain the trauma experienced by children growing up in inner-city, Baltimore, it's really amazing. It had to be very expensive to do and it goes across 20 years. But even as simple as being poor, waking up worrying about what you're going to eat, opening your front door, walking out of your front door, walk, getting from your door to school, every day, you know, your your, your bathing your brain and the stress hormones, it's stressful. And imagine living in that for your life. Imagine being 18 years old, and that is all you know, to where it's your normal. And then what we see is, you know, these individuals will act out in violent ways or substance use self-medicating. And oftentimes society will fall back and they'll say, wow, look what happened to them. They're on drugs. There are those of us who would say, how could they not be on drugs when they experience this day in and day out?

Steve Martorano 

Yeah, any, it should be obvious. And it often is not that any situation that involves a 10-11-12-year-old child who has seen one person dead -- one person dead through violence would be traumatized by that. And we as you know, these kids have seen many more than one person dead. In fact, violence can be so pervasive that the trauma goes unnoticed. Do you know I mean? I mean they're being traumatized, and not even aware of the trauma, right?

R.A. Sexton 

Community trauma, new areas, and that are a new area of research, whole communities are traumatized. The one that sticks out is the individual who is not traumatized.

Steve Martorano 

Yeah, yeah, you must look for the night and day, just to find out what shielded them from that they hadn't become a sociopath about it. It just doesn't affect them. The way it does everyone else is it's an impossible difficulty, I think, a better understanding of some of what social people social workers do in this context would go a long way towards opening people's eyes about the problem of being poor and in a minority. It's almost impossible for white people to understand what that's like.

R.A. Sexton 

There's racial trauma. There's generational trauma that's been passed on and on. There are studies that have been done that show that can trace it back to slavery, the trauma that is passed on for generations, from grandparent to child to child and it just goes down. It goes down, even been shown where it can alter the DNA, the genetics of an individual.

Steve Martorano 

Well, I certainly wouldn't surprise me if it changes your brain chemistry, it makes you rewire for survival. Yes. You know, and so, so, obviously going to pick up some bad habits if it's about survival. But I think there's so much work to be done in that area. I understand that the whole "woke" thing. It's now been used to bludgeon people over the head, the minute they act like they're interested in the other people, what's going on over there, maybe we should take a look at that. Oh, you so wake. It's really an annoying phenomenon. But it's something that must be pressed forward. R.A. Sexton was kind enough to tell me about what's going on professionally in his career. He is, of course, a member of the National Society of social workers, a gigantic organization, over I guess, 100,000 members of it, as we said, These are the people that transition, the New York chapter, it's been having a series of webinars on the issue of race, everything we've talked about, but more specifically, or certainly how it affects them in their work. And Ron said, if you're interested, is a town hall, drop-in, it's open, and you can listen. And I did. And it was fascinating. And I know it's important to you to talk about that effort to So tell us about race and social work.

R.A. Sexton 

I can tell you the Town Hall was amazing. Close to 1000 people between Facebook and a zoom meeting engaging together and the title of it was racism and white supremacy and social work. So just so the title doesn't get away from you know, when you hear the term "white supremacy," we're not talking about people walking around with, with hoods on and flags and waving them. No, we're talking about a system that upholds white supremacy and oppressing other cultures and races rarely, you know, we only see the loudest and vocal. But there's a lot that goes on underneath. You know, we engaged as social workers about racism in our own profession. And I was amazed. There's a lot of smart people.

Steve Martorano 

Yes. Thinking about it, you know, again, this notion of white supremacy or privilege is can get even fair-minded liberals set back a little bit, wait a minute, what do you mean? I think they're not, I mean, I struggle to understand what that really means. And I think I'm getting a little better at it. For instance, the phenomenon of almost always being the only person of color, in any situation, at some point, must weigh upon a person to be the only, you know, overwhelmingly, everybody around you is white, that's a different deal.

R.A. Sexton 

It is, as a social worker, you know, as an African American male social worker, I'm even rarer. When I was in graduate school. I know, there were more like me and people that look like me, but there was only one other African American male in my class. And you would think, you know when we look at the populations that we serve, that there would be more of a representation. And that begs the question, like, why is that? So why isn't there more representation of African Americans and African American males in social work? You know, I know that historically, social work, activities were carried out by affluent white women, only until recently has it crossed over, you know, have others begun doing those services.

Steve Martorano 

Yeah, tell me why -- I think I know why -- but you begin with the altruistic white women gravitating towards this field, and then occurs to me that black women would also be more inclined to wind up in a social work environment when the problem in those communities very often is a lack of men.

R.A. Sexton 

Yes.

Steve Martorano 

What are you guys doing as an organization to bring more young men into social work?

R.A. Sexton 

Well, I know that some of the chapters, for example, now there's a National Association of Black social workers. One of the issues is, though, is pay and access to education. So for example, if you're an African American male, and you're fortunate enough to make it to that point where you're ready to go to grad school, ask yourself, you know, do I want to spend probably close to six figures on this? Or do I want to do that? Also, once you're in the field, where is the representation? For those that are BIPOD - Black Indigenous People of Color - oftentimes, we're in the agency, but we're not in positions of power. To recruit and open the door for others.

Steve Martorano 

Yeah, yeah. A lot of areas where that's the case, some of the notes that you sent me to take a look at. I really need some elaboration on what you to talk about here. You mentioned the privilege of emotion. What's that mean?

R.A. Sexton 

The privilege of emotion. So this is what I got is a new phrase I learned in the town hall. I know what the meaning is, but I've never heard that said. The privilege of emotion is when you have a social worker of color, indigenous, or a color -- BIPOD -- in an agency and how we are expected to behave, we cannot be our true selves. expressions of emotion are interpreted differently. It to bring it back to the angry black woman, or if I'm passionate, I'm angry, it's perceived as anger. In fact, it has been perceived as anger. I can't be passionate and it has happened. You know, and I can't say this is specific to social work, but the blackness is policed, which makes it hard.

Steve Martorano 

Well, yeah, I know, pleases I hear you. So also completely misunderstood. The idea that a woman of color black woman, might be angry, shouldn't strike anybody as unusual, but it does, or, you know, inappropriate. I heard something in that town hall meeting that set me back I should have been aware of and I wasn't one of the participants said that she could tell and most blacks understand this, that they have to be not just competent at their jobs but better than competent, because it's unforgivable to be thought of as a weak or lousy employee if you're a person of color, and I just was struck by that, because we've all worked for people who are not particularly good at what they did, they were just assigned to, well, they're just not very good at it. There's something else that goes on when it's a person of color, who is perceived as not being, you know, up to snuff.

R.A. Sexton 

Hmm. And that's where, you know, "privilege."

Steve Martorano 

That's where that privilege is, right?

R.A. Sexton 

Yeah. It goes back to privilege of emotion, being able to be yourself,

Steve Martorano 

And you're being misunderstood. There's nothing worse than being misunderstood. When you're, you know, when you try to make a point, no matter what it is, if the other person's not hearing your point, it's very frustrating, can lead to anger certainly leads to a lack of productivity or something. Just one other item that I wanted you to expand upon. And that has to do with cultural competency versus cultural proficiency. What are we talking about?

R.A. Sexton 

Cultural competency is just one step in a continuum of cultural proficiency. The continuum starts with cultural destructiveness moves on the cultural incapacity, then on the cultural blind, then there's cultural pre competence. Then there's cultural competence. And I'm going to read from this. It's a manual for school leaders, just on the cultural competence part. "Cultural competence is defined as interacting with other cultural groups using the five essential elements of cultural proficiency as the standard for individual behavior and practices." In this stage, what we would do is we would see the difference, understand the difference that differences make? Does that make sense to us? 

Steve Martorano 

Yes, it does. The difference is, the difference is that the differences make Yeah, that makes sense.

R.A. Sexton 

So the final one is cultural proficiency, knowing how to learn about individual and organizational culture, interacting effectively in a lot variety of cultural environments, for efficient use of the five elements of cultural proficiency and ability to successfully adapt and, and provide services in response to cultural diversity at individual and institutional levels, we would see the difference and respond effectively and affirmingly, but for some reason, when I heard this term, I went and looked it up and did quite a bit of reading on it. We stopped at cultural competency when it's not optimal.

Steve Martorano 

For what? Optimal for what?

R.A. Sexton 

For an institutional change. Cultural competency isn't, this is what I'm getting as an individual is on the individual to be culturally competent, to be culturally proficient, at least in the agency, or the school or wherever we're operating needs to be comparted of the institution.

Steve Martorano 

Yes. So that we arrive at a point if I understand you correctly, where our diversity is understood, integrated, so that you can provide better help more solutions to the problem. And instead, we find ourselves still struggling as a culture with this idea that different people are to be feared and pushed away, rather than embraced, understood. And then if they have problems helped.

R.A. Sexton 

And Steve, make no mistake. The individuals we serve to benefit from this.

Steve Martorano 

I knew from listening to the town hall, that this was not just a bitch session of people telling us how hard their work was. They were saying, Yeah, my job's made harder by all this stuff. But boy, if we could just eliminate all this stuff, it would make not only my job easier but the baby the problems easier.

R.A. Sexton 

Mm-hmm. For sure.

Steve Martorano 

I took out that's what I took out of out of it. It was fascinating. And I know that effort goes on and on. They have if people want more information about this, and it's important you should if they were to go to the association's website, it's a great website, real clear National Society of Social Workers, chapter and verse on the stuff that we're talking about with Ron Sexton. So, Ron, looking forward are you hopeful about this effort? 

R.A. Sexton 

If I may hear Retreat, we were always looking for ways to improve and provide more education and training to our staff and make it a more diverse and inclusive agency.

Steve Martorano 

Yep, at Retreat they handle in addition to substance abuse clients and patients, they also have a growing mental health facility now. And clearly, in both those situations, you can, I guess, do an okay job, if all you did was treated people in those two categories, treated their symptoms, and didn't get to what's really going on underneath. And that's what I understand what we've been talking about, and what your social work encompasses. Ron this a big topic, we can do this like four times a year,

R.A. Sexton 

We could do this for hours.

Steve Martorano 

You know where we are on the Corner -- The Behavioral Corner, we're so grateful for your time, and for shedding some light on this important topic for us. Thanks so much. Just real quickly, I know the answer. Yes. All of this has been exponentially more difficult set against the backdrop of a virus, which in addition to affecting us all, has had an inordinate impact on the communities you're talking about.

R.A. Sexton 

Oh, for sure. For sure. Um, I just read a local newspaper from down in your county, where the substance was overdoses are up by like 30 or 40 over the last year? Yeah. And suicide is up. You know, I would encourage anyone to reach out socially we should really change the way we think about it socially distancing, is really just physically distancing. Exactly. A socially connected sort of like, what were you and I are doing here, Steve.

Steve Martorano 

Yeah. Yeah, really important. Lots of folks have come on and said exactly that we mean distance. We don't mean physical distance. We don't mean separation. Last Word, Ron, you can be I guess, certainly can be of some help here. The vaccine is coming. People are going to get it in the African American community. There is some difficulty for a lot of reasons. What do you say to African Americans who are a little worried about that vaccine?

R.A. Sexton 

I would say I got the vaccine. Okay. I got the vaccine. I would say that the benefits far outweigh the potential costs. African American men -- my doctor just told me -- I was in for a physical that for some reason, unknown to them yet are very impacted by the illness and it seems to be affecting us worse than it is other groups. No, that's what the research is showing. Please check in with your primary care physician, talk it over with, and consider getting a vaccine

Steve Martorano 

Ron Sexton's clinical supervisor at Retreat Behavioral Health. Come back again.

R.A. Sexton 

Yep. Thank you, Steve.

Retreat Behavioral Health 

Every storm runs out of rain. According to the great Maya Angelou. Her words can remind us of one very simple truth that storms do cross our paths, but they don't last forever. So the question remains, how do we write out this storm of COVID-19 and all the other storms life may throw our way? Where do we turn on issues such as mental health or substance abuse that begin to deeply affect our lives? Look to Retreat Behavioral Health. With a team of industry-leading experts. They work tirelessly to provide compassionate, holistic, and affordable treatment. Call To learn more today. 855-802-6600. Retreat Behavioral Health where healing happens.

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