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NMTP Newsletter Volume 1, Number 1 January, 1997 Index This is the first issue of the NMTP Newsletter. Our mission includes reporting on the formal activities of the organization, announcing events, and providing a forum for exchanges of ideas on culturally competent practice. NMTP By-Laws require the Newsletter to produce at least two issues a year, in which it must publish minutes of all meetings of the Board of Directors and Executive Committee, announce the Annual Meeting, distribute and update the Directory of members, appeal for funds, publish procedures for application for scholarships, fellowships, grants, and other fund disbursements, "and any other news, information, or opinion relevant to the purposes of the corporation." This issue includes an article reprinted by permission of Dr. Victor De La Cancela from Focus, the official publication of Division 45 of AP A, on his applications of the network model in community practice. We welcome your contribution. Other articles and notices inform you of current activities (and needs for your participation!). We include some of the accumulated Minutes of Board and Executive Committee meetings; there have been seven meetings to date. We should have all seven formal records published in the first few issues; succeeding issues will include Board and Executive Committee Minutes up to the publication date. We look forward to hearing from you. Please send us your letters and/or articles and essays. Newsletter Committee Terri Belts Kathleen Gibney Merlin Langley David Trimble This first issue of the NMTP Newsletter is distributed to a wide group of professionals and others whose actions have demonstrated commitment to the mission of the Network for Multicultural Training in Psychology. That mission, "Education, training, research, consultation, dissemination of expert knowledge, public advocacy, raising funds, and disbursing funds (e.g., scholarships, fellowships, and grants in aid) in furtherance of the competent practice of multicultural psychology," includes our near-term goals of supporting "The Program" in Boston and our wider aim to protect, support, develop, and disseminate competent multicultural practice in these difficult times. "The Program" began as the Minority Training Program at Boston City Hospital. As the Program approaches its 25th anniversary, Boston City Hospital has become (through merger with Boston University Medical Center) the Boston Medical Center, and the Program has become the Center for Multicultural Training in Psychology. Thanks in no small measure to the pioneering work of the Program and its graduates, cultural competence has firmly established its voice in the discourse of professional psychology. Our work nonetheless remains embattled When we started out, the idea that mainstream psychological practice did not suit the needs of people of color was nearly unheard of, and not well received by the profession. Leaders in the field were unwilling to confront the proposition that therapeutic practice which embodies dominant culture racism further marginalizes and oppresses people subordinated by class and race at moments in their lives when they are most vulnerable to harm. Among ourselves in the Program, we struggled with our class and racial polarizations, and our skepticism that we as professionals could develop knowledge capable of transforming mainstream psychology by challenging its practices of marginalization. Although multicultural perspectives are now legitimate, " even trendy, we still must struggle, object, challenge, and organize. Racism was more obvious in the 1970's, and we could choose to join or ally with many activist organizations. Ronald Reagan's warm and friendly leadership of the reactionary movement which still dominates North American political discourse restored the public legitimacy of racism, while polishing its production values. Nobody in mainstream polite society voices the values and beliefs which quietly inform current oppression, e.g., disassembly of social welfare, and removal of legal protections against the racial discrimination which continues to organize everyday life. The Program faces these challenges as healthcare confronts corporate reorganization of what was once public service. Some readers remember times when the Program nearly succumbed to interprofessional conflicts, twice calling on members of "The Networlc" for advocacy campaigns which saved the Program from institutional strangulation. Matters improved between Psychiatry and Psychology at Boston City Hospital years ago, under Larry Miller's leadership of the Department of Psychiatry. Dr. Miller departed in the prelude to the Boston Medical Center merger. Although the current Psychiatry administration has signalled its continuing support of the Center for Multicultural Training in Psychology, all institutional and administrative systems are uncertain vessels, easily tossed about in the stormy seas of healthcare change. Responding to these local and national social forces, some hostile, some indifferent, all unpredictable, we incorporated NMTP to embody "The Network" of professionals and community members who have been integral to the Program from its beginning. We saw the need to develop a strong, independent entity exclusively devoted to the Program's mission, capable of securing the continuity of the Program in its uncertain environment and of advancing the practice of culturally competent psychology. Experienced members of "The Network" know what's next. We need you! Those readers who have sent in membership applications and first year's dues, we thank you. If you haven't yet done so, please take the enclosed Membership Application Form and put it on top of your pile of "things to do ." Please make photocopies of this Newsletter, and try to recruit at least two like-minded colleagues to join the Network. We need your minds and deeds, as well as your money. Please respond to our call for action on the following matters of critical priority: First, we need active members of the Finance/Fundraising Committee. Our priority organizational goals for the fIrst two years are to increase the budget for CMTP internships, first by adding two intern positions then by paying for health insurance for all interns. Our Treasurer is happy to serve as custodian of our funds and financial records, but calls for a Finance/Fundraising Committee composed of activists ready to take leadership of the fundraising activities necessary to meet our goals. Whether or not you are within travel distance of Boston, your participation is welcome in planning and carrying out drives for donations, grant applications, and other activities to fund the Network's activities. We also need people willing to run to fill the two vacancies on our Board of Directors (See the Call for Nominations in this issue). Once we have a full Board in March, Board Members will be electing a new President. We particularly need volunteers to join the 25th Reunion Committee, for a gathering to be convened in the spring of 1997. It will be a celebration of the 25th anniversary of the Program, and also the first formal Annual Meeting of NMTP, specified by our By-Laws as an important venue for organizational business, and including a program evaluation activity which should revitalize us as it gives us direction for the succeeding year. The Committee's co-Chairs are Drs. Rita Dudley-Grant, Lisa Porche-Burke, and Guy Seymour. There's a lot of work to do in a short time. All program graduates can boast of formative professional experiences doing a lot of work in not enough time. What better way to celebrate our anniversary? Please choose an activity, make a commitment, and send in the form on the back page. COMPANERISMO: URBAN HEALTH AND CLIENT EMPOWERMENT THROUGH NETWORKING (Published originally in Focus, 9, 1, July, 1995) Victor De La Cancela, Ph.D.,M.PH. College of Physicians and Surgeons Columbia University This article describes how networking among both professionals and clients has influenced my practice as a clinical psychologist with a social conscience. My intent is to contribute to this issue's perspectives on "Walking the Talk" by illustrating how the personal-political struggle of making a living, making a difference and providing health care is relevant to the potential effectiveness of health care reform to improve access to care and the health status of people of color in the United States. My introduction into the
network model occurred in 1979 when I served as a fieldwork supervisor
for Boston City Hospital's Minority Training Program in Psychology (MTP),
while being employed as a staff psychologist at the Hispanic Family
Counseling Program (HFCP), Massachusetts Mental Health Center. In 1980,
my involvement expanded as the Team Leader of the Hispanic Outreach
Team (HOT), Jamaica Plain Outreach Program, Judge Baker Guidance Center,
in Boston. The intracultural and ethnic diversity of the network members and of the Latino/a populations served often led to programmatic interests in international health and political developments in Latino/a countries. Thus, the organization of health care delivery in Cuba, the empowerment pedagogy of Paulo Freire in Brazil, and the national liberation, decolonization and anti-imperialist movements of the Americas were influential in shaping a commitment to therapeutic praxis and social reparation called terapia comprometida (committed therapy). This refers to a "bond of commitment," a relationship where the political, social and psychological alliance between therapist and client is explicit. Such praxis involves an ethically non-neutral attitude toward the client's problems, which is a conscious violation of the neutral stance advocated by mainstream psychotherapy. At HOT and HFCP, being comprometido (committed) fostered the development of solidarity with the client and Latino/a community in their struggles against recurrent stress and traumas related to "differentness" in U.S. society. Client and counselor ideally entered into a relationship of companerismo (companionship) that advocated for social justice, human rights, and access to quality health and human services. In the Latino/a tradition, companerismo reflects a sense of connection and responsibility. Given the experiences of people of color with oppression, it encourages partnerships and networking to meet survival challenges. In my personal, political and professional development, companerismo evolved into self-empowerment through group empowerment or a collective identity of "nous sommes, donc je suis" (We are, therefore I am). From 1981 to 1983, I utilized companerismo in a Los Angeles County Community Mental Health Center in the San Fernando Valley to expand multicultural programming, and to establish region wide youth-oriented substance abuse prevention programs. When I returned to Boston in 1983 to become the first Director, Latino/a Mental Health Service, Cambridge Hospital, my companerismo efforts focused on Latino/a urban health. In La Colaborativa, an interagency network of health providers, including medical anthropologists, we worked together as primary care providers to minimize the effects of stress and burnout associated with serving a generally disenfranchised and impoverished Latino/a community. Since then, I and other Latino/a providers have depended upon the interdisciplinary composition and function, flexibility and adaptability , didactic capabilities and community advocacy benefits of networking. Networks have empowered us and enabled us to stretch scarce health resources. We are still facing a traditional health services delivery system for visible ethnic racial groups which is costly, often maximizes social and cultural barriers, and minimizes access and availability. Thus, it is not surprising that the health care proposals of the 1990s "re-invent" the concepts of community health, community-oriented primary care and responsive medicine. Health industry entrepreneurs advise doctors to utilize a network approach to billing, purchasing and the coordination of support personnel to realize significant economies of scale and make urban medical practice viable. But corporate health alliances lack the indigenous roots of la red: the informal supports, the extended kin, input of consumers, and community-based providers and advocates, engaged in participatory education and critical questioning. Health reform can benefit from the legacy and philosophy of the psychocultural network model developed at MTP and elsewhere. The principle of Nuestro Bienestar (our. well-being) has been proposed as a necessary paradigm shift in health service policy making for Latino/as. Nuestro Bienestar refers to a health care reform strategy based on collaboration and empowerment at the individual, family and community level. It includes the use of natural networks for supporting comprehensive and integrated approaches to health maintenance. Latino/a health policy advocates from California, Texas and New York call for family-based community health models that recognize women as significant health care managers, and children and adolescents as potential health promoters for their families and communities. They encourage the use of other natural community networks and informal groups, along with community-based organizations which currently do not target health services, such as recreation centers, neighborhood sports teams and public housing, as disease prevention initiative sites. Companerismo, Nuestro Bienestar,
and networking adhere to the spirit, commitment, survival and maintenance
of Latino/a core cultural values. It is this commitment that I recommend
health care professionals emulate in holding legislators, reformers
and policymakers accountable for delivering expanded access and coverage
for the poor and medically underserved. The liabilities in following
these recommendations are that we will be identified as irritants; the
risk in not following them is that we will cease to be contributors
to the preservation and growth of our people. |