Gaining field exposure virtually

Jackson Smith assists University of Southern California MSW students in meeting their degree requirements. But he is neither a professor nor a professional in the field. Jackson Smith is the name of the character played by an actual actor who becomes a patient in a Virtual Field Practicum (VFP) that allows USC students to pursue some of their initial field work hours outside of an actual service agency setting.

This USC initiative reflects the growing interest nationally in using technology in a number of ways to enhance training of addiction counselors as well as clinicians in related disciplines. Those involved with the USC program cite several industry factors driving the move to get more creative with the curriculum through technology.

First, the growth in the number of academic programs in social work overall has resulted in more students vying for the same field placements that are required in their training. In addition, cutbacks at the service agencies that have traditionally taken in these students have altered the field practicum experience to a degree.

“Supervisors who in the past had so much time to spend with students are now being asked to do so much more in their own jobs,” says Elizabeth Phillips, PhD, MSW, clinical associate professor at USC's School of Social Work.

The fact that service agency staff members are pressed can in turn affect what the students themselves might be asked to do, and sometimes that will extend to tasks well beyond patient interaction. “They might want the students to help with the billing,” says Phillips.

Or, what commonly occurs is that students are immediately placed with clients in the first couple of weeks of field training even though they don't yet have the skills to excel in this, she says.

Phillips adds, “It left us worried about the overall quality of the placements. We felt we had less control over the experience they were going to get.”

So while placement in the field still constitutes the majority of MSW students' required practicum hours, USC students fulfill some of their requirement through the virtual counseling experience, involving work with the actor and also the presentation of other clinical scenarios in an online format. This is not the first effort of this kind at the university: USC students who work in the military have experienced some of their Diagnostic and Statistical Manual of Mental Disorders (DSM) training through work with virtual clients.

Actor's role

The actor who is used in the VFP at USC plays the role of an individual with a behavioral health diagnosis. Various therapeutic scenarios might touch on his own issues or on problems in his relationship with his spouse, who has a gambling problem.

Students participate in the virtual sessions in an interactive small-group session with the professor also participating. What appears on each participant's computer screen resembles the tic-tac-toe board of faces seen in the opening sequence of “The Brady Bunch.”

USC developed the program in conjunction with education technology company 2U, Inc. USC also offers an entirely online academic program for MSW degree seekers.

The VFP is designed to offer intensive training in three evidence-based clinical practices: Motivational Interviewing (MI), problem solving therapy, and cognitive-behavioral therapy (CBT). It is the university's intent to have all of its MSW students be fully trained in multiple evidence-based interventions by the time they graduate.

Students also must write detailed and accurate progress notes based on what they see and hear from the actor in the VFP.

The 200 hours of virtual training that is completed over the course of a semester is intended to prepare students for the subsequent 800 hours of live field training that they must perform in a provider setting. The VFP has been in place at the School of Social Work for several months, and was formally introduced to the public in March.

Phillips adds that several individuals expressed interest in obtaining the school's materials when it presented a session on the VFP last fall at a meeting of the Council on Social Work Education.

Enhancing ethics training

The MSW program at USC also uses the virtual platform in its training on critical thinking skills, in areas such as risk assessment for clients with particular profiles, empathetic communications, and ethics.

As an example of work in the latter area, students might be presented with a video clip of a client who reveals in session that he is HIV-positive and has commenced a new relationship in which he is not using protection and the partner has not been informed of the man's HIV status. The students then are asked to research what laws or ethical guidelines would govern the clinician's desired response. (In this case, if the scenario unfolds in California, this issue is considered confidential and the therapist is not allowed to disclose the client's HIV status to another party, Phillips says.)

MSW students must manage 14 of these ethical decision-making scenarios in their training, says Phillips, and the online format assists in this effort.