“We have the opportunity to really shape how someone’s current situation is and how their future looks. And that’s a pretty amazing power.”
-Theresa Houck
Introduction
During my time at the City of Refuge, I collaborated with two LCSW social workers to create a health and wellness program in Dalton, GA. While collaboration focused on a complex and ongoing wellness program that consists of a large wellness center, Uphill Coffee, and Uphill Wellness and Workforce Development, my focus for the special project was the youth wellness group, City Lights.
In October 2020, we implemented a youth wellness group called City Lights. The first session of the program lasted approximately 8 months to ensure all domains of wellness were covered. These wellness domains include Physical, Emotional, Spiritual, Social, Intellectual, Environmental, Financial, and Occupational. It consisted of approximately 30 students at City of Refuge Dalton. The group was designed for at-risk middle and high school students who fall under the GA poverty guidelines. Every participant in the City Lights youth group identified as Latino. City Lights provided transportation to and from the weekly group and any other scheduled youth events ( Christmas party, service days, Jump park, soccer clinic, etc.). This allowed many of the youth the ability to participate as many of the youth served did not have other means of transportation. On youth nights and other events, each participant was provided with a hot meal served by the City of Refuge or their partners (local churches, locally owned businesses, and other restaurants/businesses). Many of the group participants’ families also had regular food boxes delivered from the City of Refuge to their homes to help with food insecurities.
The basis of the youth wellness group was the 8-dimensional wellness model developed by Dr. Peggy Swarbrick, which was adopted by the Substance Abuse and Mental Health Services Administration (SAMHSA). According to Swarbrick (2006), wellness is defined as, a conscious, deliberate process that requires a person to become aware of and make choices for a more satisfying lifestyle. A wellness lifestyle includes a balance of health habits, including adequate sleep, rest, and good nutrition, productivity and exercise, participation in a meaningful activity, and connections with supportive relationships” (Swarbrick, 1997). The holistic approach focuses on the following dimensions: Physical, Emotional, Spiritual, Social, Intellectual, Environmental, Financial, and Occupational. The dimensions all interconnect and impact one another. To educate the youth, the group focused on one dimension of wellness each month through various age-appropriate activities based on the stages of development ( for example, Erikson’s Industry/ Inferiority, Identity/ Role Confusion and Piaget’s Formal Operations). Each week, the dimension that was being focused on for the month was broken down into small lessons on related topics. For example, emotional wellness is defined as “the ability to express feelings, adjust to emotional challenges, cope with life stressors, and enjoy life. It includes knowing our strengths as well as what we want to get better at and living and working on our own but letting others help us from time to time (Swarbrick, 1997). Using this definition for an entire month, each week was broken down into smaller topics including identifying emotions, identifying stress, mindfulness practice, and coping skills.
Social Issue
The City of Refuge offers a range of services that meet the needs of those who are impoverished and fall under the Georgia poverty guidelines. Services are designed to meet the immediate needs of clients as well as offer opportunities for transformation. Social service programs include educational support, family support, senior support, and housing support. Through the collaboration with children, families, and the elderly a need for holistic wellness and health equity was identified. After discovering this, the team decided to begin the program with youth having the hopes that the youth could educate their family on wellness. In addition, other programs at the City of Refuge implemented holistic wellness to the adult population served.
According to the Robert Wood Johnson Foundation (2020), health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.
Interventions
So with this information, the mission of the City Lights program was to address health equity by educating at-risk youth on holistic health and wellness by putting healthy practices into action. The program additionally focused on preventing problematic behaviors and situations in the lives of teenagers before they start, especially before they have turned into a crisis.
The noted population faces many challenges related to poverty and disparity; therefore, they do not have the access to equal health or wellness. Using a variety of verbal and written assessments as well as the 8 dimensions of wellness framework, the City of Refuge provided support, advocacy, resources, and services to meet the needs of youth participants. Each month, the youth-focused on one of the 8 dimensions of wellness using the Monthly Wellness Plan. Each group night had an agenda that focused on one dimension of wellness, a group activity/exercises, and discussion. Additionally, clinical and evidence-based practices were implemented into each group. This consisted of mindfulness, coping skills, active listening skills, CBT techniques, group therapy techniques, motivational interviewing, and etc. For example, in March 2021, the group focused on the Emotional Wellness Agendas to learn about the emotional wellness dimension. In April 2021, the Social Wellness Agendas to learn about the social wellness dimension. It is also important to note that the youth had mentors to assist with any issues that were not directly related to the wellness group.
Each youth participant was an at-risk youth or a youth that is less likely to transition successfully into adulthood. This is due to poverty, family instability, adverse childhood experiences, and etc. Every youth participant lived in poverty, however, many of the youth experienced other issues such as a parent or family member being deported. The social-ecological framework was identified as it is beneficial in facilitating sustainable solutions for at-risk individuals and communities. Utilizing this framework, we identified youth participant needs and ways to achieve holistic wellness and address health equity. According to this perspective, the functioning of humans in their environment and systems is crucial as it outlines how specific factors influence an individual or a community. It specifically addresses the following areas: individual, interpersonal, community, organizational, and policy.
Attachment theory was additionally used when working with the City Lights youth group. This theory focuses on the relationships and bonds between people. Specifically, long-term relationships, such as those between a parent and child. A child’s attachment to their parents/caregivers shapes how they relate to the world, how they’ll learn, and the kinds of relationships they’ll form in the future. There are many circumstances that disrupt a secure attachment including loss of a parent, multiple caregivers, illness, substance abuse, domestic violence, and so forth. If the attachment is disrupted, the child may develop unhealthy behaviors or relationships which may lead to crisis. At the City of Refuge, many of the youth participants experienced issues surrounding disruption of attachment such as deportation, large sibling/family size, and etcetera. Using this information assisted with understanding the youth’s behaviors and or need for holistic wellness.
Results
To begin the City Lights youth group, each participant completed a Wellness Pretest. The pretest was used to determine the youth participants’ pre-existing knowledge of the 8 dimensions of wellness. Prior to ending the 8-month group, the youth participants were asked to complete a Wellness Posttest to determine what they learned. Each participant identified significant progress in several areas after the completion of the youth group. It is also important to note that there was no major crisis during the 8 month period.
Rewards for participating in the program were available to continue participant motivation. Youth participants were specifically rewarded with free time after each youth night. During free time, the youth had the ability to play on the indoor soccer field, play pool, play ping pong, read in the book nook, socialize with staff or peers, and etc. The youth were also rewarded at the end of each month with a fun day/night. This consisted of going to the jump park, game night, and movie nights.
Conclusion
Limitations for my special project arose due to financial issues. While we worked timelessly on grant writing, the application process can last several months and longer. Also, when grants are not approved there continues to be a lack of funding which causes implementation issues. Additional limitations consist of issues surrounding stakeholders and resources. Due to the nature of the program, many stakeholders and resources need to be available. This means identifying volunteers, partners, and resources that are committed and willing to provide their expertise and time free of charge. Lastly, COVID- 19 imposed limitations such as number of participants, social distancing on transportation, and wearing masks.
Even with these limitations, the implementation of the City Lights wellness group was successful and will continue after my departure as an intern.
Competencies
Competency 1:Demonstrate Ethical and Professional Behavior
Competency 2:Engage Diversity and Difference in Practice
Competency 3: Advance Human Rights and Social and Economic and Environmental Justice
Competency 4: Engage in Practice-Informed Research and Research-Informed Practice
Competency 5: Engage in Policy Practice
Competency 6: Engage with Individuals, Families, Groups, Organizations, and Communities
Competency 7: Assess Individuals, Families, Groups, Organizations, and Communities
Competency 8: Intervene with Individuals, Families, Groups, Organizations, and Communities
Competency 9: Evaluate Practice with Individuals, Families, Groups, Organizations, and Communities